On December 16, the Maine-based grocery chain called Hannafords recalled fresh ground beef products that may have been contaminated with a an antibiotic-resistant strain of Salmonella Typhimurium. The recall occurred as a result of the Hannafords ground beef Salmonella outbreak, which has sickened 14 people from 5 states (Maine, Massachussetts, New York, New Hampshire, and Vermont).  Seven people were hospitalized. 

The problem of antibiotic resistance (AR), according to the CDC:

(Antibiotics) have been used so widely and for so long that the infectious organisms the antibiotics are designed to kill have adapted to them, making the drugs less effective. Many fungi, viruses, and parasites have done the same. Some microorganisms may develop resistance to a single antimicrobial agent (or related class of agent), while others develop resistance to several antimicrobial agents or classes. These organisms are often referred to as multidrug-resistant or MDR strains. In some cases, the microorganisms have become so resistant that no available antibiotics are effective against them.

The problem is so real, and so challenging, that, in 2009, the Transatlantic Taskforce for AR (TATFAR) was established by joint Presidential declaration in 2009 at the annual summit between the European Union (EU) and U.S. presidencies.  And the EU, US, and CDC are not alone in recognizing, and taking steps to respond to, the health risks that AR presents.  According to the World Health Organization (WHO):

• Antimicrobial Resistance (AMR) kills
• Infections caused by resistant microorganisms often fail to respond to the standard treatment, resulting in prolonged illness and greater risk of death
• AMR hampers the control of infectious diseases
• AMR reduces the effectiveness of treatment because patients remain infectious for longer, thus potentially spreading resistant microorganisms to others
• AMR threatens a return to the pre-antibiotic era
• Many infectious diseases risk becoming uncontrollable and could derail the progress made towards reaching the targets of the health-related United Nations Millennium Development Goals set for 2015.
• MR increases the costs of health care
• When infections become resistant to first-line medicines, more expensive therapies must be used. The longer duration of illness and treatment, often in hospitals, increases health-care costs and the financial burden to families and societies
• AMR jeopardizes health-care gains to society
• The achievements of modern medicine are put at risk by AMR. Without effective antimicrobials for care and prevention of infections, the success of treatments such as organ transplantation, cancer chemotherapy and major surgery would be compromised
• AMR threatens health security, and damages trade and economies
• The growth of global trade and travel allows resistant microorganisms to be spread rapidly to distant countries and continents.

The scope of the problem in the ground meat industry:

Since early 2002, strains of antibiotic resistant Salmonella in ground beef have caused at least 352 confirmed illnesses, and untold thousands of unconfirmed illnesses.  Here are the major outbreaks (at least those that were identified by public health officials):

• Emmpak/Cargill Ground Beef 2002 – 47 Ill; outbreak strain of Salmonella Newport was resistant to nine antibiotics, and had decreased susceptibility to another antibiotic called ceftriaxone.
• Northeastern States Ground Beef 2003 – 58 Ill
• Safeway Ground Beef 2007 – 43 Ill (no recall was issued because investigators at the USDA’s Food Safety and Inspection Service could not identify the specific “establishments, lots and products” that received the ground beef)
• Beef Packers, Inc., Cargill, Ground Beef 2009 – 2 Ill in August (this outbreak and recall of over 20,000 pounds of ground beef was preceded, just weeks earlier, by the outbreak and recall described next, involving the same strain of antibiotic resistant Salmonella Newport)
• Beef Packers, Inc., Cargill, Ground Beef 2009 – 40 Ill in late-June and early-July (21 of the outbreak victims lived in Colorado and five lived in California)
• King Soopers, Inc., Ground Beef 2009 – 14 Ill
• Jenny-O-Turkey Burgers 2010 – 12 Ill
• And the king of them all:  Cargill Meat Solutions Ground Turkey 2011 – 136 Ill: 

The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) issued a public health alert, on July 29, due to concerns about illnesses caused by Salmonella Heidelberg that associated with the use and the consumption of ground turkey. The alert was initiated after continuous medical reports; ongoing investigations and testing conducted by various departments of health across the nation determined an association between consumption of ground turkey products and illness. On August 3, Cargill Meat Solutions issued a recall of ground turkey products. The products subject to recall bear the establishment number “P-963” inside the USDA mark of inspection. On August 4, the Centers for Disease Control published their first outbreak summary. The Salmonella Heidelberg was multi-drug resistant, resistant to ampicillin, streptomycin, tetracycline, and gentamycin. The CDC began their investigation on May 23, after recognizing an “unusual clustering” of Salmonella Heidelberg cases. About the same time, routine surveillance by a federal food monitoring system found the same strain of Salmonella Heidelberg in ground turkey in stores. On July 29, the initial outbreak strain and a second, closely related, strain of Salmonella Heidelberg was isolated from a sample of leftover unlabeled frozen ground turkey from the home of an outbreak case in Ohio. Since February 27, 2011, a total of 23 ill persons were reported to PulseNet with this second, closely related, strain. Eighty-four ill persons were infected with the initial strain. The consumer product sample originated from the Cargill Meat Solutions Corporation establishment in Springdale, Arkansas. On September 11, Cargill Meat Solutions recalled an additional, approximately 185,000 pounds, of ground turkey contaminated with an identical strain of Salmonella Heidelberg that had led to the earlier recall on August 3. As of September 27, no illnesses had been linked to the additionally recalled, ground turkey products.

What next?

Certainly more outbreaks.  Why not just implement a dedicated program for testing ground meat for antibiotic-resistant strains of Salmonella?  We have asked for such a testing program before, only to have that request rejected, requiring additional Salmonella lawsuits on behalf of victims.  Therein may be the answer, if not a solution.  As was observed by a commenter on Bill Marler’s blog post titled Marler Clark to Cargill: Start Testing and We Won’t Sue You:

And after three strikes — “After all, this outbreak marks the fourth antibiotic-resistant Salmonella outbreak for the company since 2002,” added Marler” –Cargill isn’t out — and now there’s an offer of a wrist-slap for the 4th major contamination outbreak??

I’d think this wave of salmonella-affected consumers — and all the consumers who stand a likelihood of purchasing contaminated food in the future under these spurious industry-friendly rules would deserve a lawsuit push for punit[ive] damages to the max.

Good thought.  History shows that these outbreaks will continue to happen, that the meat industry will try to block any regulatory effort to better control the problem of antibiotic resistance in its products (just like it’s trying to delay implementation of USDA’s newly-minted effort to control the big six non-O157 strains of E. coli), and that realistic policy formation and implementation takes too long to address a problem that exists now.  Don’t forget, Salmonella in ground beef is not even considered an “adulterant.”  Indeed, lawsuits on behalf of victims may be the only realistic tool we have to address the problem.