>By TODD S. PURDUM
Meat Inspections Face Overhaul, First in Nearly a Century
July 7, 1996 NY Times
WASHINGTON -- President Clinton on Saturday announced the most sweeping changes in the government's meat inspection system since it was created nearly a century ago, outlining new rules that would, for the first time, impose scientific tests for disease-causing bacteria.
The new rules call for more inspection and controls by the meat- and poultry-processing industry itself and new testing by the Department of Agriculture. Drafted over the last two years, the rules will be final upon their publication in the Federal Register next week. They are to take effect in stages, some immediately and some over the next two to three years, officials said.
"These new meat and poultry contamination safeguards will be the strongest ever," Clinton said in his weekly radio address.
"Parents should know that when they serve a chicken dinner, they are not putting their children at risk," Clinton said.
Since the federal Meat Inspection Act was passed in 1907 -- after the publication of Upton Sinclair's muckraking expose of the industy, "The Jungle" -- inspectors have relied on the "sniff and poke method" to certify that carcasses are safe to eat as they pass along a conveyor belt. But inspectors cannot always detect contaminated meat just by quickly smelling or looking for the obvious signs of decay.
The government had wanted processors to perform microbial tests for the presence of the deadly salmonella bacteria, which kills more than 4,000 people a year and sickens as many as 5 million, and for E. coli bacteria, which indicates fecal contamination and can be deadly in some forms. But in a compromise, processors will test for E. coli. and federal inspectors will conduct tests for salmonella at various stages in the process.
Consumer groups have been pressing for change since a virulent strain of E. coli bacteria traced to undercooked hamburgers at Jack in the Box restaurants killed several children in the Pacific Northwest in 1993 and sickened hundreds of others. Saturday, such groups joined industry representatives in praising the new rules.
"This rule is a landmark in improving meat and poultry safety," said Caroline Smith De Waal, director of food safety for the Center for Science in the Public Interest, a consumer group. "While it may need some fine-tuning, nonetheless it provides the blueprint. They're giving more responsibility to the industry, while at the same time providing adequate government oversight."
Gary M. Weber, director of animal health and meat inspection for the National Cattlemen's Beef Association, an industry group, said: "We're very pleased that after a 10-year struggle to redesign the meat inspection system, we're at the first stages of implementing a modern, scientific-based prevention system."
Inaugurating these new rules in an election year, the president gave credit to consumer groups, especially the parents of the young victims of the Pacific Northwest outbreak, who pressed for these changes.
"The parents of many of the E. coli victims turned their grief into a determination to help others," Clinton said. "In the face of this unspeakable tragedy, they had one insistent question: How could this have happened?"
Under the new rules, packers and slaughterhouses will be required to establish a system known as hazard analysis and critical control points, identifying each point and potential problem in the process -- such as cutting, grinding and overheating -- where contamination can occur and developing steps to prevent it. The bacterial tests are intended to assure that the new safety steps work, officials said.
Companies will have as long as 42 months to set up hazard control systems, with smaller companies having the longest time to comply. Eventually, plants will be required to reduce their salmonella contamination to below the prevailing national average for the type of meat they process. For example, 20 percent of broiler chickens are contaminated with salmonella.
Within six months, companies will also have to set up new sanitation systems to insure cleanliness.
Just months ago, when it became clear that the government would not require processors themselves to test for salmonella, consumer groups were sharply critical. But they participated in negotiations over the final rules and now seem content to claim victory.
Ms. Smith De Waal of the Center for Science in the Public Interest said that even though the industry will not be required to conduct its own salmonella testing, companies will undoubtedly have to test for the bacteria as part of their efforts to prove their safety systems are effective.
"We didn't get everything we wanted," she said. "We wanted mandatory salmonella testing by industry. But we did get it wrapped into the initial validation work the industry will have to do."
The Republicans responded to Clinton's announcement by raising questions about his behavior toward the meat industry when he was governor of Arkansas, saying his actions then "left more than half the streams in his home state too polluted for drinking, swimming or fishing."
"As usual, Bill Clinton's past raises questions about his credibility, even on an issue as nonpartisan as food safety," said a news release from the Bob Dole for President committee. "After waiting three years to take action, Bill Clinton today didn't explain how his new election year 'get-tough with the meat industry' attitude squares with his old 'easy-come, easy-go' treatment of the same industry in Arkansas."
