Showing posts with label CDC. Show all posts
Showing posts with label CDC. Show all posts

Monday, March 8, 2010

Food-borne illness: Failure of Capitalism


A new consumer research report released Wednesday has found that the health-related costs of food-borne illnesses total $152 billion a year, including the costs of medical bills, lost wages and lost productivity. That total is more than four times that of earlier estimates calculated by the U.S. Department of Agriculture.

The findings come as regulatory efforts to patrol the country's food sector are growing amid reports of a string of costly -- and sometimes fatal -- outbreaks of food-borne illness involving peanuts, jalapeno peppers, spinach, beef and other foods.

The report, sponsored by the Produce Safety Project at Georgetown University, provides a comprehensive examination of health costs associated with flaws in the nation's food safety system and "demonstrates the burden of food-borne illness," said Sandra Eskin, director of the Pew Charitable Trusts' Food Safety Campaign, a supporter of the study.

In 1997, the USDA reportedly pegged the public cost of sickness and death from eating tainted food at $35 billion a year. But that research looked at the fallout from only a handful of food-borne pathogens and didn't include as many long-term effects from such illnesses, including how they can affect a person's quality of life.

The Produce Safety Project identified 27 pathogens, said Robert Scharff, an economist who authored the newly released report. Researchers say some of the pathogens, such as norovirus or salmonella, are responsible for making a million or more Americans sick each year; others, such as botulism, sicken far fewer people.

Yet in most cases, researchers still can't pinpoint why or how people get ill from what they eat. The study attributes just over 80% of the illnesses and two-thirds of the costs to unknown food-related causes, a determination made by statistical analysis of symptoms associated with food-borne sickness such as diarrhea, Scharff said.
The contamination of perhaps thousands of food products with salmonella should be a wake-up call to apologists for the industrialized food system. It's not possible to bring the system down and get everyone to eat an all-local, all-fresh diet, as some "locavores" say they want. But to continue to pretend that our food system is just fine as it is amounts to an endorsement not only of widespread illness, but also of chronic health problems and environmental degradation.

But let's concentrate for now on outbreaks of illness. The foods were contaminated by a single ingredient, hydrolyzed vegetable protein (HVP), made in this case by a single manufacturer, Basic Food Flavors of Las Vegas. That a single company can be responsible for contaminating thousands of processed food products that are distributed across the country and even internationally is as strong an indictment of industrial food as I can think of.

HVP is a ubiquitous flavor enhancer that exists only in processed foods. "So far, recalls have been announced for 56 separate products, according to a database posted today by the FDA, including potato chips, dips, salad dressing, sauce mixes, soup bases, and 16 flavors of prepackaged meals," according to the Web site of the Center for Infectious Disease Research & Policy (CIDRAP).

"But," CIDRAP continues, "that number is expected to grow enormously over the next few weeks as details of the recall filter through the complex channels of industrial food production. The 6-page list of recalled lots of HVP posted on Basic Food Flavors' website contains hundreds of items."

Free marketeers would have you believe that the market will correct this problem. That market forces will drive companies out of business if they persist in selling products that make you ill or kill you.

The quick demise of all tobacco companies proves that, doesn't it?

And yet, the CDC reports that 5000 Americans die and another 325,000 are hospitalized out of 76 million annual cases of food-borne illness.

That's 1.66 9/11s annually, for a total estimated cost of $152 billion/year (as listed above). Since the Bush Adminstration devalued an American life to $5.9 million, only $34.5 billion/year of that is the deaths, leaving $117.5 billion/year for the other loss of productivity and medical costs.

This is what the economists call "a market failure".

Here's a hint as to why:

Food subsidies are out of whack with government policy. That speaks to gaming the system. The government says you should eat 11 servings of grains daily, but they send 74% of their subsidy money to meat & dairy producers. I wonder how that happens?

If food producers can influence government spending policy, I wonder if they can influence food safety legislation?

If you want to know more, just Google "e. coli conservatives", at the top of which you'll find Rick Perlstein's 1997 post where I believe he coined the term:
First, they came for the spinach...Next they came for the peanut butter...Then they came for the tomatoes. Then the Taco Bell lettuce. Then the mushrooms, then ham steaks, then summer sausage...They, they came for the pet food.
There's more...

