Cyclospora outbreaks show the dangers of compounded food supply

The cyclospora outbreak that has sickened thousands in the US is drawing renewed attention to a decades-long shift in how fresh food travels across the country.

While investigators are working to identify the original source of the contamination, others Food safety experts say industry networks focused on sourcing and distribution behind the wave of consolidation can help turn what was once a single contamination event into a multi-state outbreak.

“The general methods that have occurred in the food industry, the way food is obtained and distributed have a role here,” said Dr. David Relman, professor of microbiology and immunology at Stanford University.

The cyclospora parasite’s long incubation period, the difficulty of tracking it and what some experts have criticized as a heavy-handed government response have all played a role in the spreading outbreak. Some experts say that the structure of the food system has also had an effect.

“It’s possible that as the procurement and distribution of food is integrated you get to consolidate and redistribute what might have been a localized pollution problem, so that it’s now a widespread pollution problem,” Relman said.

Marion Nestle, professor emeritus of nutrition, food studies and public health at New York University, said the shrinking of the industry has increased the effects of contamination.

“Consolidation means that if something goes wrong, it goes very wrong,” said Nestle.

Central processing could further increase the reach of outbreaks, he said.

The FDA’s current investigation into cyclosporiasis focuses on iceberg lettuce distributed through Taylor Farms’ food service business, an ingredient that has reached Taco Bell restaurants and other food service customers in many states.

Relman pointed to bagged lettuce as one example of how changes in distribution can spread foodborne illness.

“Imagine the difference between a single head of lettuce and a bag of chopped lettuce that may have come from many heads,” he said. “These bags are now mass-produced and distributed far and wide.”

The industry’s growth in minority distributors has been driven in part by efficiency pressures. Nestle said that business development comes with trade to ensure food safety.

“Bigger doesn’t mean better,” he said. “The bigger the supplier, the bigger the chance of infection.”

Over the past few decades, US agriculture and food distribution have become less rigid as companies pursue greater efficiency and national standardization, according to the USDA.

For example, Taylor Farms, a salad producer under scrutiny for the recent cyclospora outbreak, has seen significant expansion through a series of acquisitions over the past decade — including Earthbound Farm in 2019, Curation Foods in 2021 and most recently Equinox Growers in March.

Meanwhile, restaurant offerings have become more concentrated, as have broadline distributors Sysco, US food again Functional Food Group serving hundreds of thousands of restaurants and institutional kitchens across the country.

While federal regulators blocked Sysco’s proposed acquisition of US Foods in 2015 on antitrust grounds, both companies continued to grow with small acquisitions of regional distributors and processors of fresh produce.

Sysco, the nation’s largest foodservice distributor, has spent the past decade growing its fresh produce business by acquiring regional distributors including Paragon Foods in Pennsylvania, The Coastal Companies in the mid-Atlantic and Greco and Sons, a specialty food distributor with 10 distribution centers nationwide.

Those deals expand Sysco’s access to fresh produce and value-added processing, allowing a larger portion of restaurants to source ingredients through the same distribution network.

In 2016, US Foods acquired Freshway Foods, an innovative fruit and vegetable processor, repacker and distributor in the eastern United States.

Some experts in food distribution believe that having a small number of companies in the industry compounds the problems when they arise.

But not everyone agrees that integration is the enemy.

Timothy Lytton, a health and safety law expert at Georgia State University, said large produce growers and processors tend to operate more complex food safety programs than small farms because they have the financial resources to invest in testing, tracking, research and quality control.

“It is not clear whether large operations have more food safety problems than small operations,” said Lytton.

In California, he added, there have been studies at farmers markets that have found that fresh produce grown by small farmers is contaminated with E. coli.

“While you may have a farmer who is more concerned about the quality of the product, in the ecological model you have a holistic view of farming that often involves animals alongside plants,” Lytton said. “That combination of animals and plants can cause food safety problems.”

However, Lytton acknowledged that when contamination occurs within large networks of handlers, the resulting recall at the distribution level becomes more widespread and difficult to control.

CNBC reached out to a group of major food suppliers about safety precautions and tracking procedures. Sysco pointed CNBC to the International Foodservice Distribution Association.

“The food supply chain that feeds our communities is complex and food service distributors are highly skilled in tracking and tracing the food they move,” said an IFDA spokesperson. “They maintain rigorous records, identifying the source, internal movement, and recipient of every product they use, and have a proven track record of providing the FDA with critical traceability information within 24-48 hours to support foodborne illness outbreak investigations and to quickly remove products from commerce.”

Relman emphasized that while mixing itself does not create contamination, it does change the results when contamination occurs.

“A lot of times we don’t appreciate a program like the food inspection program, or the public health program in general until it fails,” Relman said. “We can’t continue to do that.”