Why a top food poisoning expert won’t ever eat these foods

From: Ubiquitous (weberm...)

By Roberto A. Ferdman

In the aftermath of an E. coli outbreak at Chipotle that sickened
dozens of people across the United States last fall and led to an
overhaul of the company's food safety practices, Americans reacted
by avoiding the beloved fast-food chain. Restaurants that once
sported long lines were suddenly empty, a phenomenon that was almost
surely happening nationwide.

The risks, in other words, were simply too great in people's minds
for them to continue frequenting the Mexican-inspired favorite,
because Chipotle had a food safety problem.

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But the outrage was at least partly misplaced, according to Bill
Marler, a lawyer specializing in food-borne illness. The outbreak,
he says, was less of an anomaly specific to the chain than a symptom
of the American food system, which isn't as safe as it could be and
really should be.

Marler, who has been involved in many high-profile outbreaks over
the past 30 years, including the 1993 E. coli outbreak at Jack in
the Box, which killed several children and forced the government to
impose zero tolerance for the presence of the pathogen in food, says
that problems such as the one at Chipotle are far more common than
most people realize. Food recalls, of which there are many,
frequently fly under the radar. In 2014, the most recent year for
which data is available, more than 8,000 food products were recalled
by the Food and Drug Administration, and nearly 100 were recalled by
the U.S. Department of Agriculture. The problem touches organic
foods, too.

The industry, Marler says, does a good job of nudging people to
forget about all this, and we all do a good job of obliging, because
food safety isn't the sort of thing anyone likes to think about.

The way in which the American food system works is often perplexing,
if not entirely nonsensical, according to Marler. For this reason,
he takes precautions people less familiar with food safety oversight
might find absurd. In a recent piece, published in Bottom Line
Health, he lists six foods he no longer eats, because he believes
the risk of eating them is simply too large. The list includes raw
oysters and other raw shellfish, raw or under-cooked eggs, meat that
isn't well-done, unpasteurized milk and juice, and raw sprouts.


"You wouldn't believe some of the things I have learned over the
years," he said. "I have some crazy stories."

I spoke with Marler to hear some of these stories, learn about the
things we might want to think twice about eating, and better
understand what, exactly, people don't understand about food safety
in the United States. The interview has been edited for length and
clarity.

Q: Would the average person be horrified if they knew what you know
about the food system?

I think there are a lot of things about the food system that the
general public would find completely nonsensicalnot necessarily
frightening, but definitely nonsensical. Like how E. coli is
considered an adulterant in hamburgers, but salmonella and many
other pathogens are not. How salmonella is allowed on chickens,
which the USDA oversees, but salmonella is not allowed in any
product that the FDA oversees.

There are a lot of disparate pieces in the food safety system in the
United States, and there is no one really who is fully in control of
it. And the public health system is made up of 51 separate
departments of public health the CDC and 50 states and theyre
not necessarily playing from the same sheet of music.

I know a lot more about the flaws in the system than the average
person, and these would be incredibly perplexing to most people. If
people knew these kind of things, Im pretty sure they would
question why the system is built the way it is.

Q: So it isn't safe?

From a safety standpoint, I dont necessarily think that were the
safest food system in the world, but neither do I think that were
the worst food safety system in the world. We do have a fairly
amazing ability to surveil foodborne illnesses. Not necessarily to
find out why they happened, or what we could do to prevent them, but
were pretty good at keeping track of people who have positive stool
cultures. I speak all over the world on food safety issues, and
almost everyone around the world uses the CDC foodborne illness
statistics, and then just extrapolates those onto their populations.


In 22 years of doing this, Ive obviously seen things that are
chilling. But Ive also seen some great progress. I made hundreds of
millions of dollars for my clients in the first decade or so of my
practice off the beef industry. Most of the work we did was E. coli
cases linked to hamburgers, and those are now almost nonexistent,
because the beef industry and the government finally figured out
that it was a really bad idea to poison people, and that it was
expensive, and they created systems that allowed to lower the level
of E. coli in hamburger meat. Now there are fewer people getting
sick, and Bill Marler isnt making as much money, which is a great
thing.

Q: Why is it that the government has acted on E. coli, but not on
other pathogens, namely salmonella?