Friday, May 1, 2009

Daily Flu-ness


(HHS/CDC/DHS Webcast, sourced at PandemicFlu.gov)

Sources
Veratect Twitter Feed
Google US Flu Trend
Google Mexico Flu Tend (experimental)
FluWiki
(Illustration: Periods, Phases, Stages, and Intervals; from Flu Wiki)

Status
(Illustration: Pandemic Influenza Phases; World Health Organization)

Current WHO pandemic phase: 5
Laboratory confirmed cases worldwide: 367 in 13 countries
Laboratory confirmed deaths worldwide: 10 in two countries
Official designation: influenza A(H1N1)
Laboratory confirmed cases in US: 141
Laboratory confirmed deaths in US: 1

Discussion
International efforts to contain influenza A(H1N1) have failed. That's not surprising and it's not a fatal error. International travel is simply too widespread, too cheap, and too fast to successfully contain a disease with several days of asymptomatic or minimally symptomatic incubation like the flu. Containment was always a pipe dream.

As we approach the brink of a pandemic, there are important unknowns: how many people actually have A(H1N1)?; what is the mortality rate?; and are we dealing with a single strain? I'm sure there are others. If we are seeing 10 deaths out of 367 cases that's one thing but 10 deaths out of 10,000 cases is something very different. The number of cases and number of deaths together give us the mortality rate. A mortality rate of 0.1% is much less scary than a mortality rate of 2.5%. A single strain means that we can build a vaccine relatively quickly and be reasonably confident that it will do the job, while multiple strains lead to concern that we may see multiple waves of contagion with limited immunity conferred by surviving one wave.

At the moment, this proto-pandemic is far less lethal than a typical flu season (in the US: November through March) which hospitalizes more than 200,000 and kills 36,000 in the US. Whether A(H1N1) becomes a pandemic or not, it's entirely possible that it will remain far less lethal than the typical flu season. "Pandemic" doesn't mean "lots of people die" -- it means widespread cases and transmission. Widespread cases and transmission means the possibility of lots of people dying, and the word "pandemic" brings up images of The Hot Zone and Outbreak and Ebola Zaire killing people in the streets of Washington DC and on Maple Street, Anytown.


(Video: The Twilight Zone, The Monsters are Due on Maple Street)


We're not there yet, and we may never be there. Everyone fears a repeat of the biggest pandemic we know about: 1918-1920 (millions of deaths -- 5, 10, 50, or 100 million worldwide -- from H1N1 flu). We may have a relatively mild pandemic like 1959 (100,000 deaths worldwide from H2N2 flu) or 1968 (700,000 deaths worldwide from H3N2 flu). We are better prepared for a pandemic than ever before. We have better diagnostic technology (including genomic typing of flu strains) and vaccine design technology than ever before. We're still limited to a 6-month growth lead time in creating large quantities of a vaccine, though. And we know that there are other strains out there which may be more dangerous.

Even without a dangerous pandemic, our preparation and response carries a price. Accounting for risk and preparing for it, responding to it, always does. When this is all over, if it's mild, we can expect some people to decry the cost of our response -- maybe even if it's disastrous. But preparing and responding to risk is something that we do as a civilized society (or a network of civilized societies sharing our planet together). I predict that the people who complain about cost of response will tend to the authoritarian and conservative.

Other Stories
Q's without A's: 6 mysteries about swine flu
How swine flu virus hopscotched the globe
Swine flu may be less potent than first feared

Oh, and do you know that there were no viruses or bacteria until Adam & Eve ate the apple?
There's more...

Sunday, April 26, 2009

"Pandemic potential" for Mexican flu outbreak

(Photo: 1918 flu poster, Idaho Observer, October 2005)

Veratect's Twitter Feed
James Wilson (Veratect) Blog


[20090427 0930 PDT]
First confirmed case in Spain, a 23 year old who returned from Mexico on 22 April.
Five suspected cases hospitalized in Sweden
Five suspected cases hospitalized in Denmark
New Zealand flight attendants & crew grounded "as a precautionary measure", testing still pending on students. At least 12 and as many as 32 people are voluntarily quarantined after sharing a flight with the college (high school) students.
Probable case in Michigan.
Second suspected case in Israel.
Suspected case in Italy.
Five suspected cases in Switzerland.
Patient being tested in Norway
Suspected cases (no numbers) reported in the Netherlands
Five suspected cases in Costa Rica. Nine ruled out.
Canadian vacationing in Manchester hospitalized. Being tested.
Nine suspected cases quarantined in Australia (4 in Sydney, 5 in NSW)
Four suspected cases reported in France.
Seven new fatalities, suspected swine flu, in Mexico City.
Khazakhstan Ministry of Foreign Affairs issues travel advisory for Latin America
WHO confirms 40 cases in the US
First suspected case reported in Peru
20 additional suspected cases in Catalonia, Spain
Confirmed case in Veracruz, Mexico
Three suspected cases in Bielefeld, Germany
Three suspected cases in Murcia, Spain
Suspected cases in Mexico now at 1600
Private school closure in South Carolina because of "fears that young people who recently returned from Mexico might have been infected"

As you can see from the tweet summary, news coverage and detection of cases is accelerating. Rumour says that WHO may raise the pandemic alert phase today.

