KEY POINTS:
There's a killer in the supermarket chiller, spreading disease by stealth. Fresh chicken meat is, most likely, alive with campylobacter, a bacteria which can cause a horrible, debilitating form of food poisoning.
Pick up a pack with enough "campy" bugs on it and you can spread it around the supermarket - via the trolley handle, by opening freezers, fondling cheeses. When you get home, the same risks apply, particularly if the bag is leaking.
At least, that's the picture some scientists are painting. If the risk was that real, we'd be swimming in diarrhoea and vomit; the country would grind to a halt.
Proper cooking kills the bacteria - but not everyone does - and meantime there's the risk of cross-contamination from the supermarket to the stove. Are we playing Russian roulette with chicken - the meat we eat most? The key variable is: how much campy?
Dr Michael Baker has been warning about campylobacter for 14 years, with little effect. Last year, a record 16,000 cases were confirmed after GP visits, suggesting another 100,000 had the illness - a severe form of gastroenteritis with symptoms including diarrhoea, nausea, fever, headaches and muscle pain. More than 950 people were admitted to hospital; on average, up to three people die from it each year. It can trigger Guillain Barre Syndrome, which attacks the nervous system and can paralyse.
Chicken is thought to cause at least half of cases, so that's where health experts believe efforts should be concentrated. That's about the only point of agreement.
Baker, a public health physician at the Wellington School of Medicine, says the epidemic is so bad we need to ban fresh chicken sales until the industry can lower campy levels. Freezing chicken kills most campylobacter. This one intervention could reduce the rate of illness "30-fold", he says.
But the industry and the Food Safety Authority say freezing is not the answer. They want time to research and implement comprehensive "farm to fork" strategies. In frustration, Baker has resorted to shameless fear tactics over the disease that killed Rod Donald (due to a rare complication).
"There are actually quite a few Rod Donalds around - people who have serious complications that aren't immediately obvious from this infection."
On TV One's Close Up last week, Baker warned: "You only have to make one mistake with that bit of food and you can cross contaminate a bench, you can touch your lips while you're preparing it, you can go and look after a crying child for example and infect them."
We should vote with our feet by not buying fresh poultry. When we visit a restaurant, "make sure they don't have fresh poultry out the back because that's potentially cross-contaminating every food in that restaurant."
Close Up conducted a survey to test progress one year on from a report by Baker and his Otago University colleagues which labelled chicken "the cheap and dirty food of New Zealand". The programme sent six samples from supermarkets for analysis and found five were contaminated.
Yet this tells us almost nothing. Campylobacter is a naturally occurring bacteria in the guts of chicken (and other animals) which is killed by proper cooking. At least 80 per cent of fresh chicken is contaminated, a rate in line with the rest of the world.
What's different, say the Otago researchers, is our rate of infection. Their study last year claimed our infection rate - nearly four in 1000 people - was three times higher than Australia's and 30 times of that in the United States. The Poultry Industry Association disputes these findings.
Baker is a member of the Government's infectious diseases advisory committee. In the late-1990s, his research into meningitis risk factors helped kickstart New Zealand's (belated) response to the meningitis epidemic. At Otago's Wellington campus, he is leading US-funded research into influenza control.
With his boyish face, glasses and measured responses, he comes across like Brains, the Thunderbirds puppet - a believable boffin. But what he says is far from reassuring.
Last week, at the Veterinary Association annual conference, he renewed the call to withdraw fresh chicken, railing against "chicken rearing as a concentrated monoculture which favours the rapid spread of infections; highly mechanised slaughter and processing which distributes infected gut contents on to the bird carcasses; retention of traumatised skin on the carcass which limits the effectiveness of decontamination".
He says the campylobacter crisis is comparable to the meningococcal outbreak. "The impact on public health is probably rivalling the meningitis epidemic. We don't know that it causes quite as many fatalities but it may do - it's just that they are not always immediate."
He and his colleagues are painted as a vocal minority who have never set foot in a processing plant but they are not the only researchers raising the alarm. An Institute of Environmental Science and Research study in July last year warned of the potential for cross-contamination from the outer surfaces of fresh poultry packs and the potential for hand-to-mouth transfer.
Campylobacter can survive on hands for up to one hour, on surfaces at room temperature for 50 minutes, and in chicken juice for 24 hours. At cooler temperatures, it can live for much longer, the ESR study reported. It survives perfectly well in the fridge but only grows above 30 degrees. Illness peaks in spring and summer.
What's not known is how much of the bacteria is needed to cause illness. Consumption of 800 cells is enough to cause infection about half the time.
Supermarkets and poultry processors have responded with packaging improvements such as double wrapping and polystyrene trays to reduce leakage, but there's still the issue of what happens at home.
Baker says we cannot rely on consumers following the clean-cook-cover-chill guidelines. "The four Cs is a waste of time in this particular instance - it's a failed strategy."
