The papers have been filled with news reports indicating that Aunt Mid’s Produce Co. has been the source of an E. coli 0157:H7 outbreak — this one linked to distribution of foodservice or institutional size packages:
The Michigan Department of Community Health recently issued a public health alert in response to an outbreak of illnesses caused by E. coli and thought to be spread through industrial-size packages of iceberg lettuce. The alert names Detroit-based Aunt Mid’s Produce Co., which distributes lettuce directly to restaurants and institutions, as the common thread among some of the… people who have been sickened since September 8.
Of those affected, 10 people have been hospitalized. Aunt Mid’s has voluntarily suspended production of the lettuce until the investigation into the outbreak is complete. Some students at Michigan State University and the University of Michigan have gotten sick during the statewide outbreak.
We mentioned Aunt Mid’s during the spinach outbreak of 2006, as the company worked to reassure consumers of its food safety efforts. Now, the company is objecting to the claim that its product is associated with an outbreak:
In connection with the numerous industry and general media articles regarding the recent E. coli outbreak and its source, it is important that all persons concerned are made aware of the current status of the ongoing investigation to identify the source of the contamination.
On September 26, 2008, the Michigan Department of Agriculture notified Aunt Mid’s that its foodservice pack-size iceberg lettuce was an “item of interest” in an E. coli outbreak investigation. Aunt Mid’s immediately and voluntarily halted production and sales of any chopped or shredded iceberg lettuce products.
Since that notification Aunt Mid’s has worked around the clock with the Michigan Department of Agriculture, Michigan Department of Community Health and Michigan State University to determine whether any Aunt Mid’s product was contaminated. To that end, Aunt Mid’s has initiated with outside, certified independent laboratories an ongoing testing program of both its products and its processing facility.
Aunt Mid’s is pleased to report that these tests prove there is NO CONTAMINATION in Aunt Mid’s products. Those laboratory test results have been shared with the State of Michigan.
Aunt Mid’s has also freely and graciously extended to the various departments of the State of Michigan access to its processing facility and has provided additional product samples, for testing by those departments. The Michigan Department of Agriculture has just released to Aunt Mid’s the results of its tests of Aunt Mid’s iceberg lettuce samples and Aunt Mid’s processing facility.
Aunt Mid’s is pleased to report that the State tests confirm the results of Aunt Mid’s independent laboratory tests — NO CONTAMINATION OF EITHER AUNT MID’S PRODUCT OR PROCESSING FACILITY WAS FOUND BY THE STATE TESTS.
Food Safety is, and always has been, top priority for Aunt Mid’s. Its state-of-the-art, HACCP (Hazard Analysis of Critical Control Points) certified processing facility houses its own laboratory managed by a quality assurance and control team. Aunt Mid’s voluntarily undergoes stringent third-party food safety audits by AIB International (www.aibonline.org) on a regular basis. Aunt Mid’s consistently earns the highest rating achievable — “Superior”. Aunt Mid’s also has passed all Michigan Department of Agriculture inspections. Inspection results can be obtained by calling the M.D.A. hotline at 800-292-3939.
We wish to reiterate that, to date, after the numerous tests conducted by certified independent laboratories, NO AUNT MID’S PRODUCTS HAVE BEEN FOUND TO BE CONTAMINATED. When more information becomes available in this ongoing and complicated investigation, Aunt Mid’s will make such information available on its website. Aunt Mid’s will continue to fully cooperate with the State of Michigan investigation until a conclusion is reached.
In the meantime ace plaintiff’s attorney Bill Marler and others have been calling on Aunt Mid’s to reveal the source of its iceberg lettuce. Pointing out that if it is true that Aunt Mid’s is the source of an outbreak and, if, as is often the case, the problem starts with the raw product, others may have bought raw product from the same farm and thus other consumers may be at risk:
At least 40 confirmed cases of the infection with the highly toxic pathogen E. coli O157:H7 have been linked to commercial bagged lettuce distributed by Aunt Mid’s Produce, but the Detroit-based company refuses to name the supplier of the contaminated product. Thirty of the illnesses are in Michigan; the others have been documented in Illinois, Ohio, New York, and Oregon.
“Food borne illnesses are often difficult to trace, as we saw this summer with the tomato-pepper Salmonella outbreak,” said food safety advocate and attorney William Marler. “You want to get to the source as quickly as possible in order to stop the flow of contaminated produce and alert those who might have it in hand to discard or return it. In this case, we have a trail leading directly to the door of the distributor — Aunt Mid’s Produce — and they’re blocking the trail there. Not revealing the source of the contaminated lettuce means that there could be other contamination — in fields or in the supply chain — which is not being stopped. It’s completely irresponsible and should be illegal.”
