Category Archives: Food safety
In 2002, the Council of State and Territorial Epidemiologists (CSTE) conducted its first national food safety epidemiology capacity assessment. That assessment became the basis for development of minimum performance standards to help guide state and local foodborne disease control programs. In 2010, CSTE sent states a follow-up questionnaire and the Centers for Disease Control and Prevention recently published the results of the follow-up report. The report found that to effectively address foodborne illnesses, states need:
- More epidemiologists working on food safety;
- Additional training opportunities for existing staff;
- Greater investment in information technologies to improve detection and response capacity; and
- Continued progress in building the relationship between state and local health departments and the collaborating federal agencies responsible for the control and prevention of foodborne disease.
Other barriers to investigating foodborne outbreaks include delayed notification about the outbreak, lower prioritization of investigations and insufficient funds to pay for overtime work on the investigations.
NewPublicHealth caught up with Matthew Boulton, MD, MPH, the co-author of the MMWR report, who is an associate professor of epidemiology and internal medicine in the division of infectious diseases at the University of Michigan School of Medicine, about the report.
NewPublicHealth: What did you find beyond the general results when you looked at individual measures in the report?
Matthew Boulton: States are working hard to improve their capacity to investigate foodborne outbreaks. They generally did pretty well with e. coli and salmonella, but were a little spottier when you get into other pathogens, such as norovirus and campylobacter. What would be encouraging would be uniformity with all these pathogens, but we’re just not there yet.
NPH: Why the lack of uniformity for all pathogens?
Some farmers' markets are winding down as the weather changes and crops dwindle, but in some cities the markets continue year round. A new article by News21, an investigative reporting project at several journalism schools in the U.S., reports that chickens at farmers' markets in Washington, DC harbored bacteria that could harmful if the food were not properly cooked. The investigators also found that eggs were not kept refrigerated, as required by the U.S. Department of Agriculture.
With the growing popularity of farmers’ markets, the article can serve as a reminder to vendors to learn how to grow, store and sell their products under the safest conditions, but it’s also a reminder to consumers to follow FDA guidelines for food preparation at home. That won’t prevent all food-borne infections, but it can eliminate or reduce those bacteria that respond to safe handling during preparation and storage.
As the Food and Drug Administration starts to write new food safety rules that will go into effect early next year, the New York Times followed Michael Tayor, J.D., deputy commissioner for foods, on a farm listening tour to hear suggestions and concerns of farmers who may face significant new regulations to help protect the safety of the food supply.
"If you think the deadly E. coli outbreak sweeping through Europe is an example of a food safety problem that couldn't happen here, think again."
That's the message in an op-ed written today by J. Glenn Morris, who co-authored a recent Robert Wood Johnson-funded food safety study (read the study here). In the report, “Ranking the Risks: The 10 Pathogen-Food Combinations with the Greatest Burden on Public Health,” the authors list the number of illnesses, costs, and overall public health burden of specific microbes in particular types of food—such as Salmonella in poultry and Listeria in deli meat.
In Morris' op-ed today, he takes a look at the recent E.coli outbreak in Germany and writes that:
"...Our report didn't rank the newly emerged E. coli strain in Europe but we did look at a related version of the same pathogen known as E. coli 0157. We found that E. coli 0157 ranked as the sixth-leading disease-causing microbe in the United States. In addition, our analysis revealed that this strain, which is often found in produce or beef products like hamburger, sickens more than 63,000 Americans per year, with the cost of illness alone coming to an estimated $272 million.
The staggering cost and human toll will continue to grow unless we fix some of the flaws in our food safety system.
Right now, U.S. food safety regulators often react to the crisis of the day rather than act in a coordinated fashion to prevent the next outbreak. Making matters worse, responsibility for food safety is divided among 15 federal agencies, each with its own set of goals, regulations and priorities."
Read the full op-ed here.
Researchers at the University of Florida Emerging Pathogens Institute have identified the top 10 riskiest combinations of foods and disease-causing microorganisms, providing an important tool for food safety officials charged with protecting consumers from these costly and potentially life-threatening bugs.
The report, Ranking the Risks: The 10 Pathogen-Food Combinations with the Greatest Burden on Public Health, lists the number of illnesses costs, and overall public health burden of specific microbes in particular types of food — such as Salmonella in poultry and Listeria in deli meat.
