Food-borne illnesses, outbreaks are on the rise
The Wall Street Journal
More Americans are eating their vegetables. But the healthy trend comes with a risk: Illnesses traced to fresh produce are on the rise.
Fruit and vegetables are now responsible for more large-scale outbreaks of food-borne illnesses than meat, poultry or eggs. Overall, produce accounts for 12 percent of food-borne illnesses and 6 percent of the outbreaks, up from 1 percent of the illnesses and 0.7 percent of outbreaks in the 1970s, according to the Centers for Disease Control and Prevention.
Several factors are responsible: the centralization of produce distribution, a rise in produce imports, as well as the growing popularity of prechopped fruit and vegetables. Both the government and the industry have identified five products that are particularly problematic: tomatoes, melons (especially cantaloupes), lettuce, sprouts and green onions.

Last month, Dole Food Co. recalled 250,000 bags of precut salads after Minnesota buyers were infected with E. coli bacteria, some severe enough to be hospitalized. Two years ago, green onions imported from Mexico caused what is believed to be the largest hepatitis A outbreak in U.S. history. Three people died and more than 500 were sickened.
In response, the federal government is stepping up efforts to get everyone along the produce chain to clean up their acts. Last month, the Food and Drug Administration issued a strongly worded letter — its second in 20 months — to the California leafy-greens industry, expressing concern over lettuce-related E. coli outbreaks and a lack of effort to combat the trend.
While it acknowledged that the source of lettuce outbreaks is rarely discovered, it added that “claims that ‘we cannot take action until we know the cause’ are unacceptable.”
A group within the FDA is pushing to expand certain food-safety practices beyond food processors to cover those who harvest, store and distribute raw agricultural products. The produce industry, too, is developing detailed guidelines covering each step of the journey to market. Among the recommendations: delaying harvest or extra washing after heavy rains, which increase the likelihood of contamination from the soil.
Scientists often have trouble tracing how fresh fruit and vegetables become contaminated. Even washed vegetables can be subject to contamination. Last July, salmonella-tainted tomatoes sickened 561 people in 18 states and in Canada. While washing fresh tomatoes gets rid of bacteria on the skin, salmonella can enter the tissue through the stem or cracks in the skin, says Michael Doyle, director of Center for Food Safety at the University of Georgia. In the case of cantaloupes, bacteria from irrigation water, manure or wildlife, such as birds, can sit on the skin or enter through cracks and crevices in the rind, he says.
But scientists do know that fruit and vegetables with protective skins, such as melons and tomatoes, are more easily penetrated by bacteria when the skin is broken. Consumers and restaurants increasingly are purchasing melons, tomatoes and other produce that are pre-cut and packaged. Sales of fresh-cut produce reached $12.5 billion in 2004, almost four times their sales in 1994, says Roberta L. Cook, an agricultural economist at University of California at Davis.
Lawsuits a byproduct
Food processors say they go to great lengths to reduce the risk of contamination. But government food-safety experts say the greater the number of steps between farm and table, the greater the opportunity to introduce food-borne illnesses. And, because packages advise that washing precut produce isn’t necessary, consumers often don’t wash it.
Centralized distribution of produce also enables any contamination to spread to a wider area and makes it harder to trace the source of a disease outbreak. The FDA, which regulates fruit and vegetables, doesn’t conduct inspections of them unless there are particular safety concerns or research needs.
At the same time, more produce is grown overseas. Robert E. Brackett, director of the FDA’s Center for Food Safety and Applied Nutrition, says the agency is stepping up scrutiny of imported fruit and vegetables.
For some trial lawyers, problems with produce have been a gold mine. Bill Marler, a lawyer in Seattle who handled a 1993 Jack in the Box Inc. case involving E. coli in hamburgers, has since turned to suing suppliers and restaurants on behalf of hundreds of people who became sick after eating lettuce, cantaloupe, sprouts, spinach and green onions.
Restaurants, often the first ones hit by lawsuits after an outbreak, have stepped up monitoring their suppliers’ safety programs, says Donna Garren, a vice president at the National Restaurant Association. “Lawsuits and liability go down the chain,” she says.
Officials ‘in a quandary’
An analysis of government data by the Center for Science in the Public Interest shows there were 554 produce-related outbreaks infecting 28,315 people from 1990 to 2003. Vegetables caused 205 of them, sickening 10,358, while fruit caused 93 outbreaks with 7,799 cases. The remaining outbreaks were traced to dishes that included produce. Produce was associated with the most large outbreaks — those involving more than 200 people — though seafood caused more outbreaks overall.
The outbreaks have put government officials “in a quandary” as they try to find a balance between touting the benefits of fresh produce and alerting consumers of potential hazards, Brackett says. They don’t want to muddy the message that eating veggies is healthy, especially now that Americans are eating more fruit and vegetables. Per-capita consumption of fresh produce rose to 332 pounds in 2004 from 287 in 1990, according to the Produce Marketing Association.
One thing officials stress is the importance of washing. A survey published in the Journal of Food Protection in 2002 found that 6 percent of consumers seldom or never wash fresh produce, more than 35 percent don’t bother to wash melons, and nearly half don’t wash their hands before handling fresh produce.