“Foodborne infections can be prevented,” according to the Vital Signs report in the most recent issue of Morbidity and Mortality Weekly Report (MMWR), a series of weekly reports prepared by the Centers for Disease Control and Prevention (CDC) containing important public health information. Yet despite that conclusion, the CDC reports that contaminated food consumed in the United States causes an estimated 48 million illnesses, 128,000 hospitalizations, and 3,000 deaths annually. Based on the Vital Signs report, which has summarized the 2010 data from CDC’s Foodborne Diseases Active Surveillance Network (FoodNet), the pathogen responsible for those continued high numbers appears to be Salmonella.
In a press release issued today by the CDC in conjunction with the Vital Signs report, the agency noted that “Salmonella infections have not decreased during the past 15 years and have instead increased by 10 percent in recent years.” Shockingly, more than 1 million people in this country become ill from Salmonella each year. According to the CDC, among the reasons why the number of Salmonella infections continues to grow are the following:
- It is found in many different types of foods: meats, eggs, fruits, vegetables, and even processed foods such as peanut butter.
- Contamination can occur anywhere: from fields where food is grown to cutting boards in kitchens.
- What we eat and how we eat have changed: foods coming from one central location are widely distributed, meaning that sickness can spread quickly; we eat more meals outside the home; and more foods and ingredients come from all over the world.
- Some policies and procedures that can make a difference in reducing contamination take years to put into place.
However, these challenges should not hinder the efforts of our food regulatory agencies, urged CDC Director Thomas R. Frieden, M.D., M.P.H. “Salmonella costs hundreds of millions of dollars in direct medical costs each year. Continued investments are essential to detect, investigate, and stop outbreaks promptly in order to protect our food supply,” he said.
Echoing Dr. Frieden’s sentiments, the Vital Signs report concluded that “Salmonella infection should be targeted because it has not declined significantly in more than a decade, and other data indicate that it is one of the most common foodborne infections, resulting in an estimated $365 million in direct medical costs annually.” Specifically, the Vital Signs report found the following:
In 2010, a total of 19,089 laboratory-confirmed cases of infection, 4,247 hospitalizations, and 68 deaths were identified by FoodNet sites. Salmonella infection was the most common infection reported (8,256 infections; 17.6 illnesses per 100,000 persons) and had the largest number of hospitalizations (2,290) and deaths (29).
The statistics indicate that Salmonella is the cause of nearly half of the hospitalizations and deaths CDC tracks through FoodNet.
Significantly, however, progress has been made in other areas. Although rates of Salmonella infection remain high, the CDC announced that in the past decade, “illnesses from the serious Shiga toxin-producing E. coli (STEC) O157 have been cut nearly in half and the overall rates of six foodborne infections have been reduced by 23 percent.” In fact, the incidence of STEC O157 infection has declined to reach the 2010 national health objective target of ≤1 case per 100,000.
The CDC credits the reduction in E. coli infections to “improved detection and investigation of outbreaks through CDC’s PulseNet surveillance system, cleaner slaughter methods, testing of ground beef for E. coli, better inspections of ground beef processing plants, regulatory improvements like the prohibition of STEC O157 in ground beef and increased awareness by consumers and restaurant employees of the importance of properly cooking beef.” Perhaps the progress made in reducing STEC O157 infections will serve as a lesson that the same can be accomplished with Salmonella.
The Vital Signs report acknowledges that accomplishing similarly significant reductions in Salmonella infections “will require strong action to prevent food contamination at multiple steps along the farm to the table chain. Farmers, the food industry, regulatory agencies, food service, consumers, and public health authorities all have a role.” Importantly, though, it is not an unachievable goal.
Elisabeth Hagen, M.D., Under Secretary for Food Safety in the U.S. