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Salmonella And Tomatoes
Linked In New Mexico

If, like most of us today, you work 24/7 and, as such, live connected to your Blackberry, iPhone or PDA, the tranquility of your weekend may have been disturbed by an e-mail from PMA, United or both as they dispatched an announcement referencing an Alert issued by the New Mexico Department of Health:

DEPARTMENT OF HEALTH ANNOUNCES
LINK BETWEEN TOMATOES, SALMONELLA

Santa Fe — The New Mexico Department of Health announced today that an outbreak of Salmonella is likely caused by eating uncooked tomatoes. So far, 31 people from seven counties in New Mexico have been sick with a strain of Salmonella called Salmonella St. Paul. Several people have been hospitalized, and no one has died.

The Department of Health’s epidemiologists, Public Health staff and the Scientific Laboratory worked together to interview patients, test samples and conclude that uncooked tomatoes are the likely cause of the outbreak.

New Mexico has been coordinating the investigation between other states, New Mexico Environment Department, the Navajo Nation, Indian Health Service, Centers for Disease Control and Prevention and the Food and Drug Administration. FDA is trying to pinpoint the exact source of the implicated tomatoes.

“We have determined that eating uncooked tomatoes is the likely source of this outbreak, and we hope to provide more specific information about the type of tomatoes as the investigation proceeds,” said Health Secretary Dr. Alfredo Vigil.

Until further information is available, the Department of Health recommends the following:

Individuals and restaurants that bought tomatoes from Walmart in Las Cruces or

Farmington, Lowe’s in Las Cruces, or Bashas’ in Crownpoint since May 3 should not eat them uncooked.

Always wash tomatoes before eating.

Wash hands, kitchen work surfaces and utensils with soap and water immediately after they have been in contact with tomatoes.

Cook food thoroughly to kill Salmonella.

People began to be sick on May 6. The Department of Health continues to identify new infections.

Most people infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts four to seven days, and most persons recover without treatment. Some people may need hospitalization due to severe diarrhea. The elderly, infants, and those with impaired immune systems are more likely to have a severe illness.

The release is somewhat problematic. It says people “began to be sick” on May 6. On the other hand, it says the “Department of Heath continues to identify new infections.” We have gone through many of these outbreaks, and it sometimes seems as if a prerequisite for government office is to graduate from “Cryptic Writing School” — what does “identify new infections” actually mean? Are people still getting sick or is the state laboratory tying in cases of people who got sick weeks ago.

The advice the release gives… not to shop at three particular stores… also seems problematic. Salmonella can be due to one employee with bad health and hygiene practices as we demonstrated in this Wal-Mart story. But if it is three different stores from three different chains, that seems unlikely.

If it is not a store-based issue, then these chains use distribution centers, and surely the tomatoes have been in hundreds of stores. And even with imperfect traceability, it is a pretty simple matter for Wal-Mart, say, to know what DC supplies tomatoes to this store and what other stores it would have supplied.

We communicated with officials at FDA and in New Mexico, but they had little additional information to add. We are still investigating and hoped to know more soon. We also turned to Reggie Brown, manager of the Florida Tomato Committee and Executive Vice President of the Florida Tomato Exchange, Maitland, Florida, with whom we previously discussed food safety and tomatoes here.

We also spoke with Ed Beckman, President of the California Tomato Farmers, Fresno, California, with whom we also discussed tomatoes and food safety here.

Finally, we reached out to Dr. Trevor Suslow, Extension Postharvest Specialist for the Department of Plant Science, UC Davis, California, for a scientific perception on the situation.

Here is the conversation Pundit Investigator and Special Projects Editor Mira Slott had with Ed Beckman:

Ed Beckman
President
California Tomato Farmers
Fresno, CA

Q: What information have you learned about the tomato Salmonella outbreak reported by the New Mexico Department of Health? Could you shed light on the source of the problem?

A: The California Tomato Farmers is monitoring the current Salmonella outbreak with much concern and care for those who have been sickened. It should be noted that there were no tomatoes being harvested and shipped from California during the onset of the confirmed illnesses, and therefore, it is highly unlikely that California is the source of this unfortunate outbreak.

Our production in California started mid-May and the outbreak looks to have started in April. We’ve been working with FDA for some time improving communication. We’ve been in contact with FDA this weekend, helping to express to them production areas currently supplying tomatoes to us and looking at the distribution supply chain models to give them a better understanding of how tomatoes are making their way through the system. Not a lot is understood at this point.

Q: What is the production schedule by region during the timeframe in question? What are the likely and unlikely scenarios?

A: It’s an interesting time, because the industry is somewhat transitioning. Florida is now moving out of production and it’s now significantly more limited. Mexico is transitioning from mainland Mexico to Baja, California. As far as California, we started our season mid-May after the onset of the outbreak. We’ll see increased production from California as we get to the end of June. There are a few pockets of production coming from Canada.

When you look at the time of the outbreak… it’s important to understand when it was first reported and taking that into account. What the New Mexico Department of Public Health reported was the first part of May. There are some conflicting reports that are existing. PMA reported that it may have begun as early as late April. Anytime when something develops over the weekend, you may find conflicting reports.

Q: Have you learned if the outbreak extends outside New Mexico to neighboring states, and if any more retailers or foodservice operators have been linked to the problem?

A: From published reports, obviously the outbreak has affected a number of associations with retail consumption. A lot of this information has come up over the weekend and is still unfolding. FDA will have to do a trace back and determine where the product became contaminated in the system. It is FDA’s responsibility to investigate. We’ve made strides in the food safety programs we’re doing out here, and I can give you an update when things calm down.

Q: I remember when we spoke about food safety in the tomato industry, you mentioned that Salmonella outbreaks connected with tomatoes have been more frequently connected with East Coast production. Is this case in the Western United States unusual?

A: Salmonella issues have not been common to California. I believe this is a rather unique strain of Salmonella, reports say the sixth most common strain, but to my knowledge it hasn’t been associated with other tomato outbreaks. It did catch me off guard. This is a question that is best answered by scientists. Dr. Trevor Suslow, who is on our advisory committee, is a great asset.

While the outbreak does not seem to involve California product, whenever an outbreak occurs, it is a reminder for all of us to continually review and re-examine all food safety standards on farms and at shipping points to ensure we are producing the safest food possible for consumers.

Q: I understand from speaking with Reggie Brown that a new, innovative food safety document for fresh tomato production throughout North America is set to be released imminently. Reggie said the core was completed on Friday and is now just being fine-tuned.

A: California Tomato Farmers (CTF) was an editor of the 2nd Edition of Food Safety Guidance for Fresh Tomato Supply Chain, soon to be published by United Fresh and the North American Tomato Trade Work Group. This is a very comprehensive supply chain document that addresses food safety in a number of modules unique to each step in the tomato supply/distribution chain.

The modules begin with best practices for the field, greenhouse, and packinghouse, repacking, fresh-cut processing, and conclude with retail and foodservice guidance that provides greatly enhanced recommendations for production preparation and display.

It is the most complete document for fresh tomato handling resources, whether you’re a grower/shipper, processor, re-packer, retailer or foodservice operator. Some 40 individuals from a broad spectrum were involved in the review. Our role was that of editor of the packinghouse module. It will be coming out shortly and will be available on download from our website as well as others. It will prove of great value to the industry.

Q: Could a document like this prevent outbreaks like this most recent one in New Mexico from occurring?

A: This is a risk-based approach — the same approach we employ with California tomato farmers. The key is to focus on risk areas and develop protocol to minimize risk.

Q: What makes this second edition so different from the one already out there?

A: What’s important with this document is that the first edition was a best management document very heavily weighted to the grower/shipper. This new edition provides in-depth protocols well beyond that. A lot of food safety problems have been in the midst of distribution, especially in the fresh-cut processing arena. For example, when tomatoes are exposed to water colder than the pulp of the tomato, risk of penetration of microbials is increased. This document provides a lot of answers to food safety problems throughout the supply chain, all in one place. .

Q: How long has this been in development?

A: Many hundreds of hours; about a 10-month process. The first edition was typical to many best practices documents, placing a significant focus on the field and packing shed.

This document gives equal weight to everyone who handles tomatoes, which it should, and specific guidance to each touch point in the process. We just finished final edits on the documents last Friday. Dave Gombas at United is the final editor and could provide a better time line of when it will be released.

Q: How does this relate to the Fresh Standard’s program CTF is employing? What developments have occurred since you launched the program?

A: CTF, a cooperative formed by growers in 2006, is committed to adhere to standards governing a number of areas, including quality, food safety, worker safety and environmental stewardship. In its second year of operation, significant improvements have been made to the Fresh Standard with respect to food safety, mandatory random unannounced government inspections, and worker safety.

We’ve been fortunate to have Dr. Suslow’s input on food safety issues previously. Most recently, he discussed the issue of Salmonella and cantaloupes, which you can read here. He also contributed to a special science related issue we did here.

