U.S. Food Safety: Import Alarm Keeps Sounding

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U.S. Food Safety: The Import Alarm Keeps Sounding

By E.J.Mundell, HealthDay Reporter

TUESDAY, Jan. 15 (HealthDay News) -- One Sunday after church, Rich

headed to a local Chi-Chi's restaurant in Beaver, Pa., where he

dipped into the house salsa that came with the meal.

That simple act in 2003 changed his life forever. What didn't

know was that imported Mexican green onions in the salsa carried a

deadly passenger: hepatitis A.

A few days later, as recalled recently, " I couldn't even get

out of bed. It was like the worst case of flu that you could ever

imagine. "

His health quickly deteriorating, the 57-year-old railroad

superintendent was diagnosed with rare fulminant hepatitis A disease

-- in which the virus destroys the liver -- and was rushed to a

Pittsburgh hospital for a liver transplant.

Placed in a medically induced coma for a month, eventually

returned home, frail and unable to return to work. To this day, he

said, he has mobility problems and neurological difficulties.

Still, considers himself lucky: Four others who ate the salsa

and developed fulminant liver illness died. Overall, more than 600

people around Pittsburgh were sickened during what became the largest

hepatitis A outbreak in U.S. history.

The story is just one of many over the past few years that have swung

the spotlight on the dangers of imported foods, which now comprise 13

percent of the American diet, according to the U.S. Department of

Agriculture.

Imported Disasters

Perhaps the most high-profile examples of these potential dangers come

from last year's tainted pet food scandal and the halting of

questionable food products from China.

The pet food disaster, which slowly evolved into the largest recall of

pet food in U.S. history, involved exported wheat gluten from China

that contained the toxic chemical melamine and was used as an additive

in food sold under more than 100 brand names. Hundreds of dogs and

cats died; an official tally was never issued. In addition, U.S.

health officials disclosed that up to 3 million broiler chickens had

been fed the contaminated surplus pet food and then had been sold to

restaurants and supermarkets across the country.

That was followed by a recall of almost a million tubes of toothpaste

from China that were contaminated with a chemical used in antifreeze.

The toothpaste had been distributed to institutions for the mentally

ill, hospitals and prisons in the South.

And, shortly after that, U.S. health officials halted the importation

of farmed fish from China because of chemical contamination in the

fish feed.

But China is not alone in triggering American foodborne woes.

Last year also, a salmonella outbreak caused Dole Fresh Fruit Co. to

recall roughly 6,104 cartons of imported cantaloupes from Costa Rica

that were distributed to wholesalers in the eastern United States and

Quebec. There were no reports of illness.

But in 2006, an outbreak of nonfatal scombroid fish poisoning linked

to tuna steaks imported from Vietnam and Indonesia sickened 15 people

in Louisiana and Tennessee. And a 2001 outbreak of salmonella in

Mexican cantaloupes killed two people and sickened 25 others across 15

states.

In November, officials at the U.S. Food and Drug Administration

reacted to the newest outbreaks with a sweeping set of proposals

dubbed the Food Protection Plan. It calls for legislation that would

give the agency broader powers (including mandatory food recall),

heftier financing, and improved cooperation with producers, importers

and foreign governments to stop tainted food at the source. The plan

remains just that, however, pending Congressional action.

Still, " I think it's clearly a step forward, " said Bill Hubbard, who

spent 14 years as associate commissioner of the FDA before retiring in

2005. Hubbard, who is now an adviser for the Washington, D.C.-based

consumer advocacy group Coalition for a Stronger FDA, said, " The plan

is clearly an attempt to change the paradigm from 'inspect only at the

border' to putting more of the responsibility elsewhere, " especially

at the source of production abroad.

" Put in place procedures where you say to the importer you need to be

checking on your supplier, then the exporter in China is supposed to

be looking at his supplier and then all the way back to the producer, "

Hubbard explained. " Everybody is checking on everybody and keeping

records. And, in theory, that can work. But the FDA will need new

statutory authority to oversee something like that, and resources. "

The full scope of the problem remains unclear, however.

