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An increasing number of food-borne illnesses are being linked to raw produce, including recent hepatitis A outbreaks in Georgia and other states.
That doesn't mean consumers should shy away from fresh fruits and vegetables, food safety experts and nutritionists say. The risks are low that you'll contract a food-borne illness from eating them.
But knowing what's causing some of those outbreaks, and whether you're in a group at higher risk of food-borne illness, may affect what you choose to eat and how it's prepared.
"It's really important to your health to eat a lot of green vegetables," says Paul Blake, state epidemiologist with the Georgia Division of Public Health. "You can't confine yourself to well-cooked bacon and eggs. That'll hurt you a lot more."
Washing and peeling vegetables and fruits are important steps to protect your health. But they may not be enough.
Several factors are causing more people to get sick after eating raw produce. More people are at risk than before, because they have immune systems that don't work as well due to age (young children and those over 60), pregnancy, organ transplants, chemotherapy or diseases like AIDS. Americans eat more produce than they once did, and more of it raw.
New and more powerful germs have emerged, including E. coli 0157:H7, which has been implicated in a number of produce-related illnesses. More produce is imported, which means the potential for contaminants that Americans have little exposure to and thus immunity against, such as the hepatitis A virus. A Food and Drug Administration survey of 1,000 samples of produce also showed 4.4 percent of the imported products were contaminated, about three times the level of domestic.
"Elderly people and people with immune-compromised conditions would be safest if they ate their vegetables cooked, but everybody likes a nice salad," says Caroline Smith DeWaal, food safety director for the consumer advocacy group Center for Science in the Public Interest. "For those individuals, choosing food grown domestically may be a safer bet. Watching the newspapers for information on outbreaks is helpful, because then you can avoid certain vegetables if they've been implicated."
Once produce has been contaminated, it's difficult to sanitize it thoroughly. Washing and keeping produce at the proper temperature are consumers' major defenses against food-borne illness.
Even washing may not help. Some items linked to outbreaks in the past few years, like raspberries, cantaloupe and green onions, are difficult to clean thoroughly and traditionally are eaten raw.
"You'd have to cook it to be absolutely sure," says Michael Doyle, director of the University of Georgia Center for Food Safety in Griffin. "Not everybody wants to eat their strawberries cooked."
The other alternative, which thousands of restaurants have done since the FDA issued a warning against eating raw green onions in November: Take them off the menu. Taco Bell pulled green onions as a precaution, says spokeswoman Laurie Schalow.
"We didn't want to take the risk," Schalow says. "We're pretty confident in the system we have in place with our washes for our produce that do help eliminate those kinds of things, but we wanted to be certain."
The best defense, food safety experts say, is preventing contamination. That leads back to the farm, and also includes processors, wholesalers and retailers. Produce can be contaminated in a number of ways, from sewage-contaminated irrigation water to improper holding temperatures that encourage bacteria to multiply to high enough levels to cause human illness.
"We need to have some sort of assurance that the food supply all the way from the farm to our table is relatively protected from human feces," Blake says.
That's how many food-borne outbreaks are spread, including hepatitis A. It's also one of the areas that is easiest to fix and to check for compliance, say those who work with farmers.
"Proper use of toilets, proper use of hand-washing facilities is a huge concern," says Betsy Bihn, who helps train farmers on good agricultural practices through Cornell University.
The FDA's agricultural practice guidelines, issued in the late '90s, provide information on everything from proper sanitation for fieldworkers to proper irrigation to keeping produce cool and transporting safely to market. They're not mandatory, but many growers follow them. Often, major buyers insist on compliance with them and require third-party audits to make sure the guidelines are being followed.
Yet there are gaps. The guidelines are not mandatory. The FDA inspects about 2 percent of imported produce at the border but doesn't have the authority to regulate growing conditions on domestic or international farms.
"The current system is just begging for trouble," DeWaal says. "We're not going to have safer produce until we have more effective regulatory systems for checking produce."
Copyright 2003 The Atlanta Journal-Constitution