ATLANTA Efforts to better protect consumers from dangerous foodborne pathogens, including E. coli O157:H7 and salmonella, have virtually stalled, federal officials said last week. They also noted that the estimated incidence of infections from targeted pathogens in 2008 showed no significant change compared with the prior three years.
The continued “education of restaurant workers and consumers about [pathogen] risks and prevention measures” was cited as a possible means to reduce infection rates, according to authors of a report cited by public health agencies.
Dr. Robert Tauxe, deputy director of the Centers for Disease Control and Prevention's division of foodborne, bacterial and mycotic diseases, sounded the alarm about difficulties in the effort to reduce infections from foodborne pathogens.
His observations were based on the annual findings of the Foodborne Diseases Active Surveillance Network, or FoodNet. That network is a collaborative project of the CDC, the U.S. Department of Agriculture’s Food Safety and Inspection Service, the Food and Drug Administration and sites in 10 states.
Officials from all three agencies supporting FoodNet -- the CDC, the FDA and the USDA -- used the release of that annual report as a platform to cite efforts by their groups to better protect the public. But the findings in that document were not encouraging.
“This year’s report confirms a very important concern, especially with two high-profile salmonella outbreaks in the last year,” Tauxe said, referring to last year’s salmonella contamination of imported Mexican peppers originally believed to involve tomatoes, and the ongoing problems with peanuts processed by Peanut Corp. of America. “We recognize that we have reached a plateau in the prevention of foodborne disease and there must be new efforts to develop and evaluate food safety practices from the farm to the table.”
Tauxe added that the foodborne division at CDC plans to increase the capacity of several health departments so that outbreaks can be better detected and investigated.
The report, “Preliminary FoodNet Data on the Incidence of Infection with Pathogens Transmitted Commonly Through Food -- 10 States, United States, 2008,” can be viewed or downloaded at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5813a2.htm.
Authors of the report noted that for most infections, incidence was highest among children aged 4 or younger, but that the percentage of persons hospitalized was greatest among individuals 50 or older, as was the associated death rate. They also pointed out that none of the targeted reductions in the number of infections per 100,000 people, as outlined in the public-private Healthy People 2010 initiative, were reached in 2008.
In 2008, there were 18,499 laboratory-confirmed cases of infection from targeted pathogens in FoodNet surveillance areas, the report said. It said the number of infections and incidence per 100,000 people in 2008 were reported as follows: salmonella 7,444 infections with an incident rate of 16.2; campylobacter, 5,825, 12.68; shigella, 3,029, 6.59; cryptosporidium, 1,036, 2.25; shiga-toxin producing E. coli O157, 513; 1.12; STEC non-O157, 205, 0.45; yersinia, 164, 0.36; listeria, 135, 0.29; vibrio, 131, 0.29; and cyclospora, 17, 0.04.
The relative lack of progress in reducing infection rates in 2008, compared with the preceding three years, stands in contrast to the progress made between the onset of FoodNet surveillance in 1996 and 2004, the annual FoodNet report indicates. Between 1996 and 2004, it said, the rate of infection fell by 48 percent for yersinia, by 40 percent for shigella, by 36 percent for listeria, by 32 percent for campylobacter and by 25 percent for STEC O157.
However, the reported indicated, the rate of infection per 100,000 people for vibrio, which is often associated with uncooked shellfish, increased by 47 percent between 1996 and 2004, while infection rates for cryptosporidium and salmonella saw no significant change.
Along with better educating foodservice workers and consumers about pathogen risks and prevention steps, the report notes that greater efforts are needed to “control or eliminate pathogens in domestic and imported food,” and “reduce or prevent contamination during growing, harvesting, and processing.”
In particular, the report went on to say, “continued efforts are needed to understand how contamination of fresh produce and processed foods occurs and to develop and implement measures that reduce it.” It explained that “more outbreaks can be recognized and their causative foods identified with rapid and complete subtyping of pathogens and with rapid standardized interviews of ill persons and appropriately selected controls.”
Of the pathogens targeted by the Healthy People project, salmonella, with an incidence rate of 16.2 cases per 100,000 people in 2008, is furthest from its 2010 target of 6.8 cases per 100,000, the report said. The incidence of salmonella infections has remained between 14 and 16 cases per 100,000 people since 1996, the report noted.
The incidence rate for salmonella infection remains stable even in the face of the USDA’s three-year-old Salmonella Initiative Program, which has already significantly reduced the presence of salmonella in raw meat and poultry products, said to Dr. David Goldman, assistant administrator of USDA’s Food Safety Inspection Service.
“We have worked hard to reduce contamination in FSIS-regulated products and have seen marked success in salmonella and listeria monocytogenes,” Goldman said. “We are concerned about the lack of progress in reducing the incidence of foodborne illness and believe this report points to the need for better information about sources of infection.”
For its part, the FDA is using new tools to help predict potential threats to foods and the best options for prevention to meet the many challenges of an increasingly complex food-supply chain, said Dr. David Acheson, the FDA's associate commissioner for foods.
“The FDA is embarking on an aggressive and proactive approach in protecting and enforcing the safety of the U.S. food supply,” Acheson said. “The agency is committed to make the necessary changes to keep unsafe products out of the marketplace before they reach consumers.”
Among FDA actions apparently inspired by that aggressive new stance in recent weeks was the agency’s self-termed “proactive” advisory to consumers and businesses not to use pistachios from Setton Pistachios of Terra Bella Inc. That advisory came even though, as of this week, no illness from salmonella had been conclusively tied to the products being voluntarily recalled by that processor.
Contact Alan J. Liddle at [email protected].