Some congressional Republicans tried to block the new rules, and threatened to withhold appropriations for new inspectors and training, arguing that they might be too onerous for the industry. But administration officials said the new rules were intended to grant the industry new flexibility in exchange for its assuring the safety of its own processes.
"For years, we have had the government doing the work, the inspectors in the plants, and you hear stories of cursory checks and that's it," said Sally Katzen, administrator of the office of Information and Regulatory Affairs at the Office of Management and Budget.
"This is an attempt to get away from government micromanaging the process and instead saying to the regulated entity, 'You figure out how to do it, you're responsible, and we'll do some testing to make sure there are performance standards.'"
The regulations build on similar standards for seafood inspection issued nine months ago, Ms. Katzen said.
U.S. Department of Agriculture Food Safety and Inspection Service
By NEIL A. LEWIS
The New Meat Inspection Program
7 July 96 NY Times
WASHINGTON -- The new inspection system announced Friday by the Clinton administration provides for the government and the industry to share responsibility for monitoring and testing meat and poultry all along the processing chain from slaughter to the grocery shelf.
There are four major components of the program, which Agriculture Department officials say is a profound change from the current system that is based largely on sensory testing -- the "poke and sniff" test -- that varies from plant to plant.
"Meat and poultry inspections now are subjective tests based on seeing, feeling, touching," Dan Glickman, the secretary of agriculture, said in an interview Friday. "What these rules do is basically say we are moving to a science-based system."
Glickman described the current system as "catch as catch can." Some companies, especially the larger ones, have already put in place many of the changes that will become mandatory under the new rules. But, he said, there is no modern, systematic monitoring of the industry.
The main elements of the program are:
-- The federal government will set standards for contamination by salmonella bacteria, and the Agriculture Department, for the first time, will be responsible for conducting tests for that disease-causing contaminant. Beginning this summer, no plant will be allowed to exceed the current average contamination. Twenty percent of chicken products currently show a trace of salmonella contamination; for turkey products the level is 49 percent. Plants not meeting that standard face penalties and ultimately could be closed. The Department plans to tighten those standards in 16 months.
-- The processors will be required to test all their products for the bacteria E. Coli, which is considered a reliable indicator of fecal contamination. The department will not require the total elimination of all such bacteria but will require plants to keep contamination below a minimum level.
-- Each plant that processes meat and poultry will be required to identify a series of critical points along the chain during which the product could become contaminated, similar to what the Agriculture Department required of fish processors last year. The plants would have to check for contamination at each of the checkpoints from when the product is received from the farm to when it goes out to the grocery.
The Department of Agriculture will have to approve each plant's program of checkpoints. Michael R. Taylor, the acting undersecretary of agriculture for food safety said Friday that only a minority of the nation's processing plants currently have such programs.
-- All processing plants would have to adopt a written plan within three months to keep them free from contamination. This would include items such as what the plant does to ensure that surface bacteria from an animal's skin is not carried into the meat when it is slaughtered.
Taylor estimated the cost to the industry at $80 million annually and said it would cost consumers a tenth of a cent per pound on meat products. The government is planning to carry out the program using current funds.
Carol Tucker Foreman, a former agriculture secretary and now the head of the Safe Food Coalition, said the program was a major change in how the government views meat contamination. She said the program will not only save the lives of thousands of people each year but will also save billions of dollars in annual health costs.
Lessons Are Sought In Outbreak of Illness From Tainted Meat By LAWRENCE K. ALTMAN, M.D.
Public health officials around the country are pondering the lessons of the outbreak of illness from undercooked hamburgers sold by the Jack in the Box fast-food chain. The outbreak was the largest and most serious of a dangerous bacterium that has struck before and will surely strike again.
After the initial outbreak, which caused the death of a 2-year-old boy, the total number of confirmed and probable cases has risen to 400, Dr. John M. Kobayashi, the Washington State epidemiologist, said in an interview yesterday.
The tainted hamburger was voluntarily removed from sale on Jan. 18, and there have been no new primary cases since then. To minimize a second wave of the outbreak -- transmission from those who ate the tainted hamburger to others in their homes, day care-centers and workplace -- health officials warned people to wash their hands frequently. Whether or not for that reason, the number of secondary cases is coming in less than feared, with only 35 in Washington State. A few cases have also been reported in Nevada and Idaho.
"It's pretty encouraging," Dr. Kobayashi said, adding that his team continued to be cautious.
Nevertheless, one measure of the seriousness of the Washington outbreak was that 125 people had to be admitted to a hospital, Dr. Kobayashi said.