A crisis happened.

The Jack in the Box E. coli outbreak in January of 1993 came at an
incredibly fortuitous time to get government to pay attention to it.
It basically broke on inauguration weekend for Bill Clinton. In many
respects, and I know this because I know people who were working at
USDA and at the White House, this was one of the first things that
was on Clintons plate this E. coli crisis in the Pacific
Northwest. People wanted to know what he was going to do about it.

The USDA, in 1994, said that E. coli could no longer be in hamburger
meat, and the industry went absolutely nuts. They sued the
government, saying E. coli is a naturally occurring bacteria. To the
governments credit, they used science and the court agreed that the
government had the power to do exactly what it did. And over time,
that determination that E. coli was an adulterant worked its way
through the system and got us to the place we are now.

Where we are now is kind of where we are with vaccine and people,
where you have some people questioning the necessity of a system
that works, without question. You know, when was the last time you
saw someone with polio? But you hear people in certain parts who
take that reality and then wonder whether they need to vaccinate
their children since polio hasnt really been around. We see places
advertising that theyre undercooking hamburgers, because it tastes
better. I find that worrisome. Even though weve pushed a lot of E.
coli out of hamburgers, theyre playing with fire by not cooking
their hamburgers thoroughly.


Q: Is the presence of salmonella any less dangerous?

No. In my view, what the government did in 1994 with E. coli, was
they knew what they wanted to do, which was to get it out of
hamburger meat. They justified it by saying that the infectious dose
was low, that people dont necessarily cook hamburgers the way they
should its difficult to cook them thoroughly, and theres a high
risk of cross contamination. They had a long list of arguments as to
why they needed to take that action.

But frankly all of that applies to salmonella. The infectious dose
for salmonella is higher, but were talking about infinitesimal,
invisible quantities of bacteria. 100,000 bacterium of salmonella
would fit on the head of a pin. So youre not really looking at a
product that is grossly contaminated; youre looking at a product
that is a little contaminated, and that little bit of contamination
is enough to get people really sick. Salmonella kills more Americans
every year than E. coli does, and can cause severe long-term
complications.

Q: If salmonella is so problematic, why hasn't the government
protected consumers from it?

Theres a case that goes back to the 1970s, American Health
Association (AHA) vs. Earl Butz, who was the secretary of
agriculture under President Nixon. The AHA didnt even know about E.
coli 0157, the kind that gets people really sick, back then. They
were focused on salmonella, and they wanted to put a label on it
that said hey consumer, you need to cook this, and the meat
industry went nuts, they said, no way, were not going to do this.
So the AHA sued the government because they thought it was
necessary, and the government sided with the industry, and in
essence said it was a naturally occurring bacterium on meat, which
is untrue, and housewivesthis is actually in the case, I swearknow
how to cook it, what to do to make this food safe. That mentality is
just below the surface in the meat industry, whether its the beef,
chicken, or any other facet. That sort of mentality that theres
really nothing we can do about it, and its really the consumer that
is at fault if anybody gets sick, its their problem. This is
exactly the argument that the industry waged in 1994, with E. coli,
but there the government changed its tone because there were 700
people who got sick and 4 children who died, and it was kind of hard
to ignore that.


The government has not faced a salmonella crisis like the Jack in
the Box E. coli crisis in the early 1990s, that solidifies
consumers, government, business, and everyone else to do the thing
that would ultimately be the correct thing, which is to do with
salmonella exactly what they did with E. coli 0157. And the way the
system is set up now, with FSIS being in USDA and essentially just
being a captured, controlled agency of the industry, its just never
going to happen.

When I applied for the job, back in 2008, and allegedly made it to
the shortlist, you can imagine the industry was quite concerned
about what I might do if I actually took office.

Q: You mentioned to me in the past that you have a few major
frustrations with food safety in the United States. Can you
talk a bit about those?

I think certainly the salmonella thing is probably the biggest
frustrationand maybe the biggest public health threat. That has to
be on the top of my list.

