Minnesota's public health investigators are widely regarded as the best in the country when it comes to tracking foodborne diseases. Now there are plans to take the state's disease detection model nationwide.
Sen. Amy Klobuchar says she will introduce a bill in Congress that would draw on the state's experience to speed up the national response to foodborne illnesses.
In two nationwide disease outbreaks last year, salmonella sickened people in other states for months before the first cases appeared in Minnesota. Sen. Klobuchar says once those cases came to light, state health officials raced into action and within weeks figured out the sources of the contamination. "Now, with all due respect to the exemplary work of our Minnesota public health officials, the nation should not have to wait until someone gets sick in Minnesota to solve these national food outbreaks," she said.
Part of the problem is that there is tremendous variation in foodborne disease investigation from state to state. Minnesota places a priority on its surveillance and dedicates a lot of resources to it.
For example, the state's public health laboratory does DNA fingerprinting on every salmonella sample that it receives, so officials can determine whether multiple illnesses are caused by the same bug.
“The nation should not have to wait until someone gets sick in Minnesota to solve these national food outbreaks.”Sen. Amy Klobuchar
The Health Department also hires University of Minnesota public health graduate students, who track down every sick person as soon as possible to find out what they ate or touched. These student investigators are known as Team D, which is short for "Team Diarrhea."
"We interview all the cases that are reported to us, all the salmonella cases, all the e-coli 157 cases, with a very detailed questionnaire," said Calota Medus, an epidemiologist at the Minnesota Department of Health who supervises Team D. "And quite often we call people back with additional questions and we do this very rapidly."
Medus says other states don't interview all their salmonella cases, and when they do talk to patients, many states just use a short questionnaire form that might not reveal all of the patient's potential exposures to the disease.
Klobuchar's bill asks the Centers for Disease Control and Prevention to promote thorough disease investigation practices like those used in Minnesota.
The legislation also creates regional "Food Safety Centers of Excellence" that would be located at top higher education institutions across the country. Craig Hedberg, an early architect of Team D, says public health officials across the nation should tap the expertise in their area.
"The idea of having regional teams is a very pragmatic solution to the problem of having 50 states and 3,000 local health departments all sharing this responsibility for foodborne illness," Hedberg said. If we can build 5 or 10 more states like Minnesota to do this work we'll get on top of these multi-state outbreaks much quicker."
Jeff Almer wishes other states had done a better job in last fall's salmonella outbreak. His 72-year-old mother, Shirley, died from eating a tainted peanut product traced back to a Georgia manufacturing plant. Almer says if other states had identified their own salmonella cases earlier, his mother might be alive today.
"That's kind of what spurs me to continue to do what I do is to hope that things get changed so we don't have other outbreaks and other heartaches like our family and other families have had to go through," he said.