Food Safety and Bioterrorism: New Turmoil for Established Sciences

Thomas W. Orme, Ph.D

This article discusses food safety by assessing the potential scale, mode and response to bioterrorism, if it were targeted at food that ultimately reaches the American consumer. The author contends that the threat of a terrorist act affecting our food supply is small compared to the threat of natural disasters associated with imports, and very small in comparison to existing foodborne illness problems. Accordingly, a reinvigorated effort to address the greater problems should encompass a solution to the smaller problem.

The Problem

American food is the best in the world. It causes only 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths per year (Mead report: synopsis - http://www.cdc.gov/ncidod/eid/vol5no5/meadG.htm. Full report -http://www.cdc.gov/ncidod/eid/vol5no5/mead.htm#Figure%201. More optimistic follow-ups to this 1999 report have been published: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5115a3.htm.) Stated in another way, only 0.02% of the meals served to Americans are contaminated enough to cause foodborne illness (assuming 282 million Americans eat three meals a day 365 days per year). The average American is poisoned by the food he eats once every two years. Although chemicals such as heavy metals and pesticides receive much media attention as contaminants of food, the predominant cause of foodborne illness is microbial in nature, and the major systems of inspection and control which assure food safety are focused on microbial threats. The U.S. Food and Drug Administration (FDA) lists the major microbial causes of foodborne illness (with some other agents) as the "Bad Bugs."

Actually, the claim that American food is the best in the world is difficult to substantiate, because few countries keep statistics comparable to those published by the Centers for Disease Control and Prevention (CDC). A rough indicator of the magnitude of difference between the United States and a country like India is the World Health Organization (WHO) statistic on deaths due to diarrheal disease - a general indicator of public health control over water quality and food or fecal contamination of what goes into the mouth. In the North American area (including Mexico and Canada) there are 3,000 deaths per year due to diarrheal disease; in India with a somewhat larger, but roughly comparable population, there are 900,000 deaths due to diarrheal disease (The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected by Christopher J. L. Murray (Editor), Alan D. Lopez (Editor), Harvard School of Public Health; ISBN: 0674354486; (Dec. 1996)). India may be the jewel in the crown in some respects, but as far as public health services go, it is light years behind the United States in service and technology.

Until September 11, food security generally meant food abundance or security against famine. Americans have not experienced famine as it occurs in Somalia regularly or as it occurred in Russia and Germany during World War II. With the emergence of bioterrorism as a threat, the term food security has acquired a second definition meaning security against premeditated adulteration by a terrorist or kook. It is important to remember, however, that bioterrorism directed against food is unlikely to lead to famine. Bioterroism at its worst will cause disruption. Disruption with a very big D.

Disruption can be extremely costly in the aggregate and can destroy specific industries. Consider the Chilean grape scare, the BSE crisis in Europe (widely referred to as mad cow disease), or the Alar scare. These food contamination problems, real or imagined, led to a temporary rejection of specific foods by the public with severe losses to the industries involved, but not to general food shortages. Bioterrorism could lead to a temporary rejection of all imported food and a permanent change in procedures for inspecting food imports. By comparison, consider the impact of the World Trade Center attack on airline business - a temporary grounding of all airplanes followed by major permanent changes in procedures and costs.

The problem of a bioterrorism campaign directed against food would not be so acute if America were still the breadbasket of the world. Unfortunately, America is likely to become a net importer of food in the next five years. Hence the vulnerability is not a predisposition to famine, but the prospect that a significant component of the growing $50 billion food import business would come to a halt abruptly in response to a bioterrorist attack. (Citing optimistic projections of sales to China and new foreign markets, the USDA will vigorously deny that America is becoming a net importer of food. An extrapolation of the trend of the past ten years suggests otherwise. The reader is invited to make up her own mind by perusing the statistics presented at http://www.fas.usda.gov/ustrade.html and at http://www.fas.usda.gov/data.html.) The Farm Security and Rural Investment Act of 2002 can be construed (mercifully) as a guard against bioterrorism in this very context of a post-bread-basket trade dynamic. It subsidizes unneeded domestic production to secure the American food supply against a sudden suspension of food imports. The "unfairness" of the Farm Bill is offset by concessions to a plausible security issue. It is as if the U.S. government awarded Microsoft Corporation $70 billion non-competitively to assure that the Windows™ operating system is invulnerable to virus attack. Such an award makes sense in the context of homeland defense and terrorism, but no sense at all in a peaceful world characterized by free trade.

