One after another, diners fell seriously ill around the country. In an Atlanta laboratory, scientists saw a similarity between the genetic fingerprint of the E. coli bacteria that made some of them sick and one identified by Canadian officials as the culprit in an outbreak tied to romaine lettuce there.
The race was on to identify the exact source, issue warnings to prevent further illness and stop the December outbreak.
Widespread cases of foodborne illnesses are high-stakes mysteries that are not always perfectly solved. At the U.S. Centers for Disease Control and Prevention in Atlanta, Matt Wise ’01 is one of the key detectives working to protect the public as deputy chief of the CDC’s Outbreak Response and Prevention Branch.
“You have to weigh a lot of uncertainties,” says Wise, who earned a master’s in public health and a Ph.D. in epidemiology from UCLA after graduating from Pomona College. “We have to balance being fast and being right, and not causing unnecessary panic.”
In the recent E. coli case that sickened 24 people and caused one death across 15 U.S. states, officials were able to declare the outbreak linked to leafy greens likely over – in part because of their short shelf life – before the CDC pinpointed the exact greens involved. Because Canadian officials focused on romaine lettuce in a larger, earlier outbreak there and Consumer Reports issued an advisory against consuming romaine, Wise was tasked with explaining the CDC’s position to the media, including the New York Times.
“Leafy green outbreaks in general can be challenging,” Wise says. “There’s not a label on a salad you order in a restaurant.”
Some outbreaks are resolved more cleanly than others. Wise pointed to the E. coli outbreak in early 2017 caused by soy nut butter, a peanut butter replacement often served in childcare centers.
“That’s the last place you want a food item served that’s contaminated with E. coli, which can cause kidney failure in children,” he says. “An astute epidemiologist in California noticed a couple of people had eaten this same brand of soy nut butter. That was a very classic one, there was a recall by the company pointing to a very specific product, and a great example of getting to the right answer very quickly.”
PATH FROM POMONA
Wise arrived at Pomona in 1997 planning to become a doctor.
“By around my sophomore year, I found I wasn’t loving all the premed requirement classes,” he says, adding that those were some of his larger classes – not huge compared to classes at some major research universities, but large for Pomona, where the average class size is 15. “It wasn’t an environment where you are having intimate discussions or talking one-on-one with the professor, like my other classes. I started to realize there were other ways to be involved in medicine.”
Wise gravitated toward anthropology, psychology and sociology, and ultimately received faculty approval to design a special major in community health.
“I had some great psychology courses with Nicole Weekes and Sharon Goto, and when I was taking a Sociology of Health and Medicine class up at Pitzer, I read an article about the CDC’s Epidemic Intelligence Service, sort of like a disease detective corps, a two-year on-the-job training program primarily for people at the doctoral level – physicians, veterinarians, scientists,” he says. “That sounded really cool to me.”
Wise pursued his master’s and Ph.D. immediately after college and joined the Epidemic Intelligence Service program in 2008. He has been with the CDC ever since. As a member of the U.S. Public Health Service Commissioned Corps, an elite team of highly qualified public health professionals, he holds the rank of commander and wears a uniform to work every day.
CONNECTING THE DOTS
No small part of the CDC’s job is serving as a clearinghouse for gathering and disseminating information.
“If 14 people get sick in 14 different states, there’s no way any of those state’s health departments are going to see the connection,” Wise says. “If someone gets sick with Salmonella, E. coli, or Listeria, for example, and they go to the doctor, the doctor can do tests for what bacteria is making them ill. They then send that bacteria to the state’s public health lab where they do DNA fingerprinting on the bacteria. CDC looks for groups of illnesses across states that share that same DNA fingerprint. Once one of these groups of illnesses is identified, it comes to our group, and we start working with states on what these people have eaten in common, and conduct interviews to get that data.”
Ideally, the source can be pinpointed with laser precision, as in the soy nut butter case.
“Most of the time we publicly communicate about an outbreak with a really specific product and lot number and tell people to look in their freezer or fridge and throw it out. That’s the ideal situation,” Wise says.
So has all his knowledge made him a picky eater?
“For the most part, not too much,” Wise says. “Certainly I want to eat at restaurants where people are cooking the food well and not contaminating the salad greens with raw chicken, for example. I will say I never liked sprouts before, but since I started this job I will not start eating them.”
Nor is a restaurant chain that has had an outbreak off his list forever.
“In some ways, the companies that are dragged through the media the most, in the end, they end up with the safer food,” he says. “They’ve learned the lessons the hard way. It’s a painful process but they’ve made a lot of changes. It’s really impactful.”