Nancy Barber's abdominal cramps were excruciating, but not as painful as seeing her 4-year-old grandson, LeOndre, bleeding and doubled over in agony. The 65-year-old Burlington grandmother was taking care of the boy for several weeks last summer while his mother, Trista, was hospitalized with an even more severe case of food poisoning, as was LeOndre's 8-year-old brother, Joseph. LeOndre's other brother, Christopher, 11, and Barber's adopted son Thomas had also been food-poisoned, but not as seriously as the others.

"It was so horrible watching the little one have it," says Barber, recalling her family's terrifying bout with E. coli O157:H7, a toxic and often deadly bacteria typically found in ground beef. "He would get on his little hands and knees on the floor and he'd rock back and forth and cry and hold his stomach. And all his stools were just blood."

Despite her own crippling case of food poisoning that kept her confined to the house, Barber bathed the child several times each day to wash the dangerous microbes off his body, then disinfected the tub each time with bleach. During one bath, she was horrified to discover that the child's knees had swollen to the size of grapefruits, raising fears that he might not walk again. Meanwhile, with her daughter in the hospital with an enlarged spleen and kidneys on the verge of failure, Barber feared the worst. "That's what really scared me," she says. "I thought I was going to lose one of them."

It was several months before all six members of the family recovered from their dangerous encounter with E. coli. Barber's family was luckier than many. None of them died or was permanently disabled -- though six months later, Barber still suffers from occasional episodes of abdominal pain.

The family never found out how they were poisoned. Barber suspects it was either from frozen, store-bought hamburger patties or a meal they ate in a local fast-food restaurant, but Vermont Department of Health investigators weren't able to pinpoint the source. Not that it would have made much of a difference to the family. Under federal law, there are no civil penalties for food companies that cause outbreaks of food-borne illnesses, even those that kill. Nor can the federal government order a mandatory recall of tainted meat, the way it can for dangerous toys and defective cars. And even if Barber had sued the restaurant or food manufacturer she suspected was responsible, it's unlikely she would have won, since proving guilt in such cases is nearly impossible.

Stories like this are all too familiar to Karen Taylor Mitchell, executive director of the Burlington-based advocacy group, Safe Tables Our Priority. STOP was formed by the parents of children who died in the massive E. coli outbreak of 1993, which killed four and injured more than 700 others in the Pacific Northwest. That outbreak was eventually linked to contaminated beef that had been served at several Jack-in-the-Box restaurants. Since then, STOP has become the nation's leading food-safety advocacy group, pushing through some of the most important meat-inspection reforms in nearly a century.

Nevertheless, more than a decade after that highly publicized case, Taylor Mitchell asserts that government and industry attention to food safety still focuses primarily on consumers' proper cooking and handling techniques, rather than on removing dangerous pathogens from the food supply. And, based on STOP's caseload, she strongly suspects the problem is getting worse, rather than better.

Eric Schlosser, author of the best-selling food industry expose Fast Food Nation, agrees. During an interview last fall, he called STOP "the Mothers Against Drunk Driving of the food-safety movement." The organization fields at least one or two phone calls each day from people around the country, almost invariably parents whose children have been hospitalized, disabled or killed by food-borne pathogens.

"These people aren't motivated to call us because of a mild stomach ache or a bout of diarrhea," says Taylor Mitchell. "We're talking about drooling, horrible illnesses, excruciating pain, cascading organ failure that carries on for days and days, and kids leaving the hospital on 35 to 40 medications a day."

Considering the prevalence of food-borne illnesses in the United States, it's remarkable that there hasn't been more public outcry for tougher reforms. By any measure, the toll is staggering: Each year, food poisoning accounts for one in every 100 hospitalizations in the United States -- about 1000 per day -- as well as one in 500 deaths, or about 14 a day.

As Taylor Mitchell explains, however, the biggest impact of food-borne pathogens isn't death, but long-term disability. Of the estimated 76 million Americans who will get food-poisoned this year -- about one in three of us -- at least 1.5 million will suffer long-term or permanent health consequences such as diabetes, high blood pressure, blindness, reactive arthritis or debilitating neurological damage. The USDA estimates that the annual economic cost of those illnesses in terms of medical care, lost productivity and premature deaths could run as high as $37 billion.

