2 2 3 Lettuce and Spinach 8 outbreaks traced back to produce from Salinas, California 8 outbreaks traced back to produce from Salinas, California 21.

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3 Lettuce and Spinach 8 outbreaks traced back to produce from Salinas, California 8 outbreaks traced back to produce from Salinas, California 21 E. coli outbreaks since E. coli outbreaks since 1995 – At least 1,000 reported illnesses and 7 deaths Fresh or fresh-cut lettuce or spinach implicated as outbreak vehicle Fresh or fresh-cut lettuce or spinach implicated as outbreak vehicle 3

4 Recent E. coli Outbreaks July 2002 – WA Dance Camp July 2002 – WA Dance Camp – 50 dance campers sickened, several hospitalized, one with life-long kidney damage – “Pre-washed” lettuce September 2003 – CA Restaurant September 2003 – CA Restaurant – 40 patrons ill – Salads prepared with bagged, “pre-washed” lettuce October 2003 – CA Retirement Center October 2003 – CA Retirement Center – 13 residents sickened, 2 died – “Pre-washed” spinach Produce from all three outbreaks came from California’s Salinas Valley. 4

Dole E. coli Outbreak 23 laboratory-confirmed cases of E. coli O157:H7; 7 epi-linked cases 23 laboratory-confirmed cases of E. coli O157:H7; 7 epi-linked cases Sept. 16 to Sept. 30 onset Sept. 16 to Sept. 30 onset 2 cases of HUS 2 cases of HUS Cases in MN, OR, and WI Cases in MN, OR, and WI Statistically associated with eating Dole pre- packaged lettuce Statistically associated with eating Dole pre- packaged lettuce “Smoking Gun” – found in bag “Smoking Gun” – found in bag

6 FDA – “Adulterated” – 2005 FDA considers “adulterated” any ready to eat crops produced under unsanitary conditions §402(a)(4) of the Food, Drug, and Cosmetic Act FDA considers “adulterated” any ready to eat crops produced under unsanitary conditions §402(a)(4) of the Food, Drug, and Cosmetic Act FDA cited to research linking some or all of the outbreaks to sewage exposure, animal waste, and other contaminated water sources FDA cited to research linking some or all of the outbreaks to sewage exposure, animal waste, and other contaminated water sources “In light of continuing outbreaks associated with fresh and fresh-cut lettuce and other leafy greens, particularly from California, we are issuing this second letter to reiterate our concerns and to strongly encourage firms in your industry to review their current operations.” 6

Wendy’s E. coli Outbreak Utah - June 2006 Utah - June 2006 E. coli O21:H19 – only 4 culture-positive cases, although over 50 cases probable E. coli O21:H19 – only 4 culture-positive cases, although over 50 cases probable 3 HUS, 2 adult women, 1 with 30 days in hospital, the other with 4 months of dialysis 3 HUS, 2 adult women, 1 with 30 days in hospital, the other with 4 months of dialysis Likely lettuce from California Likely lettuce from California 7

Dole E. coli Outbreak 205 persons infected with outbreak strain of E. coli O157:H7 from 26 states 205 persons infected with outbreak strain of E. coli O157:H7 from 26 states 102 hospitalized 102 hospitalized 31 developed HUS 31 developed HUS Five deaths Five deaths

9 E. coli O157:H7 E. coli O157:H7 – Isolated from 13 packages of Dole spinach – “DNA fingerprints” of all 13 match the outbreak strain of ill people – Same strain found on 1 of 4 farms that supplied spinach to a single manufacturing facility on a particular day - cow pies, water source and wild pig gut – Other E. coli strains have now been isolated – human and bags 2006 Dole E. coli Outbreak 9

Taco E. coli Outbreaks At least 150 sickened in 7 States At least 150 sickened in 7 States – Dozens hospitalized – Several HUS cases Two outbreaks separated by a few weeks Two outbreaks separated by a few weeks Different suppliers and growers Different suppliers and growers Lettuce grown in California Lettuce grown in California 10

Peanut Butter Salmonella Outbreak CDC Figures as of June, 2007 CDC Figures as of June, 2007 – 714 culture-positive illnesses from 44 states – 71 hospitalized – Illnesses reported 2005 to late

Peanut Butter Salmonella Outbreak Marler Math Marler Math – CDC estimates that over 30 times the number of confirmed cases are never reported. Likely number of cases from peanut butter: 30 x 714 = 21,420

13 Pot Pies  272 isolates of Salmonella I 4,[5],12:i:- with an indistinguishable genetic fingerprint have been collected from ill persons in 35 states. To date, three of these patients’ pot pies have yielded Salmonella I 4,[5],12:i:- isolates with a genetic fingerprint indistinguishable from the outbreak pattern

14 Hamburger – It’s Back In recalls, ground beef companies have recalled more than 33 million pounds of E. coli O157:H7- contaminated meat In recalls, ground beef companies have recalled more than 33 million pounds of E. coli O157:H7- contaminated meat 15

Outbreaks Linked To Unpasteurized Milk 1994 – 18 ill with E. coli O157:H7 – “pasteurized” milk 1998 – 55 ill with E. coli O157:H7 – “fresh” cheese curds 2001 – 75 ill with Campylobacter – raw milk 2003 – 62 ill with Salmonella – raw milk 2005 – 18 ill with E. coli O157:H7 – raw milk 2006 – 6 ill with E. coli O157:H7 – raw milk 2006 – 27 ill with Campylobacter – raw milk 2006 – 2 ill with Campylobacter – raw milk 16

Civil Litigation - How it Works Strict Liability Strict Liability The only defense is prevention The only defense is prevention Wishful thinking does not help Wishful thinking does not help If you manufacture a product that causes someone to be sick you are going to pay If you manufacture a product that causes someone to be sick you are going to pay 17

What Will a Jury Think? A Jury =12 Consumers 18

Questions? See 19