NewPublicHealth spoke with Michael Batz, lead author of the report and head of Food Safety Programs at the Emerging Pathogens Institute. Here are some of the questions and answers from that discussion.
NewPublicHealth: What prompted the Institute to work on this report?
Michael Batz: The fundamental problem is that every year, tens of millions of people get food poisoning and thousands of these people die. This is obviously a significant problem and it’s a problem that persists in part, because we have this complex and massive global food supply. There are hundreds of thousands of firms involved and of course, food can be contaminated anywhere from the farm to the fork-that could be somewhere halfway across the world or in the kitchen of a neighborhood restaurant. On top of that complex system, we have a very fragmented and piecemeal food safety system in this country comprised of federal agencies such as the U.S. Department of Agriculture (USDA) and the Food and Drug Administration (FDA), and thousands of state and local government agencies each with their own responsibilities and with not enough coordination among them.
NewPublicHealth: Your research looks at ten combinations of foods and pathogens. If you work toward eradicating these specific combinations, are you likely to achieve some success in dealing with food-borne illness?
Michael Batz: To some extent, yes. There really is a big difference between these major problems and the lesser problems--which is not to say the lesser problems shouldn’t be concern[ing] because at the end of the day, if you’re severely ill, it does you no good to think, “Well, at least I don’t have one of the bad ones.” It’s all a matter of perspective--and our perspective is to focus on that big picture. What our report helps to suggest is that we hear about outbreaks all of the time associated with various products and it lends a perception that there’s just contamination lurking in every corner. And what we find is that despite these problems that happen, that a relatively small number of these hazards account for a significantly large portion of the overall burden.
If we want to do anything about reducing those illnesses, we have to address those pathogens in specific foods. Though, in order to create interventions, we need to identify both the foods and bacteria, viruses and parasites that are causing those illnesses. Our goal with producing this top ten is to say, where we as a society or as the federal government should be focusing more of our effort in a way that is defined not just by where the most recent outbreaks happen but trying to take an objective data-driven approach to assessing where those hazards are.
NewPublicHealth: And how could that protect people more than just say, focusing on everything, focusing on every pathogen, focusing on every food that becomes contaminated?
Michael Batz: The government with its limited resources can’t do everything. We have to set priorities and we have to make decisions about where we want to devote the most energy. And it makes sense to do that in a way that is most protecting consumers by essentially saving the most live. We’re looking at this in a way that asks, where are the most lives being saved, which are the risks that we really need to focus on?
NewPublicHealth: Now that you’ve identified these ten combinations, what would be early steps for taking your findings and putting them into action?
Michael Batz: We do identify a number of specific policy recommendations based on these findings such as a cross-agency Salmonella initiative given that it’s associated with products regulated by both the FDA and USDA and given that it really hasn’t appreciably declined in the last ten years. We also noticed that four of the top ten pathogen combinations are risks to pregnant women.
NewPublicHealth: Are there opportunities to incorporate your recommendations into the Food Safety and Modernization Act passed last year?
Michael Batz: I think so, yes. In the big picture, the [new] food-safety law is really targeted primarily at FDA. It gives the agency a mandate to follow a more risk-based approach. So, I think our methodology can help inform some of those decisions and show how we can start thinking about these problems in this kind of systematic way.
NewPublicHealth: What is a sometimes overlooked concern you think needs more attention when it comes to food-borne illness?
Michael Batz: The potential for these outbreaks to cause chronic conditions on health. [For example] sometimes after people have campylobacteriosis, [after eating a food contaminated with campylobacter] they may come down some months later with Guillain Barré Syndrome which is a neuromuscular disorder that can lead to paralysis, and people never working again, and even death. So when we talk about outbreaks, sometimes those kinds of impacts of food-borne diseases are simply not part of that discussion. Our work here really re-iterated to me the importance of understanding those impacts because the long-term impacts of food-borne illness [can] go far beyond just having a tummy ache and diarrhea for a few days.
NewPublicHealth: While your research is directed at federal officials, are there aspects of the report that industry could take a look at and itself, use your findings to be able to lower the risk to consumers by themselves taking a look at some of these combinations of pathogens in foods?
