The findings of CDC’s 2013 FoodNet “Progress” Report provides a dim view of the progress our food safety system on foodborne disease reduction, as very little progress has been made toward the Healthy People 2020 targets. Even the small advance — the incidence of Salmonella infection in 2013 was lower than during 2010–2012 – was dimmed by fact that the incidence rate (15.19 per 100,000 population) was still similar to that of 2006–2008, which is well above the national Healthy People target (11.4).
Additionally, the 2013 rate for Vibrio was up 32% from 2010-2012, and had an even higher jump – of 75% — since the 2006-2008 data report. Campylobacter was also up from 2006-2008 by 13%; although this was not significantly changed from 2010-2012, at 13.85, it is well above the target of 8.5 – the most off the mark of all the pathogens. (See figure below.)
On the whole, the overall incidence of infection by these six major foodborne pathogens measured by FoodNet (E. coli O157, Listeria and Yersinia in addition to the above) was not significantly different in 2013 than in 2010-2012 or 2006-2008. As CDC stated in its report, “The lack of recent progress toward these targets points to gaps in the current food safety system and the need for more food safety interventions.”
What does all this mean and what needs to be done?
The general “no change” trend, and the fact that CDC FoodNet data is a small fraction of what is estimated to be the full picture when undiagnosed cases are added, shows that more can be done at each step of the food supply chain to focus more attention on detecting and eliminating foodborne disease pathogens.
So as we look at whether this new report will drive any new changes or initiatives by the regulators, I have to conclude that is not likely. We already have FSMA moving forward with a focus on prevention. Plus we already have FSIS “declaring war on Salmonella.” So the regulatory initiatives are already moving forward and this just adds further justification for those who need it that we have work to do. As we look at the food industry broadly this speaks to the need to continue to work on the building of a safe food culture throughout the entire supply chain – globally as well as domestically. Do your employees understand the “why” of your food safety requirements, as well the “what”? Are your supplier mandates stringent enough? Do you have a handle on all your foreign ingredients and know, for sure, that food safety practices are being conducted in the facilities each and every day?
To take it downstream, with more than 69% of all foodborne disease incidents caused by food consumed in a restaurant, deli, or the home, do you provide handling direction to your customers and promote food-safe behavior to your consumers?
Besides these general action items, a few of the disease agents should also be addressed very specifically, particularly Salmonella and Vibrio.
As we stated in a November 2013 newsletter, and as noted above, FSIS has already declared that “Salmonella is Job One,” with the Agency’s intention to “make some dramatic progress on illnesses related to Salmonella.” With this focus going on at USDA, and Salmonella still not going down, this may put more pressure on the system to declare certain Salmonella adulterants. But I urge caution before this step is taken to truly understand the implications of such a regulatory move.
But probably the most significant relative jump has been that of Vibrio. This is not a new trend, and while the total numbers are low compared with other pathogens, we would suspect that this is likely a result of shell fish, and we have to expect that this, too, will drive more focus on shell fish. We already have seafood HACCP, but as noted in frequent warning letters, the seafood industry continues to be somewhat of a problem to FDA.
Another area of concern that isn’t even addressed in FoodNet, but has been gaining media attention, albeit primarily on cruise ships, is that of norovirus. Because reporting isn’t required and there is no widely used test for detection, a 2013 CDC report estimated that there are up to 21 million infections each year, with as many as 800 of these being fatal.
One of the key questions we have to ask is if the implementation of FSMA’s final rules, starting in 2015, will begin to brighten the picture on and reduce the incidence of foodborne illness. Is the industry already doing what it can? Or will regulated preventive controls, and other FSMA food safety measures, enforce the practices in facilities that were more lip service than action? It will be interesting to find out, but I predict that change will be slow, and since FSMA does not have any impact on food safety at retail, food service or in the home, the FSMA-related changes may be minimal
Reducing Pathogens (and Consumer Resistance?) with Irradiation
While foodborne outbreaks, tend to cause backlash from consumers, the development of technologies, such as irradiation, that can help fight against the disease-causing pathogens are often met with just as much resistance. Yet, as evidenced by the recent FDA approval of “the safe use of ionizing radiation on crustaceans (e.g., crab, shrimp, lobster, crayfish, and prawns) to control foodborne pathogens and extend the shelf life,” continued push by industry (in this case, a food additive petition submitted by the National Fisheries Institute) can move technology forward even against such resistance.
Irradiation continues to be an active issue with consumers. But the majority are fighting from a position of emotion not science; of hearing “radiation” and thinking “radioactive” and “cancer.” In contrast, FDA’s Constituent Update on the decision explains that it is based on a rigorous safety assessment that considered potential toxicity, the effect of irradiation on nutrients, and potential microbiological risk that may result from treating crustaceans with ionizing radiation.
FDA does give a nod to consumer emotion, however, by requiring that irradiated foods bear the international symbol for irradiation (radura) and carry the statement “Treated with radiation” or “Treated by irradiation” on the food label, as it enables consumers to be able to identify these foods.
But with such labeling, and the fact that FDA irradiation evaluation “also considered previous evaluations of the safety of irradiation of other foods including poultry, meat, molluscan shellfish, iceberg lettuce, and fresh spinach,” can similar approval for other foods be far behind – who knows, Yet this does indicate that irradiation is still alive, even if not gaining much traction.
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Healthy People Targets: More needs to be done by David Acheson is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.