Potential Mode of Delivery and Impact

There are two opinions about the potential impact of bioterrorism on food safety. One school contends that intentional adulteration of food is unlikely and would be an inefficient form of biowarfare because biological agents must be "weaponized." Thus, for example, aerosol delivery would be much more efficient than spot contamination, and the agents of choice would be "weaponized" strains of anthrax or smallpox rather than the "Bad Bugs" associated with foodborne illness. A second school contends that an attack with weaponized microbial agents is unlikely because it would identify an attacking "nation" rather than a terrorist group and would subject that nation to retaliation in kind, a biological MAD (mutually assured destruction) scenario comparable the nuclear MAD scenario, whereas deception is the "preferred" hallmark of bioterrorism involves deception. In my opinion, the most insidious form of deception would be to blur the distinction between an "attack" and a natural disaster. An attack with "Bad Bugs" - small in scale, but big in disruption - is not likely to evoke retaliation and could lead to a diagnostic dilemma. We would not know whether we were being attacked or were suffering from a natural disaster. The most likely vehicle for such an attack with "Bad Bugs" is imported food. It should be remembered that most of our invasive noxious weeds, insect pests, and many of our communicable diseases are imports -unwanted passengers accompanying trade. "Bad Bugs" could be easily added to this list.

Even heightened inspection probably would not prove to be a realistic or sufficient panacea. Currently, approximately 2% of containerized imports and 1% of agricultural imports are inspected. Our transportation system designed to facilitate trade has the undesirable feature of making it difficult in many instances to detect tampered or contaminated food before it reaches U.S. consumers.

Everything we import is hidden in mostly uninspected containers. The Customs Office, the USDA Animal and Plant Health Inspection Service (APHIS) and the USDA Food Safety and Inspection Service (FSIS) are overwhelmed by the magnitude of imports. A verifiable threat B such as BSE in beef - leads to closure of a market - completely. There is no possibility of differentiating between good and bad beef by testing all imported beef for BSE. All beef imports from infected countries have been banned.

Complicating the regulation of imports is the power which has been transferred in recent years to the WTO. This non-American, international authority is now making decisions about what we can and cannot do in regard to trade policy. The U.S.-China WTO Trade Agreement, for instance, is supported enthusiastically by the USDA. It provides a skeleton overview for control of the threats of agricultural trade though phytosanitation rules, but no infrastructure. Accordingly, it is unclear how Customs, USDA and FDA will regulate Chinese agriculture exports to the United States which are likely to carry foot and mouth disease virus, hepatitis virus and a host of fungal contaminants incubated by a slow, warm, moist trans-Pacific crossing. Our connections to European and South American markets have evolved as sophisticated trade partnerships involving international organizations such as WHO and FAO. Those trade partnerships provide scientific oversight designed to protect food. However, NAFTA has strained our capabilities for oversight because of the flood of agricultural goods now coming in from Mexico and Canada. The U.S.-China Trade Agreement will further strain our capacity to monitor imports and exports. In this cauldron of change, the potential for bioterrorism has arisen in a way that cannot be ignored, even if the threat it represents is minor compared with other food safety issues.

The Significance of September 11: The Attack on America.

