Sick food handlers are a food safety risk

A while back I was awarded a contract to teach food safety in correctional institutions. I clearly remember an incident when I was talking about not going to work when you are ill as this poses a food safety risk and I went to explain why. Then this massive looking dude about the size of Terry Crews jumps out of his seat yelling at me. Apparently he had worked in the food service industry and had to support a family of five without having any sick time. So, when he was sick he went to work. Thereafter it was blur as 5 correctional officers jumped in the room to detain my friend as I soiled myself from fear…

Heather Williams writes

We put a lot of trust in the people who prepare and serve our food. We expect that our food is safe to eat and handled appropriately. In the United States, we have standards for food safety and many regulations in place. Why wouldn’t we trust those who prepare and serve our food? Unfortunately, a significant number of food workers have admitted to working while knowingly being sick. There are many reasons someone might do this. Some do it for financial reasons, others for sense of duty, and then there are some who fear they may lose their job if they do not cover their shift. Could foodborne illness cases dramatically decrease if food workers could have sick leave, which would allow them monetary compensation for identifying their illness and not passing it on to other unsuspecting patrons? Let’s explore this.
Restaurants Are a Primary Source of Foodborne Outbreaks
According to the Center for Disease Control and Prevention (CDC), an estimated 48 million people become ill in the United States each year from foodborne infection. Approximately 128,000 are hospitalized and foodborne illness claims about 3,000 lives each year. Over half of all foodborne outbreaks reported to the CDC can be linked back to eating in restaurants or delicatessens.
In one study, a group of investigators gathered data from FoodNet. This resource is also known as the Foodborne Diseases Active Surveillance Network, a central database where participating sites report information regarding foodborne illness. In a study analyzing 457 foodborne disease outbreaks, 300 were restaurant related. 98% of the 300 had only one contributing factor causing the outbreak. The most common contributing factor resulting in 137 outbreaks was “handling by an infected person or carrier of pathogen.” This is a significant number considering one lapse can have such high statistical repercussions.
The purpose of the study was to identify the contributing factors in restaurant-linked foodborne disease outbreaks. 75% of the outbreaks investigated were linked to Norovirus and Salmonella. These infections were predominately linked back to transmission by food workers. Significant resources are devoted to preventing contamination of food products before they make it to the point of service. Restaurants must ensure that staff have adequate training and understanding for how to handle the food once it becomes in their custody. Food worker health and hygiene were primary factors in contributing to foodborne illness.

The rest of the story can be found be here:

http://www.unsafefoods.com/2017/08/29/sick-leave-reduce-foodborne-illness/

 

Kids, kids: Foodnet report is out

It’s my favorite day of the year: The annual U.S. Foodnet report, where data is presented, mulled over, and then crammed into politically suitable food safety fairytales.

When a scientific report leads with, “The incidence of infections transmitted commonly through food has remained largely unchanged for many years,” isn’t it time to try something different?

The U.S. Centers for Disease Control reports reducing foodborne illness depends in part on identifying which illnesses are decreasing and which are increasing. Yet recent changes in the use of tests that diagnose foodborne illness pose challenges to monitoring illnesses and progress toward preventing foodborne disease, according to a report published today in CDC’s Morbidity and Mortality Weekly Report.

Rapid diagnostic tests help doctors diagnose infections quicker than traditional culture methods, which require growing bacteria to determine what is causing illness. But without a bacterial culture, public health officials cannot get the detailed information needed to detect and prevent outbreaks, monitor disease trends, and identify antibiotic resistance.

The MMWR article includes the most recent data from CDC’s Foodborne Diseases Active Surveillance Network, or FoodNet, which collects data on 15% of the U.S. population. It summarizes preliminary 2016 data on nine germs spread commonly through food. In 2016, FoodNet reported 24,029 infections, 5,512 hospitalizations, and 98 deaths. This is the first time the numbers used for calculations of trends include bacterial infections diagnosed only by rapid diagnostic tests as well as those confirmed by traditional culture-based methods. Previously, these calculations used only those bacterial infections confirmed by culture-based methods. The most frequent causes of infection in 2016 were Salmonella and Campylobacter, which is consistent with previous years.