Food safety experts stress that it's almost impossible to sort out

whether the thousands of smaller food-linked disease outbreaks that

occur each year in the United States are attributable to domestic or

imported product. According to the U.S. Centers for Disease Control

and Prevention, about 76 million cases of food-related illness are

reported in the United States each year, including 5,000 deaths.

More Contaminants in Imported Foods

One thing is clear: You're more likely to encounter contaminants in

foods from abroad than those grown in the United States.

According to a FDA report released in 2003, pesticide violations were

cited in 6.1 percent of imported foods sampled versus 2.4 percent of

domestic products. And a report issued by the agency a few years

earlier found traces of salmonella or the dysentery-linked bacteria

shigella in 4 percent of imported fruits and vegetables versus 1.1

percent of domestic produce.

And there's more imported food in the nation's supermarkets than ever

before. According to the CDC, food imports to the United States have

almost doubled in the past decade, from $36 billion in 1997 to more

than $70 billion in 2007.

Trouble is, inspections by the FDA -- either at the source of

production or at the borders -- can't keep up. The agency is

responsible for inspecting all imported foods with the exception of

meat and egg products, which are covered by the Food Safety and

Inspection Service, part of the U.S. Department of Agriculture.

Overall, " there's been an 81 percent drop [in FDA inspections] since

1972, " noted Doyle, director of the Center for Food Safety at

the University of Georgia, in . " That's a huge reduction, and,

at the same time, compared to 1972, we have a huge amount more of food

imports. "

In fact, the FDA's own data show that the number of inspectors at its

Office of Regulatory Affairs dropped from 1,642 in 2003 to 1,389 in

2005 -- even as food imports rose from 9.3 million shipments per year

to more than 13.8 million shipments annually.

The reason for the shortfall is simple, Doyle said: " Reduced budgets. "

The bottom line, according to FDA figures, is that its inspectors now

sample just 1.3 percent of all imported food shipments entering the

country.

However, simply boosting the number of inspectors may not be the

solution, said , who helps oversee FDA foreign and

domestic inspections as director of the FDA's division of field

investigations.

" With more [money], certainly more inspections can be done, " he said,

" but that's not the panacea for total public heath protection. "

Instead , said, collaborating with business and foreign

governments to help spot tainted food before it reaches this country,

which is part of the Food Protection Plan, may be the most important

step the agency can take.

Certainly, the agency currently performs relatively few on-site

inspections of foreign farms and food processing plants.

The farm in Ojos Negros, Mexico, that was the source of the 2003 green

onion contamination had never been inspected by U.S. authorities

before the incident. And the FDA inspection that took place soon after

the outbreak makes for chilling reading.

In their report, filed in December 2003, agency inspectors said they

observed dirty runoff from the farm workers' windowless, mud-floored

shacks and crude showers seeping directly onto fields where produce

was grown. Photos of the site " show evidence of soiled diapers, soiled

feminine hygiene products, and domestic waste " lying nearby, according

to the report.

The growing fields were irrigated with water from a pond that was also

a dumping ground for human sewage and animal manure. During

processing, green onions typically passed through the hands of at

least six workers, the FDA team said, and there was no evidence that

workers were allowed time off for illness. While the firm purported to

wash all onions in chlorinated water, it could produce no evidence to

back that claim.

The Problem With China

The Chi-Chi's outbreak has been just one of many, and, in 2007, the

focus shifted from Mexico to China.

The pet food scandal, as well as a stream of toy and other recalls in

2007, spurred negotiations between U.S. officials and their

counterparts in China, which exported $4.2 billion worth of food to

America last year -- much of it in the form of ubiquitous processed

food ingredients such as wheat gluten or ascorbic acid.

