Food Safety: CDC Report Shows Rates of Foodborne Illnesses Remain Largely Unchanged

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About 1 in 6 people in the United States gets sick from eating contaminated food, a rate that has not declined in seven years.

Despite some improvements in food safety, the U.S. Centers for Disease Control and Prevention (CDC) reports that progress in reducing foodborne illnesses have stalled.

In the latest issue of the Morbidity and Mortality Weekly Report, researchers analyzed data from FoodNet, a system for tracking food-related illnesses, and found that although the number of infections acquired from food are lower than they were in the 1990s, over the last few years little progress was made in reducing exposure to foodborne pathogens even further.

The FoodNet program tracks infections with nine commonly found bacteria in food: campylobacter, cryptosporidium, cyclospora, listeria, salmonella, E.coli 0157 (including both the variety that produces shiga toxin and the strain that doesn’t), shigella, vibrio and yersinia. The database monitors illnesses among 48 million people from Connecticut, Georgia, Maryland, Minnesota, New Mexico, Oregon, and Tennessee, and selected counties in California, Colorado, and New York — about 15% of the total U.S. population. In the current report, researchers compared rates of foodborne illnesses to those from 2006 to 2008, to assess whether food safety policies were effective in controlling potential outbreaks.

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In 2012, the FoodNet program identified 19,500 infections, including 4,500 hospitalizations and 68 deaths. The rates of infection from the nine most prevalent pathogens had not changed significantly compared to the previous analysis.

The data reveal weaknesses in current food safety regulations, as well as new challenges posed by changing populations of bacteria. For example, while infections due to shiga toxin-producing E. coli (STEC) O157, found in raw ground beef, have dropped since  the 1990s, in 2012, rates remained unchanged since 2006 to 2008. “We may need to identify additional ways to reduce contamination as well as heightening awareness among consumers of the importance of properly cooking and handling ground beef in their own homes,” said Dr. Robert Tauxe, the deputy director of the CDC division of foodborne, waterborne and environmental diseases during a call with reporters.

And while the new report showed that once again, salmonella was the most common cause of food-related illness, the study found a change in the strains of the bacteria responsible for causing illness. According to Tauxe, the frequency of salmonella infections in the FoodNet population has remained constant since 1996, but the incidence of illness caused by the most common strain of salmonella has decreased, while the appearance of other strains are on the rise. The total number of salmonella infections, however, remained unchanged.

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“It represents some success that the cases of salmonella have not increased over time, but the fact that we are still where we were a decade ago means that further efforts will be needed to prevent more salmonella infections and bring that number of infections lower than they are now,” said Tauxe .

Other infections showed slight increases in recent years, raising concerns about what industry practices or food handling methods might be contributing to the trend. Rates of illness due to infection with campylobacter, which can be contracted from contaminated poultry, raw milk or produce, for example, appear to be inching upward. “We see that after real progress in the 1990s when there were declines in the early years of FoodNet’s surviellance, the incidence of campylobacter bacteria has increased recently. It is still lower than it was in the 1990s, but it has increased by 14% since a baseline period of 2006 to 2008,” said Tauxe.

Infections related to vibrio, a bacterium found in marine water that often infect oysters, also increased, by 43% compared to rates reported in 2006-2008.

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Reported infections were highest among children under age five and elderly adults over age 65. Kids are at a higher risk of severe infection and older adults have a greater risk of hospitalizations and deaths from foodborne illnesses, which  means better ways of diagnosing and treating these groups are needed in order to bring infection rates down.

The researchers are hopeful that two draft proposals for improving food safety that the Food and Drug Administration (FDA) released in January will help to lower rates of food-related infections, and ultimately result in more standard methods of preventing exposure to bacterial pathogens.

The rules were part of the Food Safety Modernization Act (FSMA) that President Obama signed into law two years ago, and the FDA was a year behind in submitting the proposals, due to extensive visits to farms and food manufacturing facilities, as well as meetings with industry and scientific experts.

Known as Preventive Controls for Human Food and Standards for Produce Safety, the draft proposals are still available for public comment. The first rule says manufacturers selling food in the United States, whether the products were grown in the U.S. or abroad, must develop and adhere to formal rules for preventing contamination of their products and correct any problems that arise.

The second rule involves foods that are meant to be consumed raw, such as berries and greens, and requires stricter standards for growing, harvesting, packing and storing such produce. The rule also requires more vigilance over sanitation during irrigation and washing of produce, as well as stringent rules for worker hygiene and cleanliness of materials such as fertilizers and manure. In order to assure potential contaminants are not introduced through exposure to animal waste, the proposal also calls for rigid monitoring of animals that enter crop fields, and sanitation of processing equipment.

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In January, when we reported on the proposals, experts heralded the rules as a much overdue step for to improve public health and lower health care costs due to foodborne illnesses:

The FDA says the new rules will lead to major savings in medical costs and less resources spent in response to large scale recalls. However, the Congressional Budget Office estimated that the bill would cost $1.4 billion to implement, from 2011 to 2015, and that funding has not yet been secured. “Resources are going to continue to be an issue,” Hamburg said during the conference call.

That could be a problem for implementing the FSMA going forward, since there are still more measures to be addressed, such as increased monitoring and standards for food importers. The FDA says approximately 15% of food eaten in the U.S. is imported, and more rules for importers to verify that foods that are grown and processed overseas meet U.S. standards are an important part of improving overall food safety. The FDA will also propose more rules for preventing contamination and illnesses from animal feed and pet food.

If implemented, the new regulations could be an important step toward nudging rates of food-related disease back down again. “We know that in the past that targeted efforts by industry and regulators have been successful for specific problems and we think that recently proposed regulatory changes and further industry efforts may well have an effect soon,” said Tauxe. “It is also important to note that consumers have a role to play in following food safety guidelines for the foods they prepare for themselves and others, especially when they prepare them for people [such as young children and the elderly who are] at higher risk for severe sickness.” Regulations, he says, can only go so far in protecting consumers. Ultimately, making sure that food is washed, handled and stored properly can also prevent unwelcome bacteria from finding a home in your food and potentially causing you to become sick.