First, there was salmonella. We scrubbed our cutting boards and grew wary of raw chicken. Then there was Mad Cow disease and the E.coli scare, so we started grilling our burgers to a crisp.There's always been botulism, so we stay away from bulging cans. And every kid knows you don't order pork medium-rare.But lettuce? What could be healthier than a nice, big bowl of California greens?Now we hear that a mass outbreak of E.coli bacteria that felled 61 people back east in the summer of 1996 has been traced to dirty lettuce from a small farm in Hollister. Fancy Cutt Farms now faces civil and criminal charges for violating food safety laws by processing lettuce in unsanitary conditions that could lead to bacterial contamination.Unsanitary? According to health authorities, they were rinsing lettuce in dirty, bacteria-laden water, in a shed 100 feet away from a cattle pen, right in the path of dust-borne manure.Great. Just when we thought it was safe to sit down to our salad. And we won't even speak about the Odwalla apple juice case in 1996, which hospitalized 70 people and killed a 16-month-old girl, dealing a crippling blow to the fresh, unpasteurized juice industry.What's going on? You could call it progress, says Monterey County Health Department director Dr. Bob Melton. Back in the 1950s, he says, most people's fresh produce came from a local grower. The grower picked it, delivered it to your corner grocer's, you bought it and ate it. Since then, we've experienced the globalization of our food supply. Produce grown in one place is shipped to another place, sometimes half-way around the world, handled by many unseen people, passing through numerous points of potential contamination all along the way.We have also seen the emergence of deadly new organisms, from the AIDS virus to E.coli 0157, the bacterial strain fingered as the culprit in several recent high-profile cases of food-borne illness, from hamburgers in 1993 to lettuce last year."These are organisms that have genetically changed and become powerfully toxic," Melton explains. "These new, highly toxic organisms are very common in livestock herd and poultry.""When you put these factors together," Melton says, "you have a set-up for very serious outbreaks of debilitating and fatal disease."E.coli 0157 first began to appear in our food in 1980. Since then, according to statistics from the Centers for Disease Control and Prevention (CDC), it infects more than 20,000 Americans a year. Five hundred of those people die. Others suffer severe diarrhea and blood and kidney disorders that can cause permanent damage.The earliest, and still the majority, of cases involve infected meat or poultry. But increasingly, E.coli and other deadly bacteria are showing up in fresh fruits and vegetables, the kinds of food health-conscious Americans are eating more of, more often.It's not that the fresh produce itself is dangerous. The E.coli bacteria breeds in animal or bird manure, which can come into contact with fresh produce in the field or during the packing or shipping process. If that tiny bit of fecal matter is not washed off that lettuce leaf or tomato slice, you can eat it and get sick.That's what probably happened in the Hollister case. In June 1996, federal and state health investigators examining the E.coli outbreaks in New York, Connecticut and Illinois traced it back to lettuce grown and packed at the small Fancy Cutt Farms in San Benito County. That July, inspectors turned up at Fancy Cutt, and discovered appalling sanitary conditions.According to the investigators' report, the lettuce was grown in the same field where cows grazed -- and deposited their manure -- during the winter. The lettuce was carted into the company's packing shed in dirty boxes. Employees without gloves swished the leaves around in wash water that was not properly recycled, and which contained another strain of E.coli. And the packing shed itself was less than 100 feet away from a cattle pen, close enough for manure to be blown or tracked in. The Food and Drug Administration (FDA) report from that investigation states that Fancy Cutt had "no quality control procedures."Last month -- a year and a half after the violations were discovered -- the state of California filed a civil suit against Fancy Cutt. The company will also be arraigned next week on criminal charges filed by the San Benito County district attorney's office. But Fancy Cutt is still in operation. San Benito County DA Harry Damkar, who filed the criminal case against the farm, says as far as he knows, no injunction has been placed against them.Part of the problem is the difficulty of proving a connection in cases of food-borne illness (see sidebar). Fancy Cutt is not charged with causing the East Coast illnesses, only with violating food safety regulations. By the time investigators arrived at the farm in July 1996, the contaminated lettuce had already been shipped, and authorities weren't able to find the same strain of E.coli on-site. There was not enough evidence to link the farm to the illnesses for legal purposes.State Department of Health Food Safety Director Jim Waddell, whose department took part in the Fancy Cutt inspection, says that while investigators were at the site, they also examined sanitary conditions