Freezing's effectiveness has been demonstrated in Iceland and Belgium, he says. "I'm not saying that fresh chicken sales should be banned [long-term]. You can have a system where, if it's contaminated, it's diverted down the deep freeze line and, if it's got a low level of contamination, it can be sold fresh."
But Food Safety Authority executive director Andrew McKenzie says freezing is a "daft idea" which does not completely eliminate the bacteria.
"When it thaws, what campylobacter is there is going to ooze out. You have to realise how complex this is. We don't even know what an infectious dose is."
He's wary of taking a "nanny state" approach. "Some sections of the media dispute that the consumer has any role to play in hygiene."
Much is at stake. Chicken represents 35 per cent of all meat consumed. Sales plummeted for a time after last year's publicity but recovered with discounting. For the full year, sales were down 6 per cent.
Poultry Industry Association executive director Michael Brooks has labelled Baker a food activist, his conclusions unscientific. He and McKenzie may have a point in querying Otago's conclusions that New Zealand's rates of illness are dramatically high compared to other countries. Brooks says campylobacter is not a notifiable disease in the US, Britain, and in Australia's most populous state, New South Wales. The low US rate is based on laboratory tests in just nine states. So is our claimed illness rate of "30 times that of the US" valid?
Baker's Wellington colleague, Nick Wilson, concedes that international differences in reporting create uncertainty. "We have always said our findings should be treated cautiously but we are confident that New Zealand's problem is not a reporting artefact, because we've seen an increase in hospitalisations as well."
It's a debate polarised by philosophical conflict: the pure public health viewpoint says take one intervention that will dramatically reduce the incidence of a severe illness. But the Food Safety Authority is taking a broader stance than its name implies and looking for a permanent fix. In the meantime, it's buyer beware.
McKenzie is wary about imposing huge expense on poultry processors for a measure which won't completely eradicate the problem.
He is worried about consumer choice and access to protein. He says chicken is our most popular meat because it is cheap - freezing would add to industry costs and potentially limit the diet of low-income consumers.
"We are working with the industry - we've got our arm up the industry's backs a little. It's the old story about a volunteer versus a conscript - you get a lot more progress [voluntarily]."
An impressive range of initiatives are under way. Judi Lee, the FSA's programme co-ordinator, says New Zealand is leading the world in its long-term strategy to control campylobacter.
Monitoring trials on farms and in slaughterhouses have been completed. Codes of practice for farms and processing plants are being prepared. In slaughtering and processing plants and in ESR laboratories, trials of immersion chilling and more hygienic processing are under way.
In the Manawatu, Massey University scientists are examining individual cases to consider human and environmental factors.
Packaging, retailer practices and consumer handling are similarly under the microscope.
"There's likely to be not one single intervention that's going to be the winner," says Lee. "We're probably looking at a combination."
The poultry association claims there are already signs of a turnaround. Notifications in the three months ended May 30 were significantly down on the corresponding period last year. Over the past 10 months there's been an 8.8 per cent drop (remembering that 2006 was an all-time high).
The strategy includes research into freezing but, says Lee, "consumers also want to buy chilled product". But the FSA's own consumer research rather undermines its fear of a consumer backlash if fresh chicken was withdrawn: it found that 64 per cent of fresh product taken home by consumers is put in the freezer.
While chicken is acknowledged as the biggest culprit, it is estimated to account for no more than 50 per cent of illness. WE NEED to do more than just freeze chicken, says Ben Harris, general manager of Southern Community Laboratories in Christchurch. Between 6 and 12 per cent of cases are thought to be travel-related. The bacteria is carried in cattle faeces so contamination from pasture into waterways is a possible source. It is spread by flies and other insects.
"If poultry could be cleaned up it may well reduce [infection] rates by half but we should still be looking at contaminated waterways and other sources - the cost is huge and there needs to be more money put into the science."
Public Health Association director Gay Keating says says she's been extremely disappointed at the response by retailers to the risks associated with fresh chicken.
"If they can't sell items which are safe to cook and eat under normal circumstances, the least they should be doing is providing clear advice on how to cook it."
The FSA and retailers "need to look at whether the right messages are getting across to the right people".
Donald Campbell, the FSA's principal public health adviser, says everyone accepts the rate of illness is too high. "We have to move forward. What we are looking for is an appreciable and prolonged drop."
What can consumers do?
* Treat all fresh chicken as contaminated.
* Keep it separated from other foods.
* Wash hands in soap and hot water and dry them after contact with raw meat and packaging.
* Thoroughly wash surfaces and utensils which come in contact with raw meat and packaging.
* Keep raw meat covered and refrigerated to avoid cross-contamination or spread of bacteria by insects.
* Cook chicken thoroughly until the juices run clear, not pink.
* Ensure frozen chicken is thoroughly defrosted so that it cooks properly.
