Fear on the Farm

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By Charles Buchanan

It’s tough to imagine weapons of mass destruction hiding in our fridges, fruit bowls, and favorite restaurants—but in the past year bacterial outbreaks traced to tomatoes, spinach, cantaloupes, and fast-food tacos have sickened or killed hundreds in the United States. Even peanut butter and pet treats can’t be trusted. And while food contamination typically is caused by a natural or accidental source, many wonder if terrorists might try to exploit vulnerabilities in America’s food supply to launch a major attack.

The idea is not far-fetched. In 1984, an Oregon cult laced salad bars with Salmonella bacteria in one small town, poisoning more than 750 people during the days before a local election in order to put their candidates in control of the county government. But could dinner-table terrorism happen in Alabama? Dugald Hall, Ph.D., says it’s possible, though the perpetrators are more likely to be homegrown agitators or disgruntled individuals rather than members of al Qaeda. Hall, an agricultural security expert in UAB’s South Central Center for Public Health Preparedness (SCCPHP), explains that the food supply is a tempting “low-cost, high-impact” target. In other words, with minimal knowledge and effort, terrorists could launch an attack almost anywhere, devastating the economy—particularly in an agriculture-heavy state such as Alabama—and spreading fear even if they didn’t cause deaths.

A Taste of Disaster

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View to a Kill?
Experts agree that collaboration is the key to effective response in an agricultural emergency. With that in mind, UAB’s Center for Emerging Infections and Emergency Preparedness has joined forces with the National Agricultural Biosecurity Center (NABC), located at Kansas State University. Funded with a $1.4-million U.S. Department of Defense grant, the centers have created online software “to improve understanding and awareness of bioterrorism-related threats to agriculture and protocols for response,” says CEIEP program manager Joel Rodgers. For the NABC’s Web site, the UAB center customized programming developed by UAB’s Division of Continuing Medical Education to create an engaging, interactive information portal. Now, visitors to the site see rotating images of animals with diseases that have the potential to become bioterror weapons. Questions pop up, challenging visitors to identify the diseases; one click leads to answers and details about the pathogens. Rodgers says the software reaches—and teaches—agriculture, food-security, and public-safety workers.

How damaging would an agroterror attack or disease outbreak be to Alabama? It’s tough to tell exactly, says Hall. “The greatest impact would stem from an outbreak of a major poultry disease, such as exotic Newcastle disease or any strain of avian influenza,” he explains. Few people would get sick or die, most likely, but the indirect effects could be devastating. As one of America’s top poultry producers, the state would take a major economic hit.

“The thousands of workers in the processing plants would be out of work for at least three months,” Hall says, with the ripple effects extending to their families and local businesses. The impact also would reverberate up and down the food supply and distribution chain, affecting trucking companies, feed suppliers, hatcheries, supermarkets, and related industries. Food shortages would be unlikely, since other states could supply poultry, but prices could rise—assuming consumers would still want to eat chicken or turkey.

“It’s more likely that people would switch to other meats such as pork or beef until after the outbreak is contained and eradicated,” Hall notes. Even then, an incident might have lingering effects. “Currently in the United Kingdom, many consumers are reluctant to eat any poultry, even though the only farm to be affected to date [by a form of avian influenza] is a turkey farm, and there is no evidence to show that avian influenza can be transmitted to humans through correctly cooked poultry.”

Attack of the Killer Tomatoes?

The reason many view agroterror as an easy proposition is that the likely agents of destruction already naturally or accidentally contaminate the food supply. Asian soybean rust drifted into the U.S. with Hurricane Ivan, and experts predict H5N1 avian influenza might accompany migrating birds. An example of accidental introduction, Hall explains, could be a traveler “returning from hiking in South America who had unwittingly been in contact with animals infected with foot-and-mouth disease—and then wearing the same boots to a U.S. cattle farm without adequately cleaning and disinfecting them.”

Contamination also can occur up and down the food chain, due to poor processing and packaging or infiltration by toxic substances such as pesticides, mercury, chromium, and arsenic. Typically, however, contamination results from “unpasteurized or improperly cooked foods, poor food storage leading to fungal growth, and contact with animals,” says Edmond Kabagambe, D.V.M., Ph.D., an epidemiologist in UAB’s School of Public Health.

