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The creamy color of a cleansed clam contrasts with the gray color of a clam before cleansing. After each 48-hour cleansing process, a state-approved lab takes water and clam meat samples for testing before the shellfish may be sold. August, 2009. A widespread typhoid fever outbreak related to eating shellfish led to the creation of the cooperative program, known as the National Shellfish Sanitation Program (NSSP), in 1925 that continues today. Through the cooperative program, the Food and Drug Administration (FDA), state regulatory agencies, and the shellfish industry work together to keep molluscan shellfish (such as oysters, clams, and mussels) safe for consumption by adhering to strict controls on their growing, harvesting, processing, packaging, and transport.