Food Safety Net

Stephanie Smith, a twenty-two year old children’s dance instructor left paralyzed from an E. coli-contaminated hamburger, filed suit yesterday against Cargill, the company that produced the meat.

Stephanie, who was profiled on the front page of the New York Times in October for her intense nine-month battle with E. coli, has acquired more than $2 million in medical bills and faces a lifetime of medical complications including brain damage and kidney failure.

What is not in Gillett’s medical record — and what Jack’s doctors and state and local health department officials could never determine — is the source of the E. coli that caused his illness, kept Jack in hospitals for three weeks, and led to 13 dialysis treatments and six blood transfusions.

“Do I want somebody to be mad at? Maybe,” Gillett said during an interview at the family’s Rockford home. “I just want to know how this happened to my son. I want to have the knowledge.”

Her 10-year-old son’s ordeal and the lack of certainty about what caused his illness illustrate two troubling, though not widely known, aspects of food-borne illness. Even as tainted food causes thousands each year to endure long-lasting illnesses, health agencies are having a difficult time finding the cause of the problem.

Conventional wisdom holds that food-borne illnesses are mostly minor and short-lived. And while the vast majority of victims do not see a doctor, blaming their symptoms on a routine virus, some victims experience serious and long-lasting medical consequences such as kidney failure or paralysis. In the US, of an estimated 76 million food-borne illness victims each year, some 300,000 are hospitalized and close to 5,000 die.

It also is often assumed that the cause of these illnesses is eventually tracked down — and often connected to a major outbreak, like the ones that tainted spinach in 2006 and caused three deaths.

In fact, in nearly 60 percent of outbreaks, a source of the pathogen is never found; the illness remains a public health mystery, according to the US Centers for Disease Control and Prevention.

In cases not tied to an outbreak, determining the source of a pathogen can prove even tougher. It is difficult, if not impossible, to recall a week of meals and snacks eaten during a food-borne illness’s incubation period, much less find what remained from the tainted meal or unused ingredients to test.

“Really, the only time you nail these things down with any satisfaction is when you have a really, really large outbreak,” said Dr. Glenn Morris, director of the Emerging Pathogens Institute at the University of Florida. “With an individual patient, it’s exceedingly difficult to identify the source.”

There are obstacles to identifying the food source of a pathogen throughout the food safety system. While molecular fingerprints of the pathogen, taken by lab workers, help identify it, if the tainted food has not been found, then researchers can only link victims to each other, not to a source.

Food safety advocates say a quicker response to illnesses may help identify sources, as would better tracking of food through the manufacturing process.

Among the other goals are improving communication between hospitals and relevant health authorities.

“People just aren’t communicating the way a good system should be. We’ll never be able to figure out how to prevent long-term consequences if we don’t know what’s making them sick,” said Vaughn Grooters.

Over the course of three weeks in two hospitals, Jack had 13 dialysis treatments and six blood transfusions, according to his mother and the medical records she has maintained.

Jack’s odyssey with a food-borne illness began in July 2008, when he accompanied his parents on a three-day driving trip through Illinois and Indiana to Kentucky, where Jack’s father, Bruce, had business.

Along the way, the family stopped at restaurants, including fast-food places, and stayed in a motel. One night, Jack and his father had a bout of diarrhea, but it was over quickly, and Gillett assumed it was just a virus. When they returned to Rockford, Jack again had diarrhea and was vomiting, had a fever and suffered pain on his right side. His mother feared the boy’s appendix was inflamed.

Gillett took Jack to a doctor, but the doctor said Jack had a bug and told Gillett not to worry. When Jack continued to decline, and after he had bloody diarrhea, the family took him back to the doctor. He then went to a hospital, and E. coli was identified as the cause of his illness. Jack was transferred to a hospital in Madison and, as his kidneys failed, placed in an intensive care unit.