U.S. Not Gaining Ground in Preventing Food-Borne Illnesses

Most Americans don’t think about food-borne illness until they become ill from unknowingly consuming contaminated food. In the not so distant past, outbreaks of food-borne illness were relatively small and localized. Illness could be traced back to local gatherings or events such as weddings and church dinners where a large number of people ate the same food. Food was grown, produced, and distributed on a local basis. But today’s food is produced in vastly different ways from those of even several decades ago. Food production is now centralized and on a larger scale. Products made in a single processing plant in mass quantities are shipped all over the country, sometimes throughout the world, and large amounts of food are imported each year.

The FDA is charged with protecting the public by assuring the safety, efficacy and security of our nation’s food supply, regulating $417 billion worth of domestic food and $49 billion worth of imported food each year—everything we eat except meat, poultry, and some egg products, which are regulated by the U.S. Department of Agriculture. For years, the FDA has been under fire by food safety advocates, as well as on Capitol Hill, for being remiss in its oversight of the food industry. President Obama and other leaders have pledged to renovate the agency and elevate food safety and the ongoing national salmonella outbreak linked to peanuts has prompted about a half-dozen bills now pending in Congress to reform food safety.

Now a new study provides further evidence that an overhaul is needed in what many perceive as a broken food-safety system. The report from the Foodborne Diseases Active Surveillance Network, a collaborative project of several government agencies known as FoodNet, looks at the occurrence of infections caused by eight bacteria and three parasites found in food in ten states. Because of the sample’s mix of geography and demographics, health officials believe it’s nationally representative.

Overall, the report found 18,499 laboratory-confirmed cases of food poisoning in 2008 among the 10 states involved, which represent an estimated 15 percent of the U.S. population. Infection rates for five food-borne illnesses exceeded national goals set by the Centers for Disease Control and Prevention (CDC). In the case of salmonella, the national goal in 2008 was seven illnesses for every 100,000 people, but the actual number was 16—more than twice the goal—and did not include the outbreak of salmonella illness linked to peanut products that began in late 2008 and has caused at least 690 confirmed illnesses in 46 states, and may have contributed to nine deaths. Campylobacter and shigella were the second and third most common food-borne illnesses, occurring at rates of about 13 and 7 per 100,000, respectively.

There were geographic variations in disease rates among the states. For instance, the highest occurrence of salmonella was in Georgia and New Mexico, campylobacter was most common in California, while E. coli thrived best in Colorado. This was no doubt influenced by specific outbreaks that caused more illnesses in some states than others, said Elliot Ryser, a professor of food science at Michigan State University.

Experts say that in reality, the number of food-borne illnesses is likely much higher than the study implies. For a case to be included in FoodNet, a person must become sick enough to see a doctor, the doctor must be concerned enough to get a stool sample, and the laboratory that analyzes the sample must be part of the government’s system.
 
“This year’s report confirms a very important concern, especially with two high-profile Salmonella outbreaks in the last year,” said Robert Tauxe, deputy director of CDC’s Division of Foodborne, Bacterial and Mycotic Diseases. “It reflects the complexity of the problem with many different foods becoming potentially contaminated, including more fresh produce. It reflects the fact that pathogens like E. coli 0157 and salmonella can spread in the environment and contaminate a number of different foods, some of which we have not seen in the past. And the food industry is also complicated and changing with a variety of different arenas and components from all over the world.”

“We recognize that we have reached a plateau in the prevention of food-borne disease and there must be new efforts to develop and evaluate food safety practices from the farm to the table,” Tauxe said. “The food-borne division at CDC is planning to increase the capacity of several health departments so that outbreaks can be better detected and investigated.”

Dr. David Acheson, director of food safety and security at the Food and Drug Administration (FDA), said the agency was “embarking on an aggressive and proactive approach” aimed at protecting and enforcing the safety of the country’s food supply.  He said the FDA has expanded its presence overseas and now has offices in China, Latin America, Europe and India, and has hired more than 150 additional inspectors and more than 30 additional scientists and consumer safety officers in the past year to help ensure food safety in the United States. They have also set up rapid response teams in six states to help the agency react more quickly when an outbreak occurs, with plans to add more. “The Agency is committed to make the necessary changes to keep unsafe products out of the marketplace before they reach consumers,” Acheson said. “I think it has become clear preventive controls are critical.”

The CDC estimates that each year 76 million cases of food-borne illness occur, more than 325,000 persons are hospitalized and 5,000 Americans die from consuming contaminated foods. Consumers can reduce their risk for food-borne illness by following safe food-handling and preparation recommendations and by avoiding consumption of unpasteurized milk, raw or undercooked oysters, or other raw or undercooked foods of animal origin such as eggs, ground beef, and poultry. Risk also can be decreased by choosing pasteurized eggs, high pressure-treated oysters, and irradiated produce. Everyone should wash hands before and after contact with raw meat, raw foods derived from animal products, and animals and their environments.

The research appears in this week’s issue of a CDC publication, Morbidity and Mortality Weekly Report.