When food illnesses spread, Minnesota team gets the call

ST. PAUL -- Three days before Christmas, a call to Minnesota's food-borne illness hotline set off bells: A nursing home had three residents sickened by salmonella.

Salmonella cases had been bubbling up in Minnesota for a month, longer in other states. Here was a potential cluster. Minnesota's food-borne illness team sprang into action. State workers pored over the nursing home's menus, looking for clues. Another case popped up at a different nursing home, then two at a school. More menus were compared.

Within three weeks, Minnesota identified King Nut peanut butter as the culprit, and Peanut Corp. of America as the producer. It was the first big break in a case that has sickened more than 677 nationwide, might have led to nine deaths and has caused one of the largest food recalls in U.S. history, affecting more than 3,000 products.

Without the Minnesota break — and the presence of a cluster of cases from a confined population such as the nursing home's — the outbreak "could have dragged on for who knows how long," says Tom Safranek, state epidemiologist in Nebraska.

Minnesota's prowess in investigating food-borne illness outbreaks — in contrast to less successful efforts by other states — exposes weaknesses in the nation's ability to quickly track and contain outbreaks, food safety specialists say.

That's because the national system for identifying food-borne illnesses relies on the efforts of hundreds of local, regional and state health departments, all with differing capabilities, budgets, priorities and procedures. If an outbreak starts in a region ill-prepared to investigate cases, it may not be stopped as quickly as if it had started elsewhere, food safety officials say.

"People die who don't need to die. It happens all the time in food-borne illness outbreaks," says Michael Osterholm, director of the Center for Infectious Disease Research & Policy at the University of Minnesota, who testified last year before Congress on the issue. "If each state was as effective as Minnesota, more of these could be detected."

Minnesota's fast work has protected the public from contaminated food before. Last year, its team was among the first to blame hot peppers — not tomatoes, the initial suspect — for the largest salmonella outbreak in a decade. In 2007, the team found pot pies to be the source of another salmonella outbreak. In both cases, Minnesota took less than a month to find what turned out to be a confirmed culprit when people had been falling ill in other states for months.

When it comes to food-borne illness investigation, "Minnesota is leap years ahead of … most of the rest of the nation," says James Phillips, head of infectious diseases for the Arkansas Department of Health.