Like a lot of other Americans, journalist Nicols Fox, a former editor at the Washington Journalism Review and a correspondent for The Economist, first heard about the deadly E. coli O157:H7 bacteria in 1993. That was the year it attacked a group of Northwestern children, all of whom had eaten hamburgers at area Jack in the Box restaurants. Four of them died.
Nicols Fox, a "reluctant vegetarian," gave up hamburger first because E. coli contamination can easily spread throughout the meat.
Originally an art critic, Fox found herself increasingly drawn into the E. coli case. “At first I thought Jack in the Box was just an anomaly,” she says, “but after checking with the Centers for Disease Control, I found that it wasn't just isolated on the west coast—it was happening all over. Here was a fascinating story, a new bacterium that had somehow gotten into the food supply. Finding out how that happened became my obsession.”
With the writing of her 1997 book, Spoiled: The Dangerous Truth About a Food Chain Gone Haywire (Penguin), Fox answered her questions about E. coli, but she also looked at other frightening pathogens that have invaded our food supply. These include Salmonella and Campylobacter, both of which have become almost omnipresent in poultry; and “mad cow” disease, which has invaded British beef and killed a dozen people in England (see the cover story, this issue).
Fox is convinced that we can get these dangerous contaminants out of our food supply, and that Sweden's model programs of scrupulous cleaning and disinfecting show how it can be done. “Over here we're trying to deal with the problem through meat irradiation and other solutions, instead of attacking it at its source,” says Fox. “We know what factors in chicken rearing, for instance, are responsible for Salmonella outbreaks. Some reforms have been made but, unfortunately, the U.S. Department of Agriculture (USDA) doesn't have the authority to order sweeping changes.”
Fox, who lives in rural Maine, is working on a new book, It Was Probably Something You Ate: A Practical Guide to Avoiding and Surviving Food-Borne Disease.
E: Spoiled is a very scary book about the ways in which modern agricultural and factory farming methods have left us with a food system that is dangerously contaminated. Maybe you could start with an overview of what you found.
Fox: First of all, I found that it was really very complicated. Why are we having all of these cases of food-borne illness? The answer lies in modern processing and factory farming. They both contribute, but the consumer also has a hand in it as well. There are many factors. We have changed our entire relationship to food. We've changed how we produce it, how we process it, how we distribute it. We've also changed what we cook, how we cook it, and how we buy it.
For instance, consumers want fresh fruits and vegetables all year-round. That means the produce has to come from all over the world, and it does. If you go to your local supermarket, the fruits and vegetables may come from 26 different countries. Every time we consume that produce, we are actually consuming the environment in which those foods were produced. We are consuming the quality of the water and the soil, and the sanitary conditions of the people who pick and pack them.
One of the things that scared me most was what you wrote about meat. You describe an incredible amount of contamination in, for instance, poultry. You say that 99 percent of chickens were found by the USDA in a sample to be contaminated with generic E. coli bacteria, indicating fecal contamination. And one E. coli O157:H7-infected cow can contaminate 16 tons of hamburger. Also, 72 percent of chickens in one study were found to be contaminated with Salmonella. If 99 percent of chickens are contaminated with generic E. coli, and 72 percent infected with Salmonella, how dangerous is that to people, assuming they buy chicken at the supermarket and they cook it properly? It puts an incredible onus on the cooking process.
It certainly does. Cooking can kill these microbes and render the food safe for you to eat, but there's also a danger that you will cross-contaminate other things in the kitchen. Take chicken, for instance. Virtually all of the chickens we buy are contaminated with something called Campylobacter, which you may have never heard of. Yet it is the most frequent cause of diarrheal disease in most parts of this country. If we are cooking our chicken thoroughly, why are so many people getting sick? Some studies have shown that the person most likely to become sick is the person preparing the chicken, because it's on their hands—it may also get on the counters, on the cutting boards, etcetera. You have to be very careful not to transfer the bacteria that are on these products into things that you are going to eat without cooking, like salad ingredients.
You note that when cooking hamburgers on the grill, you have to be careful not to put the cooked hamburgers on the platter that also held the uncooked hamburgers. You can re-contaminate the meat that way.
That's exactly right. Anything that you have touched with that uncooked meat product should be washed before it touches a cooked meat product, and that would be something like a spatula. People don't even think of that. There are actually cases where people have become seriously ill because of the spatula that was used to transfer an uncooked, then a cooked burger. To me it is really asking the consumer to operate a kind of biohazard lab, and that's too complicated for me. I just stopped bringing meat into the kitchen.
You're what you call a “reluctant” vegetarian.
I'm sad to say that, really, I've always enjoyed meat in my diet. The first thing I gave up was hamburger. I think I wouldn't have been so concerned about it if it were something I'd ground myself. But hamburger now is mass produced in places like Iowa or Nebraska from all the scraps left over from cutting meat. As you've already pointed out, one contaminated cow can contaminate a significant amount of meat, because hamburger may contain a hundred different animals from four different countries. Some of these animals may be dairy cattle carrying infections.
You're essentially saying what Oprah Winfrey said. Would you go so far as to recommend that people not eat hamburger?
