Back on February 3, 2010, in the wake of another big salmonella outbreak linked, ultimately, to an FDA regulated product (pepper), I authored a blog-post titled "The slow flow of information about food outbreaks."  It discussed what was perceived as unreasonable delays in acting on infromation that suggested there was a problem with a particular product.  Today, Alison Young at USA Today conjured up some old memories, as she detailed what appear to have been more delays in the ever-expanding salmonella outbreak and recall linked to eggs from Wright County Egg and Hillandale Farms. 

State and federal health agencies identified an Iowa egg company as a likely source of illness at least two weeks before the firm launched a massive egg recall Aug. 13 and the public got its first hint of a growing national salmonella outbreak, health officials said in interviews with USA TODAY.

In late July, the Centers for Disease Control and Prevention even considered reminding the public generally about the dangers of eating undercooked eggs, said Ian Williams, chief of the agency’s outbreak response branch. The CDC decided it would be more effective to wait until the Food and Drug Administration (FDA) completed its investigation of the company, Wright County Egg in Galt, Iowa.

One of the problems is, as the USA Today article notes, "The FDA didn’t contact Wright County Egg until Aug. 10 and didn’t provide detailed information until Aug. 12," according to company spokeswoman Hinda Mitchell. "The recall decision was made after a discussion with FDA officials the next morning," she said.  The FDA’s version of events differs slightly, but even it acknowledges that it didn’t contact Wright County Egg about the need to recall eggs until August 11.

So to summarize, the CDC and Pulsenet notice an approximate 4-fold increase in Salmonella enteritidis illnesses in multiple states since late April.  Two of the most competent epidemiological units in the world (California and Minnesota) are able to finger Wright County Egg as the common supplier in multiple restaurant outbreaks involving the exact same strain of Salmonella enteritidis as was involved in the 4-fold increase.  Notably, this information is available in late July, which is not too long after the peak illness count in the outbreak (late June/early July); yet the FDA isn’t able to get confirming information sufficient to "encourage" Wright County Egg to recall until August 11 or 12? 

The full scope of this outbreak–including the number of illnesses that occurred after public health officials knew of the likely link to Wright County Egg–is not yet known.  But we certainly have enough information to know that more timely, efficient action by federal regulators could have prompted an earlier recall.  But this is obviously not the result of simple regulatory inattention:  the FDA certainly did not want more people to get sick than already had in the outbreak through late July, when it learned of the link to Wright County Egg. 

Again the USA Today, identifying one of the problems:  "The FDA doesn’t have the power to require companies to recall products, and regulators often must convince companies there’s enough evidence for them to take the costly action of launching a voluntary recall. A bill pending in Congress would give the FDA mandatory recall authority."  

To the extent that the delays evident in this outbreak are the result of a somewhat-hamstrung federal agency, S 510, a/k/a "The Food Safety Modernization Act," needs to finally pass the last house of Congress so that people don’t continue to get sick well after outbreaks like this should have been discovered and the contaminated product identified.  In a recent Fortune magazine article, Bill Marler discussed the issue in depth:

The section of the bill that calls for increased surveillance may be the most pertinent to the current salmonella outbreak. Bill Marler, a Seattle attorney who specializes in taking on food recall cases (including the current egg outbreak), thinks that particular proposal, which calls on the Department of Health and Human Services to establish a pilot project to improve tracking methods and enhance surveillance systems, could have helped regulators catch the outbreak much earlier.

"There’s no question in my mind that, if there was more communication and coordination going on between health departments, this thing would have been figured out months ago," says Marler.

Though the salmonella outbreak began in May, the first egg recall didn’t occur until mid-August. Such delays are common, says Marler. "If you look back historically at every major food-borne illness outbreak, by the time the CDC or state or local health departments are announcing an outbreak that’s nationwide in scope, the outbreak is usually over," he says.