January 4, 2004 Chattanooga Times Free Press (Tennessee) by Alison Young

But mad cow disease wasn't the culprit. Indeed, not a single American is known to have contracted the human form of the disease from eating food in this country. Instead, salmonella, E. coli, listeria and other dangerous bacteria routinely take a huge toll on public health, yet get little of the attention that's now focused on the beef from one Washington state Holstein found infected with mad cow disease, also known as bovine spongiform encephalopathy.

"There is not enough attention to general food-borne diseases," said Dr. Christopher Braden, the Centers for Disease Control and Prevention's chief of outbreak response and surveillance in the food-borne disease branch. "While bovine spongiform encephalopathy is of concern, it's not the greatest public health concern we face in food-borne disease."

The toll from food-borne disease is staggering: 76 million illnesses, 325,000 hospitalizations and 5,000 deaths in the United States each year, according to CDC estimates.

Salmonella, for instance, caused 32,000 confirmed illnesses in 2003 -- and many times that number probably were sickened by the bacteria but never had tests to confirm it. "Certainly if this were a disease hitting the radar screen and it was the first time it had ever been discovered and there were 30,000 cases reported, it would be an uproar," Braden said Tuesday.

Organisms that consumers may never have heard of cause many illnesses.

Campylobacter, a bacteria associated with raw or undercooked poultry, causes about 2 million cases of diarrhea, nausea and vomiting each year and sometimes causes life-threatening infections or triggers rare immune-system responses. Listeria monocytogenes, a cold-loving bacteria found in ready-to-eat luncheon meats and hot dogs, causes about 2,500 illnesses a year, and most of those people are so ill they are hospitalized. About 500 will die, the CDC estimates.

Brad Matthews, of Raleigh, N.C., no longer takes for granted that the food he eats is safe.

At age 27, he's been unable to work since July 2001, when he was hospitalized during a bout of food-borne illness caused by campylobacter. He recovered from the nausea and vomiting, but then developed Reiter's syndrome, a painful inflammation of the joints believed to be triggered by the bacteria.

"I was an administrative assistant just right out of college," Matthews said. "My future looked bright, and it just happened out of the blue." The pain in his joints has made it impossible to live normally, he said. He can't drive, walk his dog or even play the guitar.

The public needs to pay more attention, Matthews said.

"I don't think people really care. I knew about these food-borne diseases, but I thought to myself it wouldn't happen to me," he said.

Food safety advocates hope that the furor over mad cow disease and calls for reform will help focus the attention of policy makers and the public on broader issues in farming and food manufacturing that could help reduce the number of Americans sickened by what they eat.

"I don't think mad cow is a public health crisis," said Carol Tucker Foreman, who was an assistant secretary of agriculture in charge of food safety during the Carter administration. "I do think we have a serious public-health problem with regard to food-borne illness. And it's not just meat and poultry, but fresh fruit and vegetables, eggs and fish."

Worldwide, 153 cases of the human form of mad cow disease have been reported. The overwhelming majority -- 143 -- occurred in England, where the disease was first detected in 1996. Six cases have been documented in France, and one each has been reported in Italy, Ireland, Canada and the United States. The one U.S. case is a Florida woman who once lived in England and is currently dying of the disease. All the other cases also have been linked to the mad cow epidemic in England in the 1980s.

Foreman, who heads the Food Policy Institute at the Consumer Federation of America, said the mad cow situation -- and efforts by regulators to find the Holstein's birth herd -- had demonstrated the need for a system that allowed cattle to be traced.

"We've urged the USDA to establish an animal trace-back system for 20 years," she said. "Not only do you need to trace back an animal that has signs of mad cow disease, but you also could trace back an animal that has a gut full of E. coli 0157:H7."

Advocates also have urged for years that the U.S. Department of Agriculture and the Food and Drug Administration be given the authority to order companies to recall tainted products. The current system allows only for voluntary company recalls, Foreman said.

While USDA officials have said they didn't lose any time negotiating with the plant over launching the recall of 10,400 pounds of meat from the infected Holstein and 19 others slaughtered with her, Foreman said it sometimes could take days to get companies to agree on how much food they're willing to pull off the market.

From 1998 through 2000, nearly 109 million pounds of meat and meat products were recalled in the United States for problems ranging from contamination with dangerous bacteria to undercooking of ready-to-eat foods. But just 24 percent of that meat -- 26 million pounds -- was recovered, according to a Knight Ridder analysis of the most recent recall data available on the USDA's Web site. In 2000, the data show, only 17 percent of recalled meat was recovered.

The mad cow situation has spurred calls for more testing of cattle for that disease. But Foreman and Braden said there should be more and better microbiological testing of all kinds, and greater attention to good agricultural and manufacturing practices.

As the population of the United States grows older, the risk from common food-borne illnesses will increase. The people most at risk are those with compromised immune systems, including people with AIDS, lupus and transplanted organs. Also at higher risk are elderly Food industry officials said consumers needed to do their part to make sure the food they ate was safe.

"Salmonella, listeria, E. coli, they can all be easily controlled with simple procedures at home," said Stephanie Childs, a spokeswoman for the Grocery Manufacturers of America, the leading trade group for brand-name foods. Cooking foods thoroughly, not allowing raw meats to contaminate other foods and washing hands will go a long way to keeping people healthy, she said.