With 29 people now dead, listeria-tainted cantaloupe has caused the deadliest recorded U.S. outbreak of food-borne illness, surpassing a 1985 outbreak with similarly tainted Mexican cheese.
Just a few weeks ago, food safety experts said the contaminated musky melons were behind what was shaping up to be the worst cluster of food-related illnesses and deaths in a generation. On Wednesday, that was largely confirmed when the federal Centers for Disease Control and Prevention reported the 29th death from Listeria monocytogenes linked to melons from Jensen Farms, based in Holly, Colo.
Depending on whose figures you use, the fruit-linked outbreak is, at the very least, just as deadly as a 1985 listeriosis outbreak that killed 29 Southern Californians who ate Mexican-style soft cheeses such as queso fresco and cotija.
In its final report, the CDC tallied 29 deaths from the cheese: eight in infants, 13 stillbirths and eight others in non-neonates. But a Sept. 29, 1988, article in the New England Journal of Medicine, which followed additional review by the CDC, the Los Angeles County health department and the Food and Drug Administration, revised the 1985 death toll downward to 28 -- 20 infants and 18 adults. The revision would give the current cantaloupe outbreak the grim distinction of being the worst ever.
Although the rate of newly confirmed cantaloupe cases has slowed, more Americans could still succumb because listeria can deliver its wallop months after the invisible trip from a plate into the depths of the digestive system. In addition, after someone starts feeling sick, they may delay seeing a doctor and the illness may not come to the attention of public health officials until a laboratory confirms the diagnosis and ties it to other cases.
Since Aug. 15, tainted cantaloupes, which also caused a pregnant woman in northwest Iowa to miscarry, have sickened 139 people with four strains of listeria. All were traced to cantaloupe grown and processed by Jensen Farms.
Listeriosis infections may cause fever, stiff neck, muscle aches, headache, confusion and vomiting; the most serious complications are sepsis, a potentially fatal blood infection, and meningitis, inflammation of the membrane surrounding the brain.
Of the 142 people sickened in the 1985 cheese-linked outbreak, 93 were pregnant women or their children, underscoring the risk that rod-shaped listeria bacteria pose to pregnant women, who can miscarry or transmit the infection to their fetuses.
Also vulnerable are infants, the elderly and anyone else with a compromised immune system.
The number of people sickened or killed in the current outbreak could very well increase, especially given that some victims are still fighting for their lives.
"I have two clients who are in the ICU, both in their 80s, both in Colorado," said Bill Marler, a Seattle food safety attorney whose law firm is representing the families of 26 victims of the current outbreak (10 who died and 16 who survived).
Although relatives of the two ICU patients remain hopeful about their prognoses, both have been hospitalized a month and a half and subjected to the risks of prolonged hospitalization, including additional infections and pneumonia.
Marler has represented thousands of victims of food-borne illness since 1993, when he won a $15.6 million settlement from Jack in the Box for Brianne Kiner, who survived a life-threatening infection with E. coli 0157:H7 from a tainted hamburger.
So far, he has filed eight lawsuits against Jensen Farms and Frontera, the Texas-based wholesaler that handled the melons.
"We also will be suing the grocery stores," he said.
He estimated that the cost of litigation for 139 people sickened and 29 dead "is probably $125 million to $150 million -- what they're going to have to pay out in damages, in past medical costs, in future medical costs."
The monetary costs extend beyond that, he said, to the cost of the recall and the cost to other growers whose cantaloupes went unsold because of fear.
Then, there are the psychic costs that make eating some fresh fruits and vegetables seem more risky than eating processed foods with artery-clogging fats.
The current outbreak, which has spread to 28 states, most recently Nevada and Utah, was traced in September to Jensen Farms. On Sept. 14, the FDA announced that Jensen Farms had voluntarily recalled whole cantaloupes, and subsequently Carol's Cuts of Kansas City and Fruit Fresh up of Buffalo, N.Y., recalled cut cantaloupe and cut mixed fruit containing cantaloupe produced by Jensen Farms.
FDA and Colorado inspectors who visited the Jensen processing plant on Sept. 10 detected listeria on machinery, and found some of the equipment couldn't easily be cleaned and sanitized, according to an FDA assessment released on Oct. 19.
"Here you've got listeria, which loves cool, wet environments," Marler said. "You basically have a washing and packing facility that wasn't cleaning the cantaloupe, it was infecting the cantaloupe."
Outrage at contamination in Chicago's meat-packing plants, fueled by Upton Sinclair's graphic depictions in his novel "The Jungle," led to passage of the Pure Food and Drug Act in 1906 and eventually to creation of the Food and Drug Administration. Yet more than 100 years later, the most advanced country in the world remains plagued by food-related illnesses. Asked why, Marler blamed human nature.
"Humans make mistakes," Marler said. "Humans don't pay attention to details. The question is how do you set up systems that help humans not make mistakes and how do you help them pay attention to details?"
Some companies do a good job, he said.
"A lot of companies out there make food safe every single day and they never poison anybody," he added.
Some industries have shown they can set and follow minimum standards for bacterial and viral contamination. He cited the example of the "leafy green industry," which got together and set up minimum standards after a 2006 E. coli outbreak traced to fresh spinach sickened more than 200 people and killed three.
Since 2006, "Have we had a couple of outbreaks involving leafy greens? Yes. Have they been big? No. Do I expect big ones in the future? No," he said.
"The problem we have is we don't really set hard standards that everyone has to play by," Marler said. "And we have no inspections because the FDA inspection force has been absolutely decimated over the last decades, so these plants never get inspected."
The country needs a system that works consistently, so that "you don't feel that every time you go to the fresh fruit and vegetable aisle, or the salad bar, you think, 'Is this going to be my last time?'"