SPOILED - Why Our Food Is Making Us Sick and What We can Do about It by Nicols Fox, Penguin Books, New York, 1998, 434 Pages, $15 (Paperback) ISBN: 0-1402 7555-X (Catalogued by the Library of Congress as SPOILED: The dangerous truth about a food chain gone haywire)

Bacteria, by any reasonable criterion, were in the beginning, are now, and ever shall be, the most successful organism on earth.--Stephen Jay Gould, 1966

When Nicols Fox read about the widespread outbreak of food borne disease linked to fast-food hamburgers on the West Coast, she decided that there was something missing in the story. The news reports of hundreds of people getting sick and children dying from a "urinary tract infection" just didn't add up to what she had learned in college biology--Fox knew that E coli was common in the human gut. It took some time, but gradually her research came together, it all pointed to a particular E Coli that went by the serotype name: O157:H7.

Robin Cook, in his book, TOXIN, cover the type of outbreak Fox describes in her chapter "Hamburger Bacteria." Fox presents an array of outbreaks, describing the anatomy of "Salmonella and the Bad Egg," "Campylobacter and the Poultry Connection," as well as the "Mad Cow" problem. She also adds a chapter on the "Politics of Denial."

The epilogue includes the disconcerting story of the Anderson farm, where a young couple tried to fulfill their dream of raising organic beef. But disease struck their herd; they lost nearly every one of their 60 calves. The person carrying off the dead animals always inquired about when the calves died. He did have connections to a veal slaughterhouse where he allegedly took the ones who most recently died rather than to the rendering plant. The Vermont dept of Agriculture refused to get involved and made comments similar to those that the USDA made in Robin Cook's book. After the story broke, the young couple had to force their way through a group of journalists and TV news people just to go between their house and barn. With all the bad press, the couple gave up their dream and move. They were, however, able to stow away one calf that harbored the coliform which has not yet been serotyped. This calf is not ill--it appears like a Typhoid Mary. The couple still hopes the mystery will be solved.

This book is a very valuable adjunct to Robin Cooks TOXIN. It illustrates that the government that so many people trust to protect their health, is the biggest obstacle to that end. Spoiled provides a valuable service to our profession and patients. However, it's hard to read more than one story on any given day without getting sick.

Del Meyer, MD