Table of Contents:



I. Storm Gathering

1. 1918

2. Master of Metamorphosis

3. H5N1

4. Playing Chicken

5. Worse Than 1918?

6. When, Not If

II. When Animal Viruses Attack

1. The Third Age

2. Man Made

3. Livestock Revolution

4. Tracing the Flight Path

5. One Flu Over the Chicken's Nest

6. Coming Home to Roost

7. Guarding the Henhouse

III. Pandemic Preparedness

1. Cooping Up Bird Flu

2. Race Against Time

3. Tamiflu

IV. Surviving the Pandemic

1. Don't Wing It

2. Our Health in Our Hands

3. Be Prepared

V. Preventing Future Pandemics

1. Tinderbox

2. Reining in the Pale Horse


References 1-3,199

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Five tons of animal manure is produced in the United States every year for every man, woman, and child in the country,996 and some of it ends up in the food and water supply. Excess manure nitrates can cause a condition called methemoglobinemia, or “blue-baby syndrome,” a rare but under-recognized cause of illness and death among U.S. infants, as well as asphyxiating aquatic ecosystems with algae blooms.997 In the 1990s, this ecological problem bloomed into a public health issue as well with the emergence of the carnivorous algae Pfiesteria piscicida (Latin for “fish killer”).998

Likened to grass feeding on sheep, this tiny plankton releases a toxin that skins fish alive to feed on their flesh. More than one billion fish have been killed,999 and fish are not the only ones affected. Fishermen, recreational boaters, and swimmers along the eastern seaboard of the United States started developing skin lesions and neurological deficits, such as memory loss, disorientation, and speech impediments. One Pfiesteria researcher was sent to the hospital1000 and was still experiencing neurological symptoms years later.1001 Experts blame poultry manure runoff for the emergence of this “cell from hell,”1002 leading to tighter poultry industry regulation.1003

In our kitchens, animal excrement leads to food poisoning. The risks associated with this “plate waste” have intensified along with the industry that created it. In its landmark 1992 report, Emerging Infections: Microbial Threats to Health in the United States, the National Academy of Sciences’ Institute of Medicine states that “the introduction of feedlots and large-scale poultry rearing and processing facilities has been implicated in the increasing incidence of human pathogens, such as Salmonella, in domestic animals over the past 30 years.”1004 As microbiologist John Avens told a poultry meeting, “Salmonella infection of animals will occur more frequently and affect more individual animals as concentration of confinement increases.”1005

The World Health Organization estimates the number of people killed worldwide from foodborne microbial diseases in the millions, with animal products topping the list of causes.1006 The WHO attributes the global rise in foodborne illness not only to the “greater consumption of foods of animal origin,” but the “methods of intensive production” required to supply such a demand.1007 About half of all known foodborne pathogens have been discovered within just the past 25 years.1008

In industrialized countries, the incidence of reported infectious food- and waterborne illnesses has more than doubled since the 1970s.1009 According to the best estimate of the CDC, an astonishing 76 million Americans come down with foodborne illness annually. That’s nearly one in four every single year. Remember that “24-hour flu” you or a family member may have had last year? There’s no such thing as a 24-hour flu. It may very well have been food poisoning.1010 In today’s food safety lottery, each year Americans have approximately a 1 in 1,000 chance of being hospitalized, and about a 1 in 50,000 chance of dying, simply from eating.1011

It may be from E. coli O157:H7 in hamburgers, Salmonella in eggs, Listeria in hot dogs, “flesh-eating” bacteria in oysters,1012 or Campylobacter in Thanksgiving turkeys. According to the executive editor of Meat Processing magazine, “Nearly every food consumers buy in supermarkets and order in restaurants can be eaten with certainty for its safety—except for meat and poultry products.”1013

The latest comprehensive analysis of sources for foodborne illness outbreaks found that chickens were the premiere cause overall. In fact, poultry and eggs caused more cases than red meat, seafood, and dairy products combined.1014 This British analysis showed that fruits and vegetables carried the lowest disease and hospitalization risk, whereas poultry carried the highest. The researchers conclude, “Reducing the impact of indigenous foodborne disease is mainly dependent on controlling the contamination of chicken.”1015 Good luck. In the United States, the overwhelming majority of the 9 billion chickens raised each year are stocked in densities between 10 and 20 birds per square yard,1016 ,1017 unable even to stretch their wings.1018 Under this avian carpet is a fecal carpet of filth most of the birds spend their lives upon.1019

