Most experts agree that the meat supply in America is safer than ever before. But since the Jack in the Box E. coli outbreak in 1993, Americans are increasingly aware of the possibility that dangerous pathogens may be lurking in their food. So how prevalent is food-borne illness and contaminated meat? And what can American consumers do to eat more safely? Here are some answers from former U.S. secretary of agriculture Dan Glickman, Dr. Robert Tauxe of the Centers for Disease Control, Patrick Boyle of the American Meat Institute, consumer advocate Carol Tucker Foreman, epidemiologist Dr. Glenn Morris, and journalists Michael Pollan and Eric Schlosser.

How Safe Is America's Meat Supply?

U.S. Secretary of Agriculture, 1995-2001

How safe is meat today?

Meat and poultry is safe. It's safer than it's probably ever been. I think it could probably be made even safer. But it's probably the safest thing we eat, because it's inspected, whereas seafood is not really inspected in this country, and fresh vegetables and fresh fruits are not really inspected. A lot of imported food is not really inspected. At least meat and poultry is largely inspected. ...

[The] big picture [is]: Food is pretty safe in this country. I mean, any evidence of food-borne pathogens is bad. And [if] anybody gets sick and [dies], [it] is a national tragedy. But, by and large, we have a pretty close to an incident-free society in America, from the aggregate perspective. ... There are still a significant amount of food-borne illnesses, too many. But, from a big picture perspective, we do not have a national epidemic of food-borne illness in this country ... . Saying that, it could be a hell of a lot safer.

Chief, food-borne and diarrheal diseases branch of the Centers for Disease Control

How safe is our meat supply?

Our food supply is a lot safer than it was 100 years ago, but food-borne disease remains an important public health problem. We estimate that there are 76 million cases a year -- about one in three or one in four Americans have an important food-borne disease every year. Much of it goes undiagnosed, because people stay home for two or three days, or miss a couple of days of work or school, but they don't see a doctor. ...

Let's look back over 30, 40, 50 years. Has there been a trend in terms of food-borne illness?

The one food-borne illness we have the longest run of information on is salmonella; collection of salmonella reports began in the 1940s. At the beginning, there were a very small number of reports, but those increased in the 1950s, and in the 1960s, and in the 1970s. They continued to go up and up until about 1990. In 1990 and thereafter, salmonella began to level off. And in the last five years or so, it actually seems to be decreasing.

We don't have as good information for other food-borne infections. But we know that several other food-borne infections, like campylobacter and listeria, have also appeared to decrease slightly in the last few years. These modest decreases are a lot better than the regular increases we're used to be seeing. But we've set targets for where we want to be in 2010, and food-borne disease is not decreasing fast enough to get us there. ...

CEO of the American Meat Institute

If you look at USDA figures -- and I'm not attempting to minimize the food-safety challenge -- but if you look at USDA figures, the incidence of E. coli in beef is less than 1 percent. We obviously want it to get to zero out of every 100 tests. But today it's less than 1 percent. That's a reduction from as recently as the mid-1990s. So that's progress. And the progress is attributable to the investments in new technologies that we've implemented in our plan. ...

We've seen the salmonella rates going up from the 1940s, 1950s, 1960s, up to the 1990s. We've seen the E. coli and the damage that it's done. Those are probably two of the most obvious health effects [of the consolidation of the meat industry]. And there are very high levels of food-borne illness. One in four Americans sickened some time during the year with food-borne illness, 25 percent to 30 percent of those estimated to be from meat; 5,000 deaths. Those are high.

