Since the 1980's, food imports to the United States have doubled. But Federal inspections of those imports by the Food and Drug Administration have dropped to less than half what they were five years ago.
Now, public-health scientists say they are seeing more and more outbreaks of disease linked to imported food, particularly fresh fruit and vegetables.
These are known to have sickened thousands of Americans, and those reported cases are a small fraction of the actual number of people made ill, according to scientists at the Centers for Disease Control and Prevention in Atlanta.
The scientists' list of outbreaks in the 1990's implicates imported foods -- including raspberries from Guatemala and carrots from Peru; strawberries, scallions and cantaloupes from Mexico; coconut milk from Thailand; canned mushrooms from China; an Israeli snack food, and a multinational batch of alfalfa sprouts -- in a variety of infectious diseases.
The increase in imports has strained the nation's food-safety system, said Dr. David A. Kessler, the Food and Drug Administration commissioner from 1990 through February 1997. ''We built a system back 100 years ago that served us very well for a world within our borders,'' he said in an interview. ''We didn't build a system for the global marketplace.''
Most of the food imported to the United States is wholesome. Consumers, knowing that fresh produce is good for their health, can now buy reasonably priced fruits and vegetables imported from around the world, regardless of the season, and without ill effect.
But the illnesses that have been imported along with some of the produce are an unintended byproduct of the boom in international trade -- a boom long advocated by the Reagan, Bush and Clinton Administrations as crucial to economic growth.
There is ''a tension between the two goals of safety and trade,'' said Mickey Kantor, President Clinton's first trade representative, who helped push global trade to the top of Mr. Clinton's agenda. ''You want to open markets but not lower standards. And that's easy to say, but very, very difficult to carry out.''
Scientists are recognizing that ''free trade may present problems that are associated with food poisoning,'' said Dr. Marguerite A. Neill, an infectious disease specialist and a member of a Federal advisory panel drafting new food-safety standards. These problems cut both ways: radish sprouts from Oregon seeds sickened people in Japan in March, and South Korea said it detected E. coli bacteria in a shipment of frozen United States beef last week.
The problems imports may pose for American consumers include polluted water used to grow food in third-world nations, faulty safety systems in countries where the foods are produced, and a lack of natural immunity to exotic microbes rarely seen in this country. ''Certain viruses, bacteria and parasites may be posing a unique problem in the U.S. because we haven't tended to be exposed to them,'' Dr. Neill said.
Dr. Yasmine Motarjemi, a World Health Organization food-safety scientist, said the organization also believed that global trade ''brings new pathogens into countries which are not immune.''
Those problems were foreseeable -- and foreseen.
In 1994, a Centers for Disease Control report said, ''As trade and economic developments like Nafta take place, the globalization of food supplies is likely to have an increasing impact on food-borne illnesses.''
In 1993, the Food and Drug Administration, in a memorandum citing ''enormous inefficiencies in the current food-protection system'' and the ''ever-increasing challenges'' posed by rapidly growing imports, asked the Clinton Administration for legislation giving it power to bar all food -- including fruits, grains, vegetables and fish -- imported from any country with an inferior food-safety system.
The Department of Agriculture has such authority over imported meat and poultry. But the F.D.A. never acquired that power though legislation or executive order.
Dr. Kessler said in an interview that he had told the Bush and Clinton Administrations that the safety system for imported food was inadequate and outdated.
''How is it physically possible to insure the safety of imported food?'' he said. ''You don't have police power throughout the world. Inspecting at the border has a limited value. You're left with real risks.''
Now these risks figure in the political debate about free trade.
The Clinton Administration wants the power to sign new free-trade pacts without Congress's changing the language of those agreements. Opponents of this ''fast track'' authority raise the food-safety flag. Some food growers say that the risks from imports are insignificant, and that the C.D.C. exaggerates them.
The C.D.C. says diseases borne by domestic and foreign foods kill thousands of Americans and sicken millions, perhaps tens of millions, every year -- mostly the very young, the very old and the very ill. Its scientists say almost none of those cases are ever traced back to their cause. As a result, they say, they lack the data to show how many people get sick from imported food, and whether that food is safer or less safe than domestic food.