at the adjacent Specialty Produce farm. "It was even worse over there," says Waddell.Specialty Produce has been slapped with a civil suit by the state, and will be arraigned Feb. 19 along with Fancy Cutt on similar criminal charges, plus other charges related to improper state registration. Like Fancy Cutt, Specialty Produce is still doing business. Both companies are still growing, packing and selling lettuce. Fancy Cutt's owners told a New York Times reporter that there are "a dozen or more" other local lettuce processors with more hazardous operations than theirs.Consumer-Driven CrisisThis latest food safety crisis is, to a large extent, consumer-driven. Increased public demand for fresh fruits and vegetables, and the growing popularity of ready-to-eat packaged salad mixes and fresh juices, has encouraged many small companies to enter an increasingly competitive field. In particular, small-scale farmers who used to just grow lettuce and radishes have now started cleaning, chopping and processing their own salad mixes. Some of them, health authorities charge, have little understanding of correct safety procedures, or little incentive to implement them. And because most of this produce is eaten raw, high-heat techniques to kill bacteria such as boiling or pasteurization are not applicable. Scrupulous cleanliness at every step of the operation, from harvesting through processing, becomes paramount."The nature of the industry is changing," says Waddell. "High-end operations like Dole and Fresh Express used to be the only ones out there [selling pre-mixed packaged salad]. But as salad mixes became more popular, more and more smaller growers have started chopping and blending, and they're not always aware of the concerns. They receive all the instructions when they register, and they have to register, but that doesn't mean they are really aware.""The problem usually occurs with the small, Mom-and-Pop operations, where they're not as aware of the issues," says Monterey County Director of Environmental Health Walter Wong. "At the big corporations, like Dole [Fresh Vegetables, Inc. in Salinas], there are all kinds of PhDs running around, working in food safety. The smaller operations haven't been keeping up with modern food safety technologies as well as the big corporations. They're often just struggling to get by.""These little start-ups just get going," says San Benito County Agricultural Commissioner Mark Tognazzini. "Maybe the guy worked for someone else, and says, 'Hey, I can do this.' So he puts a horse trough in the barn to wash the lettuce, and goes into business."What's great about the fresh produce industry, Tognazzini points out, is that it's open to the little guy. That's the kind of small, family-owned business we'd all like to encourage. But when it comes to food safety, that's also where much of the problem lies.A recent New York Times article on the Hollister case quoted federal health authorities as warning that we could soon see major outbreaks of food-borne disease emanating from the fresh produce industry, particularly small farms like those fast proliferating in California. Wong doesn't disagree."It's not just regulations we need, it's more education for small growers," he says.Wong's department regularly inspects Monterey County farms for adherence to sanitation regulations in the field and the packing shed. In the field, growers are required to provide toilet and washing facilities for their fieldworkers on a per-head basis. This becomes increasingly important in smaller farms, where the same workers who pick the produce in the field then wash and pack it in the farm's shed. County health inspectors also examine sanitary conditions in the packing shed, checking the cleanliness and chlorine levels of the water used in rinsing lettuce, for example.No Monterey County growers or processors have faced the kind of charges brought against Fancy Cutt or Specialty Produce, says Monterey County Agricultural Commissioner Dick Nutter, whose office also sends out field sanitation inspectors. Nutter also says the most common violations at local farms are insufficient washing facilities for fieldworkers, and irregular recycling of water used to wash and cool the produce prior to shipping.Local growers are pretty good about complying with field sanitation regulations, he says. Since local strawberries were implicated two years ago in a cyclospora bacterial scare (which was later found to originate with imported raspberries, by the way), county health authorities have been "looking carefully" at fieldworker washing facilities, Nutter says. Citations are issued to growers with insufficient facilities, but they invariably get back up to code within a day or two.Slipping Through the CracksThe worst food safety problems -- according to Wong -- occur when regulations are non-existent or ignored. The proliferation of small growers, and their quick entry into the lucrative pre-mixed salad market, has led to a rise in the number of growers who "neglect" to register with the proper state authorities. Two of the three criminal charges Specialty Produce faces have to do with improper registration. "No one had control over them, to make sure there was no animal or human waste contaminating the produce," Wong