Due to avian influenza concerns, there’s a non-negligible chance we’re going to have agricultural surveillance discourse here, so let’s discuss agricultural microbial surveillance briefly. Much of the surveillance in the U.S., especially on the agricultural side of things, is voluntary. This is a legislative problem, in that these agencies haven’t been granted the authority to mandate sample collection and so on. To the extent this is due to ‘corruption’, it occurs not at the individual agencies, but among our elected officials who allow this state of affairs to continue.

Because of this lack of authority, these agencies (federal, state, and local) need to make nice with those they monitor, and they need to pick and choose their battles. This isn’t unique to agriculture (but it is worse today there than clinical settings), and a clinical example (MRSA) shows this in action.

In the old days, MRSA wasn’t really monitored at the federal level, so many state health departments, which at the time were the places that could do molecular epidemiology, had a “don’t ask, don’t tell policy.” They didn’t ask a lot of questions about who had the infections or if those infections were hospital-acquired because they were worried hospitals would wait until it was too late to get assistance, the outbreak then would explode and patients would die.

Obviously, this is not an optimal situation, but it was the best the state labs could do given the regulatory environment at the time. In other words, it’s not like the movies or silly novels where ‘THE CDC’ (or some other agency) has massive regulatory authority. Often, they really don’t have any authority at all.

Anyway, so the real scandal is the unwillingness of elected officials to give regulators the authority to do what they need to do to protect us (and to prevent economic catastrophe for those willing to cooperate).