Identifying the actual frequency of food-borne illness is difficult, because so little of it gets reported. In 2004, Barber and her family members were among 12 E. coli cases reported to the Vermont Department of Health, but that figure may be higher once all the data from the year is compiled. And as state epidemiologist Patsy Tassler points out, assessing the prevalence of food-borne diseases in Vermont is further complicated by the fact that some pathogens, such as E. coli, can be contracted in other ways as well. In addition, fatalities from food-borne diseases are often misdiagnosed or are never indicated on death certificates. An unknown number of other cases go unreported because their victims never seek medical help.

What is known, however, is that food-borne illnesses disproportionately afflict the very young. E. coli O157:H7 is now the leading cause of acute kidney failure in children under 5. Each year, as many children die from food-borne illnesses as from cancer and gunshot wounds. In fact, as Schlosser commented during his visit to Burlington last fall, while researching his book he discovered that most contaminated meats turn up in prisons and public schools.

STOP's mission is threefold: to help victims of food-borne illnesses, to change public policy, and to combat the vast amounts of misinformation and propaganda that keep the public in the dark about the costs and consequences of food-borne diseases. Compounding that last problem, Taylor Mitchell contends, is the dual and often contradictory nature of the USDA's mission, which is to both inspect meat and promote its sale.

"There's a vast perception that our food supply is safe, and that's no accident," she says. "It's because every week you have someone from the USDA going out making speeches saying that America's food supply is the safest in the world. But there's no evidence to back that up."

A timely example, she says, is the government and meat industry's approach to dealing with bovine spongiform encephalopathy (BSE), or Mad Cow Disease, which has once again captured national headlines with the recent discovery of three new cases in North America. For years, the U.S. government and meat industry have resisted consumer groups' efforts to institute a nationwide animal tracking system to trace the origins of food-borne contaminations. Although some money has since been devoted to that program, Taylor Mitchell points out that the system will not identify any diseases transmittable to humans other than BSE. In fact, a rancher who offered to voluntarily test all his cattle for BSE was prohibited from doing so by the feds.

In other respects, the deck is stacked in favor of industry at the expense of the public. As the state of California recently discovered, the U.S. government won't even allow state health officials to tell the public which restaurants and stores may have received BSE-contaminated meat. California lawmakers were so outraged by that policy that they passed a bill requiring the meat industry to disclose those records. The bill was vetoed later by Governor Arnold Schwarzenegger.

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Beef and poultry may be major culprits in the spread of food-borne diseases such as E. coli and salmonella, respectively, but Taylor Mitchell emphasizes that they're not the only areas of concern. "Here, let me introduce you to some other people," she says, pointing to a bulletin board in her office filled with photos, most of them showing smiling children who were the victims of tainted foods.

Among them is Haylee Bernstein, a 3-year-old girl who was left partially blind after contracting E. coli by eating organic, pre-washed lettuce. Taylor Mitchell cites this case as just one example of how the organic food industry has largely overlooked this crucial aspect of food safety. While she acknowledges that organic foods may be safer than conventional varieties because they don't have pesticide residues on them, currently there is no evidence that organic produce is any safer from biological contaminants. One reason, she explains, is the lack of national water-quality standards for irrigating crops.

"I see a huge, gaping need for the organic community to come out as leaders on this issue," she says. "They're the ones who are most concerned about food safety."

The influence of STOP at the national level is impressive, especially considering the group's size. Unlike larger nonprofit organizations that deal with food-safety issues -- Public Citizen, the Government Accountability Project, the Center for Science in the Public Interest -- STOP has just two full-time employees and operates on a shoestring annual budget of about $160,000. Nearly all its work is done by volunteers who are self-educated experts -- primarily people whose lives were irrevocably altered by food poisoning.

"I've got a volunteer from Pennsylvania who has logged 12,000 miles in two years driving between her home in Pennsylvania and Washington, D.C.," Taylor Mitchell says. "She does it because her grandson was killed by a food-borne illness."

For her part, Barber says that she knew virtually nothing about the subject before it afflicted her family. Nevertheless, she hopes to get more involved in the cause, perhaps by visiting local community centers to share her experience with others.

"It was horrible, horrible, horrible," Barber says. "I never suffered so much in my life. No one should ever have to go through what we went through."