The tainted meat has led to kidney failure in at least 29 people and forced 21 to undergo kidney dialysis, said Dr. Ellis D. Avner, a kidney expert at Children's Hospital in Seattle. Seven children with kidney damage caused by the ailment were still in the hospital and three of the four undergoing dialysis were in critical condition yesterday.
A 2-year-old girl also died in the outbreak in Washington, but health officials have not been able to link her case to Jack in the Box hamburgers or to any other case. They are still investigating.
Public health officials have many reasons to be concerned about E. coli 0157:H7, the bacterium that causes the illness involved in the outbreak. It can crop up anywhere from municipal water and apple cider to rare hamburgers, one of Americans' favorite foods. Doctors have not yet decided on the most effective treatment and in most cases at present can do little more than let the disease take its course. Antibiotics do not seem to help and may even make the disease worse. The symptoms can range from mild to extremely violent, leading occasionally to death, especially among children and the elderly.
E. coli 0157:H7 is a variant of one of the most common bacteria that live harmlessly by the billions in the human gut.
The bacterium can cause diarrhea that is often bloody, severe bleeding, anemia and kidney failure that requires dialysis. The bacterium can also produce a wide variety of baffling symptoms, even fooling doctors into performing unnecessary surgery.
The bacterial illness was unknown until 11 years ago, when it was linked to tainted hamburger and added to the small list of potentially fatal food-borne ailments.
Now the ailment is an important and growing public health problem. But Federal health officials say that the true scope of the problem cannot be measured because laboratories do not routinely test for the particular bacterium because of time and cost.
Many experts have urged that more laboratories use the special culture medium that is needed to identify E. coli 0157:H7 because identifying the organism can affect therapy, eliminate the need for expensive unneeded diagnostic procedures like barium enemas and colonoscopies, and can lead to recognition of outbreaks.
Epidemiologists have found that many cases go undetected unless there is a cluster of kidney failure cases, or because large numbers of people are hospitalized simultaneously with severe diarrheal illness.
Washington is one of the few states where E. coli 0157:H7 is a reportable illness. More active surveillance is needed in other states to detect cases and prevent further outbreaks, said Dr. Patricia M. Griffin, an expert in the ailment at the Centers for Disease Control and Prevention in Atlanta.
She and other experts have urged studies to determine the risks and benefits of antibiotic therapy for the ailment.
Outbreaks can be particularly difficult to avoid because cattle are a key reservoir of the bacterium. Dr. Griffin and other experts said there was a critical need for studies of the mechanism by which meat becomes contaminated with E. coli during slaughter and processing and of ways to reduce such contamination. They suspect that most meat is contaminated at the time of slaughter and that undercooked hamburger is the chief means of spread. Undercooking is believed to be a greater problem than contamination by an infected food handler.
E. coli 0157:H7 differs from other members of the E. coli family in that it clings to the wall of the cell in the bowel and produces a toxin that can cause bleeding. Precisely how the toxin damages tissues throughout the body is not known, and it might be this factor that makes antibiotics ineffective.
Doctors and individuals can recognize the infection by its spectrum of symptoms, which in addition to bloody diarrhea can include abdominal cramps and vomiting, but often without fever. The illness usually resolves itself in about a week. But complications can develop at any time, most commonly in the very young and in the elderly.
The most feared complication is hemolytic-uremic syndrome, which is the leading cause of acute kidney failure in children. Many children may need to undergo dialysis. Although most soon recover, about 15 percent go on to need permanent dialysis or a kidney transplant.
"It always hits healthy kids," said Dr. Howard Trachtman, a specialist in kidney diseases of children at Schneider Children's Hospital in New Hyde Park, L.I. He is working with Robert Galler, who has established a foundation to increase awareness and support research for a cure for the ailment that killed his daughter, Lois Joy Galler, last July.
The ailment can easily be misdiagnosed. Severe abdominal pain and intestinal bleeding from E. coli 0157:H7 infection has led surgeons to operate unnecessarily and remove sections of the bowel and to mistakenly diagnose inflammatory bowel disease.
E. coli's newly recognized role in human disease resulted partly from happenstance in 1982 through an investigation of two outbreaks of a distinctive bloody diarrheal illness among those who ate tainted hamburgers, including customers at a McDonald's in Oregon and Michigan.
