Jerry and Judy Roth loved eating steak.
Jerry Roth, who did most of the cooking for the Parma, Ohio, couple, always served the meat medium well done-barely pink in the middle-because the retired supermarket worker knew that food-borne bacteria can make you sick.
But precautions weren’t enough. Judy Roth became fatally ill over the Memorial Day weekend with a virulent strain of E. coli, the toxic bacteria that has become a growing public-health peril.
E. coli 0157:H7 killed three Seattle children and sickened hundreds who ate Jack-in-the-Box hamburgers last year. But safe-food activists say there have been dozens of E. coli outbreaks across the country-no one knows exactly how many-since the highly publicized deaths in Seattle.
The worst of it, activists say, is that the outbreaks have occurred despite a new Agriculture Department program to crack down on tainted beef.
Exactly how Judy Roth, 53, picked up the bacteria remains a mystery. Because the couple were careful to cook their beef properly at home, Jerry Roth said, he believes his wife may have gotten sick from eating take-out sandwiches at work.
They were not alarmed at first when Judy Roth developed stomach cramps. But when she experienced bloody diarrhea, a common symptom of E. coli victims, her husband rushed her to a hospital emergency room. Tests confirmed she had contracted the bacteria. She died two weeks later.
Since the Seattle episode in January 1993, the Centers for Disease Control and Prevention has counted at least 24 E. coli outbreaks, each involving multiple cases. In those, a total of at least 1,672 people were stricken. Hundreds of those people were hospitalized and 19 people died.
This year, among the cities where outbreaks occurred are Omaha, where 23 people became ill; Minneapolis and St. Paul, affecting at least 6 people; Bismarck, N.D., affecting 14 people; and San Luis Obispo, Calif., affecting two people.
CDC epidemiologists acknowledged their statistics are sketchy and preliminary-they don’t even count isolated cases of E. coli-and could well reflect only a tiny percentage of the actual numbers. Data collection is hampered because 20 states are not required to report E. coli cases, though the CDC is urging all states to do so.
This month, Illinois is joining the ranks of states where cases must be reported, state officials said.
“There’s no question the incidence (of E. coli) is rising,” said Dr. David Swerdlow, a CDC epidemiologist. “We’re seeing a lot of outbreaks this summer. We don’t know if that’s because of summer cookouts or why it’s happening.”
The overall rise is due in part to the fact that health officials are keeping a sharper lookout for cases. But it’s also because the bacteria seems to be more common in cattle, Swerdlow said.
One citizens group that tracks E. coli cases agrees that they are increasing. Donna Rosenblum, chairman of Safe Tables-Our Priority (STOP), blames the situation on inadequate inspection procedures by the USDA, which she said is making changes “at a glacial pace.”
Mary Dixon, a spokeswoman for the Agriculture Department, said the meat inspection system has improved since the government implemented tightened procedures in the wake of the Seattle outbreak.
However, a recent study by the Government Accounting Office criticized the USDA for being outdated and limited in its ability to detect deadly bacteria on meat. The study said that recent changes have only marginally improved conditions.
E. coli is found in the digestive system of cows and typically is spread to meat in the slaughtering process. In human beings, the bacteria causes reactions ranging from slight illness to death, with children and the eldery being most vulnerable.
According to the GAO report, issued May 24, the USDA system “cannot effectively identify and prevent meat contaminated with pathogenic bacteria like E. coli from entering the nation’s food supply.”
Although the department has known about microbial contamination of meat for at least 15 years, “its major initiative in response-creating a new inspection system-still is years away,” the study said.
The GAO and other critics say that a major failing of the system is the continued reliance on visual inspections, which aren’t adequate for detecting microscopic bacteria on meat. Meat still can be tainted through contact with hands, knives or other equipment.
The USDA’s Dixon acknowledged there’s room for improvement. But she said the department is working on further changes that would modernize the system, including a quick test for microbial contamination. She couldn’t say when that test would be in place.
Defending the department’s actions so far, Dixon said that under the department’s “zero tolerance” program, federal inspectors have the authority to stop or slow meat processing lines when they see fecal matter contamination. They can order that it be trimmed off the meat.