We wanted to get to the bottom of this situation and so asked Pundit Investigator and Special Projects Editor, Mira Slott, to find out more:
Q: How did this outbreak investigation unfold?
A: We were informed by the Michigan state agencies that there was an E. coli outbreak; several E. coli cases reported. They contacted us on September 26, telling us that iceberg lettuce was one item of interest. Ever since, we’ve been working with the agencies handling the investigation. Upon contact, we stopped selling and processing iceberg products.
Q: How have you participated in the investigation?
A: We sent numerous product samples to independent labs, as well as the same samples to the Michigan Department of Agriculture, all of which have come back negative. We also conducted environmental tests simultaneously with the Michigan Department of Agriculture at our processing facility. Those were pretty extensive. All of our environmental tests have also come back negative.
The Michigan Department of Agriculture has also contacted us that they removed samples from the Lenawee County Jail linked to some of the cases, and all the test results from there came back negative. That was their testing, not ours. As a matter of fact, all of our tests have come back negative and there are no outstanding tests out.
Q: Is there any concern that contaminated product could be out in the market?
A: We stopped selling and processing iceberg lettuce in cooperation with the investigation, not because there is anything wrong with it. Our action was voluntary. We are waiting for some case study information from the state, and have already begun our trace-forward investigation. The information the state gathered prior to notifying us on the 26th should be readily available, but we haven’t gotten that back yet.
Q: The Illinois Department of Public Health warned consumers of a connection between E. coli cases in the state with those in the Michigan outbreak. It identified Aunt Mid’s as the distributor of iceberg lettuce consumed by six Illinois residents during late August to mid-September who have been diagnosed with E. coli 0157.
A: We have not been contacted by the Illinois Department of Health or any of the Illinois agencies, so we are not a part of their investigation as of yet. We believe they are taking the news from Michigan and extrapolating it.
After numerous tests, there is no contamination in Aunt Mid’s products.
Q: Could you elaborate on your food safety measures?
A: Food safety is a top priority at Aunt Mid’s. We go to great measures to provide safe working and processing conditions. We go to growers who are certified in the same way. Good manufacturing practices through HACCP plans third-party audited. We undergo stringent food safety audits by AIB International, consistently earning the highest superior rating, as well as regular inspections by the Department of Agriculture. All records can be obtained through a hotline.
The truth is coming back to us through our customers. Our customers have supported us so greatly this last week, sympathizing with how our name is being dragged through the mud. Our customers know the steps we’re taking to insure food safety. We have proved this over time, and that’s why they are standing behind us.
Q: Are you speculating that the epidemiological study and analysis was flawed or incomplete and perhaps led to an immature link to your company?
A: The Michigan agencies have not provided us with the case study, and that should tell us more about why. We’ve requested it and are still waiting. The only one saying it is Aunt Mid’s is the Michigan Department of Community Health on September 26. We don’t have a recall. We voluntarily stopped selling and processing iceberg product, but nothing was found.
Q: If you are voluntarily halting production and sale of iceberg lettuce, why not do a recall of the product already out in the market as well?
A: If they said we identified this problem on this day with these lot codes — boom, we would recall immediately through our distribution system. No contamination has been found since the beginning of this investigation. We voluntary stopped processing and selling iceberg lettuce as a show of good faith and cooperation with Michigan authorities, not because we thought there was anything wrong. We continue to sell other products.
Q: Just to clarify, although you didn’t recall product, wouldn’t customers or establishments that had Aunt Mid’s product in stock pull it anyway in reaction to the press releases?
A: Some customers have suspended orders till the problems are resolved. Anything that was shipped prior to September 26 was not recalled by us. Some distributors that received our product but had not sold it, returned it to us, but we didn’t recall anything. There was no official recall. The turnover time period in produce is different than beef.
This is the world and we’re in a business where outbreaks and food safety issues are a part of things. We are not running from it; we’re addressing it head on.
Q: I’m sorry your company name has been tarnished through this ordeal, and hope that in the end you’ll be vindicated.
A: On the 26th, when the Michigan Department of Community Health issued their press release with iceberg lettuce as an item of interest, they named Aunt Mid’s, but they named us without proof. Anytime your name is mentioned in the same sentence with any pathogen, you might as well sit in the electric chair. We have a panicked public. We know how the public is going to react.
We believe at this point, our name is associated with the Illinois Department of Public Health press release only because they saw the Michigan report. We’re not working with Illinois state agencies. They’ve pretty much taken the news from Michigan. That’s an assumption on my part. We’d be happy to supply the State of Illinois with all our independent test results and other information that could help in the investigation.