 Incidence and Trends of Infections with Pathogens Transmitted Commonly Through Food and the Effect of Increasing Use of Culture-Independent Diagnostic Tests on Surveillance — Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2013–2016

Marder EP, Cieslak PR, Cronquist AB, et al.

MMWR Morb Mortal Wkly Rep 2017;66:397–403. DOI: http://dx.doi.org/10.15585/mmwr.mm6615a1

https://www.cdc.gov/mmwr/volumes/66/wr/mm6615a1.htm?s_cid=mm6615a1_e#suggestedcitation

The incidence of infections transmitted commonly through food has remained largely unchanged for many years. Culture-independent diagnostic tests (CIDTs) are increasingly used by clinical laboratories to detect enteric infections.

What is added by this report?

Compared with the 2013–2015 average annual incidence, the 2016 incidence of confirmed Campylobacter infections was lower, incidences of confirmed Shiga toxin-producing Escherichia coli (STEC), Yersinia, and Cryptosporidium infections were higher, and incidences of confirmed or CIDT positive–only STEC and Yersinia infections were higher. However, CIDTs complicate the interpretation of surveillance data; testing for pathogens might occur more frequently because of changes in either health care provider behaviors or laboratory testing practices. A large proportion of CIDT positive specimens were not reflex cultured, which is necessary to obtain isolates for distinguishing pathogen subtypes, determining antimicrobial resistance, monitoring trends, and detecting outbreaks.

What are the implications for public health practice?

Some information about the bacteria causing infections, such as subtype and antimicrobial susceptibility, can only be obtained for CIDT positive specimens if reflex culture is performed. Increasing use of CIDTs affects the interpretation of public health surveillance data and ability to monitor progress toward prevention measures.

Foodborne diseases represent a substantial public health concern in the United States. CDC’s Foodborne Diseases Active Surveillance Network (FoodNet) monitors cases reported from 10 U.S. sites* of laboratory-diagnosed infections caused by nine enteric pathogens commonly transmitted through food. This report describes preliminary surveillance data for 2016 on the nine pathogens and changes in incidences compared with 2013–2015. In 2016, FoodNet identified 24,029 infections, 5,512 hospitalizations, and 98 deaths caused by these pathogens. The use of culture-independent diagnostic tests (CIDTs) by clinical laboratories to detect enteric pathogens has been steadily increasing since FoodNet began surveying clinical laboratories in 2010 (1). CIDTs complicate the interpretation of FoodNet surveillance data because pathogen detection could be affected by changes in health care provider behaviors or laboratory testing practices (2). Health care providers might be more likely to order CIDTs because these tests are quicker and easier to use than traditional culture methods, a circumstance that could increase pathogen detection (3). Similarly, pathogen detection could also be increasing as clinical laboratories adopt DNA-based syndromic panels, which include pathogens not often included in routine stool culture (4,5). In addition, CIDTs do not yield isolates, which public health officials rely on to distinguish pathogen subtypes, determine antimicrobial resistance, monitor trends, and detect outbreaks. To obtain isolates for infections identified by CIDTs, laboratories must perform reflex culture; if clinical laboratories do not, the burden of culturing falls to state public health laboratories, which might not be able to absorb that burden as the adoption of these tests increases (2). Strategies are needed to preserve access to bacterial isolates for further characterization and to determine the effect of changing trends in testing practices on surveillance.

FoodNet is a collaboration among CDC, 10 state health departments, the U.S. Department of Agriculture’s Food Safety and Inspection Service, and the Food and Drug Administration. FoodNet personnel conduct active, population-based surveillance for laboratory-diagnosed infections caused by Campylobacter, Cryptosporidium, Cyclospora, Listeria, Salmonella, Shiga toxin-producing Escherichia coli (STEC), Shigella, Vibrio, and Yersinia for 10 sites covering approximately 15% of the U.S. population (an estimated 49 million persons in 2015). Confirmed bacterial infections are defined as isolation of the bacterium from a clinical specimen by culture. Confirmed parasitic infections are defined as detection of the parasite from a clinical specimen by direct fluorescent antibody test, polymerase chain reaction, enzyme immunoassay, or light microscopy. CIDTs detect bacterial pathogen antigen, nucleic acid sequences, or for STEC, Shiga toxin or Shiga toxin genes, in a stool specimen or enrichment broth.§ A CIDT positive–only bacterial infection is a positive CIDT result that was not confirmed by culture. Hospitalizations occurring within 7 days of specimen collection are recorded. The patient’s vital status at hospital discharge (or 7 days after specimen collection if not hospitalized) is also recorded. Hospitalizations and deaths occurring within 7 days of specimen collection are attributed to the infection. FoodNet also conducts surveillance for physician-diagnosed postdiarrheal hemolytic uremic syndrome (HUS), a potential complication of STEC infection, by review of hospital discharge data through a network of nephrologists and infection preventionists. This report includes HUS cases among persons aged <18 years for 2015, the most recent year with available data.

