By SARA IN…S CALDER”N
The Brownsville Herald
December 5, 2005 — The incidence of food-borne illnesses in the Rio Grande Valley far exceeds statewide figures.
While some say this is because of proximity to Mexico, incidence rates in the border counties of El Paso and Laredo say otherwise.
For five consecutive years, Texas Department of State Health Services data shows the Valley has had much higher rates of food-borne illness, such as hepatitis A and salmonella.
Figures provided by the state health department are only based on confirmed cases reported by local doctors. There may be cases that are not reported, so actual rates may be even higher than reported rates. Official’s say reporting across the Valley is reliably standard.

According to the Centers for Disease Control (CDC) 76 million cases of food-borne illnesses are reported each year in the United States. The majority cause mild symptoms that disappear after a few days, the CDC reported.
More serious consequences result from food-borne illnesses, with 5,000 deaths and 325,000 hospitalizations annually, the CDC reported. The hardest-hit populations are the very young, the very old, those with weakened immune systems and people affected by high doses of a deadly organism.
State and county health officials have given a variety of answers why the Valley is a leader in food-borne illnesses.
Sometimes there are just random outbreaks of diseases, which can cause a spike in reported data.
Proximity to the Mexico border, where food care standards may not match those of the United States, may also be a factor.
“It stands to reason we have increased numbers than the state (being on the border), but I wasn’t aware it was that consistently,” said Herb Tolentino, director of nurses for the Cameron County health department.
Tolentino said food sold at informal locations, like a mobile stand, could be one cause of the high rates of diseases.
“Not all restaurants follow the same inspections as this side of the border,” he said, “It’s a tough job for them,” he said of the Mexican government’s task of enforcing health codes.
A lack of education in the general population about sanitation is also a big factor in illness, officials said. People may not know how to adequately clean or prepare food.
Poverty in the Valley, which raises the question of adequate access to clean water and overcrowded living conditions, is probably the biggest contributor to the high number of food-related illnesses.
“We have more people living in sub-standard housing, lower income, but we don’t have a complete explanation,” saidAllison Abell, an epidemiologist with the state health department.
Harry Dur*n, another epidemiologist with the state health department, said “socioeconomic factors,” including different food preparation, hygiene and the care taken with food, may be to blame.
“The availability of running water means limited water for hygiene in a household,” he said. “Also, if you have crowded living conditions, if you have a large number of people sharing the same toilet, you can get the spread of diseases.”
While proximity to Mexico may be convenient to explain the high incidence of hepatitis A and salmonella in the Valley, the truth is that is an incomplete explanation, all health officials referred to in this article said.
“We really don’t know why,” Abell said. “We do know that there are higher rates of poverty, in general, in the Valley than some other parts of the border, but I don’t think it would be safe to say that we could point our fingers to Mexico and say that Mexico is at fault.”
Pointing the finger south is not statistically viable, anyway, since rates for El Paso and Webb counties, which also border Mexico, do not reflect the similar numbers of cases per 100,000 people.
Raw meat and poultry, eggs, unpasteurized milk and raw shellfish are the foods most associated with food-borne infections, according to the CDC. Proximity to the ocean and shellfish may be another factor in high infection rates in the Valley, Tolentino said.
In 2004, the rate of salmonella per 100,000 people in Texas was 11.82. In Cameron County, it was 25.5 people per 100,000, while El Paso County was 11.15 and Webb County was 12.18. This number for Cameron County over time is also higher than the other two counties, with few exceptions.
Some of the most common food-borne illnesses, according to the CDC, are the bacteria campylobacter, salmonella and E. coli (0157:H7). The first two almost always had higher incidences in the Valley, as compared to the state figure.
Campylobacter causes fever, diarrhea and abdominal cramps and stems from undercooked chicken or food contaminated with juices from raw chicken. Similarly, the CDC reported that salmonella causes the same symptoms and is transmitted through a variety of foods “of animal origin” but can cause life-threatening infections.
E. coli (0157:H7) is derived from cattle and similar animals and can be transmitted by food or water that has been contaminated with even microscopic amounts of animal feces, the CDC reports. Symptoms can include bloody diarrhea, painful abdominal cramps, but small fevers and consequences can include anemia, bleeding and kidney failure.
“E. coli and salmonellosis are primarily transmitted through food and are less likely to be transmitted through human contact,” Dur*n of the state health department said.
“Where salmonella and E. coli use food to multiply in, shigella can be effective without having food to multiply in,” Dur*n said. Shigellosis and salmonella are more common in South Texas than in other counties, he said.
“Campylobacteriosis is also transmitted through food but is caused by poor personal hygiene,” Dur*n said. “Bad hygiene leads to fecal contamination of food. In all of the food-borne illnesses, there is a breakdown in the hygiene.”
This also applies to hepatitis, he said.
People infected with these diseases are routinely treated with hydration, sometimes with special drinks like Pedialyte and anti-diarrheal medications such as Pepto-Bismol, according to the CDC. Only a doctor can diagnose an illness or prescribe medication.
The only real solution to the high incidence of food-borne illnesses is prevention, officials said.
“A lot of time this food-borne illness will come from the home,” Tolentino said. “All we can do is educate. Having more physicians is not going to solve the problem.”
The numbers point to a problem, but few seem to have a solution.
“Can we say the full explanation?” Abell of the state health agency asked. “No, we really can’t.”
sicalderon@brownsvilleherald.com