You mentioned two pathogenic bacteria, E. coli O157:H7, and salmonella. In terms of the meat and poultry supply, we began testing for E. coli O157:H7 in the early 1990s, both industry and individual companies, as well as the federal government as part of the inspection program. If you look at their data, the incidence of E. coli in all ground beef has decreased from the early 1990s to the late 1990s. If you look at government data on salmonella in raw meat and poultry products, it has decreased dramatically throughout the 1990s. [According to] the public health data from the Centers for Disease Control ... the incidence of salmonellosis, which is the disease attributed to salmonella, has remained relatively stable, although it's decreased somewhat, even though we've had a dramatic decrease in the amount of salmonella on raw meat and poultry products. ... Salmonella [on] raw meat, down dramatically this decade. Salmonellosis as a food-borne illness, down somewhat. Those are good trend lines.E. coli O157:H7 in ground beef, down significantly in this decade. The incidence of E. coli-related illness probably about stable, which suggests that just reducing or eliminating pathogens on raw meat and poultry products, in and of itself, is not really going to have the kind of public health impact that we would hope. There are other factors at work. There are other sources that enter the food supply, ones which we come in contact through nonfood sources that cause public health illness in the United States. ...

We've made significant reductions in the presence of salmonella in raw beef, in the presence of E. coli in ground beef. We're not to zero yet, but the trend lines are very positive. And they're a direct result of the investments that we've made in achieving and implementing a much more sophisticated process in the beef industry. ...

How does the consumer know what is safe meat or not?

What the consumer should know is that the beef industry has made demonstrable progress in achieving significant reductions in all bacteria on raw beef products, pathogenic and nonpathogenic. That progress is quantified and confirmed by ongoing USDA tests. And we continue to invest millions of dollars in making further improvements in the safety and the wholesomeness of our beef products. ...

For the consumer, I would suggest that there is still a responsibility, even with all this improvement, to handle the food in a proper manner. And that means, cooking it properly; keeping it chilled before you cook it; store it properly. It is a safe and wholesome food supply, but it is not a zero-risk supply. And there are some responsibilities at the end of the process that still exist, and frankly probably always will exist.

His New York Times Magazine article "Power Steer" (March 31, 2002) traces the life of a cow destined for slaughter

When the animals arrive at the meatpacking plant from their homes on the feedlot, they're carrying quite a bit of manure. They've been sleeping in it and resting in it, so their bodies are caked with it. They are then, of course, passing through that door on their way to becoming food. So you need to make sure that you remove their hides in such a way that you get all of the manure, and none of it ends up on the meat. And a great deal of the effort, which is now 99.9 percent of the time successful, is essentially keeping the manure out of the meat. But it doesn't; it's not a perfect system. And it's bound to happen, and does happen.

The problem is that that manure is particularly lethal, because it contains now certain microbes like E. coli O157 is a strain of a common intestinal bacteria which is now very common in the manure of feedlot animals. It's principally a feedlot microbe. And if we ingest only 10 of those bacteria, they can kill us, because they release this lethal toxin. The great problems that you've read about of contaminated hamburgers and the Jack in the Box episode from several years ago, are a result of this particular pathogen.

The story of this pathogen really illustrates the ecological links between the health of these animals and the health of us. I was surprised to learn that E. coli O157 is relatively new -- it wasn't isolated until the early 1980s -- and that it essentially doesn't exist in the gut of animals that eat grass. It is a problem associated with feeding animals corn.

And here's how it works. The rumen, which is not an acidic environment normally, becomes acidic when it's fed corn. These [E. coli] bacteria evolved to be able to withstand the acid of the rumen. So they are acid-tolerant bacteria. Therefore, when they get into our guts -- through the manure, onto the carcass of the animal, into the hamburger -- they can survive our digestive processes; whereas in the past, if you had an equally lethal microbe resident in the gut of a cow, it probably was not acid-tolerant, since it didn't live in such an environment, so our stomachs gave it a gastric shock. ... All the acids in our stomach would just kill it off. This is one of the protections built into the food chain that we've messed with by acidifying the guts of these animals. ...The industry's response -- and the industry is working very hard to keep the meat clean, there's no question about it -- is a series of high-tech solutions, such as sprays. There's a spray based on milk, made from milk, that seems to kill it. They have these steam cabinets that they pass the meat through -- bags of hot water. This kills a lot of the bacteria, or most of the bacteria. And now irradiating it. This is why we want to irradiate meat. Make no mistake, the need to irradiate meat is because there is a certain amount of manure in the meat. So the idea is to kill the microbes in the manure rather than keep the manure out, which they're trying to do also. But better to kill it after; it's easier and cheaper.