Incidence of infection for each pathogen is calculated by dividing the number of infections in 2016 by the U.S. Census estimates of the surveillance area population for 2015. Incidence is calculated for confirmed infections alone and for confirmed or CIDT positive–only infections combined. A negative binomial model with 95% confidence intervals (CIs) was used to estimate changes in incidence of confirmed bacterial and parasitic infections and confirmed or CIDT positive–only bacterial infections in 2016 compared with 2013–2015, adjusting for changes in the surveillance population over time. For STEC, incidence is reported for all STEC serogroups combined because it is not possible to distinguish between serogroups using CIDTs. Insufficient data were available to assess change for Cyclospora. For HUS, the 2015 incidence was compared with incidence during 2012–2014.

Cases of Infection, Incidence, and Trends

During 2016, FoodNet identified 24,029 cases, 5,512 hospitalizations, and 98 deaths caused by confirmed or CIDT positive–only infections. The largest number of confirmed or CIDT positive–only infections in 2016 was reported for Campylobacter (8,547), followed by Salmonella (8,172), Shigella (2,913), STEC (1,845), Cryptosporidium (1,816), Yersinia (302), Vibrio (252), Listeria (127), and Cyclospora (55). The proportion of infections that were CIDT positive without culture confirmation in 2016 was largest for Campylobacter (32%) and Yersinia (32%), followed by STEC (24%), Shigella (23%), Vibrio (13%), and Salmonella (8%). The overall increase in CIDT positive–only infections for these six pathogens in 2016 was 114% (range = 85%–1,432%) compared with 2013–2015. Among infections with a positive CIDT result in 2016, a reflex culture was attempted on approximately 60% at either a clinical or state public health laboratory. The proportion of attempted reflex cultures differed by pathogen, ranging from 45% for Campylobacter to 86% for STEC and 88% for Vibrio. Among infections for which reflex culture was performed, the proportion of infections that were positive was highest for Salmonella (88%) and STEC (87%), followed by Shigella (64%), Yersinia (59%), Campylobacter (52%), and Vibrio (46%).

The incidence of confirmed infections and of confirmed or CIDT positive–only infections per 100,000 persons was highest for Campylobacter (confirmed = 11.79; confirmed or CIDT positive–only = 17.43) and Salmonella (15.40; 16.66), followed by Shigella (4.60; 5.94), Cryptosporidium (3.64; N/A**), STEC (2.85; 3.76), Yersinia (0.42; 0.62), and lowest for Vibrio (0.45; 0.51), Listeria (0.26; N/A), and Cyclospora (0.11; N/A). Compared with 2013–2015, the 2016 incidence of Campylobacter infection was significantly lower (11% decrease) when including only confirmed infections, yet was not significantly different when including confirmed or CIDT positive–only infections. Incidence of STEC infection was significantly higher for confirmed infections (21% increase) and confirmed or CIDT positive–only infections (43% increase). Similarly, the incidence of Yersinia infection was significantly higher for both confirmed (29% increase) and confirmed or CIDT positive–only infections (91% increase). Incidence of confirmed Cryptosporidium infection was also significantly higher in 2016 compared with 2013–2015 (45% increase).

Among 7,554 confirmed Salmonella cases in 2016, serotype information was available for 6,583 (87%). The most common serotypes were Enteritidis (1,320; 17%), Newport (797; 11%), and Typhimurium (704; 9%). The incidence in 2016 compared with 2013–2015 was significantly lower for Typhimurium (18% decrease; CI = 7%–21%) and unchanged for Enteritidis and Newport. Among 208 (95%) speciated Vibrio isolates, 103 (50%) were V. parahaemolyticus, 35 (17%) were V. alginolyticus, and 26 (13%) were V. vulnificus. Among 1,394 confirmed and serogrouped STEC cases, 503 (36%) were STEC O157 and 891 (64%) were STEC non-O157. Among 586 (70%) STEC non-O157 isolates, the most common serogroups were O26 (190; 21%), O103 (178; 20%), and O111 (106; 12%). Compared with 2013–2015, the incidence of STEC non-O157 infections in 2016 was significantly higher (26% increase; CI = 9%–46%) and the incidence of STEC O157 was unchanged.

