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Why Do We Keep Having E. Coli Outbreaks?

Thanksgiving cooks got a surprise instruction on Tuesday from the American government: If romaine lettuce is anywhere on the menu, ditch it now.

The United States and Canada are undergoing an E. coli outbreak that's so far infected 18 Canadians and 32 Americans, 13 of whom had to be hospitalized, according to the Centers for Disease Control and Prevention. The bacteria responsible for this outbreak appear to be related to critters on leafy greens, which sickened 25 Americans and killed one person late last year. The current illnesses aren't related to another E. coli outbreak in romaine that ran from March to June of this year. That infected 210 people; caused 96 people to be hospitalized, including 27 who developed kidney failure; and killed five.

Why do serious food poisoning outbreaks keep occurring in the U.S.? One important reason is that the fresh foods like fruit, vegetables, and meat that make up healthy diets are more vulnerable to microbial contamination than packaged goodsAs Kathryn Miles reported for Pacific Standard in 2016:

An estimated 48 million Americans become sick each year because of something they ate. Annually, over 3,000 die because of contaminated food. Both numbers are projected to rise in the coming decade, along with our reliance on imported food. And here's the irony: A big reason for that increase is that we've developed healthier eating habits. On average, we eat 14 percent more fruits and vegetables than we did in 1970. We're eating beet greens with bee pollen and drinking kale-and-date smoothies. And those foods—which is to say fresh foods—are the very hardest to police....

Just as importantly, however, government processes for overseeing food safety in the U.S. need work. The networks of which agencies are responsible for what foods are complex, making them more prone to error. "Even the people inside this system agree," Miles reports. "It's a real headache." That headache is one of the reasons the Government Accountability Office put federal oversight of food safety on its high-risk list in 2007. In 2017, the office issued an update saying the Food and Drug Administration and other agencies have made improvements, but more needs to be done.

In 2010, Congress passed the Food Safety Modernization Act, which gave the FDA more authority to prevent food poisonings. "On paper, the FSMA is an indisputably big deal," Miles writes. But some provisions are still getting off the ground. For example, the act created new regulations requiring farms to test water used to irrigate and wash produce. Dirty water is an important source of E. coli infection: Authorities suspect water from a contaminated canal in Yuma, Arizona, caused the unrelated E. coli outbreak in romaine lettuce from earlier this year. But small farms still don't yet have to comply with the FSMA regulations, The New Republic reports, and no farms have to report their results to the FDA until 2019.