MRSA in UK Turkeys Raises Questions of Communication, Transparency and Risk

Two years ago, I celebrated Thanksgiving here on Superbug by announcing some new studies on resistant bacteria being found in turkey meat in the US. That did not go over well; so this year, I saved the bad-turkey news for the post-holiday week. And here you go:

Just in time for our Thanksgiving -- and in the ramp-up to English Christmas, for which turkey is a traditional dish -- the UK's Animal Health and Veterinary Laboratories Agency announced that livestock-associated MRSA, drug-resistant staph, has been found in UK poultry for the first time. From their not-very-informative press release:

The Animal Health and Veterinary Laboratories Agency (AHVLA) has identified the presence of Livestock-Associated Meticillin Resistant Staphylococcus Aureus (LA-MRSA) in poultry on a farm in East Anglia... Once the poultry have been slaughtered and sold the owner will carry out cleansing and disinfection of their accommodation to ensure the next birds do not become colonised when they arrive on site. The AHVLA will revisit the farm after depopulation and thorough cleansing and disinfection to determine whether LA-MRSA is still present.

Media reports filled in some of the details. The announcement was covered by the BBC, Mirror, and Express, but (as I'll explain below) their stories are short on independent reporting and don't give their readers the information they need. The most complete news-gathering looks to me to be inthe Norwich Evening News, in a poultry-growing area:

Specialist Norfolk poultry auctioneer Fabian Eagle says he has not been given any details of the country’s first case of low-risk MRSA in turkeys. Mr Eagle, a national member of the poultry industry’s stakeholder group, said: “We’ve been kept totally in the dark. The AHVLA (Animal Health Veterinary Laboratory Agency) are keeping everything close to their chest,” said Mr Eagle.

“I understand that the birds are safe to continue in the food chain,” added Mr Eagle, of the Poultry Farm, North Pickenham, near Swaffham.

The first case, which was found in a single turkey on an East Anglian farm, followed routine testing for another poultry disease. When this case of low-risk Methicillin Resistant Staphylococcus Aureus (MRSA) was identified, further tests were carried out and two-thirds of the flock was also found to be infected. It was not found in geese on the same farm.

And the Daily Mail asks important questions about the decision not to identify the farm, pointing out the damage to trust in UK meat as a result of the horsemeat-for-beef scandal last year:

Officials are under fire for keeping details of an outbreak of the MRSA bug in Christmas turkeys secret from consumers.
The Food Standards Agency (FSA) and Defra, the food and farming ministry, have refused to identify the East Anglia farm involved. They have also decided to allow the turkeys to be sold as normal. Officials claim any risk to consumers is ‘very low’.
But food industry experts have said it is vital consumers are given the full facts about safety issues. Nick Martin, of Trace One, a technology company that works with supermarkets, said: ‘As the horsemeat crisis has shown, transparency is key when it comes to addressing consumer concerns over food products to avoid a public backlash.
‘Defra and the FSA have a duty to report the full details of the MRSA infection to consumers.’
The strain of MRSA was found on a small farm that sells thousands of turkeys to independent butchers and markets, rather than to a major supermarket.

Most of the coverage takes its cue from the government press release, which quotes three separate experts averring that livestock-associated MRSA (LA-MRSA, also called MRSA ST398 for the results of one identifying test) is not risky for consumers so long as they cook their turkey thoroughly.

Honestly, this is journalism by press release, and the news outlets that followed the government line did their readers a disservice.

If you've been reading here for a while, you'll know that MRSA ST398 is an interesting and difficult problem. (If it's new to you, or you need a refresher, my past posts on ST398 are here, with more here.) Short version: This is a strain of drug-resistant staph that is different from either the hospital or community variety. It was first found in pigs in the Netherlands in 2004 and has spread widely across Europe and into Canada and in the US. By molecular analysis, it is clearly linked to antibiotic use in livestock-raising, and it is frequently found on retail meat. And, of most importance for the UK reports, it does cause human infections: sometimes mild, but sometimes very serious.

It's narrowly correct to say that LA-MRSA is less common, and causes less illness, than the other forms; that's probably because, in most countries, so much MRSA is already in circulation that there's effectively no living space left for this newer form to occupy. But it's disingenuous to say that there is no risk from it because cooking kills it, for several reasons.

First, because MRSA doesn't cause classic "food poisoning." (Other forms of staph do.) The risk with LA-MRSA is not that you'll cook your food insufficiently, swallow the still-living organisms, and get a gastrointestinal illness; the risk, instead, is that the organism will spread to surfaces in your kitchen, and thence to your skin, and cause either a skin infection that is drug-resistant, or a much more serious illness. (As in, for instance, this very sad outbreak in a residential-care facility in 2009.)

Second, because the "if cooked properly/if hygiene maintained" assertion removes any responsibility from the meat producers who are using antibiotics in their poultry, making it only the job of consumers to protect themselves. And finally and exasperatingly, because we already know that, in aggregate, consumers are unable to behave in their kitchens with absolute cleanliness and absolute hygiene 100 percent of the time.

In the US, millions of people every year develop foodborne illnesses that they would not have acquired if their kitchen behavior was perfect. In the UK, as the Mail put it, "Hundreds of thousands of people in the UK are believed to fall ill every year because they do not handle and cook poultry with the necessary care." Most people don't operate their home kitchens with the rigor of a laboratory or the sterility of an autoclave. Blaming them for illness that occurs if they don't is a failure of responsibility by the agencies tasked with protecting them.

It's surprising to me that news outlets -- especially news outlets in a country that has already suffered a major food scandal -- didn't do a better job of sorting out for their readers where the concerns in this MRSA finding are, and where the real responsibilities lie.