FoodNet identified 62 cases of postdiarrheal HUS in children aged <18 years (0.56 cases per 100,000) in 2015; 33 (56%) occurred in children aged <5 years (1.18 cases per 100,000). Compared with 2012–2014, in 2015, no significant differences in incidence among all children or children aged <5 years were observed.

Discussion

The number of CIDT positive–only infections reported to FoodNet has been increasing markedly since 2013, as more clinical laboratories adopt CIDTs. Initially, increases were primarily limited to Campylobacter and STEC; followed by substantial increases in Salmonella and Shigella beginning in 2015 (6). The pattern continued in 2016, with large increases in the number of CIDT positive–only Vibrio and Yersinia infections. When including both confirmed and CIDT positive–only infections, incidence rates in 2016 were higher for each of these six pathogens. The increasing use of CIDTs presents challenges when interpreting the corresponding increases in incidence. For example, the incidence of confirmed Campylobacter infections in 2016 was significantly lower than the 2013–2015 average. However, when including CIDT positive–only infections, a slight but not significant increase occurred. For STEC and Yersinia, the incidence of confirmed infections alone and confirmed or CIDT positive–only infections in 2016 were both significantly higher than the 2013–2015 average; the magnitude of change approximately doubled when analyzing CIDT positive–only infections.

Because of the ease and increasing availability of CIDTs, testing for some pathogens might be increasing as health care provider behaviors and laboratory practices evolve (2). Among clinical laboratories in the FoodNet catchment, the use of CIDTs to detect Salmonella, for which the only CIDTs available are DNA-based gastrointestinal syndrome panels, increased from 2 per 460 laboratories (<1%) in 2013 to 59 per 421 laboratories (14%) in 2016 (FoodNet, unpublished data). This increased use paralleled significant increases in incidence of Cryptosporidium, STEC, and Yersinia, and slight but not significant increases in incidence of Campylobacter, Salmonella, Shigella, and Vibrio, all of which are also included in these panel tests. The increase in STEC incidence is driven by the increase in STEC non-O157, which is not typically included in routine stool culture testing because it requires specialized methods. Routine stool cultures performed in clinical laboratories typically include methods that identify only Salmonella, Campylobacter, Shigella, and for some laboratories, STEC O157 (4,5). The increased use of the syndrome panel tests might increase identification, and thus, improve incidence estimates of pathogens for which testing was previously limited.

Results are more quickly obtained using CIDTs than traditional culture methods (3). Because of this, health care providers might be more likely to order a CIDT than traditional culture (2). Increased testing might identify infections that previously would have remained undiagnosed. However, sensitivity and specificity vary by test type. Evaluations of DNA-based syndrome panel tests have indicated high sensitivity and specificity for most targets (3). However, among pathogens for which antigen-based CIDTs are often used, such as Campylobacter and Cryptosporidium, sensitivity and specificity have varied more widely, with a large number of false positive results (7,8). Including CIDT positive infections to calculate incidence, some of which could be false positives, might provide an inaccurate estimate. When interpreting incidence and trends in light of changing diagnostic testing, considering frequency of testing, sensitivity, and specificity of these tests is important. The observed increases in incidence of confirmed or CIDT positive–only infections in 2016 compared with 2013–2015 could be caused by increased testing, varying test sensitivity, an actual increase in infections, or a combination of these reasons.

These changes in testing are also important to consider when monitoring progress toward Healthy People 2020 objectives.†† The current objectives were created before the use of CIDTs and were based on confirmed infections. In the future, just as incidence measures should adjust for these changes, objectives should also be evaluated in light of changing diagnostics.