Chicken of the Sea® is an ironic brand name for canned tuna. The only food animal industry with greater stocking density than poultry production is fish farming, where tanks routinely squeeze up to a ton of animals into a dozen cubic yards of water (9m3).1020 Floating cages have been known to hold up to four times more.1021 The water can become so saturated with feed and feces that these fish-in-a-barrel operations may be more aptly dubbed fish-in-a-toilet. As the chief of the CDC’s Special Pathogens Branch has pointed out, whether in a human megacity, a broiler chicken shed, or an aquaculture tank, any time one crowds a monoculture of single species together, one is asking for trouble.1022 Combined with the stress associated with overcrowding and poor water quality, it is not hard to imagine how the factory farming methods associated with the so-called “Blue Revolution” expansion of fish farming in the 1980s1023 resulted in the emergence of another zoonotic disease.1024

Discovered first in an Amazon dolphin in the 1970s from which it got its name, Streptococcus iniae (inia is the Guarayo Indian word for “dolphin”1025 ) started wiping out fish stocks on intensive fish farms around the world with epidemics of acute meningitis.1026 By the 1990s, the dolphin wasn’t the only mammal discovered to be infected. In 1995, the first confirmed spread to humans who handled fish in their kitchens was published in the New England Journal of Medicine. Most of the human reports involved just skin infections, but in a few cases, the bacteria became invasive, spread through victims’ bloodstreams, seeding infection in their joints, hearts, or even brains`. Thankfully, none have yet died from this emerging disease.1027

“The demonstration of another new pathogen linked to the food industry is not surprising,” conclude the investigators, “considering that changes in the production, storage, distribution, and preparation of food, as well as environmental changes, provide increased opportunity for humans to be exposed to new organisms that may be pathogenic.”1028 Other pathogens emerging on aquaculture farms include a class that threatens immunocompromised persons in particular,1029 as well as wildlife pathogens escaping from hatcheries and threatening the survival of wild rainbow trout, for example, in many streams in the western United States.1030

The latest foodborne pathogen linked to poultry is “ExPEC.” Urinary tract infections (UTIs) are the most common bacterial infections in women of all ages,1031 affecting millions every year in the United States. From a physician’s perspective, they are getting harder and harder to treat as antibiotic resistance among the chief pathogen, E. coli, becomes more and more common.1032

When most people think of E. coli infection, they think about the Jack-in-the-Box E. coli O157:H7 strain, which starts as hemorrhagic colitis (profuse bloody diarrhea) and can progress to kidney failure, seizures, coma, and death. While E. coli O157:H7 remains the leading cause of acute kidney failure in U.S. children,1033 fewer than 100,000 Americans get infected every year, and fewer than 100 die.1034 But millions get “extraintestinal” E. coli infections—urinary tract infections that can invade the bloodstream and cause an estimated 36,000 deaths annually in the United States.1035 That’s more than 500 times as many deaths as E. coli O157:H7. We know where E. coli O157:H7 comes from—fecal contamination from the meat, dairy, and egg industries1036 —but where do these other E. coli come from?

Medical researchers at the University of Minnesota published a clue to the mystery in the April 2005 issue of the Journal of Infectious Disease. Taking more than 1,000 food samples from multiple retail markets, they found evidence of fecal contamination in 69% of the pork and beef and 92% of the poultry samples as evidenced by E. coli contamination. More surprising was that more than 80% of the E. coli they recovered from beef, pork, and poultry were resistant to one or more antibiotics, and greater than half of the samples of poultry bacteria “were resistant to >5 drugs!” (One rarely finds exclamation points in the medical literature.) But what was most surprising was that half of the poultry samples were contaminated with the extraintestinal pathogenic E. coli bacteria, abbreviated ExPEC. UTI-type E. coli may be food-borne pathogens as well.1037

Scientists suspect that by eating chicken and other meat, women infect their lower intestinal tract with these antibiotic-resistant bacteria, which can then creep up into their bladder. Commonsense hygiene measures to prevent UTIs have included wiping from front to back after bowel movements and urinating after intercourse to flush out any infiltrators. Commenting on this body of research, Science News suggested meat avoidance as an option to “chicken out” of urinary tract infections.1038

Even if we ate vegetarian foods, though, we would still not be able to escape exposure to pathogens found in animal wastes. Apple cider freshly squeezed from apples collected in an orchard where an infected calf grazed caused an outbreak of cryptosporidiosis, a parasitic disease.1039 This was the same disease that caused a record 420,000 cases of severe gastroenteritis in the Milwaukee area in 1993, when cattle defecated upstream of a major source of the metropolitan water supply.1040

The alfalfa sprouts lining the whole-grain avocado sandwiches of the California health conscious led to a Salmonella outbreak in 2001.1041 Since the first reported sprout outbreak in 1973, there have been at least two dozen more in the United States,1042 including both Salmonella and E. coli O157:H7, infecting thousands of people.1043 How did chicken and cow bacteria get onto sprouts? It was contained in manure used as fertilizer.1044 As the level of infection in herd and flock feces has risen with intensification, so has the contamination of produce crops it has fertilized.1045