Laboratory workers, suspecting another microbe, were surprised to detect E. coli 0157:H7 in cultures from a few cases. Because the particular type had never been linked to human infection, though E. coli has been known for about a century, proof of its causal role required further investigation. Even then, E. coli 0157:H7 was thought to be a medical oddity.
Then came a link to the hemolytic-uremic syndrome, which had been a puzzle since it was first reported in 1955 in Switzerland. Because such cases occurred in clusters, scientists had theorized that it was caused by a microbe. But the many microbial candidates fell by the wayside as researchers ran into many dead ends before E. coli was suspected.
Now, epidemiologists are finding that the ailment can strike anyone at any age, with the highest rates in children under 5, especially for the kidney complications. Adults may develop a bleeding disorder known as thrombocytopenic purpura, or TTP.
The ailment has been reported throughout the world. Canada has noted a problem with it, and for unknown reasons most of the cases in the United States have been in states like Washington and Minnesota that border on Canada and that have active surveillance programs.
Limited surveillance has shown that outbreaks in restaurants can occur at any time but that sporadic cases occur most frequently in the summer.
Hamburger seems to pose the greatest risk because such meat is ground and mixed, providing a large surface area for growth of the bacteria. Little risk of illness from these bacteria exists if hamburger has been thoroughly cooked, as pork usually is. But if hamburger is undercooked, bacteria inside a hamburger patty may escape destruction. If the bacteria are on the surface of steak and rib meat, they are generally killed when the outside is cooked even though the inside may be rare, health officials said.
As a result of the investigation of the Washington outbreak, the Food and Drug Administration has recommended that the Federal minimum cooking temperature for ground beef be raised to 155 degrees from 140.
Mike Espy, the Secretary of Agriculture, has also pledged to tighten Federal meat inspection standards.
But some critics contend that only irradiation of meat will eliminate the hazard of infection from E. coli 0157:H7 and other dangerous microbes because no meat is sterile and most contains millions of bacteria.
Tainted Hamburger Raises Doubts on Meat SafetyBy TIMOTHY EGAN
Jan. 27, 1993 NY Times
At Children's Hospital here, a 9-year-old girl is hanging on to life by a thread after eating tainted hamburger. A 2-year-old boy has already died, and 16 other children are being treated for severe illness brought on by the same contaminated meat.
Federal officials say the cries of these children are raising alarms across the nation about how meat, particularly hamburger, is processed, inspected and cooked. In the last two weeks, more than 200 people in the Pacific Northwest and a handful of people in other Western states have been stricken with E. coli 0157:H7, a bacterium that has killed 16 people nationwide since it was first identified 10 years ago.
The hamburgers in the most recent outbreak came from the Jack in the Box food chain, which has 1,170 restaurants, all west of the Mississippi. In an interview today, Robert Nugent, president of company, said the chain cooked its meat below a standard set by Washington State. More Illness Expected
"This is a catastrophe," Mr. Nugent said. "It has become clear that we were not cooking our meat in compliance with Washington State standards." The company has 60 restaurants in the state.
He added: "This has opened up a lot of people's eyes. We know all meat has bacteria, but how much of that bacteria will kill somebody?"
He said the company was in violation of the safe-cooking regulations because it was unaware that last May Washington had set a higher temperature requirement of 155 degrees inside the meat, a level that normally produces a medium hamburger. That required temperature is the highest in the nation.
This state's chief epidemiologist, Dr. John Kobayashi, said he expected the toll of serious illnesses to continue to climb for the next few days. Although the tainted meat was recalled last Monday, the illness has an incubation period of up to nine days, he said.
"This has been a nightmare for the parents," said Dean Forbes, a spokesman for Children's Hospital, whose doctors first alerted health authorities about the outbreak. "To think that something as benign as hamburger could kill a kid is just startling to most people."
In the wake of the food poisoning outbreak, Federal officials say they are considering raising the minimum guidelines for cooking processed beef to something above the current level of 140 degrees. That is the standard most states follow and close to the level at which Jack in the Box was cooking the meat that has been traced to 200 cases of severe food poisoning. Batch Was Contaminated
But it is not just the cooking of meat that has come under criticism. After laboratory analysis by state and Federal health scientists, Jack in the Box last Monday recalled about 28,000 pounds of frozen hamburger patties from a batch of meat found to have been heavily contaminated with the strain of bacteria that health officials say caused the outbreak. Another 40,000 patties were consumed, officials said, in Washington, Nevada and parts of Southern California.
