The editor of Nieman Watch at the Nieman Foundation for Journalism at Harvard University tracked me down in Florida a couple of weeks ago -- it's not hard, I'm always plugged in, zing -- and asked me to pen the following, which he greatly improved with some editing. Below, Powell's take on the top-5 food-safety questions journalists should be asking.

Food safety is not a trivial issue. The World Health Organization (WHO) reports that up to 30 per cent of individuals in developed countries acquire illnesses from the food and water they consume annually. Active disease surveillance by U.S., Canadian and Australian authorities suggests this estimate is accurate.

WHO has identified five factors of food handling that contribute to these illnesses: improper cooking procedures; temperature abuse during storage; lack of hygiene and sanitation by food handlers; cross-contamination between raw and fresh ready-to-eat foods; and acquiring food from unsafe sources.

There has been some excellent media coverage of microbial food safety issues since the 1993 E. coli O157:H7 outbreak linked to Jack-in-the-Box that killed four and sickened over 600; there has also been some terribly misleading coverage.
Reporters interested in covering this important story should be asking these five questions:

1. Will more government involvement mean fewer sick people?

While the Internet and the mainstream media were all excited about the potential passage of new food safety legislation by the U.S. House in early August -- it passed -- I was hanging out with some food safety dudes at Publix supermarkets HQ in Lakeland, Florida. And I saw far more in Lakeland that would impact daily food safety than anything the politicians, bureaucrats and hangers-on were talking about.

When it comes to the safety of the food supply, I generally ignore the chatter from Washington, as well as the Internet commentaries and conspiracy theories. If a legislative proposal does emerge, such as the creation of a single food inspection agency, or the bill that passed the House – and just the House –  I ask, Will it actually make food safer? Will fewer people get sick?

As the Government Accountability Office pointed out in a report a year ago, “The burden for food safety in most … countries lies primarily with food producers, rather than with inspectors, although inspectors play an active role in overseeing compliance. This principle applies to both domestic and imported products.”

Publix, with over 1,000 supermarkets, its own processing plants, and thousands of food products moving through its shelves, can’t afford the luxury of chatter. After a  visit to headquarters in Lakeland, Fla., I went to the local Publix in St. Petersburg Beach to verify what I’d heard at HQ. Sure, the bosses know food safety, but do the front-line staff?

I ordered some shaved smoked turkey breast from the deli, and the sealable bag the meat was delivered in bore the following message:

“The Publix Deli is committed to the highest quality fresh cold cuts & cheeses; Therefore we recommend all cold cuts are best if used within three days of purchase; And all cheese items are best if used within four days of purchase.”

This was the first time I’d seen a retailer provide information to consumers on the accurate shelf-life of sliced deli meats. It didn’t require Congressional hearings; it didn’t require some hopelessly-flawed consumer education campaign; it required the company’s food safety officials to say, this is important, let’s do it.

Same thing with fresh fruits and vegetables -- the leading cause of foodborne illness in the U.S. for the past decade.

Late last month, U.S. regulators announced plans to strengthen safety protocols for fresh fruits and vegetables -- except those plans are simply extensions of plans published by the U.S. Food and Drug Administration in 1998. Plans and guidelines don’t make food safe: people do.

It’s nice that food safety is once again a priority in Washington and that politicians are trying to set a tone. But chatting doesn’t mean fewer sick people -- actions do.

Journalists can hold politicians, producers and industry accountable. There are lots of plans and proposals, but will any of them translate into fewer sick people?

2. Is local/natural/sustainable/organic/raw food really any better than other types of food?

A U.S. government extension agent with a PhD and at a prominent university e-mailed the other day to ask if I had any data on foodborne illness from farmers’ markets because she was preparing for a presentation and was, “trying to make the case that there are very few cases of foodborne illness from local foods relative to our globally based food system.”

But the idea that food grown and consumed locally is somehow safer than other food, either because it contacts fewer hands or any outbreaks would be contained, is the product of wishful thinking.

Barry Estabrook of Gourmet magazine recently invoked the local-is-pure fantasy, writing: “There is no doubt that our food-safety system is broken. But with the vast majority of disease outbreaks coming from industrial-scale operations, legislators should have fixed the problems there instead of targeting small, local businesses that were never part of the problem in the first place.”