Steve Cockerham, a USDA meat inspector for 16 years and an outspoken critic of the zero-tolerance program, said the program has improved sanitary conditions at the packing plant where he works in Nebraska but not enough to guarantee safe meat.
He said that today’s high-speed processing lines and a lack of high-technology procedures, such as routine bacterial testing, make it impossible for him to ensure that the plant isn’t producing tainted beef.
“Some of the cleanest beef I’ve ever seen is going into the cooler,” Cockerham said. But he added, “I can’t guarantee it’s bacteria-free. Even the best inspector is going to miss some (contamination) when lines are processing 330 carcases an hour. We’re trying to push beef through too fast. And we just don’t have the tools to identify bacteria.”
A panel of medical experts recommended Wednesday that at least some of America’s hamburger meat be treated with sterilizing radiation to kill E. coli.
The panel, organized by the American Gastroenterological Association and sponsored by federal health agencies and the food industry, said radiation will kill the bacteria and may be the only way to control E. coli contamination in butchered beef without affecting its quality. He said the health benefits would far outweigh the cost to industry. It is questionable, however, whether consumers would accept irradiated beef.
According to the CDC data, recent outbreaks have been smaller in scope than the Seattle outbreak. No one is sure why, but one reason could be that some restaurants are cooking hamburgers longer.
One of the largest outbreaks came last spring in Omaha, in the heart of cattle country. It was traced to supermarket ground beef from a local packing plant. Federal inspectors subsequently cited the plant, Northern States Beef, which is owned by agribusiness giant ConAgra Inc., for sanitary violations.
Among those sickened by the toxic bacteria were six Boy Scouts on a camping trip who snatched hamburgers off a grill while they were still rare. A physician, nurse and high school home economics teacher also were affected.
Dr. Thomas Safranek, Nebraska state epidemiologist, described the victims as “a well-heeled group,” many of whom got sick after improperly handling contaminated beef even though they were aware of the dangers of uncooked meat.
Critics of the inspection system say that the USDA should institute a traceback system that would enable officials to more quickly pinpoint the original source of tainted meat. Subsequent corrective action, consumer warnings and product recalls could prevent or contain E. coli outbreaks, they say.
Under the current system, tracebacks are time-consuming and often piecemeal exercises that don’t help consumers much.
For example, Safranek said that after Omaha residents began getting sick in mid-April, it took until mid-May to trace the source of the contaminated meat to the packing house. By then, health officials figured that most of the bad beef probably had been consumed.
But some of it still may be in consumers’ refrigerators, not only in Nebraska, but in Chicago and other cities where people never heard of the outbreak, Safranek acknowledged.
He said that records show that part of the batch of contaminated ground beef responsible for the Omaha outbreak was shipped to grocers in the Midwest and East, including Chicago.
But because plant officials made no effort to recall the bad beef-there was no requirement that they do so-consumers outside Nebraska had virtually no way of knowing they might have purchased it.
Yet health officials still seem unclear over where the tainted meat ended up.
Carl Langkop, an epidemiologist for the Illinois Public Health Department, said that after being informed in May about the bad meat shipment, state officials contacted the grocer involved, which he didn’t name, and local health departments in the Chicago area, alerting them about possible E. coli cases. But he said that a week or so later, the USDA put out a revised report saying the meat hadn’t gone to Illinois.
Even though E. coli is considered one of the most serious food-related health threats, public health officials often have no guidelines to follow in trying to contain outbreaks.
Residents of Bismarck, N.D., for example, were angered in May when local health officials refused to identify a restaurant involved in an E. coli outbreak there. The officials cited confidentiality rules.
The outbreak in May sickened 14 people. It was traced to a popular Bismarck eatery whose motto is “The World’s Best Hamburger.”
Apparently concerned about the impact on the local economy, officials refused to identify the restaurant or the packing house that produced the tainted hamburger, according to David Schweigert, attorney for two of the victims. They picked up E. coli changing the diapers of a toddler who ate at the restaurant.
Eventually, the owner publicly admitted his restaurant’s role. But Schweigert said he is still trying to get officials to disclose the packing house involved.