Mitchell Hamline Health Law Institute Food Safety Panel Carrie Rigdon, PhD MDA Food & Feed Safety Division

Inspect Investigate Educate To give you a brief summary of what we do regarding food safety at the Minnesota Department of Agriculture, we inspect, we investigate, and we educate. We inspect food manufacturers and retailers, we investigate sources of foodborne illness and food contamination, and we educate the businesses we regulate and the public on food safety.

The Chain of Regulatory Responsibility Farm Processor Distributor Retail Restaurant The regulatory responsibility among local and state entities may be different state by state, but in Minnesota, the state department of agriculture has authority from farm to retail, with the health department regulating restaurants and the BAH regulating food animals. The FDA and USDA have authorities at the federal level (a bit complicated so won’t go into that today).

Dairy Producers & Processors Retail/Groceries Food Manufacturers Meat Processors Feed Mills & Pet Food Mobile Sales Dairy Producers & Processors Here are examples of the types of facilities that MDA regulates.

Anatomy of an Outbreak Investigation: Integrated Approach Disease Surveillance Epidemiological Investigation Laboratory Analysis Environmental Investigation Traceback / Traceforward Shifting to investigation, here are the elements of an outbreak investigation. Finding the ill cases, interviewing them and identifying exposures, lab analysis on the human side to identify clusters of common source and on the food side to identify contamination, investigating where and how food was prepared, tracing back food items to identify a common source, and once at the source doing a root cause investigation to find out how and why the food was contaminated. Many of these components are occurring concurrently but not all. Success requires an integrated approach and constant communication. Product Investigation

Data and Information Epidemiologic info. from ill person interviews (Health) Laboratory (Health & Ag) Records (Health & Ag) Menus Process Shipping/Receiving Sanitation Traceback (Ag) To drive that point home, investigations require analyzing a lot of data and coordination. At the state level, those are shared responsibilities between the Departments of Health and Agriculture and the locals. In multi-state investigations, the CDC will be involved to support Health and the FDA or the USDA will be involved to support Ag. There’s an example of a simplified traceback diagram of blueberries from a few years ago.

Now I want to shift gears a bit Now I want to shift gears a bit. This panel was billed as a review of “hot topics”, so I want to use some cartoons and headlines to illustrate some of the challenges in food safety. This first cartoon is by Tom Toles from February of 2009 after one of the largest outbreaks (over 700 illnesses) that was linked to peanut butter. Regulation is not very popular in many people’s eyes. But at its heart, regulations are meant to protect and offer a level playing field. There is tension – I think a healthy tension – around what that line is.

One of the challenges around regulations is that they can appear to stifle innovation. I’m a foodie and I’m very excited about the innovations going on now in the food and culinary world. But at heart, you have to know what you’re going and know when trying something new may be getting you into unsafe territory. Let me give you an example… Botulism in quick rice Now, on the other hand, there are regulations that are very proscriptive and can make it hard to innovate Making kimchi in restaurants So that highlights some of the regulatory tensions. The focus should be on risk and whether you are in control of your process – and that is where new regulations like FSMA are focusing on.

Sometimes, it definitely feels like there is nothing safe to eat anymore. We keep learning so much about the organisms that make us sick – how they survive and adapt. And how we can prevent contamination. A lot of it goes back to the basic preventive controls that are outlines in the new Food Safety Modernization Act. Case in point – Listeria in Caramel Apples.

2015-16 Multistate Outbreak of Listeriosis Linked to Commercially Produced, Prepackaged Caramel Apples (35 illnesses in 12 states) There ultimately were 35 illnesses in 12 states. This one took a while to crack because the food vehicle was so unexpected, but once caramel apples were on our radar, the investigation moved very quickly. MN was involved not only because of the illnesses but because we had 2 manufacturers linked to illnesses.

The cases were linked back to apples harvested in California The cases were linked back to apples harvested in California. Research at the Univ. of Wisconsin showed that Listeria was not killed by the hot caramel and in fact thrived in the room temperature environment. But basic controls were not in place at the harvest and packing location to prevent contamination. This could have been prevented if basic actions had been taken.

2016 Multistate Outbreak of Shiga toxin-producing Escherichia coli Infections Linked to Flour (63 ill in 24 states) Contrast that with an E. coli outbreak linked to flour. This is a much trickier risk to manage. Unlike apples, which are a ready-to-eat product for which some basic washing and sanitation steps can prevent contamination, flour is a raw agricultural product – meant to be cooked – and is very hard to treat to kill or remove pathogens.

This article came out after the FDA advised consumers to not eat or play with raw dough and to wash hands and utensils. Food safety needs to be a shared responsibility.

Lastly, I want to recognize the evolving definition of “food safety” Lastly, I want to recognize the evolving definition of “food safety”. I and many of my colleagues think first and foremost about food contamination – mostly with pathogens – that cause immediate, or acute, illness. But many are now including the long-term health causes of food that get more at the intrinsic nature of food. This is taken from the Minnesota Food Charter, a roadmap designed to guide policymakers and community leaders in providing Minnesotans with equal access to affordable, safe, and healthy food regardless of where they live.