I last communicated with you on June 11, 2008 and have been reticent to send another e-mail since the manner by which this investigation has played out, by both the FDA and the CDC, has been less than stellar with significant confusion to the consumer, to retail and to food service facilities. Many of you have asked for an update with recommendations and interpretation of what you have been hearing in the media.
As many of you are aware, the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) has publicly admitted not only that they have not found any tomatoes that have tested positive for Salmonella saintpaul, nor for any other Salmonella, but that the epidemiological association to tomatoes may have been incorrect. Having said that, the CDC in its latest release dated July 2, 2008, still maintains that they are "broadening the investigation to be sure that it encompasses food items that are commonly consumed with tomatoes". There has been inference to constituent ingredients in such popular food items such as salsa and Pico de gallo that have other commodities along with tomatoes. However, there are still, as of the latest count, almost 900 confirmed human cases with at least one death associated in an immunocompromised individual. The information released thus far is still maintaining a statement warning consumers about the outbreak and its link to the consumption of "some raw red plum, red Roma, round red tomatoes, and products containing these raw tomatoes".
The FDA has listed the following States, Counties and Countries in their July 1st release as not being related to the outbreak to the extent their investigation has revealed:
EHA's recommendations, which are based on our experience with investigating outbreaks of Salmonella that were associated with tomatoes, has taught us that a tomato can be grown in one state, transported to another state to a packing shed, and that the state of origin on a box is often not reliable. This is due in part to a practice in some facilities of re-using or swapping of boxes, which further adds confusion to the true origin of the tomatoes in the box. We believe this is what the FDA is finding out as well.
Some of our clients have asked whether we recommend utilizing tomatoes from the "cleared" states as long as the boxes identify a state or county that has been cleared by the FDA. Our opinion is that, until there can be certainty as to what the true commodity that is responsible for this outbreak of Salmonella saintpaul is ascertained (maybe or maybe not tomatoes) which has been identified from both a laboratory and an epidemiological basis with more strength than the current study, that only tomatoes that are locally grown, preferably procured at Farmers Markets, be utilized unless the tomatoes are:
We will continue to monitor this situation and provide you with appropriate updates as necessary. From a public health perspective, this investigation is embarrassing and, although it seems that the FDA doesn't stand out on this outbreak, quite bluntly, I do not believe that the CDC and the states have spent enough time with the controls in the case control studies to see how the well individuals, who consumed tomatoes, procured their tomato products and then have an appropriate and comprehensive trace back. This could actually implicate, as well as eliminate, both types of tomatoes through an entire distribution system.
There is no question that everyone is frustrated by this situation, but one also has to remember, that in every state there are plenty of wholesome tomatoes that have been caught in this quagmire that has a significant and negative impact to an industry that is, by and large, made up of smaller family businesses who are suffering significant economic damage due to the lack of understanding of what is causing almost 900 people to have Salmonella saintpaul. Additionally, the tomatoes that have rotted and are rotting on the vine also are a source of nutrition, much of which is being lost in this chaotic and bungled investigation.
I hope this has shed some additional light and given guidance for you to follow in your individual units. To learn more about the current status of this outbreak, additional updates and more specific information concerning Salmonella and produce safety, please visit the FDA website at www.fda.gov and/or www.cdc.gov. This outbreak is on the homepage of both agencies.