Health officials from five Southern California counties are reporting dramatic increases--ranging from 700% to 1,782%--in illnesses linked to contaminated eggs over the past six years, according to a copy of a report obtained by The Times that will be released today.
The unprecedented joint action--by Los Angeles, Orange, Riverside, San Bernardino and San Diego counties--is meant to warn consumers, grocers and restaurateurs about the potential presence of salmonella in raw eggs and to urge adoption of extra handling and cooking precautions.
The largest numbers of cases, caused by a strain of salmonella known as Salmonella enteritidis, were reported in Orange and Los Angeles counties.
Los Angeles County's infection rate for this strain soared 900%, to 1,131 cases from 1989 to 1994, officials said. Over the same period, Orange County's Health Care Agency reports that the strain was isolated as the cause of 320 illnesses in 1994, or a 1,782% increase from six years before.
The greatest year-to-year change--about 225%--in both counties occurred between 1993 and 1994, indicating that the problem is accelerating.
"In 1994, it just took off," said Dr. Hildy Meyers, Orange County's medical director of communicable disease control and epidemiology.
Egg industry representatives were made aware of the sharp increase in illnesses last week during a meeting of a joint task force of government and producer representatives gathered in Sacramento to address the salmonella problem.
Anne Downs, executive director of the Pacific Egg and Poultry Assn., said the public- and private-sector group is formulating a California Egg Quality Assurance Plan that targets salmonella.
"We've come together voluntarily to deal with the issue of not just salmonella, but food-borne illnesses in general," she said. "And part of the problem is the way the eggs are handled after they leave the processors."
Salmonella infections typically cause diarrhea, fever and abdominal pain that can last up to a week. The infection can be severe, and sometimes fatal, among high-risk groups such as infants, the elderly, pregnant women and those with compromised immune systems, such as cancer or AIDS patients.
Consumers can protect themselves in a variety of ways, including thoroughly cooking eggs--whether boiling, frying or poaching--to 140 degrees Fahrenheit, or until the white and the yolk harden.
"This strain of salmonella first became a problem in the eastern United States in the 1980s and has been associated with consumption of eggs," the advance copy of the report says. "National data indicate that in at least 80% of . . . S. enteritidis (outbreaks), eggs have been implicated as the source of the infection."
Salmonella enteritidis contamination of eggs has been a problem for about a decade. Researchers believe that the potentially harmful bacteria are present in the hen's oviduct and are passed to the embryonic egg even before a shell is formed. Therefore, an otherwise perfect-looking egg may contain the pathogen.
The infection of egg-producing flocks has spread throughout the country since the first reported human illnesses in the mid-1980s. The contamination is believed to have reached California flocks in recent years.
The rise in S. enteritidis infections in Southern California far surpasses what has been occurring nationally, according to a recent report by the federal Centers for Disease Control and Prevention in Atlanta. The number of cases of the illness nationwide has increased 90% during the same period, according to the CDC.
Dr. Shirley M. Fannin, Los Angeles County's director of disease control programs, said the most likely cause of the increase is that the eggs being distributed in Southern California are "highly infected with S. enteritidis. "
"No, people are not dying in the streets, but in medical terminology we consider this an epidemic," she said.
Dr. S. Benson Werner, chief of the disease investigations section of the state's Health Services Department, said there does not appear to be a similar rise in S. enteritidis cases in Northern California. But he cautioned that health officials there have not looked at the problem as closely as those in Los Angeles and Orange Counties.
In August, 1990, the U.S. Food and Drug Administration added shell eggs to a list of potentially hazardous foods including raw meats, poultry and seafood. As a result, processors and retailers are required to store raw eggs at or below 40 degrees. Cooked eggs must be heated to 140 degrees and served immediately.
The health departments issued several recommendations to decrease the risk of contracting S. enteritidis:
* Refrigerate eggs at 40 degrees or lower.
* Thoroughly wash hands with soap and hot water before and after handling eggs.
* Wash all utensils and surfaces such as cutting boards and kitchen counters that come in contact with raw eggs.
* Do not use eggs with cracked shells.
* Avoid eating foods that contain raw eggs, such as hollandaise sauce, Caesar salad and raw dough. Restaurants, schools and other institutions should use pasteurized eggs if possible.
* Cook eggs until both the white and the yolk are firm. Some of the traditionally undercooked egg dishes include soft, running or wet scrambled eggs, soft-boiled eggs, poached eggs and French toast.