Michael Batz: Well, I hope so. You know, you need to have good policies and good practices in place from the time the field is watered until the food is cooked in the kitchen-and there are obviously a lot of parties along that chain. In our report, we do recommend that towards the end of that chain, businesses should focus on improving their food-safety culture and ensuring that they are following good and established practices. There are some industries that may look at this report and question it at first, whether their product is responsible as we are suggesting they are. But I hope that when they do look at the numbers and look at the analysis, they come to recognize the scope of this problem and the scope of the challenges they may face in helping to reduce the burden. I think it’s easy to look at this report and suggest that we’re trying to point fingers here, and that’s not really our goal. Somebody has to be number one, and when we do the analysis, that ends up to be poultry. Certainly, the poultry industry has been wrestling with salmonella for some time. I don’t think it will be a surprise for them to hear that their products-their chicken or turkey-is associated with illness, but I hope that this does help inform their understanding in the bigger picture.
NewPublicHealth: What’s next for you in this research field?
Michael Batz: Glenn Morris [director of the Emerging Pathogens Institute] and myself are currently working on another food safety project funded by a grant from the Robert Wood Johnson Foundation. The project, "Developing and applying a descriptive framework for analyzing food safety resources" is examining how federal, state, and local food safety agencies expend their resources. The Association of State and Territorial Health Officers [ASTHO], the Association of Food and Drug Officials [AFDO], and the National Association of County and City Health Officials [NACCHO], are partners in this project, and we hope to publish our results later this year.
Read previous NewPublicHealth.org Q&As with newsmakers and difference makers in public health.
A new report released today provides a valuable tool to help better detect contaminated foods before they reach consumers. Proposed steep budget cuts for federal food agencies and ongoing concerns over food safety make this report — from the University of Florida Emerging Pathogens Institute — a timely resource for public health officials.
The report, Ranking the Risks: The Ten Pathogen-Food Combinations with the Greatest Burden on Public Health (pdf), identifies the top ten riskiest combinations of foods and pathogens. Funded by the Robert Wood Johnson Foundation, the report offers food regulators a better way to target resources towards the most concerning food-pathogen combinations.
The researchers found that out of 31 individual pathogens that cause human illness, just five — Campylobacter, Salmonella, Listeria monocytogenes, Toxoplasma gondii and Norovirus — result in $12.7 billion in economic loss.
The top 10 pathogen-food combinations make up $8 billion of that amount. Those ten particular combinations are also responsible for about 85% of food-borne illness in the U.S., says Michael Batz, head of food safety programs at the Emerging Pathogens Institute and lead author of the new report. (RELATED: Read an in-depth Q&A about the report with Michael Batz)
Key findings in the report:
- The top-ranked pathogen-food combination is poultry contaminated with Campylobacter, a combination that sickens more than 600,000 people in the U.S., at a cost of $1.3 billion per year. Recommendation: The report questions whether new safety standards for chickens and turkeys are tough enough and recommends that the U.S. Department of Agriculture (USDA) tighten these standards over time.
- Salmonella is the leading pathogen overall, causing more than $3 billion in disease-related costs annually. In addition to poultry, Salmonella-contaminated produce, eggs and other affected foods all rank in the Top 10. Recommendation: The researchers suggest that the Food and Drug Administration (FDA) and USDA develop a joint initiative on Salmonella.
- Four combinations in the Top 10—Listeria in luncheon meats and dairy products and Toxoplasma in pork and beef pose serious risks to pregnant women. Infection with these pathogens can cause illness in the mother and developing fetus or newborn. Recommendation: Federal agencies should strengthen prevention programs aimed at these pathogens and improve educational efforts for pregnant women.
UPDATED — APRIL 28: The report has now been released, detailing valuable information about food safety for public health officials. NewPublicHealth also interviewed the report's lead author, Michael Batz, providing additional context and background.
ORIGINAL POST: Each week seems to bring another announcement about contaminated food. These contaminated products sicken millions — and kill thousands — of people every year.
Tomorrow, researchers from the University of Florida Emerging Pathogens Institute will release a useful report to help health officials and others more accurately identify and address the most significant sources of food-borne illness.
The new report — supported by a grant from the Robert Wood Johnson Foundation — identifies the riskiest combinations of foods and disease-causing microorganisms, finding they cost the United States billions of dollars each year and represent a serious public health burden.
The Food Safety Modernization Act, passed last year by Congress, broadly directs the Food and Drug Administration to create a more prevention- and risk-based approach to food safety — but the law doesn’t spell out exactly how to accomplish this critical goal.