CIDTs pose additional challenges because they do not yield the bacterial isolates necessary for essential public health surveillance activities, such as monitoring trends in pathogen subtypes, conducting molecular testing, detecting outbreaks and implicating vehicles, and determining antimicrobial susceptibility. Reflex culture performed to yield an isolate places an additional burden on laboratories’ budgets, personnel, and time. Specimen submission requirements differ by state and pathogen, and this responsibility often falls to state public health laboratories (9). As CIDT use increases and more pathogens are affected, state public health laboratories will be challenged to sufficiently increase their testing capacity and will likely have to prioritize specimens on which to perform reflex culture (10). Clinical laboratories should review state specimen submission requirements and the Association of Public Health Laboratories guidelines§§ for reflex culture and submission of CIDT positive specimens.

The findings in this report are subject to at least two limitations. First, the changing diagnostic landscape with unknown changes in frequency of testing, varying test performance, and decreasing availability of isolates for subtyping make interpreting incidence and trends more difficult. Second, changes in health care–seeking behavior, access to health services, or other population characteristics might have changed since the comparison period, which could affect incidence.

Foodborne illness remains a substantial public health concern in the United States. Previous analyses have indicated that the number of infections far exceeds those diagnosed; CIDTs might be making those infections more visible (11). Most foodborne infections can be prevented, and substantial progress has been made in the past in decreasing contamination of some foods and reducing illness caused by some pathogens. More prevention measures are needed. Surveillance data can provide information on where to target these measures. However, to accurately interpret FoodNet surveillance data in light of changes in diagnostic testing, more data and analytic tools are needed to adjust for changes in testing practices and differences in test characteristics. FoodNet is collecting more data and developing those tools. With these, FoodNet will continue to track the needed progress toward reducing foodborne illness.

Acknowledgments

Foodborne Diseases Active Surveillance Network staff members, Emerging Infections Program; Brittany Behm, Staci Dixon, Elizabeth Greene, Jennifer Huang, Clare Wise, and FoodNet Fast Development Team, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Sporadic illnesses, outbreak illnesses, are similiar

Outbreak data have been used to estimate the proportion of illnesses attributable to different foods. Applying outbreak-based attribution estimates to non-outbreak foodborne illnesses requires an assumption of similar exposure pathways for outbreak and sporadic illnesses. This assumption cannot be tested, but other comparisons can assess its veracity.

vomit-FBOur study compares demographic, clinical, temporal, and geographic characteristics of outbreak and sporadic illnesses from Campylobacter, Escherichia coli O157, Listeria, and Salmonella bacteria ascertained by the Foodborne Diseases Active Surveillance Network (FoodNet). Differences among FoodNet sites in outbreak and sporadic illnesses might reflect differences in surveillance practices. For Campylobacter, Listeria, and Escherichia coli O157, outbreak and sporadic illnesses are similar for severity, sex, and age. For Salmonella, outbreak and sporadic illnesses are similar for severity and sex. Nevertheless, the percentage of outbreak illnesses in the youngest age category was lower.

Therefore, we do not reject the assumption that outbreak and sporadic illnesses are similar.

Comparing characteristics of sporadic and outbreak-associated foodborne illnesses, United States, 2004-2011

Emerging Infectious Diseases, Volume 22, Number 7, July 2016, DOI: 0.3201/eid2207.150833

E.D. Ebel, M.S. Williams, D. Cole, C.C. Travis, K.C. Klontz, N.J. Golden, R.M. Hoekstra

http://wwwnc.cdc.gov/eid/article/22/7/15-0833_article

Campy up, E. coli O157 down: Foodborne diseases active surveillance network (FoodNet)

The U.S. Centers for Disease Control and Prevention Foodborne Diseases Active Surveillance Network, or FoodNet, has been tracking trends for infections transmitted commonly through food since 1996.

cdc.food.safety.14FoodNet provides a foundation for food safety policy and prevention efforts. It estimates the number of foodborne illnesses, monitors trends in incidence of specific foodborne illnesses over time, attributes illnesses to specific foods and settings, and disseminates this information.

“FoodNet has matured and transformed over 20 years, and continues to evolve as technologies change,” says Dr. Olga Henao, FoodNet Team Lead.

The Foodborne Diseases Active Surveillance Network, or FoodNet, has been tracking trends in foodborne infections since 1996.

FoodNet provides a foundation for food safety policy and prevention efforts by estimating the number of foodborne illnesses, monitoring trends of specific foodborne illnesses, conducting studies to understand the causes of these illnesses, and informing the public about its findings.