While no major outbreaks of human foodborne illness tied to Chinese

products have occurred recently, they're not unlikely in the future,

Hubbard said. Much of the food in China that's destined for U.S.

dinner tables is grown and processed by mom-and-pop producers with

little or no oversight, he said.

" What they've got is this vast cottage industry of producers making

this stuff. Sometimes you might have a producer making just five or

six sacks of flour per week in the hinterlands of China, " Hubbard

said. " China experts tell me that the central government in Beijing

has very little influence out in the countryside where this is made. "

China has reacted recently to international pressure by signaling that

it is ready to tighten food safety standards. In December, the United

States and China signed an agreement that places new registration and

inspection requirements on 10 food products exported by Chinese

companies. The products include some preserved foods, pet foods and

farm-raised fish, all of which have come under suspicion of being tainted.

Those types of market reactions may help fix things in countries of

origin such as China, experts say, but weaknesses remain here at home.

Topping the list: a chronic underfunding of FDA inspection services,

according to critics. " If you look at the Bush Administration's fiscal

year 2007 budget proposal, the Produce Safety and other food programs

are going to be cut by $22.6 million from 2006 levels, and the

staffing would be reduced by 105 full-time employees, " Doyle noted.

One private industry food safety inspector, Ed Sherwin, said he

doesn't blame management or workers at the FDA for what he considers

to be poor oversight of imported foods.

" What I've found is that the federal inspectors from FDA and USDA are

excellent in their work, but they are understaffed and overworked, "

Sherwin testified at a special Congressional hearing on the issue in

October. In the meantime, " profits take priority over food safety, "

Sherwin said. " Food service operators tend to rely on their suppliers

to provide the products that best meet their needs at the lowest

price. Operators don't care if the crabmeat is from land or

Malaysia, the grapes are from California or Chile. "

Lack of 'Traceability'

Inspections at the border and ports of entry can help spot trouble,

but experts say the FDA currently has full-time inspectors in place at

just 90 of the nation's 300 import points of entry.

Then there's what's known as " port shopping, " where shoddy goods are

moved from one port to the next until they can be slipped past inspectors.

" Importers know that if FDA only looks at 1 percent, then even if they

get caught at port A, chances are they won't get caught at port B, "

Hubbard explained. " Or they'll sometimes use things like inland ports

for seafood. Shippers will enter their food through Las Vegas, where's

there's no [FDA] seafood person, because it's an inland port. "

Testifying at the congressional hearing, Caroline DeWaal, of the

Center for Science in the Public Interest, said imported food is often

hard to track once it gets by port inspectors. " For example, with

produce, it can all go into the same warehouse, " she said. As part of

normal distribution, she added, " they can mix boxes, and produce from

several different countries can be reshipped out again without any

kind of labeling. "

This lack of " traceability " can make it tough to uncover the source of

an outbreak and can cause worried consumers to avoid all brands of a

given food, severely affecting an entire industry.

That scenario unfolded in the early days of the 2006 U.S. spinach

scare, experts noted, with consumers simply avoiding the leafy green

altogether, regardless of where it was grown.

Finally, there's the problem of what everyone calls the FDA's lack of

clout in punishing companies that import dangerous foods. The agency

is allowed by law to recall dangerous pharmaceuticals, but it has no

such power over potentially deadly foods. The new Food Protection Plan

does include a provision calling for mandatory recall authority, but

it remains to be seen if legislators will grant the agency those new

powers.

Moves toward more thorough and frequent inspections offer little

comfort to food-poisoning victims such as , who reached an

out-of-court settlement of his lawsuit against Chi-Chi's before the

company went out of business in the United States in 2004.

said his story should remind Americans just how close the link

is between what's on their forks and what's in fields thousands of

miles away.

" Disease knows no boundaries, " he said. " I know that we are still

going to have outbreaks -- nothing is perfect, and you can't stop

everything. But we have to lessen it, and lessen its impact. "

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