Food Safety Diagnostics
The United States has the safest food supply in the world. Because various regulatory agencies continuously monitor food safety, Americans take the safety of their food for granted. Still, each year up to 81 million Americans suffer food-borne illnesses, and 9,100 die.
U.S. troops are deployed worldwide to places where commercial food sanitation standards may be inferior and enforcement of those standards may be less than optimal. Food-borne disease outbreaks are a significant threat to our deployed fighting forces, capable of incapacitating many troops at any given moment. This is a risk the Army cannot afford to take. The Army Veterinary Service must do all it can to conserve the Army's fighting strength through an active food-safety surveillance program. Americans expect safe, high-quality food, and U.S. military personnel expect no less.
Having soldiers consume only operational rations in a theater of operations would minimize the threat of a food-borne outbreak. However, consuming only operational rations without class A (freshly prepared food) supplementation would create a serious morale problem with deployed troops. Therefore, field commanders want to maximize the availability of freshly prepared meals. Class A rations, particularly locally procured food items, present the highest danger as a source of food-borne diseases.
In the past, Army food inspectors were unable to ensure food safety in a field environment because portable diagnostics were not available. They based their food-safety efforts on sanitary inspections of food establishments and periodic tests of food in a centralized laboratory. Installation-level veterinary inspection programs sought to identify food quality problems. However, recently developed commercial technology allows for rapid, presumptive screening of high-risk food for bacterial pathogens, spoilage organisms, and pesticides in the field before it is served to soldiers. The 18th Medical Command Veterinary Services, part of U.S. Forces Korea (USFK), is using this technology to ensure that the food we provide to soldiers during peacetime is safe. This technology also will permit high-risk foods to be screened on the battlefield.
The position of the 18th Medical Command Veterinary Services is that to ensure a safe food supply in a forward deployed theater, rapid food-safety laboratory diagnostics must be used.
Food-borne disease threats
The majority of food-borne disease outbreaks result from unintentional contamination of a product as a result of inappropriate processing or handling. Outbreaks caused by substandard sanitation or improper food handling are well documented. In 1985, an estimated 350 school children and staff at a Georgia elementary school developed febrile gastroenteritis associated with the bacteria Salmonella enteriditis. The food source was identified as turkey salad that had been refrigerated improperly before it was served. In 1997, the largest beef recall in history occurred as a result of Escherichia coli bacteria-contaminated ground beef processed by Hudson Foods of Columbus, Nebraska. The extent and swiftness of this recall resulted in less than 20 illnesses, compared to the Jack-In-The-Box fast-food restaurant outbreak in 1993 that resulted in over 700 illnesses and several deaths. In 1996, a large food-borne disease outbreak occurred in Japan, causing more than 5,000 illnesses and 6 deaths—primarily among schoolchildren. School lunches contaminated with E. coli bacteria were identified as the source.
Intentional contamination of our food supply with biological or chemical agents also is a significant threat. Bioterrorist attacks on our food supply could be covert or announced and could be accomplished with selected bacterial pathogens or toxins. The United States actually experienced one such attack in 1984. In The Dalles, Oregon, a religious cult contaminated 10 salad bars in restaurants with the incapacitating bacteria Salmonella typhimurium on Election Day to influence the results of county elections. Within 1 month, over 750 cases of Salmonella typhimurium were diagnosed. It took more than 2 years of diagnostic effort to determine that this food-borne outbreak was intentional. Similar intentional acts of bioterrorism against U.S. forces are a real threat and could be difficult to detect without an active food-safety surveillance program.
The Charm Sciences, Inc., Lum-T is an instrument used to complete several diagnostics, such as sanitation validation, fluid dairy shelf-life prediction assay, and pesticide assay.
U.S. Government initiatives
President Clinton's fiscal year (FY) 1999 budget requested $101 million to improve the safety of the Nation's food supply. The request included an increase in research to develop new tests to detect food-borne pathogens and assess risks to the food supply. Further, the President's FY 2000 budget includes a $144 million request for the Department of Health and Human Serv-ices for "bioterrorism preparedness."
A key step in establishing an effective food-safety program in a forward-deployed theater is to have adequate laboratory diagnostics that can identify and characterize rapidly any agent that could cause a food-borne disease outbreak. Within the 18th Medical Command, food-safety efforts have focused on monitoring potentially hazardous foods as they move through the supply system. To enhance current USFK food-safety and -quality programs, the veterinary services decided to use commercial rapid-screening food laboratory diagnostics. Some capabilities of these diagnostics include:
Commercial rapid food-safety diagnostics have been procured and deployed throughout the Republic of Korea as an integral part of our active food-safety surveillance program. The immediate availability of laboratory data at key food distribution points within the Republic of Korea ensures that all USFK personnel have safe, high-quality food.