The BCCDC reminds us that cases reported here are "mild". Dr. Danuta Skowronski:
It’s reassuring that this swine influenza virus does not automatically mean hospitalization and death ... It may have just the typical influenza-type presentation and symptoms. … This is not necessarily scary monsters.


[20090426 2300 PDT]
Michael Osterholm, University of Minnesota:
What makes this so difficult is we may be somewhere between an important but yet still uneventful public health occurrence here — with something that could literally die out over the next couple of weeks and never show up again — or this could be the opening act of a full-fledged influenza pandemic
Death toll in Mexico reaches 103 (confirmed and suspected swine flu cases).
Canada confirms two cases in BC, institutes surveillance at YVR (Vancouver International Airport).
Bronx day care tests negative (5) or "inconclusive" (1).
Suspected cases in Dallas-Fort Worth (3).
Australia suspected cases from Queensland test negative (2). Two NSW residents being tested.
Three more students in New Zealand test positive for Influenza A.
Mexico City produce vendors/taxi drivers report business down 50% in last two days.
Sacramento (grade?) school ordered closed until no influenza-like illness detected for one week.

Pandemic preparation funding in the stimulus bill was attacked by Republicants.
HHS nominee has been opposed in the Senate by Republicans.
Swine flu: thoughts for the day on 20090426


[20090426 0900 PDT]
Overnight, Mexico raised the total of confirmed flu deaths to 64, then 68, then 81. Unconfirmed reports of over 200.

In NY, preliminary testing of "probable" swine flu cases does not match any known H1/H3 subtypes. CDC performing further analysis.

Price gouging on face masks in Mexico City. Mayor says 70% of bars, clubs, & restaurants are shut down. All public events canceled for 10 days. All Sunday masses in Mexico canceled.

Suspected cases: France, Israel, Spain, Chile.

New Zealand suspected cases confirmed.


[20090425 2311 PDT]
Margaret Chan, director-general of the World Health Organization, says that the current outbreak of flu in Mexico has "pandemic potential".

Wikipedia is wonderfully up to date.

Mexico has seen 1300 potential cases, with 20 confirmed flu deaths and as many as 83 possible deaths. At the upper end, that's about a 7% mortality rate, and apparently the deaths are skewed to young adults. Flu mortality is usually a 'U', with highest mortality in the very old and the very young. Higher rates of mortality in the young or middle adult ranges is unusual, and the most famous example of that mortality profile is the 1918 flu pandemic.

Potential non-Mexican cases are in the US (CA, TX, NY, KS), Canada (Montreal, Nova Scotia), the UK (one member of a flight crew who's been to Mexico recently), and New Zealand (college students).

Biosurveilliance has a timeline up and Veratect is on twitter.
There's more...

Friday, August 15, 2008

Weekend Libations


Forbes magazine has a story and accompanying slide show of "America's Hardest Drinking Cities." Leading the pack is Austin, Texas. My home town of Philly doesn't make the top 20. Lots of other cities that you would expect and a few surprises.

Austin ranks high for its drinking habits across the board. According to the Centers for Disease Control and Prevention's (CDC's) 2007 Behavioral Risk Factor Surveillance System Survey, 61.5% of adult residents say they have had at least one drink of alcohol within the past 30 days, and a staggering 20.6% of respondents confess to binge drinking, or having five or more drinks on one occasion.

With all of this roller coaster politics, the election is sure to drive us all to drink. Bottoms Up!
There's more...

Saturday, July 12, 2008

Salmonella Saintpaul Continues to Infect Americans; FDA and CDC Still with No Answers


More on the Tomato-Cilantro-Pepper Ban and Salmonella Saintpaul.

Since April, 1090 persons infected with Salmonella Saintpaul with the same genetic fingerprint have been identified in 42 states, the District of Columbia, and Canada.


Only 6 persons infected with this strain of Salmonella Saintpaul were identified in the country during April through June of 2007. The previous rarity of this strain and the distribution of illnesses in all U.S. regions suggest that the implicated food is distributed throughout much of the country. Because many persons with Salmonella illness do not have a stool specimen tested, it is likely that many more illnesses have occurred than those reported. Some of these unreported illnesses may be in states that are not on today’s map--from the CDC

Following this closely and I remain of the opinion that this kind of thing is going to become more common and more dangerous unless we look at our entire industrial food chain and make radical changes.
There's more...