Both sides in the fast track debate use the Centers for Disease Control's data to make their cases -- and both sides mischaracterize what the data show, according to the scientists.
Now the Administration is preparing a proposal to address the problems posed by imported food -- nine months after announcing a sweeping food-safety initiative that largely ignored them, and days after a bill to revamp the Food and Drug Administration was passed by the Senate.
The Food Chain
Modern-Day Travels Of Tainted Products
The United States has its own food-safety problems at home. Urgent questions about the integrity of America's food supply were raised when three American children died and 144 people were hospitalized after eating fast-food hamburgers in 1993. A reminder of the problem came this summer, when tainted hamburger meat from a Nebraska plant made 16 people sick.
But this spring and last, in an outbreak that attracted less attention, tainted raspberries from Guatemala made thousands of Americans sick. They were victims of a nearly invisible, dimly understood parasite called cyclospora, a species almost never seen in the United States before 1996.
To know the story of raspberries and cyclospora, Dr. Michael T. Osterholm, one of the nation's leading epidemiologists, wrote recently, ''is to know food-borne disease in the modern world.''
Not a single raspberry grew in Guatemala a decade ago. They grow today because the United States helped introduce them.
In the 1980's, during the height of the Guatemalan Army's campaign against leftist guerrillas, the United States Agency for International Development tried to win over the peasants by introducing them to the riches of global trade. Spurred by the Reagan Administration's Caribbean Basin Initiative, a 1983 free-trade measure that cut or eliminated tariffs on imports, the agency spent tens of millions of dollars promoting ''nontraditional'' agriculture in Guatemala.
It persuaded rural Guatemalans to switch from planting corn and beans for themselves to growing exotic crops for North Americans. It financed Guatemalan exporters and American importers who bring raspberries and other produce to the United States.
The raspberry trade exploded two years ago. Guatemala shipped less than 4,000 pounds of raspberries to the United States in 1992 -- and about 700,000 pounds in 1996. The growers timed their first harvest of 1996 for late April and early May, when they would have the United States market almost completely to themselves.
But every April and May, when the spring rains come to the highlands, thousands of Guatemalans fall ill. They think something in the water flowing from the mountains makes them sick. And when the raspberries came to the United States in spring 1996, thousands of Americans fell ill as well. Many experienced weeks of misery -- debilitating diarrhea, severe cramps, chills, fever, nausea, weight loss, depression.
The Centers for Disease Control's scientists never found cyclospora on the raspberries, but they found it in the stools of the Americans who ate them. And they are fairly certain that the parasite lay hiding in the water in Guatemala -- the water with which the berries were sprayed and irrigated just before they were picked, shipped and eaten fresh and raw days later in the United States.
The case underscores the C.D.C.'s recent warning that ''improving the microbiological safety of drinking water and food production'' overseas is crucial ''to insure the safety of the increasing amounts of food imported to the United States.''
After that experience, American scientists and Guatemalan growers, working together, did everything they could to prevent another outbreak. But when this spring came, it happened again: Hundreds, perhaps thousands, of Americans who ate Guatemalan raspberries fell sick.
The cyclospora case is now the biggest outbreak of food-borne disease in the United States in years. The Centers for Disease Control count at least 2,300 people sickened this year and last. They are ''the tip of the iceberg, and we don't know how big the iceberg is,'' said Dr. Barbara Herwaldt of the C.D.C. The Centers for Disease Control still know little about the parasite. But they established this spring that cyclospora is a common cause of diarrhea in Guatemalan children, and is still present in the water that runs through the highlands. The C.D.C. has shown that a polluted stream in a third world field can spawn a mysterious bug that can sicken a diner in midtown Manhattan.
''We eat out of everybody else's garden now,'' said Dr. Dan Colley, director of the Centers for Disease Control's division of parasitic diseases. And on an increasingly crowded planet, not everyone's garden is well kept.
