Melons Blamed in Second Death

State and federal health officials are blaming a second California death on contaminated cantaloupe as they struggle to identify the source of a salmonella outbreak.

But their search faces tremendous odds, health officials acknowledge--and critics say the outbreak illustrates a flawed system that leaves consumers unprotected against contaminated produce.

The latest in a series of such cases became public last week when the California Department of Health Services linked 20 illnesses statewide and the death of an elderly Riverside woman to contaminated cantaloupes. Authorities believe an additional 13 illnesses outside the state were caused by the contamination.

The second death, an elderly San Diego man, was announced Tuesday. All of the people who got sick--elderly adults or children--ate tainted cantaloupe from April 6 to May 4, officials said. None of the fruit has been recalled, so there is still a chance more people could become ill.

Not included in the tally are an unknown number of victims who did not report their illness to public health authorities. Among those is Stephanie Robinson, 32, of Studio City, who got sick Tuesday after eating cantaloupe from a local grocery store. She didn’t associate her diarrhea and vomiting with the fruit until she saw a news broadcast about the outbreak.

“I thought maybe [the store] just didn’t wash it,” said Robinson about the melon that she purchased, “But who washes cantaloupe, anyway?”

Washing is the best way to prevent illness from contaminated fruit, said Jim Waddell of the state Health Department. Cantaloupe--with its rough creviced surface--may harbor bacteria that are carried into the edible flesh by a knife when cut.

Tracing the source of bacterial contamination in food--from eggs to sprouts, raspberries or poultry--is difficult, Waddell said. The hunt may lead investigators from a grocery store to a farm where contamination was spread by a worker’s hands or fertilizer in the soil. Often, the source is never located.

“We may end up with a dead end,” he said. “It’s not a very clear process. . . . It could have been temporarily occurring conditions that led to the condition, and that condition could have stopped.”

Public health advocates, while sympathetic to such difficulties, said the government should devote more time, money and effort to preventing outbreaks.

“The investigations after the fact are not as good as trying to get to the farms in advance,” said Caroline Smith DeWaal, director of food safety at the Center for Science in the Public Interest. Regulating and enforcing proper agricultural practices on farms should be the top priority, DeWaal said.

In recent years, California has faced outbreaks of food-borne illness from strawberries infected with hepatitis A, sprouts infected with salmonella and raspberries infected with cyclospora, a parasite that causes gastrointestinal illness. Cantaloupe was blamed for another outbreak of salmonella poisoning last year that sickened 13 people. The source was traced to a Mexican farm, state health officials said.

Authorities have not located the source of the current outbreak, although they have ruled out California because the state’s cantaloupe harvest began around May 8 or 9, after the illnesses were reported, said Stuart Richardson of the state health department.

The search for a source begins with illness reports, said Dr. Laurene Mascola, chief of the acute communicable disease unit for the Los Angeles County Health Department. Six illnesses in the current cantaloupe case were reported in Los Angeles County. All of those infected had Salmonella poona, an uncommon form, she said. Alerted by physicians, county health workers interviewed those who were ill, asking such questions as: “Do you eat eggs? Lettuce? Cantaloupe?” or other foods that have a history of contamination.

Once a common food is identified, investigators go to the retailers. They determine where the food was purchased or prepared, and look at receiving, stock rotation, inventory, handling and shipping procedures, according to the federal Food and Drug Administration, which is responsible for interstate and international traces.

Tracing Culprit Often Difficult

The search continues to the distributor, and back to the farm where the product was harvested. If the farm has been cited repeatedly for contamination, it may be shut down.

Although state and federal officials have a detailed tracing method in place, it is still like trying to find a needle in a haystack, Mascola said.

A computer network established in 1998 helps to speed the process. The system creates a DNA-like imprint of a pathogen that allows inspectors across the country to match outbreaks.

Food contamination may come from a variety of sources. The produce may be contaminated in transit, or an ailing farm worker could have worked with the produce, Mascola said. In the case of cantaloupes, which are grown on the surface of soil, contamination may also be caused by manure on the farms.

“The standards for growing fresh fruits and vegetables should be high enough to protect consumers from outbreaks,” said DeWaal.

Waddell said the state does not regularly monitor or inspect harvesting practices of farms. FDA officials say regular farm inspections are outside their jurisdiction. But even efforts that are under FDA control have been criticized.

A report issued in 1998 by the U.S. General Accounting Office called federal efforts to ensure safety of imported foods “inconsistent and unreliable.” Though the FDA has the authority to inspect food at ports of entry, less than 2% is inspected.

The reason: “We don’t have enough people out there in the field in order to be able to look at a larger proportion of the produce,” said LeeAnne Jackson, health science policy advisor for the FDA.

In 1999, the agency began sampling produce to help it target imports with higher rates of contamination. Cantaloupe is one of the items inspectors are focusing on.

Health officials said the best prevention for food-borne illness is to take precautions when preparing and eating produce.