Editor's note: This is part of the four-part coverage of the 2006 E. coli spinach outbreak.
 
 
In an unusually moving moment from the October 2006 Produce Marketing Association Fresh Summit, PMA CEO Bryan Silbermann talked to the audience in his State of the Industry address about the recent deaths linked to E. coli on spinach, and the effect of the tragedy on the industry.
 
He asked the industry to grieve for victims of the outbreak as if they were from their own families.
 
“Any loss of life, any suffering from illness caused by fresh produce product is one too many,” Silbermann said. “Our aim must be zero illness because the public will judge us based on their perception, not ours.”
 
Showing a picture of Kyle Allgood, a two-year old who died in the outbreak, Silbermann concluded his address by saying “Never again, Never ever again.”
 
That shared industry conviction to do more about produce safety gave birth to many initiatives, including the California and Arizona Leafy Greens Marketing Agreements, the Produce Traceability Initiative, the Center for Produce Safety, numerous commodity specific produce guides and, by early 2007, the industry’s acceptance of federal food safety oversight.
 
“Never again” was and still is the aspiration of the industry, but according to the Centers for Disease Control and Prevention, there have been a number of produce-related outbreaks since 2006. By far the most deadly was a 2011 multi-state listeria outbreak linked to Jensen Farms cantaloupe, which sickened 147 and killed 33.
 
Both the industry and government have changed in the past 10 years. According to a Food and Drug Administration statement, before August 2011, the agency would assemble a response team after identifying an outbreak. Those staff members would go back to their usual jobs once the response was over.
 
Today, the agency has five full-time groups that work on various aspects of outbreak investigations from signals, to response and post-response activities. 
 
These groups are a result of the creation of CORE, the Coordinated Outbreak Response and Evaluation Network. CORE brought together a full-time team with expertise in medicine, public health, veterinary medicine, environmental health, microbiology and public policy, according to the FDA. The group looks for potential outbreaks in the U.S., investigating them, and developing policies and guidance to prevent future outbreaks. 
 
“This new structure speeds the response, ensures continuity, and standardizes processes,” according to the FDA. CORE includes a network that with resources in the agency, the federal government and state and local partner agencies.
 
Inside the agency, the network consists of the Office of Crisis Management, the Office of External Relations; experts at the Center for Food Safety and Applied Nutrition and the Center for Veterinary Medicine, staff from Office of Regulatory Affairs, and the Office of International Programs.
 
The 2006 spinach outbreak would play out much differently if it happened today, said Jim Gorny, Produce Marketing Association vice president of food safety and technology.
 
There is a lot of awareness of food safety on the production side from grower-shippers and the processors, and that would lower the probability of an outbreak, he said.
 
Beyond that, federal and state regulatory agencies are much better prepared than in 2006. The FDA’s rapid response team is in place and California and federal health officials train and work together to respond to foodborne illness outbreaks.
 
With state and federal emergency response teams, health officials are better prepared and know what to expect and how to sample on farms. Better tools, such as whole genome sequencing, would also help.
 
“I think it would play out a lot faster and a lot quicker with a lot less damage,” Gorny said.
 
Tom Stenzel, president and CEO of the United Fresh Produce Association, said that there is no question the FDA is better able to trace contamination of the food supply quicker.
 
“Whole genome sequence is going to allow us to see where the pathogen came from,” Stenzel said.
 
The produce safety law won’t preclude foodborne illnesses but should limit the number of people affected.
 
“The public expects zero risk but it is not possible, so I think it will be a challenge for us going forward.”
 
 
Then and now
 
Technology played a role in breaking the investigation in 2006, said Bob Brackett, vice president and director of the Institute for Food Safety and Health at the Illinois Institute of Technology.
 
“If that outbreak had occurred five or ten years earlier, we probably would have never seen it,” he said. “Because of the ability of PulseNet and the Internet to link the cases from around the country into a pattern, we were able to identify that,” he said. PulseNet, operated by the Centers for Disease Control and Prevention, compares the DNA fingerprints of bacteria from patients to find clusters of disease.
 
The technology of 2016 is even more advanced, Brackett said.
 
“Now today it has even gotten more sophisticated with whole genome sequencing, where FDA or states could identify not just whole batches but the exact genetic fingerprint from a piece of produce and link it to just one case,” he said.
 
Brackett said investigators can truly get a smoking gun now.
 
“An example would be that there is a specific genetic strain of salmonella and they identified in a patient and also identified in a sample from the packing shed. They can assume it came from a packing shed — it is not foolproof but it sure is powerful.”
 
 
Traceability and detective work
 
The Produce Traceability Initiative provides a shared industry approach to traceability, but it is not used by all.
 
Gorny said that FDA officials believe there is tremendous ability to trace produce from the farm level to the distribution center. However, traceability capabilities can fall apart when the product gets to the distribution center.
 
“We really don’t know where it goes forward from there, in the retail distribution chain or in the food service distribution chain,” Gorny said. That, he said, is because PTI traceability is typically down to the pallet level right now.
 
”You can go to the case level, but it isn’t tracked to individual stores or restaurants,” he said. 
 
Gorny said the bigger issue related to foodborne outbreaks is the epidemiology.
 
“That’s the slow part,” what the CORE group does is they look for emerging issue and epidemiology from states and the CDC. “That’s really the slow part yet is trying to identify what the likely food vehicle was,” he said. “That’s was really part of the issue with the 2006 spinach outbreak,” he said.
 
“They thought it was spinach from talking to people and doing all that gumshoe detective work, they said it was spinach and they were correct, but they didn’t know what type of spinach,” she said. “They didn’t know if was fresh-cut, whether bunched or frozen. Spinach was just taken off every menu in the U.S.”
 
While the 2006 E. coli spinach outbreak was an industry issue, Tim York, CEO of Salinas, Calif.-based Markon Cooperative, said the damage from an outbreak today would be more targeted.
 
“We are in a much better position as an industry now, number one around traceability and number two, around being able to specify the (food safety practices) we have,” he said.
 
That means an outbreak would be “owned” by an individual grower rather than the entire industry, he said.