When cyclospora struck in the United States again this spring, Guatemalan berry growers acted swiftly. First, they voluntarily suspended their shipments. Then they kicked the C.D.C.'s field investigator off their farms. Then they denounced the American scientists as snipers fighting a trade war on behalf of the growers' California competitors.
Roberto Castenada, vice president of the Guatemalan Berries Commission, said in an interview: ''Last year the guerrillas were in the fields asking my workers about their conditions, asking, 'Do you have bathrooms?' And this year, it was the C.D.C. The C.D.C. is killing us. They kill us every time they open their mouths.''
Gabriel Biguria, a former president of Gexpront, the Guatemalan agricultural export group, said his country was the victim of an unfair trade practice.
''Cyclospora?'' he said. ''They can't find it. We find a tremendous possibility that people in California are using this as a very dangerous tool for protectionism. Protectionist forces find bugs or whatever to protect their market. It's a commercial war.''
This dispute illustrates how science and politics collide in the arena of trade.
Some of the biggest food-trade fights have centered on the safety of American products. European nations did not want hormone-injected beef or chlorine-rinsed chicken. So far, the United States has won those cases. But now the United States sometimes finds itself on the other side of the fence, fighting with trading partners about the safety standards for their imports.
''Where we see a safety issue, they see a trade issue,'' said Dr. I. Kaye Wachsmuth, a leading Federal food-safety official.
Import-Ban Power For the F.D.A.
Things were simpler when most of the food Americans ate was grown near their homes. Traditionally, food illness came from under-cooked or mishandled domestic meat and poultry. Today, people depend more on global trade to satisfy their hunger.
''Go to a restaurant and take a look at your supper,'' said Dr. Robert Tauxe, chief of the food-borne and diarrheal disease branch at the Centers for Disease Control. ''How many different continents are on your plate?''
The food chain that fills those plates has become unimaginably intricate.
For example, alfalfa sprouts gave salmonella to hundreds of people in 24 states this year and last. The seeds for those sprouts were bought from Uganda and Pakistan, among other nations, shipped through the Netherlands, flown into New York and trucked around the United States, Dr. Tauxe said.
Previously unknown pathogens are being discovered years after they arrive in the United States. Take the case of the Peruvian carrots, which took years to break.
In a coming issue of the Journal of Infectious Diseases, Dr. Osterholm and his colleagues will report their discovery of a new strain of E. coli bacteria, linked to a shipment of carrots from Peru. It took them six years to connect the new strain to a 1991 outbreak at a Minneapolis convention.
Most of the data on food-borne disease come from a relatively small number of outbreaks at big gatherings -- conventions, restaurants and receptions. Most cases are never reported at all, said Dr. Osterholm, Minnesota's chief epidemiologist.
''If you get an outbreak of 500 people in a state, but no more than a few in any one household, you'll never pick it up,'' he said.
Because one percent or less of the actual number of outbreaks are reported, analyzed, identified and successfully traced back to the source, the C.D.C. says, its scientists cannot identify the causes of a great majority of food-borne diseases.
International food-borne outbreaks, said Dr. Colley of the Centers for Disease Control, are increasing and ''can be expected to worsen as the world moves toward a global food economy.''
Detecting microbes at the border is about as effective as detecting illegal drugs.
The Food and Drug Administration's inspectors test an ever-dwindling fraction of the 30 billion tons of food now imported into the United States. The responsibilities of individual inspectors have increased, but their resources have dwindled. They sampled 17,000 food items in 1996, less than one percent of 2.2 million food shipments, down from 30,000 samples, or about 3 percent of 1.1 million shipments, in 1992.
A more fundamental defense -- insuring the safety of food at its source -- does not exist. The F.D.A.'s inspectors can seize suspect imports, but they lack the power to automatically bar imported food just because it comes from a country with an inferior food-safety system.
Congress has never granted them that power. The White House has never publicly asked for it -- until now, as it seeks fast track authority for trade pacts that is being seriously challenged in Congress over food-safety issues. The Administration plans to announce a proposal seeking to give the Food and Drug Administration the new powers this week.