points out.Another serious health hazard concerns the cleanliness of shipping trucks, which is also not regulated. Trucks used to transport poultry from farm to market one day can be used to ship fresh vegetables the next day, and no law says how that truck must be cleaned. "There's an assumption that if fresh produce is contaminated, that contamination got into it during the processing," says Tognazzini. "And that's just not true." For example, he tells of a truck that showed up at one local farm to ship fresh produce while it was still filled with chicken blood from a previous delivery. "Sometimes hamburger meat can be stored on a shelf above lettuce in the truck," Tognazzini points out. "There are many possible sources of bacterial contamination."Media critics have focused attention on the nation's health inspection process, which has been called insufficient to meet our growing food safety crisis. The FDA has only 700 inspectors to cover 53,000 food processing companies, meaning that each company can only be inspected once every 10 years. In fact, inspectors are usually only called out in response to a specific disease outbreak, as in the Fancy Cutt and Odwalla cases.Perhaps in answer to that criticism, California is beefing up its inspection schedule. The state department of health will send inspection teams our way sometime this spring. Waddell says they'll be focusing on fieldworker cleanliness in particular. "It's a real risk," he says. "Especially with the smaller growers, fieldworkers involved in the actual harvesting then physically put the produce in the bags. It's a direct avenue for contamination."Before we throw out our oil and vinegar cruets, let's put the whole thing in perspective. True, CDC reports note an upswing in the number of food-borne illnesses traceable to fresh produce. But the numbers are still infinitesimal. To drag out an old aphorism, you're more likely to be struck dead by lightning than felled by a fecal-speckled lettuce leaf."Fresh produce grown in California is the safest in the world," says Waddell. "Our recommendation is still the consumption of five portions of fresh fruit and vegetables every day."Despite their differences in other areas, California health authorities and growers come together in supporting Waddell's assessment. The agriculture industry is working hard, growers say, to reduce an already tiny danger to microscopic proportions. California's field sanitation regulations set the industry standard, notes Walter Wong. And food safety guidelines developed last year by the Irvine-based Western Growers Association were cribbed unashamedly by the Clinton Administration as the basis for proposed federal food safety guidelines expected to be released by October.Much of the responsibility for food safety rests with the consumer, experts agree. Growers are quick to point to CDC figures that claim just three percent of food-borne illnesses are traceable back to the farm. They say the other 97 percent is traceable to contamination that occurs after the product leaves the field, most likely in a restaurant or a consumer's home. Even given that statistics on food-borne illnesses are underreported, and skewed in favor of large-scale outbreaks, these figures still show that you can't lay all the blame on the farmer."Wash all produce before consumption, in good, running water," Waddell advises. That includes salad mixes, even those marked "triple-washed," whether you buy it in a pre-packed bag or in loose form from a supermarket shelf or at a farmer's market. "Wash it anyway," Waddell says.Nuke 'Em?Proper sanitation is one way to reduce the risk of food-borne disease. Another way would be for producers to adopt certain processing techniques designed to wipe out bacteria, such as pasteurization of fresh juices or irradiation of fresh fruits and vegetables.These techniques, however, are unacceptable to many growers: to organic growers on ideological grounds, and to conventional growers on practical grounds.Irradiate tomatoes? Why not just throw them in a nuclear reactor before you sell them? "Irradiation is contrary to organic industry protocol," says Bob Snowcroft, executive director of the Santa-Cruz based Organic Farming Research Foundation. "There's a lot of concern about the lack of research around [irradiation] and what it does to live foods."Teresa Thorne, communications director for the California Strawberry Commission, points out that there aren't any irradiation facilities for fresh produce in California, anyway. The nearest ones are in Florida. "Can you imagine shipping all our produce to Florida for irradiation?" she asks.Pasteurization, which involves heating liquid to extremely high temperatures in order to kill bacteria, also affects the taste and texture of fresh juice. That's why Odwalla avoided it. But after 70 people were hospitalized and one little girl died from E.coli contamination in one October 1996 batch of fresh Odwalla apple juice, the company announced it would begin pasteurizing all its juices.Other apple juice producers don't agree with Odwalla's assessment. "I don't see a need for pasteurization," says Mitch Gizdich, owner of the 90-acre Gizdich Ranch in Watsonville, which has been making and selling fresh apple juice for 24 