The fact that so much contaminated meat could be shipped to retail outlets without being detected has called attention to the meat safety process itself. Federal officials say that 7,400 inspectors examine the carcasses of 120 million animals a year and that very little contaminated meat gets through. But the inspections are limited to visual examinations, for discolored meat, rather than laboratory analysis of certain samples.
"It's unbelievable that such a low level of inspection exists in a society so advanced," said Joseph Dolan, whose two young daughters suffered kidney failure after eating contaminated cheeseburgers from Jack in the Box. "No matter where you buy ground beef, you're susceptible to getting sick."
Federal officials say about 6,000 cases of illness caused by E. coli 0157:H7 are reported each year. The strain, first discovered in 1982, is a particularly virulent form of a bacteria found in the intestines of warm-blooded animals. In about 10 percent to 15 percent of the reported cases, it will cause hemolytic uremic syndrome, an illness that can lead to a failure of the kidneys and heart, and to death. Children and the elderly are particularly vulnerable.
Washington raised its meat-cooking standards last May in response to a previous outbreak of E. coli here, in 1986, when two people were killed.
Roughly four million cases of some type of food poisoning are reported annually, but the strain of bacteria that caused this outbreak is one of the few kinds that can kill people. "In terms of severity, this is one of the worst," said Dr. Douglas Archer, director of the Federal Government's Center for Food Safety and Applied Nutrition.
Dr. Archer, like other food inspection officials interviewed, emphasized that the nation's food supply might be the safest in the world. "How many billions of hamburgers are consumed annually with no resulting illness?" he said. "People should put this case in context."
But many food experts, in and out of Government, say this outbreak in the Northwest has pointed to a need to upgrade the inspection system and cooking process. Despite the elaborate system of inspections, the safety of meat depends, ultimately, on whether it is cooked adequately enough, officials say.
"Raw meat is flesh -- tissue -- and all tissue contains bacteria," said Jim Greene, a spokesman for the Food and Safety Inspection Program of the United States Agriculture Department. "You're never going to get sterile meat." Sampling Begun
The Government is starting to examine samples from selected meat processing plants to see whether E. coli and other dangerous bacteria are widespread. If they find a high level of contamination, they may change the inspection process to include more laboratory sampling, officials said.
The tainted meat from Jack in the Box was processed by Vons Companies of Arcadia, Calif., from cattle slaughtered in California, Colorado and Michigan. Julie Reynolds, a spokeswoman for the meat processor, said the company was in compliance with all Federal regulations and, like other plants, has Federal inspectors who work on the premises.
"We are confident the contaminated meat did not occur as a result of processing from Vons," Ms. Reynolds said.
Other officials have speculated the meat was contaminated at the time it was slaughtered, but Government investigators have yet to confirm where it was tainted.
Even though the meat was badly contaminated, the bacteria could have been eliminated had the meat been thoroughly cooked to reach the temperature of 155 degrees or above, Federal officials said.
But Mr. Nugent, the company president, said he questioned whether cooking the meat at the Washington threshold would have killed the bacteria.
"I think there is a responsibility at both ends of the food chain," he said. "How do you explain the fact that for more than 30 years we've been selling hamburgers without a problem then all of a sudden -- Bam! -- this happens." Higher Cooking Temperature
The company has since raised the minimum temperature for cooking hamburgers in all its outlets to 155 degrees, Mr. Nugent said, and has apologized in full-page newspaper advertisements in the Seattle area.
Jack in the Box's parent company, Foodmakers Inc., lost 30 percent of its value in the stock market last week. It has since regained much of the loss. The company had $1.29 billion in earnings last year; nearly two-thirds of the revenue came from Jack in the Box outlets, Mr. Nugent said.
The McDonald's Corporation, the leader in fast-food hamburger sales nationwide, has long cooked it burgers to a temperature of at least 157 degrees, said Rebecca A. Lewis, a customer relations representative at the company's headquarters in Oakbrook, Ill.
Federal officials said most food poisoning from meat comes from home cooking, particularly on outdoor grills. The Government recommends that people cook hamburger to a temperature of 160 degrees.
The death and illnesses in Washington has caused some parents here to question the safety of fast food. But other parents say they believe that the incident is a freak occurrence.
"I don't want to steal my children's joy at going to McDonald's," said Mr. Dolan, who lives in the Seattle suburb of Kent. "It's part of growing up. My daughters really enjoy eating there. And I don't want them punished for this episode."