The need has been apparent for years, Federal food-safety officials said. They cited the case of the tainted coconut milk from Thailand. In 1991, frozen coconut milk processed at a Bangkok plant, and exported by a Thai trading company to the United States, set off an outbreak of cholera. The life-threatening disease was thought to have been eradicated in this country.
''The Thai authorities were unaware of the existence of the plant,'' Dr. Tauxe said. ''It was unlicensed, uninspected, unregulated.''
Nor is it clear that the new powers the White House is planning to seek would have prevented the outbreak.
''I can't imagine an F.D.A. inspector in every country overseas,'' said Peggy Foegeding, a principal author of a landmark 1994 study on food-borne pathogens.
The United States is second to none at stopping food-borne disease after it breaks out. The Clinton Administration says it will lift up public-health and food-safety standards around the world until they meet those of the United States, in order to insure the safety of imported food.
But the United States' public-health systems today ''cannot properly identify, track and control food-related illness, or prevent, to the extent possible, future cases from occurring,'' said a Federal report published in May as part of a food-safety initiative now nearing passage in Congress.
The Safety Net
Eroding Resources For Surveillance
Some Federal agencies are helping their foreign counterparts improve their public health systems. But ''the United States cannot really build public health structures for the world,'' said Kerri-Ann Jones, a top White House science official.
The Clinton Administration says it wants more surveillance, more research, more F.D.A. inspectors. But ''Federal budget constraints will likely prohibit significant funding increases in the future'' for the F.D.A., said the food-safety initiative report published in May.
Many state health departments are overburdened and underfinanced, in part because of the AIDS crisis. Twelve states have no system for reporting food-borne disease, largely because of budget restrictions, public health officials say.
And many countries are reducing their own disease-surveillance abilities. ''Economic globalization has also increased the need for governmental budget austerity,'' and countries around the world are cutting spending on public health to streamline their economies, according to a coming study by World Health Organization officials.
Scientists have fought new diseases spread by trade, travel and technology before. One night in 1849, a British doctor, John Snow, had a brainstorm. Having realized that cholera was spread by contaminated water, he ripped the handle off a water pump in a London slum and stopped an epidemic.
Global trade, the gigantic pump bringing the essentials and luxuries of life, and the small but rising threat of disease pose more intricate challenges for scientists.
Dr. Kessler and other prominent scientists, while acknowledging the problems with domestic food, said those challenges could be summarized by two questions:
As the world's nations become more intertwined, interdependent and intensely competitive, will the rest of the world's standards become more like those of the United States, with its relatively safe water, sound hygiene and state-of-the-art science? Or will the United States, despite its high standards, become more vulnerable to the rest of the world's microbes?
''The challenge for the United States,'' Dr. Kessler said, ''is to raise everyone else's standards.''
Photos: A parasite rarely seen in this country has been traced to raspberries from Guatemalan farms like the one where this woman works. (Nancy McGuirr for The New York Times)(pg. A1); TAINTED FRUIT -- Raspberries from Guatemala have made thousands of Americans ill. Mayan women weeded a raspberry field recently. (Nancy McGuirr for The New York Times)(pg. A10)
Graphs: ''More Foreign Produce At Local Markets''
The amount of fruits land vegetables imported to the United States has risen in recent years, although tests of imported foods by the F.D.A. have been cut nearly in half. Graph shows examples of rising imports, tracking import figures for a wide variety of fruits and vegetables, from 1990 through 1997. (Source: Agriculture Department)(pg. A10)
''BY THE NUMBERS: More Imports, Fewer Tests''
Food imports into the United States have risen while the F.D.A. has reduced the number of imports it examines. Graph tracks dollar amount of agricultural imports (from 1993 through an estimated 1997) and number of imported food and food-related items tested by the F.D.A. (from 1992 through 1996). (Source: Agriculture Department)(pg. A10)
Source Citation:Gerth, Jeff, and Tim Weiner. "TAINTED IMPORTS -- A special report.; Imports Swamp U.S. Food-Safety Efforts." The New York Times (Sept 29, 1997): NA. General OneFile. Gale. Alachua County Library District. 26 Oct. 2009
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