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Who's behind that outbreak? Sometimes, CDC won't say

Salmonella strain that sickened 109 people, including a man who died, was initially identified only as
Salmonella strain that sickened 109 people, including a man who died, was initially identified only as

When government health officials wrapped up a three-month investigation of a salmonella Enteritidis outbreak that sickened 68 people in 10 states, the final report on Jan. 19 included nearly every detail -- except the name of the place that sold the food.

The Centers for Disease Control and Prevention has refused to identify the source, other than as “Restaurant Chain A,” a Mexican-style fast-food chain.

That’s the second time in a little more than a year that the agency has masked the source of foodborne illness at a similar chain. In August 2010, a final CDC report found that 155 people in 21 states were sickened by two rare strains of salmonella traced to an anonymous Mexican-style fast-food chain eventually identified as Taco Bell.

Two other recent outbreaks with initially hidden sources -- laboratory-supplied salmonella Typhimuirium identified only as “strain X,” and an outbreak of E. coli O157:H7 in romaine lettuce from “grocery store Chain A” -- have spurred new scrutiny of the agency’s willingness to keep the entities behind some infectious outbreaks secret.

Food safety advocates say the practice keeps the public in the dark about which firms have been linked to illness.

“It will eventually come out and it will be the company that looks bad,” said Doug Powell, a professor of food safety at Kansas State University and author of a food safety blog. “A lot of these problems could be reduced if government agencies were more transparent about how they decide when to go public.”

Dr. Robert Tauxe, a top CDC official, defended the agency’s practice of withholding company identities, which he said aims to protect not only public health, but also the bottom line of businesses that could be hurt by bad publicity. The CDC, the Food and Drug Administration and state health departments often identify companies responsible for outbreaks, but sometimes do not.

“The longstanding policy is we publicly identify a company only when people can use that information to take specific action to protect their health,” said Tauxe, the CDC’s deputy director of the Division of Foodborne, Waterborne and Environmental Diseases.  

“On the other hand, if there’s not an important public health reason to use the name publicly, CDC doesn’t use the name publicly.”

Because companies supply vital information about outbreaks voluntarily, CDC seeks to preserve cordial relationships.

“We don’t want to compromise that cooperation we’ll need,” Tauxe said.

But critics such as Bill Marler, a Seattle food safety lawyer, say that the government owes the public early and full disclosure during illness outbreaks.

“In today’s society, where transparency is so important for decision-making, I just don’t think government has the right to withhold that information from the public,” said Marler, who has pushed hard for the CDC to identify the firm behind the latest outbreak.

He all but outed Taco Bell in a blog post late Monday that chronicled in which states with illnesses certain Mexican fast-food chains operate.

If Taco Bell were indeed the entity involved in the latest outbreak, the information would allow consumers to decide whether they wanted to continue eating at a fast-food chain implicated in similar outbreaks in 2006 and 2010, Marler said.

In 2010, the CDC withheld the identity of the Mexican-style “Restaurant Chain A.” But when the name was released in error to media outlets, the CDC confirmed it, said Lola Russell, an agency spokeswoman.

The agency has not confirmed that the “Restaurant Chain A” in the 2010 outbreak is the same as in the 2011 incident, and they will not comment on whether it’s Taco Bell, Russell said.

Officials with two other Mexican-style fast-food restaurant chains with sites in the affected states, Qdoba and Chipotle Mexican Grill, told they were not questioned in connection with the outbreak.

Taco Bell officials did not return calls or e-mails from seeking comment.   

In the case of the outbreak of commercially produced salmonella Typhimurium that sickened 109 people between August 2010 and June 2011, including one man who died, the CDC withheld the specific strain that caused the illnesses. The victims of "strain X" were mostly clinical and teaching microbiology lab students and their families, but they could have spread the germs to the general public on contaminated lab coats and cells phones, investigators suggested. It was those lapses in lab practice, not the particular strain of bacteria, that caused most concern, officials said.

“In that case, we don’t think that one salmonella is a lot different from another salmonella,” Tauxe said. “The concern is not the strain, it’s what are the safety procedures and practices they use in the laboratory.”

The trouble, say food safety advocates, is that it’s not clear when or why CDC officials decide to withhold the identity of firms involved in outbreaks and when they decide to go public.

"No one is happy, and that's largely because there are no guidelines people can at least point to, whether they agree with the guidance or no," Powell said.

Tauxe acknowledged there’s no written policy or checklist that governs that decision, only decades of precedent.

“It’s a case-by-case thing and all the way back, as far as people can remember, there’s discussions of ‘hotel X’ or ‘cruise ship Y,” he said.

That just doesn’t pass muster, said Marler and other critics. 

“If the CDC has a good, rational reason for doing what they’re doing, fine,” he said. “Then write it down and hold it up for people like you and I to scrutinize.”

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