But whenever you hear someone say there’s “no doubt” in this field, you should be filled with doubt. Foodborne illnesses are vastly underreported. Someone has to get sick enough to go to a doctor, the doctor has to be bright enough to order the right test, the state has to have the known foodborne illnesses listed as reportable diseases, and so on. For every known case of foodborne illness, there are an estimated 10 to 300 other cases, depending on the severity of the bug. Most foodborne illness is never detected. It’s almost never the last meal someone ate, or whatever other mythologies are out there. A stool sample linked with some epidemiology or food testing is required to make associations with specific foods.

Maybe the vast majority of foodborne outbreaks come from industrial-scale operations because the vast majority of food and meals is consumed from industrial-scale operations. To accurately compare local and other food, a database would have to somehow be constructed so that a comparison of illnesses on a per capita meal or even ingredient basis could be made.

Then there are the whoppers that are repeated daily, somewhere, like this one by raw milk advocate Sally Fallon, who said, “Raw milk is like a magic food for children. … Without the green grass, you're missing a lot of vitamins. Also, it's much safer. When cows are eating green grass, you don't find pathogens in their milk.”

With such statements, public advocacy becomes public health risk.

The natural reservoir for E. coli O157:H7 and other verotoxigenic E. coli is the intestines of all ruminants, including cattle -- grass or grain-fed -- sheep, goats, deer and the like. The final report of the fall 2006 spinach outbreak identifies nearby grass-fed beef cattle as the likely source of the E. coli O157:H7 that sickened 200 and killed four.

A table of raw dairy outbreaks is available at http://www.foodsafety.ksu.edu/articles/384/RawMilkOutbreakTable.pdf. Kids are often the ones that get sick.

And be wary of claims that food is local.

3. Is that food safety advice really accurate?

Everyone eats, so everyone’s an expert when it comes to food. Food, Inc. may be a popular movie among the foodies, but has some terrible food safety advice. Microorganisms that make people sick exist in whatever kind of food production and distribution system we smart humans come up with. But government, industry and academic advice can often be of limited use -- or wrong. Do people really need to wash their hands for 20 seconds -- or will 10 seconds suffice? It will.  Does the water have to be warm? No. Are paper towels better than blow driers at removing pathogens? Yes, it’s the friction that counts. Food safety types argue about these things all the time. If someone says, “food safety is simple, just follow this advice,” don’t believe it. Question everything.

4. With all of the attention, resources and talk, why hasn't there been a reduction in the estimated incidence of foodborne illnesses in the past five years?

The U.S. Centers for Disease Control reported in April 2008 that foodborne illness remains a significant public health issue in the U.S., with Salmonella infections increasingly problematic: “Although significant declines in the incidence of certain foodborne pathogens have occurred since 1996, these declines all occurred before 2004,” the CDC reported.

“Outbreaks caused by contaminated peanut butter, frozen pot pies, and a puffed vegetable snack in 2007 underscore the need to prevent contamination of commercially produced products. The outbreak associated with turtle exposure highlights the importance of animals as a nonfood source of human infections. To reduce the incidence of Salmonella infections, concerted efforts are needed throughout the food supply chain, from farm to processing plant to kitchen.”

The CDC data show existing efforts to reduce foodborne illness have stalled. Signs stating “Employees must wash hands” may not be the most effective way to compel good food safety behavior. New messages using new media should be explored to really create a culture that values microbiologically safe food.

5. Why don’t producers, processors, and retailers market microbial food safety directly to consumers?

There’s lots of marketing of food safety, but it is done indirectly. One of the reasons people buy organic/natural/local/whatever is they perceive such food to be safer -- in the absence of any microbiological data. Grocery stores say all food is safe, yet the weekly outbreaks of foodborne illness -- the ones that consumers hear about -- suggest otherwise. The best farms, processors, retailers and restaurants should brag about their microbial food safety efforts and accomplishments. With so many sick people each year, there’s an attentive audience out there.

Dr. Douglas Powell is an associate professor of food safety at Kansas State University. He also runs barfblog.com, a blog about food safety.