Secondly, the failure of government to have sufficient resources to
allow for the level of inspection that should be required for FDA
overseen products, which are differentmeat, generally, is overseen
by the USDA. So for instance, the USDA, or really FSIS [Food Safety
and Inspection Service] in particular, looks at meat products save
for fish. Theres an inspector in every single meat plant in
America. That came about post The Jungle, by Upton Sinclair. And,
allegedly, the legislation was such that the industry was supposed
to pay for the inspectors. But, unsurprisingly, the industry got
taxpayers to pay for the inspectors. Now those inspectors are
unionized, and now theres an inspector in every plant, and thats
the system.

On the FDAs side, which is 80 percent of our other food supplies
and imports, theres a skeleton crew of inspectors. Most of the
foodborne illness outbreaks that I have been involved in over the
past 20 or 30 years, most of the manufacturing facilities have never
had an FDA inspector in them. Even if they did, it was five to ten
years earlier. And thats just the systemwe chose not to have a
system, which basically grew up post World War IIthe mass
manufacturing of foods is really a post World War II phenomenonand
by the time we started looking at that in terms of what we needed
for inspections, we didnt have much interest in paying for what was
safest. Whats funny, or really tragic, is that we, the consuming
public, pay billions of dollars every year for a sort of half-
hearted system of inspections, called third party audits, where the
Wal-Marts and the Costcos and the McDonalds of the world tell their
supply chain that they need to pay for an audit of their businesses.
And thats been a well known problem for the industry, because when
you pay for your own audit, the likelihood that youre going to get
a bad or unfavorable audit is remarkably close to zero. When you
look at the audits that have been performed during some of the worst
outbreaks that have occurred in the United States, its really
troubling.

The lack of taxpayers stepping up and the government stepping up,
and the allowing of third party audits that are in many respects a
complete sham, is just really frustrating.

So yeah, Id say that salmonella and government inspections are
really my two main major frustrations. I think we could have a much
safer food system and food supply, if we applied the rules of
adulteration across the board, regardless of the product, and we had
an inspection core that would actually be available. And I think we
could actually make this happen, if we wanted to.

Q: While reporting on Chipotles recent foodborne illness outbreaks,
several food safety experts, including yourself, suggested the
company might have a hard time implementing its new rules,
because the poultry industry is pretty resistant to more
stringent testing for pathogens. Whats up with the poultry
industry?

The poultry industry is a tough one. If you just look at the Foster
Farms outbreak that went on for 18 months, it gives you a really
good sense. PBSs Frontline did this fantastic documentary about the
outbreak, which I was involved in, and it really showed the scary
level of symbiotic relationship that exists between the FSIS, which
is the government agency tasked with overseeing food safety in the
United States, and the poultry industry. Since salmonella, for
reasons I cannot understand, isnt considered an adulterant, they,
the FSIS, couldnt do a thing about an ongoing, clear outbreak, that
was sickening several hundred people that we know about, and many
times more, because the real number is something like 30 times that
due to underreporting. So youre looking at an 18,000 to 20,000
person outbreak, that the government isnt doing a damn thing about,
other than writing letters.

There was this great scene in the documentary, where the interviewer
is talking to an official from FSIS. He asks what they did to Foster
Farms, and the official says oh, well, we wrote him a letter. Then
he asks him what he did next, and the guy says well, we wrote him
another letter. He asks him again, and he says the same thing. And
then he asks what theyre going to do if it keeps happening, and he
says 'well, were going to keep writing them letters. And thats
the problem, we really dont have the ability to hold companies
accountable.

Look, you and I in about five minutes could draft a speech for FSIS
about why salmonella is an adulterant. Theres plenty of explanation
and evidence for how risky salmonella is, and how consumers dont
handle chicken properly and how they dont cook it properlyreally,
the same exact arguments that were made for E. Coli 0157. You could
easily make this argument, and the court would back you up. Youd be
bucking a lot of angry chicken guys, but nevertheless you could get
it done.

Really, this is the story of an emasculated agency, and one where
they dont even want to ask for that authority.

Q: The issues of food safety really come to life when there are big
scares or stories. But its the companies that are associated
with themlike Chipotle, most recentlythat suffer the PR blow.
Are companies like Chipotle to blame, or is the framework or
system they function within the real problem?

Each outbreak is differentthe players, the causes, the size. If you
look at the Chipotle case, they had six outbreaks in six months,
thats pretty unprecedented. I mean, I cannot think of any
restaurant, any chain, anything where there have been six outbreaks
in that short of a period.