With little hard evidence regarding this New Mexico outbreak, we again turned to Dr. Suslow for a better understanding of the science regarding Salmonella and tomatoes.

Pundit Investigator and Special Projects Editor Mira Slott spoke with Dr. Suslow:

Trevor Suslow
Ph.D., Extension Research Specialist
Postharvest Quality and Safety
Department of Plant Sciences
University of California, Davis

Q: Ed Beckman mentioned that the strain of Salmonella being linked to the current tomato outbreak is not typically associated with tomatoes. He said you would be able to provide more scientific background on this.

A: You can talk to various sectors of public health and get different information on this. As far as I know, the Salmonella Saintpaul strain is not a subtype associated with tomatoes or other tomato outbreaks in the past. It’s relatively common in salmonella outbreaks in the U.S.

One of the things they’re trying to sort out is the background for this particular type. Is this a normal level of illness or unusual? They started doing epidemiology research to make the link. Salmonella Saintpaul is fairly common; reported to be the sixth most common serovar (subtype) in humans in the U.S. It has a wide host association among humans and animals, including production, recreational and domestic pets. Salmonella Saintpaul has a very broad host range and can be found in many animals; that includes cows and amphibians.

Q: Do you have any scientific assessment of where the contamination occurred?

A: My pure guess would be it’s likely associated with where the tomatoes were originally sourced. Animal vectors or reservoirs for this particular type, whatever factors brought this together; whereas in other areas, the problem is more associated with birds being a primary vector. They often have a more typical host, but can easily pass through many animals including human animals.

We’re all trying to absorb information as it dribbles out to us. I hate to speculate until more information is known about the growing and shipping areas and how they were handled. Salmonella Saintpaul is not a rare strain. Rare strains help the Department of Health more easily identify an outbreak. My understanding is this strain is relatively prevalent, which makes discovering of the source more challenging.

Q: Have you been involved in the new North American food safety guidance for fresh tomatoes? What is your scientific perspective of the document?

A: Certainly there have been a lot of efforts to target more commodity-specific and in this case tomato-specific practices at harvest through processing to retail display. This document is a work in development, but at some point the industry needs to move forward and recognize as more scientific data comes out, we can amend it.

My perspective is that there are areas, as painful as it is to hear, that have to be tightened down more to implement certain practices. It’s a much better document, but still can be much better.

Q: In what ways? Would you point to particular areas in the supply chain that present greater risks?

A: Yes. The industry needs to standardize any post-harvest water use, the levels and monitoring of dose effectiveness to prevent cross-contamination. There are still some difficulties in defining what the appropriate standards are for water treatments, and that is a key area for preventing cross-contamination and broad distribution of microbials if they are introduced into the product. Also, it is critical to try and pinpoint appropriate standards for irrigation water, using available information; there has to be contribution from research, but utilizing knowledge we’re aware of, they might have to tighten things down a bit more.

It is hard to make much of all the reports. In addition to New Mexico, there are people reported sick with Salmonella in Arizona, Colorado, Idaho, Illinois, Texas and Utah, but there is no link established to tomatoes or any other food.

Certainly what this does establish is two things:

One, the industry efforts on traceability, which we have chronicled here and here, cannot relent. We are writing this at almost midnight Monday evening, and these alerts went out on Saturday. That here it is Tuesday morning and the industry cannot definitively reassure consumers and regulators which brands, which geographies, etc., are not implicated is simply unacceptable.

Second, Salmonella in general is a real problem. Because the spinach crisis focused on E. coli 0157:H7, that got all the attention. But salmonella is popping up a great deal. We have had extensive coverage to the issue of the FDA import alert on Honduran cantaloupes, which was prompted by an alleged epidemiological link with Salmonella. And, as we mentioned, Trevor Suslow spoke to us about cantaloupes and Salmonella here.

Yet literally, while we are writing this we get a notice from the Canadian Food Inspection Agency that they call a Health Hazard Alert telling us that Fisher Ranch Corp. cantaloupes imported from Blythe, California, into Canada by Gambles Ontario Produce, may contain Salmonella. We know even less about this than we do about the New Mexico tomatoes, so if, where and how are still to be determined.

But if the tomato industry is going to come out with new food safety guidelines, it is imperative that they have consensus of food safety experts as to the sufficiency of the efforts. Like politics and horseshoes, when it comes to food safety, close doesn’t count.

Many thanks to Ed Beckman and Trevor Suslow for helping the industry understand the situation more completely.

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