There is, it turns out, a much simpler solution. There is research that's been done that shows simply by putting cows on grass or hay for the last several days of their life, the E. coli population in their gut plummets by as much as 80 percent because, again, they can't tolerate the change in the pH in the stomach. A scientist, a very well-respected researcher at Cornell named James Russell, has proposed this in a series of articles. But as far as I can tell, the industry doesn't want to hear about it. It would just be too cumbersome to bring all that hay into a feedlot. They would lose gain; they would lose pounds at the end, switching them to hay, because they don't grow as fast. ... It's King Corn. King Corn runs the American cattle business. And this is considered an anti-corn message. So this research, as far as I can see, has fallen largely on deaf ears.

Director of the Food Policy Institute at Consumer Federation of America

Are you concerned about the safety of the meat supply?

I am concerned about the safety of the meat supply. People like to say Americans have the safest food in the world. The evidence is that it's not safe enough. We have 5,000 deaths a year attributed to food poisoning from common bacteria. Many of these are traced to meat and poultry. I'd say that's not acceptable. ...

None of us really know how safe the meat supply is. ... We know people get sick from cross-contamination that comes from contaminated meat. And they get sick from meat that hasn't been cooked enough to kill the bacteria. We know that people get listeriosis from meat that is packaged and cooked and says "ready to eat" on it. We know that people get sick from campylobacter in chickens. So the meat supply may be safer than it was 10 years ago, but it sure isn't safe enough. ...

We talk about a high level of food-borne illness, and even of deaths related to food-borne illness. But you're not hearing on the news about large outbreaks. Where are the victims of food-borne illness?

Well, I know about them. The Chicago Tribune ran a four-part series a couple of months ago about children who'd been made ill by contaminated food in school lunches over a period of several years in Chicago. Three years ago you had the Sizzler E.coli 0157:H7 outbreak, where contaminated meat dripped on fresh vegetables and one person died and a number were made ill. There was the Ball Park Franks listeria outbreak three years ago, where 16 people died, and five women had babies that were born dead, because it was fatal for fetuses. Those were really played rather prominently in the news media ....

Professor and chairman of the department of epidemiology and preventive medicine at the University of Maryland Medical School

People talk about pathogens and microorganisms. What do they mean?

Most of the bacteria in the world are relatively innocuous so far as we humans are concerned. They cover our skin, they fill up our intestinal tract. They generally don't do us any harm. However, there are certain bacteria that, because of certain genetic capabilities or the ways in which they have evolved, have the ability to cause disease. Those are the ones we call pathogens. We say they're "pathogenic," they cause disease in humans.

The ones we worry about most, in terms of the meat industry would be salmonella, campylobacter and E. coli O157:H7. E. coli O157:H7 tends to be a particular problem in terms of red meat, particularly hamburger.

Anywhere from 1-3 percent of cattle may be carrying E. coli O157:H7 in their intestinal tract. If great care is taken when the cow is slaughtered, there shouldn't be a problem. But even when care is taken, sometimes there's the opportunity for contamination from bacteria that are present in the intestinal tract getting onto the meat.

What about listeria?

Listeria is actually more of a problem for prepared meats. Salmonella, campylobacter, and E. coli 0157:H7 live in the intestinal tract of animals, and consequently, they tend to get on meat or chicken during the slaughter process. In contrast, listeria is an environmental microorganism. It lives in plants. It lives in water droplets on the ceiling and in the drains on the floor. It tends to cause problems in processing plants where foods come through that are not subsequently re-cooked. For example, deli meats or hot dogs, or cheeses that are not pasteurized.

Describe E. coli.