The fact is, outbreaks are inevitable, despite the regulations, high-tech testing, and safeguards already in place. The Centers for Disease Control and Prevention (CDC) estimates that 76 million cases of food-borne illness occur each year nationwide, meaning there’s a one-in-four chance that a person will get sick in any given year. That means the focus should be on preparation—building knowledge and networks to quickly react to and limit the impact of incidents. At UAB, the SCCPHP and the Center for Emerging Infections and Emergency Preparedness (see “View to a Kill?”) spearhead efforts to shape a coordinated, informed approach.

“While the food production system is more secure than it has been, there are still numerous vulnerabilities at the grower level that need to be addressed,” says Peter Ginter, Ph.D., the SCCPHP’s principal investigator. His group helps meet those challenges through its Agricultural Security Conference and joint training courses, both coordinated by Hall and rooted in the latest findings from the fields. “We work closely with the Alabama Department of Agriculture and Industries and the Alabama Department of Public Health to determine what areas they consider priorities for training,” Hall says.

Growing Networks

Since 2005, the Agricultural Security Conference has been one of the few forums nationwide dedicated to addressing agroterror year after year. Each time, it attracts more than 300 participants from Alabama and six other Southeastern states, with presenters from as far away as Kansas and Minnesota. The conference has been so successful that this summer the SCCPHP held two of them—in Alabama and Mississippi. Hall says the attendees, who include agricultural producers and professionals in public health, veterinary medicine, law enforcement, academia, and the military, learn “how they or their agency fits into the federal and state response plan.”

These conferences also provide an overview of the “interrelated nature of animal and human health,” Hall says. This is crucial knowledge, since many diseases can affect both—and often infect animals first. In any disaster, Hall says it’s especially important for “the multitude of responding agencies to work together to ensure a well-coordinated reaction and utilize available resources in the most efficient manner. By providing a forum where personnel from diverse disciplines and agencies can meet and learn about each other, we hope to improve interagency cooperation and communication.” Pooling information also helps attendees identify areas in which additional surveillance will allow them to pinpoint potential food-supply problems early.

The joint training course, which the SCCPHP introduced throughout Alabama this year, dissects every phase of the response to an agricultural incident, from first response to the diagnostic laboratory. The goal is to craft an effective multidisciplinary response—before disaster strikes.

Home-Cooked Concerns

While the professionals spring into action, what should the rest of us do if an agricultural emergency hits? Don’t panic, say UAB’s experts. “Most food-borne illnesses are cleared by treatment, cessation of ingestion of the toxin or pathogen, or the immune system,” says Kabagambe; the CDC reports that most cases are mild, with symptoms lasting only a day or two. Kabagambe adds that some diseases can have a more serious, long-term impact, particularly on children younger than five years old, the elderly, and people with compromised immune systems. The CDC estimates that food-borne illnesses are responsible for 5,000 deaths each year.

Media coverage of food-borne outbreaks and agroterror threats may help raise food safety awareness among consumers. But Kabagambe and Hall agree that concerted educational efforts can reduce fears before and during an incident. “I like labels that remind people how improperly cooked meats can lead to illnesses, but I often wonder why there are no such labels on fruits and vegetables, which in recent years have been a major source of E. coli and Salmonella outbreaks,” Kabagambe says. Hall advocates clear, concise, timely messages from public health professionals addressing food safety issues. As it turns out, communication and education may be the most powerful weapons in the defense of America’s fruited plains.

Safety in Numbers

Edmond Kabagambe, D.V.M., Ph.D., an epidemiologist in UAB’s School of Public Health, suggests six ways to help keep food safe.

1. Keep highly perishable foods cold at all times.

2. Immediately refrigerate leftovers instead of letting them sit on a plate while you finish your meal.

3. When cooking, wash cutting boards often. Do not use the same board to prepare two different foods (such as meats and vegetables) unless you are sure it is thoroughly washed.

4. Check expiration dates on highly perishable foods such as meats. For canned foods, check expiration dates and the integrity of the cans—avoid any with rust or dents.

5. When eating foods in institutional settings, avoid salads or uncooked foods unless you can see that they are chilled.

6. Always wash your hands before you prepare foods and before you eat.