The Michigan Department of Agriculture has been in our facility day and night testing alongside with us. They’re being very careful of what they’re saying. They are truly doing their investigation and we’ve been fully cooperating. The Michigan Department of Community Health contacted us originally in tandem with the Department of Agriculture. It was a conference call. We’ve had little to do with that department beyond September 26.
This relatively small outbreak actually illustrates some very important issues and poses some very important questions for how we can deal with problems such as this in the future.
During the Salmonella Saintpaul situation, we ran a piece from Jim Gorny of UC Davis that focused on the difficulties of epidemiology — you can find that article here. However, the fact that epidemiology is difficult, time-consuming and can be incorrect, does not mean that the very science of epidemiology is invalid.
In fact, if the produce industry adopts the position that only DNA evidence found as a “smoking gun” on product is sufficient to tie a producer to an outbreak, the produce industry will wind up discredited and irrelevant.
As such, although it is reassuring that Aunt Mid’s has done lots of testing and others have done lots of testing, and it has come out negative, as they teach in law school “the absence of proof is not proof of absence.” In other words, these tests are being done on different product at different times and simply don’t prove anything about what was or was not happening weeks ago when this product would have been packed.
One thing that all processors should do is hold back under refrigeration samples from each lot so when there is suspicion, at least we can test product from the relevant lots. Because this product is stored under continuous refrigeration, it generally lasts longer than any product on the market, so by the time the samples are rotten, the product is no longer in the market.
One big caveat, and we very much hope that the public health community will join us in this, is that while we will fight hard to make sure the produce industry recognizes the value of epidemiology, the public health community needs to acknowledge just as much that mistakes can be made and that there must be a standard of evidence met before consumers are told to panic and businesses are destroyed.
We were horrified to read this line from Mira’s interview with Dominic Riggio:
“We are waiting for some case study information from the state, and have already begun our trace-forward investigation. The information the state gathered prior to notifying us on the 26th should be readily available, but we haven’t gotten that back yet.”
Epidemiology is a science and, as such, those who practice it need to be able to make their case. The very first time public health authorities called Aunt Mid’s, the authorities needed to be willing and able to present the epidemiological evidence that led them to indict Aunt Mid’s Produce Co.
There have been cases in which Federal authorities have walked into produce companies demanding recalls and they were shown that their epidemiological evidence was being misinterpreted.
We have begged and pleaded, with the produce associations to help their members by retaining on contract a world-class epidemiologist who would be in a position to be available to a firm such as Aunt Mid’s in the event of a situation such as this.
During the Salmonella Saintpaul situation, we ran an important interview with Michael T. Osterholm, a renowned epidemiologist now based at the University of Minnesota. It was exceedingly influential because his critique of the epidemiological study done in the Salmonella Saintpaul situation was telling.
The Pundit cut his eye teeth in the business on the Hunts Point market, so we understand exactly how the Riggio family must feel and we appreciate that they are doing all these tests to fight back and vindicate their name in the only way they know how. Unfortunately, no amount of testing today will ever persuade public health authorities about whether there was a food safety outbreak several weeks ago.
To do that, what Aunt Mid’s and all produce companies in such situations require is a good epidemiologist who will look at the evidence at the start and quietly point out errors and alternative interpretations and thus prevent these issues from erroneously breaking to the public.
It is also possible that the epidemiologist would be the one pointing out that public health authorities are withholding information and thus preventing anyone from vetting the accuracy of the epidemiological report.
Finally, the epidemiologist may confirm that the public health authorities are correct and that a company is implicated.
But what is required is not for the industry to do endless testing — but for the associations to facilitate the availability of world-class epidemiological expertise so that the industry can speak the language of public health.
As for our friend Bill Marler, we would certainly join his effort to get the product sources revealed in the case of outbreaks. His logic is 100% correct — we need to trace back and then trace forward to minimize illness. The issue, however, is whether or not Aunt Mid’s has been properly implicated. The mere assertion that they are implicated, without any supporting evidence, is not sufficient.
As an officer of the court and a representative of a system in which our courts are not only courts of law but of equity, we hope Bill Marler will join our effort to insist on transparency by public health authorities, including a timely revealing of case studies and epidemiological evidence so that these can be reviewed by third parties for accuracy.
We think Bill Marler is too good a lawyer to defend a system in which public authorities in effect declare themselves prosecutors, judge and jury and then conduct a “secret trial” and never feel obligated to reveal the basis of their judgments. We don’t see how anyone can believe in the rule of law and believe in a system such as that.
Many thanks to Dominic Riggio for taking the time to explain the position of Aunt Mid’s to the industry.