WASHINGTON – In an unimposing laboratory tucked away on a ninth-floor hallway at the University of Maryland School of Medicine, a three-person team spends its days trying to keep one step ahead of food-borne illness outbreaks.
Maryland has one of the nation’s nine federally funded FoodNet offices, which monitor gastrointestinal symptoms, usually diarrhea, and flag potential large-scale food contamination to the Department of Agriculture for recall, if needed.
It is decidedly unglamorous work. But the proactive approach of the FoodNet — the Foodborne Diseases Active Surveillance Network — has recently been touted as a possible weapon in any war against food-borne bioterrorism.
The Baltimore office shrugs off the newfound attention. They say they have plenty to do even without bioterrorism, noting that 76 million instances of food-borne illness occur in the country each year, resulting in 323,000 hospital admissions and 5,000 deaths.
The Maryland chapter of FoodNet has been working since 1998 to diagnose outbreaks of food-borne illness as quickly as possible. It now covers Baltimore City and Baltimore, Anne Arundel, Carroll, Harford, Howard, Prince George’s and Montgomery counties, but will be expanded in January to include the entire state.
Dr. Marguerite Hawkins, petite and soft-spoken, heads up the office, which collaborates efforts of state and local health departments, the University of Maryland School of Medicine and Johns Hopkins University. The Food and Drug Administration and USDA are also involved in the project.
“The project is very integrated with existing public health activities,” Hawkins said. “We provide guidance and assist with making sure we get data and analyze it in a timely manner.”
The FoodNet lab looks like a galley kitchen, but with four refrigerators and no stove. The sink is filled with beakers and bottles.
“Once you’ve seen one lab, you’ve seen them all,” Hawkins said.
The counters are cluttered with test tubes and petri dishes filled with brown or red gel. There are half a dozen extra-large beakers, closed tight and pressurized just right to simulate the environment for bacteria to grow and fester, an environment like a human intestine.
There is barely room for the stool where microbiologist David Torpey perched in his white lab coat recently to examine some of the brown dishes.
“That’s shigella,” Torpey said of one of the bacteria in the lab, brandishing an open dish dotted with translucent lines across its shiny surface.
Three times a week, the state health department and private laboratories send Torpey, Hawkins and microbiologist Jonigene Ruark stool samples from sick people who have tested positive for one of nine known food-borne pathogens.
FoodNet tests bacteria from the samples to see if they match strains found elsewhere in Maryland or any other state, the first indicator of an outbreak. The goal is to find out whether someone simply got sick from leaving the egg salad out too long, or whether there is a wider contamination.
“We only see the tip of the iceberg,” said Hawkins.
Which is why FoodNet also does random surveys in an effort to detect cases that may not have been reported to the doctor. An outside firm surveys residents across the state, asking what kinds of foods they have eaten, if they have been sick recently and if they have gone to the doctor.
“This is more active surveillance, rather than passive,” said David Blythe, the incoming FoodNet coordinator at the state Department of Mental Health and Hygiene. “We don’t want to wait for the reports to come in. We seek out cases of food-borne illness.”
Besides analyzing positive cases, Torpey, Ruark and Hawkins test chicken and pork from area groceries for pathogens that could make people sick. They also compare stool samples from healthy people with samples from ill people.
Blythe said FoodNet has improved the traditional way health officials gather data.
“The goal is to have to better data,” Blythe said. “This gives everybody a better idea of what’s really out there and how many people are getting sick.”
He said traditional reporting systems are still good, but FoodNet picks up outbreaks faster, with more complete data. Speed would be especially important in the case of food-borne bioterrorism.
The state FoodNet system is funded by a grant for the Centers of Disease Control and Prevention, along with the USDA and FDA. But it is already on the third year of a five-year grant, Hawkins said, and an extension or additional funding will be needed to keep the project alive.
Blythe said FoodNet would be worth the additional investment.
“It’s a real good bargain,” he said. “You pick up a whole lot for a relatively low cost.”