The findings of the new report will help FDA and other agencies prioritize limited resources to the most serious food safety problems, a preventive approach that will ultimately help protect consumers.
Even when food-borne pathogens do not result in death, they can still significantly burden Americans. These pathogens can saddle patients and families with medical care costs and lost productivity from sick days. Serious complications or disabilities — which bring additional expenses — can also result from illnesses related to contaminated food products.
Check back with NewPublicHealth.org tomorrow for further coverage of the report release.
Salmonella is in the news again after federal investigators detected the bacteria in a single lot of cucumbers. That’s the sort of bacteria source that can be expected every now and then.
However, the Centers for Disease Control and Prevention is also alerting health departments and individuals to a less conventional source of salmonella: water frogs. As of April 18, the CDC had received reports of 216 people in 41 states infected with salmonella transmitted through contact with water frogs, particularly African dwarf frogs.
According to the CDC:
- A single breeder in California has been identified as the source of the salmonella-carrying African dwarf frogs.
- Children under age 5 are especially susceptible to serious salmonella infections, so should avoid contact with water frogs, their water and aquariums/tanks used to house the frogs.
- Others at high risk include pregnant women and those with compromised immune systems.
The CDC has created an online map that shows the states involved in the outbreak.
The Food and Drug Administration has a new website aimed at helping get food recall information to consumers. NewPublicHealth spoke with FDA food safety spokesman Douglas Karas about the site.
NPH: How does the new website advance and improve upon what the FDA had before?
Karas: To provide greater ease of use for consumers, the search results provide data from news releases and other recall announcements in the form of a table. That table organizes information from news releases on recalls since 2009 by date, product brand name, product description, reason for the recall and the recalling firm.
The table also provides a link to the news release on each recall for more detailed information. The news releases were chosen as the source of information for the table because they provide the most up-to-date and user friendly information about any recall.
The new display of the search results is markedly different from the previous display, which provided links in a scroll-down.
This link shows you a comparison of the search results display.
NPH: Did the FDA work with stakeholder groups to develop the new site?
Karas: Prior to launching the new Web search, the FDA consulted with stakeholder groups — including the Center for Science in the Public Interest, Consumers Union, Food Marketing Institute, Grocery Manufacturers Association, the Pew Health Group and Safe Tables Our Priority — to gain their insights on how to most effectively and easily communicate recall information to consumers.
NPH: What's next in improving the site?
Karas: We will further evaluate the current format and any comments we receive on it from stakeholders and our customer service line. Then we will consider whether improvements are needed and what they might be.
NPH: On its main website, the FDA also provides details on how information is provided during a major recall. In those cases, the FDA will also create special web pages and other resources. Information on some past major product recalls is available here.
Weigh In: Would this FDA tool be helpful to post on a public health department website to give the community increased access to recall information?
Read previous NewPublicHealth.org Q&As with newsmakers and difference makers in public health.
Think movie theatres should have to post the calorie count of a large bucket of their popcorn (about 1,000 calories) or a 24-ounce super cup of regular soda (about 300 calories)? Or should they be exempt? The Food and Drug Administration wants to hear your thoughts.
The agency is currently seeking comments on long-awaited food labeling rules that were released late last week. The proposed rules would mandate that many food outlets post calorie counts and other nutritional information on menus and menu boards. Labeling would also be required on many food vending machines. (Labeling rules right now are issued by some state and local governments and can vary widely.)
In the proposed rules, movie theaters and certain other establishments — such as bowling alleys and airplanes, whose primary purpose is not food sales — are exempt from the nutritional postings. But some question that decision. A New York Times article quotes Margo G. Wootan, nutrition policy director at the Center for Science in the Public Interest which has long advocated for labeling rules: “It doesn’t matter whether you happen to be watching a movie while you’re eating. Those calories still count,” said Wootan.
CSPI’s statement on the proposed rules cites a Stanford University study that found that Starbucks locations in New York City with labeled menus saw an average 6 percent drop in calories per purchase.
FDA’s comment period on the rules is open until June 6 for menu labeling and until July 5 for vending machine labeling. Information on how to post comments about the proposed food labeling rules is available on the FDA site by scrolling down to the heading “We want to hear from you.”
QUESTION: Have calorie counts on menus ever affected your order?