Because of September 11 we are at war. The 19 Arab terrorists from Saudia Arabia and Egypt killed over 3,000 Americans and their foreign guests in planned attacks on the World Trade Center and the Pentagon. The attacks were coordinated by Osama bin Laden and the al Quaida terrorist network. We will be at war for a long time. If the 20th century was the century of total war, the 21st century is likely to be a century of partial war - suicide bombings, sneak attacks, and random acts of violence against Americans at home and abroad perpetrated by terrorists and kooks. We have responded. Since September 11 we have gone from a nation with a trillion-dollar surplus to one in deficit spending. Our $48 billion increase in the military budget exceeds the combined European budget for defense. The FBI and CIA have made a dramatic shift from the vagaries of Cold War intelligence gathering to a more focused effort to identify terrorist threats. The posthumous award of a visa to terrorist Mohamed Atta indicated stunningly that a top to bottom reorganization of the INS is appropriate. We have responded to the attack on the World Trade Center by al Quaida, and we have responded to a less well understood attack on the Brentwood Post Office involving anthrax bioterrorism. If we are to win the longer war against terrorism B domestic or foreign B we must think now about the efficient utilization of resources. We cannot afford to address bioterrorism the way the CDC addressed the anthrax crisis.

Some response already is underway, of course. For example, in the Defense Appropriations Act enacted this year, $367 million was targeted for biosecurity efforts, including strengthening programs for food safety, pest and animal disease protections and research, and upgrading USDA facilities and operational security. (http://www.cfsan.fda.gov/~dms/secguid.html, http://www.nga.org/nga/legislativeUpdate/1,1169,C_ISSUE_BRIEF%5ED_3316,00.html). Some of these measures may help. Simply throwing more money at the problem, however, is not going to solve the potential for harm.

The Solution

1) We are at war. Food is a strategic material. We must recognize that promoting free trade is incompatible with, or at least antagonistic to, our effort to control food contamination. If we are going to continue with free trade in agriculture and eschew the option of Fortress America, we must rethink our ability to identify and react to food contamination threats of domestic origin and in imports.

2) We cannot solve the problem of imported contaminants and terrorist acts by going from 1-2% inspection of food imports to 100% inspection. We need to enlist the help of our mathematicians to devise an affordable, effective "sampling" algorithm. We need better intelligence about who may be planning to contaminate our food and who among our friends may inadvertently contaminate our food, and we need improved intelligence about disease and pests in foreign countries which can be exported to America before such exports arrive.

3) We need rapid detection methods for microbial contamination of food, and we need to know what to do with the data. We need a device that can identify definitively a single bacterium in less than one minute and can transmit results instantly to computers. We need to redefine what is meant by significant contamination as is being done, for example, in the poultry industry with respect to Salmonella contamination (see, for instance, http://www.fsis.usda.gov/OPHS/salmdata.htm on pathogen reduction and HACCP.)

4) We need to support and upgrade state public health programs. The war we are waging should be fought at both the state and federal levels. State inspectors make far more decisions about food than the federal government does.

Conclusions

Americans experience 76 million cases of food borne illness each year that are severe enough to cause 325,000 hospitalizations and 5,000 deaths. The cause is overwhelmingly microbial contamination of food by the "Bad Bugs." Bioterrorism directed at the food supply is not likely to be a problem of the same magnitude, but it has the potential of being very disruptive, especially to imports. In addressing the terrorist threat to food, the best path is to support and strengthen the established scientists and institutions who are addressing the "conventional" food borne illness problem and to build on a knowledge base that has served us well for 50 years. In particular, we should look to the needs of the state public health services. The invention, discovery and development of new rapid detection methods for identifying food contaminants deserves "Manhattan Project" status. Branches of the federal government - CDC, Customs, State Department, CIA, FBI, Department of Defense, FEMA, USDA and FDA - have leading roles to play in the battle against bioterrorism, but the front line is at the state level. We should avoid "federalizing" the response to bioterrorism.

Resources available on the Internet

Thomas W. Orme, Ph.D, is an expert in food safety and other toxicological issues. He is president of the Thomas and Evelyn Orme Learning Center at Grandale Farm and consults on toxicology and related issues. He can be contacted at Orme_T@mediasoft.net.