Cold Cuts Served To Elderly Despite Risk

By Tom Blackwell, National Post

Canada

August 29, 2008

Amid the debate over the role of Canada's meat-inspection system in the listeriosis outbreak, a much simpler question about the affair is emerging: Could the death toll have been slashed simply by keeping deli meats off nursing home menus?

A background article posted on the Health Canada Web site almost three years ago noted that the elderly are among the most susceptible to the disease, and that such high-risk people should avoid "non-dried" deli meats, among other foods. And yet it appears most of the outbreak's victims were senior citizens living in long-term care facilities, apparently served the kind of cold cuts linked to the bacteria's recent spread.

Some experts say banning such food in nursing homes and hospitals would be an overreaction to a rare event, and ignores other food, like milk and even cabbage, that has been linked to listeria in the past. Others say institutions should have acted sooner.

"Certain groups should probably be avoiding those foods, and that would be the elderly, pregnant women and people who are already sickened by a weakened immune system," said a spokeswoman for the Food Safety Network at the University of Guelph.

"I definitely think it should be taken into further consideration by long-term care facilities," Marnie Webb said.

Still, Ms. Webb acknowledged that nursing homes face a balancing act, since the softness of luncheon meats make them easy to eat for older people.

Other experts say it is not necessary to deprive so many people of a major source of food, noting that the huge volume of deli meats sold in Canada has resulted in very little disease, despite the tragedy of the current crisis.

"The outbreak we're going through right now is more or less a fluke," said Dr. Michel Laverdiere, past president of the Association of Medical Microbiology and Infectious Disease Canada. "This was a break in the food preparation. I don't think we should go overboard and say that all of those prepared foods should be banned from old-age homes."

Federal officials reported yesterday that there had been 29 confirmed cases of listeriosis -- the disease caused by listeria bacteria -- and 15 deaths, eight of which have been clearly tied to the outbreak and seven of which are still under investigation.

Ontario officials have revealed that most of the deaths there occurred in long-term care facilities.

Health Canada's November, 2005, article on listeria and food safety lists pregnant women and their fetuses or newborn children, the elderly, and people with weakened immune systems as the most at risk to develop serious illness if they come in contact with the bacteria.

It suggests a number of precautions to avoid infection, such as sanitizing utensils and surfaces that were in contact with raw meat. The article also suggests that high-risk people avoid certain foods, including non-dried deli meats. Dried and salted deli meats such as salami generally do not support growth of listeria, the article notes.

Asked yesterday if Health Canada would tell long-term care facilities to stop serving deli meats, Dr. Jeff Farber of Health Canada said only that the educational material the department has available now is effective, and will be improved in future.

Dr. Andrew Potter, an infectious disease expert at the University of Saskatchewan, argued against banning individual items, noting that almost any food can be a source of some harmful microbe. Past listeria outbreaks have stemmed from milk and cabbage, spinach sometimes carries E. coli and unpasteurized apple cider harbours salmonella. It is better to prevent contamination at the source, with safer meat processing or by developing vaccines for animals, he said.

"There's a risk associated with everything, whether it's deli meat or eating a hamburger," said Dr. Potter, head of the Vaccines and Infectious Disease Organization at the university. "Food is not a 100% safe commodity, much as we would like to believe it. It's just the nature of the beast."

Dr. Jill Hobbs, another University of Saskatchewan professor who specializes in the economics of food safety, also dismissed the idea of keeping certain foods from the elderly. She advocates better tracing of food so recalls can be more effective.

"We risk implying that all deli meats are dangerous," she said. "It's like throwing the baby out with the bathwater."

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