I think everyone has to make their own decision. If you really are a hamburger fanatic and are so unwise as to want to eat it rare, then you probably ought to go to the grocery store, buy a chuck steak and bring it home. Grind it up yourself in your own clean grinder, which you make sure to wash thoroughly afterwards. I know that's a lot of trouble, but when I say that, I'm surprised at the number of people who say, 'My grandmother used to do that.' I think that we've become very complacent about our food. We don't want to give it any time or attention, and we put it so low on our scale of values. It's really become no more than a refueling process.
One of the implications of what you're saying is that you are not necessarily safe if you're a vegetarian. Vegetables and fruits are easily contaminated. If you buy, say, a commercial salad in a supermarket packaged in a bag, I imagine it is very easy for that salad to become contaminated.
Well, yes. We have t
o ask, what was this lettuce washed in? Who cut it up for us? I think it's ironic that we turned a lot of food safety activity over to the lowest-paid workers in our entire economy. Some of those salad bags come labeled “triple washed” and the implication is clearly that these foods are ready for the salad bowl. And yet, I took a bag of that “triple-washed” lettuce, washed it and found about a tablespoon of dirt in the bottom of the pan. Not enough consumers are aware that just about everything you eat needs to be washed, and even that's not a guarantee. But I have to go back and say that you are more likely to confront these disease-causing microorganisms on animal products, which are contaminated by animal waste. Fecal matter gets onto the meat during slaughter, and there are various things that occur in processing that can exacerbate it. Vegetables are less likely to be contaminated with animal waste, but it can happen.
Let's talk about Salmonella and eggs a little bit. You wrote that cooking eggs the ways millions of Americans like them, sunny side up, for instance, doesn't necessarily kill Salmonella.
"I think we have become complacent about our food," Fox says. "It's really become no more than a refueling process."1997 Robin Bowman/People Weekly
That's right. These were tests carried out in England. What has happened to the egg is nothing less than a tragedy, because the egg is such a versatile food. I was looking in my master French cook book and found 123 main course dishes that contained egg. If you cooked them the way we are now directed to cook them, there would only be 23 of those dishes left, an 83 percent decline. In these English tests, they inoculated eggs with Salmonella and then checked to see how hard they had to be before the Salmonella died. And they found that only scrambling them quickly at a very high heat, boiling them for nine minutes or longer, or frying them until the yolk solidified was enough. When the Minnesota Public Health Department did a survey of people who had Salmonella infections, the great majority of them had eaten undercooked eggs, just in the ordinary way many of us had: Sunny side up, poached or something like that.
How could we effectively rid ourselves of Salmonella contamination?
I eat organic eggs from a small producer in Massachusetts. They are fed grain, not the kind of chicken feed that may contain ground-up chickens and animal protein which may contain bacteria. The chickens go outside. And they don't get antibiotics, which is another factor in stressing these birds. Most importantly, though, these birds are tested three times in their life for Salmonella and the tests have come up negative.
Most eggs in the United States are raised in factory operations where you have something like 70,000 birds in a huge hen house. How do we mainstream the kind of conditions you're talking about?
We'd have to change the way we're producing eggs, because all of the factors in intensive production have contributed in one way or another. For instance, we breed chickens for producing eggs on a very regular basis—we select for the best producers. So if you go into a commercial hen house, all the chickens are actually like clones, as close as you can get without actually cloning them. This means that they're all identically susceptible to disease. The feed that they get may well be contaminated; it often is. They are fed antiobiotics, which not only selects for certain bacterial strains, it seems to lead to antibiotic resistance in these strains. Rats and mice may get in the house and run on the conveyer belts that feed these birds and then take away their eggs. They may run from house to house so that disease may spread between the houses. The water may be dirty. All of these factors are going to contribute to the birds being susceptible to certain diseases, and in one way or another they can pass them on to us.
Unfortunately, what I see facing the world is an imperative to produce food intensively because of population increases. The U.S. is likely to double its population by 2100. Many countries have doubled or tripled their populations very recently. Just to keep up with feeding people, some observers say we more or less have to go with intensive crop management, using a lot of pesticides and intensive animal agriculture.
That's operating on the assumption that the only way we can produce this amount of food is through intensive farming, and I don't believe that is necessarily true. Organic farmers are not finding that it is as difficult as it originally was thought to produce high-quality, high-yield food in a competitive situation.
I think we also need to look closely at the things that are making disease worse. For instance, we might have more of a variety in chickens in these houses. We might have smaller houses, and more of them. We might not have them connected with conveyer belts, which can spread disease. The houses should certainly be kept clean, and the animals need clean food and water—that's only common sense.
We in the United States have the cheapest food in the world, and that's been a matter of USDA policy. We need to look again at that policy and see whether it is truly helpful to us as a nation. It may be resulting in more food-borne disease, which just shifts the true cost elsewhere. That's not to say that more expensive food is always safer, because it certainly isn't. Look at the people who got sick from expensive imported raspberries. There are many factors creating this increase in food-borne disease. We just need to take a saner approach.