What Happens After a Foodborne Illness Outbreak?


May 13, 2015

Almost 50 million people get sick in the United States every year after consuming contaminated food. Over the last decade, we’ve heard of outbreaks of foodborne illness linked to everything from E.coli in spinach, salmonella in turkey and peanut butter, and most recently, listeria in ice cream.

When an outbreak happens, it usually falls to the two main federal agencies in charge of food safety — the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) and the Food and Drug Administration — to determine how to keep tainted food off grocery shelves and hold companies accountable. In extreme cases, they can shut down a plant. Other times, they’re unable to take any action whatsoever.

So how do they decide? Here is brief guide to their main options.


More often than not, nothing happens after a foodborne illness outbreak. That’s because tracing the source of an outbreak back to a specific plant can be difficult and time-consuming. And outbreaks that can’t be traced back to a specific product or company end with no resolution.

“There are outbreaks that they’re never able to link to a product or company,” Christopher Waldrop, director of the Food Policy Institute at the Consumer Federation of America, told FRONTLINE. “It is very difficult to make that link. It requires a whole lot of steps, a whole lot of investigative and epidemiological work.”

In 2013, for example, 818 foodborne disease outbreaks were recorded by the Centers for Disease Control and Prevention. These outbreaks resulted in 1,062 hospitalizations and 16 deaths, but public health officials only linked 46 percent of them to a type of food. Just 14 of the outbreaks ever resulted in a product recall.


While 15 different agencies are in some way connected to food safety, the main two are the FSIS, which regulates meat, poultry and processed egg products, and the FDA, which is responsible for everything else, including seafood, processed food and beverages.

If the agency in charge is able to help trace a pathogen like salmonella, listeria or E. coli back to a food processing plant, it will then carry out an investigation, trying to figure out exactly what went wrong. If the plant’s standards are found to be lacking, the agency asks the company to develop a plan to reduce levels of the contaminant.


If the federal agency feels it has enough evidence that contaminated food came from a particular plant, that’s when recall talks begin.

In some cases, certain pathogens are considered so dangerous that they trigger an automatic recall. The rest of the time, it’s more case by case.

The FSIS, by law, cannot force a company to issue a recall for products contaminated with pathogens it doesn’t outright ban — like salmonella. Instead, they only have authority to request a recall.

Yet even if the FSIS requests a recall, “Companies don’t have to recall the meat,” Caroline DeWaal, director of the food safety program at the Center for Science in the Public Interest, told FRONTLINE. “It’s not a federal order.”

Food safety experts say companies will normally comply with a recall request because refusing would be bad for their brand.

That’s what happened in July 2014 when the FSIS traced the source of a salmonella Heidelberg outbreak back to Foster Farms, the largest poultry producer on the West Coast. The outbreak that triggered the request began in March 2013 and ended up sickening 634 people by the time it ended 16 months later.

Unlike the FSIS, the FDA has broader leeway to issue mandatory recalls — an authority it gained through the Food Safety Modernization Act of 2011 — if a company doesn’t first comply with a voluntary recall request.

“They have that sort of in their back pocket, so they can use it if a company refuses to do a recall,” Waldrop said.

Since gaining that power, the FDA has used it twice: Once for salmonella-tainted pet treats and a second time for dietary supplements that were linked to severe liver illnesses among the people who used them.


If the FSIS can’t get a recall, it has the option to issue a public health alert to consumers signaling that it has concerns about a certain product or company. The alerts serve to give consumers instructions on what to do if they have a potentially tainted product, such as how to safely cook it or dispose of it.

In 2013, for example, the FSIS had yet to find the exact match between the salmonella Heidelberg that was making people sick and the Foster Farms products it inspected, so it issued a public health alert. At that point in the outbreak, 278 people across 18 states had already gotten sick.

But critics argue that a public health alert is not nearly as effective as a recall. With Foster Farms, the public health alert was issued in October, but the outbreak lasted another nine months and sickened around 350 more people.

“Recall is really where you want to go, because consumers know what that means. Companies know what that means,” Waldrop said. “A public health alert doesn’t have the same sort of affect in consumers’ mind … A recall really has more gravitas to it.

For the most part, public health alerts are rare. In 2014, for example, the FSIS only issued two public health alerts. The year before, there was only one.

The FDA has safety alerts and advisories too, but they are more general consumer advice about certain products.


The FSIS can shut down a plant by pulling its inspectors, effectively forcing it to stop operating. In practice, though, this doesn’t happen often.

In the Foster Farms case, the agency sent the company a “notice of intended enforcement” on the same day as the public health alert stating that it would pull inspectors unless the company responded with plans to correct problems at plants that were suspected at the time of being involved in the outbreak. Because the FSIS received a response from the company outlining operational changes it deemed sufficient, the threat was never carried out.

“We are serious about the threat,” David Goldman, assistant administrator of the FSIS, told FRONTLINE. “We often don’t carry it out because we get a response … we get the attention of the plant.”

The FDA’s method of shutting down a plant is different. Facilities that manufacture, process or hold food for animal or human consumption have to register with the FDA. The FDA gained the power to suspend that registration and stop a plant from operating in 2011, as part of the Food Safety Modernization Act.

“I think that’s going to be a very rare authority, and it’s going to be a very egregious situation if they ever use it,” Waldrop said.

In 2012, for example, the FDA suspended the registration of Sunland Inc. after an outbreak of salmonella Bredeney that made at least 42 people sick was traced back to the company’s peanut butter. In 2014, it suspended the registration of Roos Foods after listeria-tainted cheese made eight people sick, causing seven hospitalizations and one death.


The problem, critics say, is that both agencies lack the authority to directly issue a penalty.

“That’s something we’ve pushed for a long time – civil and criminal penalties – and the agencies do not have that authority. FSIS does not, FDA doesn’t really either,” Waldrop said.

The FSIS can refer a case in which a company or individual has violated inspection laws to a U.S. attorney — for example, knowingly selling uninspected or adulterated food or forging counterfeit inspection labels — but this is extremely rare in connection to foodborne illness outbreaks.

One example of an outbreak that resulted in criminal charges involved salmonella-tainted peanut products that killed nine people and sickened more than 700 in 2008 and 2009. It took more than five years, but Stewart Parnell, the former owner of Peanut Corporation of America, and two other defendants were found guilty on Sep. 19, 2014. They have not yet been sentenced, but Parnell could face up to three decades in jail.

Priyanka Boghani

Priyanka Boghani, Digital Reporter & Producer, FRONTLINE



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