years. "Fresh juice has more nutrients, more flavor, and more of the enzymes people look for in their food. When you pasteurize it, you lose all that."Growers are rushing to pasteurize because of media hype rather than real safety concerns, says Gizdich. "The apple industry took a bad rap because of one company," he says. "There's no reason why a good, sound quality fruit shouldn't make good juice. It all comes down to having a good quality assurance program."And even that is no guarantee against all health hazards. "Even if you pasteurize, a bug could drop into the juice, or a chip of plastic could fall in," he says. "Nothing is 100 percent in this world."Sidebar OneWhat's in a number?Ninety-seven percent of food-borne illness is due to contamination after produce leaves the farm. Seventy percent of food-borne illnesses come from meat or poultry.How reliable are these CDC and USDA figures? Not very, says Monterey Country Health Department epidemiologist Karen Ehnert. It's very hard to track down the cause of a food-borne illness, mainly because incidents are not reportable to health authorities unless two or more unrelated people get sick after eating the same food at the same event. Government health authorities estimate that less than 5 percent of food sickness cases are reported at all.In fact, Ehnert states, the vast majority of actual illnesses caused by food contamination are suffered by one individual. Maybe 99 out of 100 cases, she believes. But we don't hear about them because they're not reported. And when those people consult a doctor, they are treated symptomatically. Tests are rarely done, Ehnert says. In this age of managed health care, who's going to order a $40 investigative test?"Not only that, but people who get sick always think it's the last thing they ate, when it usually isn't," she says. "And they always think it's something they ate at a party or restaurant. It's never something from their own kitchen. If they get sick at home, it's always the stomach flu."Statistics can be skewed both ways, says Nancy Nagle, vice president of research and development for Dole Fresh Vegetables, Inc. "The CDC is identifying more instances of what they say are food-borne illness related to fresh produce, but some of that is related to increased surveillance and reporting," she says. People are asked leading questions during outbreaks of suspected food-borne illnesses, she notes, such as "Are you sure you didn't eat any chicken?"It's in the kitchen that food contamination can either be stopped, or encouraged, through safe food-handling techniques (see below). "People think they can use the same chopping board for meat and vegetables, as long as they run it through water in between," Ehnert says. That's a great way to spread salmonella infection.Careful washing of all fresh produce, even pre-packaged salad mixes, is a must. Washing will remove most harmful bacteria. Put a little bleach in the water when washing fresh produce that has been on or grown in the ground, she suggests.And don't think that fruit with a rind, like melon, is safe. When you cut through the rind, your knife can track bacteria through every slice. If you don't wash the rind, and you pile up slices with rind touching fruit pulp, the same thing can happen. "Cantaloupe has been implicated this way," Ehnert warns."People aren't being taught about food safety in school anymore," she continues. The home economics classes of the 1950s are pass today, but they taught generations of women how to prepare and store food safely for their families. "We're trying to cook dinner a lot faster today, and we don't always take the time to do it correctly," she says.We're also getting a lot more imported produce in our supermarkets, from Mexico and other countries where food safety regulations are more lax. "When I advise people travelling to South America or Asia, I tell them not to eat salads, eat only fruit you can peel, make sure your food is well-cooked," Ehnert says. "Now we're getting that produce directly in our stores. We have to start handling all our produce as if we were in a foreign country."In an effort to improve public awareness of safe food-handling practices, the county health department will focus its Public Health Week this April on food safety and emerging pathogens."It's no longer 1963," says county health department director Dr. Bob Melton. "The world is different. The risks are there."Sidebar TwoFood Safety Tips1. Always wash fresh fruit and vegetables before eating. That includes packaged salad mixes! Wash in cold running water. Use a little bleach on produce that has been in or on the ground. Wash the rinds, too. You're going to touch those orange slices after you peel the fruit, right?2. Use separate cutting boards for meat/poultry and food you will eat without cooking: fruit, vegetables, bread, etc.3. Don't store raw meat next to fresh produce or dairy products in your refrigerator.4. Don't leave prepared foods or raw meat sitting out on the counter.5. Cook meat and poultry all the way through.6. Be careful using the microwave to cook meat or poultry. Heating is uneven, and can leave patches of meat raw or partially cooked, a breeding ground for bacteria.7. If it smells funny or looks peculiar, dump it. Why take a risk?