FoodNet began to collect information on two pathogen cases identified by CIDT in 2009 and expanded the collection to other pathogens in 2011.

FoodNet has conducted surveillance for laboratory-confirmed cases of infection in humans  caused by Campylobacter, Listeria, Salmonella, Shiga toxin-producing E. coli (STEC) O157,  Shigella, Vibrio, and Yersinia since 1996, Cryptosporidium and Cyclospora since 1997, and STEC non-O157 since 2000. FoodNet staff in state health departments contact clinical laboratories in the surveillance area to get reports of infections diagnosed in residents.

Special Studies

Although foodborne outbreaks are common, most foodborne infections are sporadic, meaning they are not related to an outbreak. We can only rarely determine how one person got an infection but, by studying a large number of people with the same type of infection, we can often determine risk factors for getting ill.

Major Contributions

FoodNet is the only U.S. system focused on obtaining comprehensive information about sporadic infections caused by pathogens transmitted commonly through food. The network’s contributions to food safety policy and illness prevention include:

Establishing reliable, active population-based surveillance to understand who gets sick and why;

Developing and implementing studies that determine risk and protective factors for foodborne infections;

Conducting population surveys and laboratory surveys that describe the features of gastrointestinal illnesses, medical care-seeking behavior, foods eaten, and laboratory practices; and

Improving our ability at the federal and state level to track and study foodborne illnesses and respond to new issues as they arise. 

About FoodNet

Surveillance in an area that includes 15% of the U.S. population (approximately 48 million people)

Collaboration among CDC, 10 state health departments, the U.S. Department of Agriculture’s Food Safety and Inspection Service, and the Food and Drug Administration. (Image: U.S. map showing FoodNet sites.)

Principal foodborne disease component of CDC’s Emerging Infections Program

Provides the data necessary for measuring the progress in foodborne disease prevention.

Foodborne Diseases Active Surveillance Network—2 decades of achievements, 1996–2015

The Foodborne Diseases Active Surveillance Network (FoodNet) provides a foundation for food safety policy and illness prevention in the United States.

FoodNet.pyramid.fbi.OverviewFoodNet conducts active, population-based surveillance at 10 US sites for laboratory-confirmed infections of 9 bacterial and parasitic pathogens transmitted commonly through food and for hemolytic uremic syndrome.

Through FoodNet, state and federal scientists collaborate to monitor trends in enteric illnesses, identify their sources, and implement special studies. FoodNet’s major contributions include establishment of reliable, active population-based surveillance of enteric diseases; development and implementation of epidemiologic studies to determine risk and protective factors for sporadic enteric infections; population and laboratory surveys that describe the features of gastrointestinal illnesses, medical care–seeking behavior, frequency of eating various foods, and laboratory practices; and development of a surveillance and research platform that can be adapted to address emerging issues.

The importance of FoodNet’s ongoing contributions probably will grow as clinical, laboratory, and informatics technologies continue changing rapidly.

Foodborne Diseases Active Surveillance Network—2 decades of achievements, 1996–2015

Emerging Infectious Diseases, Volume 21, Number 9,  September 2015

Olga L. Henao Comments to Author , Timothy F. Jones, Duc J. Vugia, Patricia M. Griffin, and for the Foodborne Diseases Active Surveillance Network (FoodNet) Workgroup

http://wwwnc.cdc.gov/eid/article/21/9/15-0581_article

Hey kids, the snails are back: CDC releases 2013 FoodNet data

That’s the tagline from a Far Side cartoon and what immediately came to mind upon reading yet again that reductions in foodborne illness were stagnant for 2013.

There were successes, failures and shifting profiles of what foods lead to foodborne illness, because whatever Americans choose to eat, under whatever production system, some smart bug is going to figure out how to flourish.

And the FoodNet data remains the best and most publicly available surveillance data in the world; that’s right, best in the world.

The Foodborne Diseases Active Surveillance Network (FoodNet) monitors the incidence of laboratory-confirmed infections caused by nine pathogens transmitted commonly through food in 10 U.S. sites, covering approximately 15% of the U.S. population. This report summarizes preliminary 2013 data and describes trends since 2006. In 2013, a total of 19,056 infections, 4,200 hospitalizations, and 80 deaths were reported. For most infections, incidence was well above national Healthy People 2020 incidence targets and highest among children aged <5 years. Compared with 2010–2012, the estimated incidence of infection in 2013 was lower for Salmonella, higher for Vibrio, and unchanged overall. Since 2006–2008, the overall incidence has not changed significantly. More needs to be done.