Commercial rapid food-safety diagnostics
Today's consumers demand safe food. The commercial food industry's ability to identify bacterial pathogens and unsafe residues has resulted in an almost fivefold increase in food recalls by major manufacturers since 1988. New technology allows Government regulatory agencies to identify a bacterial pathogen and trace it back to its source more rapidly. The key to this new technology is the availability of rapid food-safety diagnostics.
These rapid food-safety diagnostics provide a quick, "positive or negative" answer before the food product enters the distribution system. Tests take up to 30 hours to complete because of the requirement for a bacterial growth enrichment period. This growth enrichment period is necessary to increase the total number of bacteria so they can be detected using current technology. A negative answer means that the product does not contain that particular bacteria or toxin and no further testing is required. A positive answer means that further testing is needed at a reference laboratory using standard laboratory methods to confirm the actual presence of the bacteria or toxin. For example, rapid screening for Salmonella typhimurium requires approximately 24 hours to complete. To confirm the existence of this organism, standard laboratory methods of isolation for 96 to 120 hours must be used.
USFK food-safety diagnostic capabilities
The 18th Medical Command Veterinary Laboratory has the following rapid food microbiology capabilities:
The threat of weapons of mass destruction is very real. One concern that faces the U.S. Government daily is bioterrorism. Kits
for detecting chemical agents in water are well developed and effective. However, our ability to detect chemical and biological
agents in food is very limited. Majesco Biologics and the Army Soldier and Biological Chemical Command in Natick,
Massachusetts, working independently, are developing biosensor technology to identify bacterial pathogens and toxins in only
15 to 30 minutes by eliminating the requirement for a 24-hour bacterial enrichment phase. This new technology is extremely
sensitive and can detect much lower levels of bacteria and toxins than current rapid diagnostics can. Although fielding of
biosensor technology is 2 to 3 years away, these advances should be adopted by the Army Veterinary Service to maintain an
This proactive approach to food safety and bioterrorism prevention does not agree with a White Paper published recently by the Office of the Surgeon General entitled "The Vulnerability of the DOD Food Supply to Chemical/Biological Terrorism—The Role of the Army Veterinary Service." This paper advocated a post-epidemiological investigation to determine the source of a biological agent attack. The authors stated that the use of current surveillance technology was too expensive and too manpower intensive. Admittedly, no surveillance system can be 100-percent accurate. In the event of a food-borne disease outbreak, intentional or unintentional, faster identification and characterization of the agent will aid in the medical treatment of those affected. It also will help our medical personnel determine if exposed but asymptomatic personnel require prophylactic treatment. It is the 18th Medical Command Veterinary Services' position that having the capability to screen routinely for select bacterial pathogens and toxins would be a deterrent to bioterrorism.
In support of the Army Medical Department's Medical Reengineering Initiative to redesign its combat health support units, the Army Veterinary Service has developed a food procurement detachment with a portable food microbiology capability. This capability emphasizes rapid food-safety diagnostics in division rear and corps and echelons-above-corps areas of operations. Fielding is scheduled for fiscal year 2002 in the Republic of Korea.
In my opinion, there does not appear to be a collaborative effort between commercial industry and military research laboratories. However, it is encouraging that various Government agencies, such as the Army Soldier and Biological Chemical Command, are developing biosensor technology. Technology continues to improve at a very rapid pace; equipment that is state-of-the-art today may not be tomorrow. Therefore, the contents of the field food microbiology set will be an ongoing evolution. As one item becomes obsolete, it will be replaced by the newest off-the-shelf technology. This new technology will not be intended solely for field use but will be part of our ongoing, active food-safety surveillance program during peacetime.
Natural food-borne outbreaks and bioterrorism will continue to occur worldwide. An active food-safety surveillance program that conducts rapid, presumptive laboratory testing helps to ensure a safe food supply. Our goal is to provide food inspectors with real-time laboratory data for making on-the-spot recommendations concerning food safety and quality. Making use of available commercial technology is the easiest and most efficient way to achieve this goal.
Capt. John C. Beach currently is pursuing a master of science degree in food microbiology at Texas A&M University. He was the chief of U.S. Forces Korea Food Safety in Yongsan, South Korea, when he wrote this article. Capt. Beach has a doctor of veterinary medicine degree from Oklahoma State University and is a graduate of the Army Medical Department Officer Advanced Course.
An Army Logistician story from the May-June 2000 issue.