Mshev / Shutterstock.com

(Hint: When in doubt, throw it out.)

Click through the FDA's list of recalls and you'll find at least one on almost every day of the week. The reasons range from labeling errors to stowaway metal pieces, but just in the past few months, several high-profile recalls have been linked to the potentially-lethal pathogen Listeria. There was Amy's Kitchen in March and Sabra in early April. The ongoing Listeria outbreak linked to Blue Bell ice creams has sickened at least ten patients and resulted in three deaths; in a rare move, the company recalled its entire product line. And yesterday Jeni's Splendid Ice Cream announced that it too was recalling all of its products due to a Listeria scare. (At this time there's no evidence to suggest a connection between the two cases.)

The Listeria bacteria growing on a petri dish. (Ggw1962/ Shutterstock.com)

Foodborne illness outbreaks do appear to be on the rise nationwide. While some of the uptick can be attributed to better detection methods—in the Blue Bell case, for instance, whole genome sequencing technology allowed scientists to identify more cases than previously possible—the increased centralization of America's food system also plays a role in dispersing foodborne illness. A single factory might handle products that go to multiple grocery store chains, expanding the scope of an outbreak across state lines. According to the FDA, outbreaks are now "happening over longer periods of time and often occur in widely separated areas, making them difficult to detect."

From the consumer perspective, the government response to outbreaks may appear jumbled, involving an alphabet soup of federal agencies including the USDA, FDA, CDC, and EPA. (Broadly speaking, the CDC deals with human illnesses, while the FDA deals with specific foods and the companies that produce them. The USDA handles meat, eggs, and poultry products, and the FDA just about everything else.) The Food Safety Modernization Act of 2011 was supposed to eliminate some of this bureaucratic confusion, encouraging partnerships between agencies and giving the FDA broader authority to enforce preventive controls for food safety. But, four years later, the law remains woefully underfunded and crucial components of it are not yet finalized. The recent rash of outbreaks highlights the need for better and more responsive regulation.

How Recalls Happen

State and local health departments are constantly sending reports of foodborne illness to the Centers for Disease Control and Prevention (CDC). In most cases, this is when the CDC first gets wind of an outbreak, defined as two or more cases of foodborne illness caused by the same pathogen, linked to the same product or food service operation, and occurring during a limited period of time.

The CDC uses a system called PulseNet to find these "clusters" of foodborne illness nationwide, matching the DNA fingerprints of the bacteria that made people sick. In recent years this system has become more sophisticated, with the advent of whole genome sequencing. The technology maps all of an organism’s DNA, allowing scientists to make precise matches between strains. In the Blue Bell case, the CDC used genome data to link recent listeriosis cases with ones dating as far back as 2010. Matthew Wise, the agency's outbreak response team lead, says that without this technology, the CDC "wouldn’t have been able to say with confidence whether or not [the 2010 cases] were related to the current outbreak investigation."

The FDA usually gets involved once a food product is identified as the source of the outbreak. The agency works with CDC and with state and local health departments to figure out how the product became contaminated, identifying the brand and the facility (or facilities) where it was processed. The FDA alerts the public to the food safety risk, and may order or recommend a product recall. It just gained the power to order mandatory recalls under the Food Safety Modernization Act, but companies often recall their products voluntarily, as Blue Bell did.

Sometimes an outbreak investigation runs in the opposite direction, from the source of contamination to the affected patients. That’s what happened in Blue Bell’s case, which began with the discovery of Listeria during routine product sampling at a South Carolina distribution center. Public health officials then worked “backwards,” looking for a cluster of illnesses in PulseNet that matched the DNA fingerprint of the bacterial strain in question.

Foodborne illness remains a significant public health problem nationwide: the CDC estimates that it affects 48 million people, or about 1 in 6 Americans, every year. Since recalls often happen after products have already been sold and eaten, prevention on the consumer level isn't always possible. But here's what you can do after a recall:

What Consumers Should Do

These recommendations pertain to the Listeria outbreak. For detailed information on other foodborne illnesses, consult the FDA and CDC's websites.

Don’t eat the product. This goes for everyone, but it’s especially important for pregnant women, people ages 65 and older, and people with compromised immune systems, who are at higher risk for infection.

When in doubt, throw it out. The CDC recommends placing the product in a closed plastic bag inside a sealed trash can to prevent other people or animals from eating it. Do not compost the product—you shouldn't be composting dairy anyway. And if you need to dispose of large quantities of tainted products, the EPA says you should check with your local waste authority first.

You can also return the product (packed and sealed as above) to the place of purchase for a full refund. Blue Bell is asking consumers to call 1-866-608-3940 or go to bluebell.com with any additional questions.

Clean anything that came in contact with the product. This includes countertops, utensils, and the inside walls and shelves of the refrigerator. Listeria thrives in cold environments—the longer it's stored in the fridge, the more it can spread. The FDA advises that you sanitize these materials with a solution of one tablespoon of chlorine bleach to one gallon of hot water, then dry with a clean cloth or paper towel.

Wash your hands. To prevent cross-contamination, always wash hands with warm water and soap for at least 20 seconds before and after handling food, and after the cleaning and sanitization process. Wipe up spills in the refrigerator immediately and clean the refrigerator regularly.

See your doctor if you develop symptoms of listeriosis. It can take up to two months for symptoms (such as fever, stiff neck, and vomiting) to manifest, but in most cases it only takes a couple days. If you do start to feel ill, seek medical attention and tell your doctor that you may have consumed Listeria-contaminated food.

Top image: Mshev / Shutterstock.com

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