Yes, more needs to be done. Part of that involves abandoning archaic communications and invoking current, compelling and credible food safety messages using a variety of media, at the places where people make food decisions – whether it’s the local market or the megalomart.

cdc.fbi.annual.13The complete report is available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6315a3.htm?s_cid=mm6315a3_e

Incidence and trends of infection with pathogens transmitted commonly through food — Foodborne Diseases Active Surveillance Network, 10 U.S. sites, 2006–2013.

CDC MMWR 63(15);328-332

Stacy M. Crim, Martha Iwamoto, Jennifer Y. Huang, Patricia M. Griffin, Debra Gilliss, Alicia B. Cronquist, Matthew Cartter, Melissa Tobin-D’Angelo, David Blythe, Kirk Smith, Sarah Lathrop, Shelley Zansky, Paul R. Cieslak, John Dunn, Kristin G. Holt, Susan Lance, Robert Tauxe, Olga L. Henao

cdc.foodnet.13

Salmonella numbers still high, O157 way down; new Foodnet numbers

Salmonella infections in the U.S. have not declined in a decade, and should be targeted in new public health initiatives.

So says the U.S. Centers for Disease Control in the annual Foodnet update.

The report says the incidence of E. coli O157 infection has declined to reach the 2010 national health objective target of ≤1 case per 100,000.

The prevention measures that reduced STEC O157 infection need to be applied more broadly to reduce Salmonella and other infections.

Same as it Ever Was: U.S. FoodNet data for 2009 shows nothing has changed

I finished our U.S. taxes early this morning and filed before the April 15 deadline.

Amy wasn’t taking advantage of our full deductions, so I pompously declared I would do the taxes this year – my first time filing in the U.S. – and then of course waited until the last day to file.

They’re done, at least until we get audited, so it’s back to foodborne illness and the annual FoodNet data which is awesome because it provides an annual snapshot, and sucks because it shows nothing is changing.

All the talk in Washington, all the outbreaks, all the Pulitzer-prize winning media coverage, all the ridiculously boring coverage of so-called foodborne illness in the vanity presses by those who can afford them and … the incidence of foodborne illness isn’t changing. So maybe it’s time to do something different.

In 2009, a total of 17,468 laboratory-confirmed cases of infection were identified. In comparison with the first 3 years of surveillance (1996–1998), sustained declines in the reported incidence of infections caused by Campylobacter, Listeria, Salmonella, Shiga toxin-producing Escherichia coli (STEC) O157, Shigella, and Yersinia were observed. The incidence of Vibrio infection continued to increase. Compared with the preceding 3 years (2006–2008), significant decreases in the reported incidence of Shigella and STEC O157 infections were observed. For most infections, reported incidence was highest among children aged <4 years; the percentage of persons hospitalized and the case fatality rate (CFR) were highest among persons aged ≥50 years. In 2009, the Healthy People 2010 target of ≤1.0 case per 100,000 population for STEC O157 infection (objective 10-1b) was met (2). Further collaborative efforts with regulatory agencies and industry are needed to sustain and extend recent declines and to improve prevention of foodborne infections.

Maybe someone should take leadership and stop gassing on about collaboration.

\

Efforts to reduce foodborne illness remain stalled; new approaches needed so fewer people barf

The Centers for Disease Control reported today that foodborne illness remains a significant public health issue in the United States, and that, “fundamental problems with bacterial and parasitic contamination are not being resolved.”

Douglas Powell, an associate professor of food safety at Kansas State University, says that more training, testing and inspecting is not the answer.

"There are way too many people getting sick," Powell said. "The CDC data show existing efforts to reduce foodborne illness have stalled. We need new messages using new media to really create a culture that values microbiologically safe food."

Powell publishes barfblog.com and conducts research on human food safety behavior from farm-to-fork. He can be reached by phone at 785-317-0560, or e-mail dpowell@k-state.edu.

His bio is at
http://www.k-state.edu/media/mediaguide/bios/powellbio.html