I look at what happened with Chipotle, and I just think they were so
focused on their mission to serve food with integrity, as defined by
their commitment to local, organic, non-GMO, and humanely raised
food, that they used those words as a proxy for safe food. I think
they believed, and probably people did too, that it was true. If you
asked people six months ago whether they thought McDonalds or
Chipotle was safer, more than 90 percent of people would have said
Chipotle in an instant.

But the problem isn't really Chipotle. It's the system, which allows
for these sorts of things to happen too often. Chipotle was, for the
most part, complying with food safety standards. In many senses,
they were exceeding them.

Q: You were trending on Facebook recently, because you listed a
handful of things that people love to eat but you refuse to eat
for safety reasons.

It depends on how you look at it. I mean, if I went back and looked
at all the foods I have been involved in that have poisoned people,
you could make a very long listthe things you would be left with
would be very short. When I made that list, I stuck a couple things
together, like unpasteurized milk and juice. Its based on more than
20 years of experience, that has taught me that these are the food
items that are, from my perspective, the ones that have caused more
issues, and, especially in a restaurant setting, where youre not
controlling the handling of your food, are best left alone. This
doesnt mean that other things, like cantaloupe couldnt find their
way onto the list. But these are the ones that I have had to deal
with the most often over the years.

Q: You keep telling me that you have all these crazy storiesall
these things I wouldnt believe. Can you share one of them?

I actually have the perfect one, which I told at a recent
conference, and really floored people.

Do you know the juice Odwalla? Well, the juice is made by a company
in California, which has made all sorts of other juices, many of
which have been unpasteurized, because its more natural. Anyway,
they were kind of like Chipotle, in the sense that they had this
aura of good and earthy and healthful. And they were growing very
quickly. And they had an outbreak. It killed a kid in Colorado, and
sickened dozens of others very seriously, and the company was very
nearly brought to its knees. [The outbreak, which was linked to
apple juice produced by Odwalla, happened twenty years ago].

If you look at how they handled the PR stuff, most PR people would
say well, they handled it great. They took responsibility, they were
upfront and honest about it, etc etc. Whats interesting though is
that behind the scenes, on the legal side of the equation, I had
gotten a phone call, which by itself isnt uncommon. In these high
profile cases, people tend to call meformer employees, former
government officials, family members of people who have fallen ill,
or unknown people giving me tips. But this one was different. It was
a SaturdayI remember it welland someone left me a voicemail
telling me to make sure I get the U.S. Army documents regarding
Odwalla. I was like 'what the heck, what the heck are they talking
about?' So I decided to follow up on it, and reached out to the Army
and got something like 100 pages of documents. Well, it turned out
that the Army had been solicited to put Odwalla juice on Army PXs,
which sell goods, and, because of that, the Army had gone to do an
inspection of a plant, looked around and wrote out a report. And
heres whats nuts: it had concluded that Odwallas juice was not fit
for human consumption.

Q: Wow.

Its crazy, right? The Army had decided that Odwallas juice wasnt
fit for human consumption, and Odwalla knew this, and yet kept
selling it anyway. When I got that document, it was pretty
incredible. But then after the outbreak, we got to look at Odwallas
documents, which included emails, and there were discussions amongst
people at the company, months before the outbreak, about whether
they should do end product testingwhich is finished product
testingto see whether they had pathogens in their product, and the
decision was made to not test, because if they tested there would be
a body of data. One of my favorite emails said something like once
you create a body of data, its subpoenable.

Q: So, basically, they decided to protect themselves instead of
their consumers?

Yes, essentially. Look, there are a lot of sad stories in my line of
work. Ive been in ICUs, where parents have had to pull the plug on
their child. Someone commented on my article about the six things I
dont eat, saying that I must be some kind of freak, but when you
see a child die from eating an undercooked hamburger, it does change
your view of hamburgers. It just does. I am a lawyer, but Im also a
human.

That Odwalla story is one of the crazier stories I can think of, but
there are many others, and there would be many fewer if the way we
handled food safety here made more sense.


--
Democrat Primary choices:
1. An out-of-touch crusty old relic that wants to tax you to death
2. Bernie Sanders.

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