Even though spout producers may soak sprout seeds in a solution of bleach, pathogens seem able to hide inside microscopic crevices in the seeds. The latest outbreak in California led both the CDC and FDA to reiterate their recommendation that everyone cook their sprou1046 It is noteworthy that the CDC found only 32 people affected by the 2001 outbreak.1047 In 2005, the CDC released its latest estimate as to the number of Americans who get Salmonella from eggs every year. While sprouts have been associated with about 100 infections annually in the United States, eating eggs is estimated to sicken 182,000.1048

Tragically, food poisoning can be the gift that keeps on giving. Although thousands die from food poisoning every year in the United States, the vast majority suffer only acute, self-limited episodes. Up to 15% of those who contract Salmonella, however, go on to develop serious joint inflammation that can last for years. An estimated 100,000 to 200,000 Americans suffer from arthritis arising directly from foodborne infections every year.1049 One of the most feared, long-term complications of food poisoning is Guillain-Barré syndrome, in which infection with Campylobacter, a bacteria contaminating up to 98% of retail chicken meat in the United States,1050 can lead to being paralyzed for months on a ventilator.1051 With the virtual elimination of polio, poultry products are now the most common cause of acute flaccid paralysis in the developed world.1052

Campylobacter is a spiral-shaped poultry bacteria1053 that corkscrews its way into the lining of the intestine “with a speed that cannot be matched by other bacteria.”1054 Just as H. pylori bacteria has been linked to stomach cancer, Campylobacter, according to a 2004 report in the New England Journal of Medicine, may trigger cancer as well, a rare lymphoma of the intestines.1055 Campylobacter, not even proven to cause human illness until the 1970s,1056 is now the suspected cause of up to 25% of cases of irritable bowel syndrome1057 and is currently the number-one bacterial cause of food poisoning, sickening millions of Americans every year.1058 The bacteria in a single drop of chicken “juice” is enough to make one sick1059 and can persist on a cutting board for hours.1060

The new U.S. meat inspection system—HACCP (Hazard Analysis Critical Control Point system)—was originally designed by NASA and represents a welcome scientific departure from the century-old “poke and sniff” method.1061 Unfortunately, its implementation has been handed over to the industry guarding its own henhouses, leaving some USDA inspectors to deride HACCP as more of a “Have A Cup of Coffee and Pray” system.1062 “As an analogy,” says the president of the U.S. Meat Inspection Union, “imagine that as a driver you must write yourself a ticket every time you exceed the speed limit because you’re breaking the law. Some [chicken packing] plants cheat; others won’t cheat until they’re forced to in a competitive environment….”1063 Veterinarian and academician David Waltner-Toews writes in his book Food, Sex, and Salmonella, “The most serious problems [with foodborne disease] invariably come back to the willingness of pureblooded capitalists to take risks with other people’s lives.”1064

Few public health issues are more public than food safety, yet not only do the state and federal governments continue to lack the power to order mandatory recalls of contaminated meat, the meat and poultry industry don’t even have to divulge where the infected meat went. Federal agencies have more power to recall defective toys than meat. When the industry is left to do it voluntarily, less than half of the tainted meat is recovered. Following the largest meat recall in U.S. history—”ready to eat” chicken and turkey products harboring Listeria bacteria1065 —the Government Accountability Office, the watchdog arm of Congress, called for an overhaul of the process in 2004, including granting the federal government mandatory meat recall authority.1066

Instead of cleaning up its own act—reducing the overcrowding of birds, relieving production stresses, and improving hygiene to lower infection rates—the U.S. poultry industry has tended to push for more cost-effective alternatives, such as irradiation to kill off bacteria and viruses in the fecal material remaining on carcasses before they hit the store. One former USDA meat inspection administrator claims, “All irradiation will do is add partially decontaminated fecal matter to the American diet…. The solution to the food safety problem is to produce safe food.”1067

One novel solution that “holds great promise” is the application of bacteria-destroying viruses to chicken meat, although the industry expressed concern over initial reports revealing “consumer resistance” to the idea.1068 For a similar reason, the industry prefers the term “cold pasteurization” to irradiation.1069

Another innovation the industry is considering to cover up its dirty secret of fecal contamination is “gluing shut the rectal cavities of turkeys and chicken broilers” in the slaughter plants before they hit the scalding tanks.1070 There are concerns, though, about glue residues contaminating the final product. Other ideas for sealing up the birds’ rectums include some type of mechanical plug or stapling technology.1071 The name of the poultry superglue product currently on the market is “Rectite®.”1072