E. coli is a very common bacterial species. It's one of the most common bacteria in your intestinal tract. However, there's certain groups of E. coli, a certain subset of E. coli that carries some genes that make it particularly nasty. Most of these strains fall under a group that we call E. coli O157:H7.

What's nasty about it?

They are particularly nasty because they produce certain types of toxins that can cause pretty bad things to happen in humans. It can cause kidney failure, it can do bad things to your red blood cells. If you get infected with E. coli O157:H7, there is a possibility that you could develop what we call hemolytic uremic syndrome, which can be, in some instances, a fatal illness.

Tracking Food-borne Illness

Chief, food-borne and diarrheal diseases branch of the Centers for Disease Control

How do you know how many people get ill? Is it an easy thing to measure?

We've had some important improvements in our ability to measure food-borne disease. The CDC has set up something called FoodNet, which is in several areas around the country. We count all the food-borne diseases that are diagnosed in hospitals, and we interview people at random to see how often they're sick and how often they visit a doctor. We also check whether the doctor gets a sample that might allow the illness to be diagnosed. Using those interviews, and using the information we get from the laboratories, we make our estimates more precise than they were before.

But there are a lot of different food-borne diseases, and that makes for a problem in trying to count a lot of different kinds of infections. Some infections, like salmonella or E. coli O157 are regularly monitored by the public health departments. Other infections, like some common virus infections, are not counted by public health departments. ...

How does PulseNet work?

PulseNet is a network of all the state public health laboratories around the country, which are now fingerprinting E. coli O157 and other food-borne bacteria on a routine basis. There are a lot of different fingerprints for E. coli O157, and usually no two will match in a given period of time.

But if a state public health department sees a whole string of cases where the fingerprints match, or if we at CDC learn of cases in different states that all have the same matching fingerprint, that suggests to us that those people have something in common. Our investigations then focus on those people, and try[ing] to find out what they had in common. Using fingerprinting allows us to sharpen our analytic pencils. We can point to cases that must be related, and others that are not related. By equipping all of the state public health laboratories with this technology, they compare what they find through the Internet. They can find clusters of E. coli infections that have matching fingerprints in people who may be in 22 different states.

Because of PulseNet, we're able to identify outbreaks sooner than we used to. And we're able to identify a new category of outbreaks that we never would have identified before. ...

What Can Be Done?

Food safety expert hired by Jack in the Box after the E. coli outbreak of 1993

[For the average person out there, how do they know whether they're buying safe meat or not?]

[Consumers] can do the same things we do [at Jack in the Box]: make sure the products they get are fresh, look good, are cold, not discolored or things like that; keep them refrigerated and cold; follow shelf life information, coded information. And then when you cook them and prepare them, make sure you wash and sanitize your hands. Clean your utensils. ... Ground beef should not be served medium rare or rare. Juices should run clear. Internal temperatures should be over 155. ... Rare hamburgers need to be a thing of the past.

Why is it a thing of the past? What's changed that makes it impossible or unsafe to have a rare hamburger?

Today we know that there are pathogens in these products that can cause illness, injury, and even, conceivably, death. ... There's a number of bacteria that can be present, and no testing program in the world today can guarantee that there's none in there. That's just not possible. A testing program can make sure that if it's there, it's at a very low, manageable level. But what can a consumer do to make sure that they're not exposed to that? By thoroughly cooking [meat], all those bacteria are killed, and that hazard or that risk is controlled. And that's why it has to be done. ...

CEO of the American Meat Institute

Part of the challenge is that there are only two technologies available today that we know in the industry can guarantee that the ground beef is pathogen-free, E. coli-free, bacteria-free. One is to cook the product. We sell a lot of precooked ground beef out of our plants. But most of the ground beef in America is cooked in restaurants or in our own kitchen. That is one technology, one step that is available, sure-fire. ... The other technology would be irradiation. Some companies are irradiating raw ground beef; some have yet to embrace the technology. Some consumers and retailers -- and frankly, some beef companies -- are concerned about the market response to that technology. But today there are only two steps or technologies that we know will eliminate the E. coli in beef. And that's cooking it properly when we handle the food; or irradiating it before we purchase the food.

