‘How quickly should health officials notify the public about foodborne illness outbreaks?’

How soon should health officials alert the public about a fooborne illness outbreak? Picture: iStock.

Food safety researchers are calling on public health agencies to develop clear guidelines on when to inform the public about foodborne illness outbreaks.

The US researchers discovered federal Centers for Disease Control and Prevention (CDC) to state and local agencies make decisions about sharing information on a case-by-case basis.

11 case studies

Co-authors Maria Sol Erdozaim, former undergraduate, Kansas State University, and Douglas Powell, founder, Powell Food Safety evaluated 11 case studies of large outbreaks, dating back to 1996.

The results are printed in the report, ‘Going public: Early disclosure of food risks for the benefit of the public health’, in the Journal of Environmental Health.

“The best case is to share what you know, and what you don’t know, in an open and transparent way,” said Ben Chapman, lead author and associate professor, agricultural and human sciences, North Carolina State University.

“Talking about uncertainty may be uncomfortable for officials, but they need to have a plan for how to do so.”

As an example, researchers found on June 2, 2008, CDC announced an investigation of an ongoing multistate outbreak of human Salmonella serotype Saintpaul infections.

It identified the consumption of raw tomatoes as the likely source of the illnesses in at least two states and a public advisory was issued.

By the time the outbreak was officially declared on August 28, 2008, 1,442 people had been infected, at least 286 people were hospitalized, and the infection may have contributed to two deaths.

Despite the early identification of tomatoes as a potential pathogen source, jalapeño peppers were subsequently identified as the major source, with some implication of serrano peppers as well.

Uncertainty

It questions whether the public advisory to avoid raw tomatoes issued too early in the outbreak investigation, despite its intent as a control measure? Florida Tomato Committee may believe so considering the outcome of the investigation: the estimated economic cost to the tomato industry was more than $600m in Florida and close to $100m in Georgia (Beach, 2013).

Chapman claims not only is there no clear consensus on how to respond to a foodborne illness outbreak, but there is no system in place to help officials decide when to tell the public about it.

At the same time, withholding information until there is less uncertainty may increase public health risks because the source of the illness may remain accessible to unwitting consumers.

According to Paul Mead, foodborne illness epidemiologist,  CDC, food safety recalls are always either too early or too late. If you’re right, it’s always too late. If you’re wrong, it’s always too early.

Sharing information early in an outbreak means consumers can make informed decisions about their food choices that limit risk. But there can also be uncertainty about that information.

Pressure from social media, or from companies, has sometimes influenced when health officials release information, which is problematic,” added Chapman.

Officials need to have clearly defined processes for determining when information should be made public, and those processes don’t appear to exist right now.

There are advantages and risks to sharing and withholding information.

For example, officials may be investigating a particular restaurant or type of food, but the investigation could ultimately find that the culprit was a different source altogether.”

The report found, in 2012, the US Government Accountability Office (GAO) identified weaknesses in the Food and Drug Administration’s (FDA) food advisory and recall process.

According to the GAO report, FDA officials indicated they use professional experience to look for a tipping point, defined as the time when evidence collected is sufficient to allow the agency to provide consumers with information that will help them avoid unsafe food (GAO, 2012).

Without predetermined guidelines, determining the right time to provide the public with information becomes a subjective, rather than an objective, decision. 

In conclusion the researchers claim establishing some ground rules and publicizing them would build public trust.

Communication is important for educating the public about steps that individuals can take to reduce the spread of infectious disease and to protect themselves,” said Chapman.

Not naming the source of an outbreak or giving recall information too late affects the public’s trust in agencies. Furthermore, when the agencies themselves do not have a standard procedure regarding when to name or not name implicated firms in an outbreak, it seems as though the agencies’ priority is the firm and not public health.”

Source: Journal of Environmental Health

Title: ‘Going Public: Early Disclosure of Food Risks for the Benefit of Public Health’

Author(s): Benjamin Chapman, North Carolina State University; Maria Sol Erdozaim, Kansas State University; Douglas Powell, Powell Food Safety

Published: March 2017.

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