Chief, food-borne and diarrheal diseases branch of the Centers for Disease Control

What do you do differently when you go to the grocery store to buy your meat?

There are a number of things that the concerned consumer can do. One is to look for evidence in a restaurant or a grocery store that the people who work there have been trained in food safety. I'd rather buy my meat from people who understand the basic principles of food safety. The meat I buy is probably no different than the meat that lots of people buy. But I bag it separately, and I handle it carefully, and I cook it thoroughly.

Do you cook your burgers really well done?

Yes, I do. And sometimes I even buy precooked burgers. We don't yet have irradiated ground beef for sale in this part of the country, but it is for sale in other parts of the country. If it were available, I would buy that.

You support the irradiation of meat?

I think irradiation of ground beef and of other high-risk meats is going to be a really important public health tool, just like the pasteurization of milk has been. The irradiation process that's used for meats does not induce any radioactivity in the meat. It doesn't introduce any important changes in the meat at all, except that it kills the bacteria that might be present. So I'm not concerned about the safety of the meat after it's been irradiated.

Author, Fast Food Nation

I don't think there have been any large-scale epidemiological studies of people eating irradiated meat over long, long periods of time. I hope irradiated meat is safe, and it very well may be. But before you start irradiating the meat, I think the meatpacking industry should be cleaning up its plants, because if you just start irradiating the meat, you're allowing them to essentially irradiate the feces on the meat.

So there's two questions. Firstly, should we be selling and buying irradiated meat? I think that's up to the consumer, ultimately. But the second point is, this irradiated meat should be clearly and unmistakably labeled as irradiated meat. And the industry has tried very, very hard to avoid that and to come up with all kinds of euphemisms for what's happening to the meat and what's in the meat.

There are many companies right now that are producing very clean ground beef without irradiation. And my fear about irradiation is it'll be a perfect excuse for this industry not to clean up its act in the way that it really needs to. ... Right now, there are meatpacking companies who are doing a very good job at producing clean meat. And there are companies that are doing a very bad job. Irradiation levels the playing field. In a way, it punishes the companies who are spending the extra money, doing the testing in order to do things right.

I think irradiation is a way for this industry not to be forced to clean up its act. I don't think we should introduce something that helps the sloppiest companies compete against the really good companies.

Because ultimately you're sanitizing fecal material?

Well, when you're irradiating meat, you're irradiating it and everything on it, including the fecal material. I would prefer to have meat without fecal material, as opposed to meat with irradiated fecal material. ...

The meat industry says that meat should not be labeled "irradiated," it should be called "cold pasteurization." What does that mean? Why not "irradiation"?

I think that they're trying to avoid revealing what's actually been done to the meat. "Cold pasteurization" is a phrase that's been invented to cover up the fact that this meat has been irradiated. And, I think much more important, is if they're going to irradiate the meat, they should openly reveal that's what they're doing to it so that consumers can decide if they want to eat it or not.

U.S. Secretary of Agriculture, 1995-2001

The industry says that what we need to be doing in terms of food safety is that the consumer needs to be cooking the product better, and we also should be using more irradiation. Do you think that that's an adequate response?

It's a part of a response, it's not a complete response. It reminds me, H. L. Mencken once said, for every complicated problem, there is a simple and a wrong solution. Well, washing your hands is great, it's important, and we could eliminate a lot of food-borne illnesses if people washed their hands and cooked their food better. Irradiation has a place, but it's certainly not an exclusive way of making food safe. ... We've found that irradiation can in fact be a positive factor in certain kinds of foods. It's quite expensive, some foods are more suitable for it than others, [but] you can't have irradiation in every food establishment in America. So it is no magic answer. It's not the cure-all, [but] it's part of the answer. ...

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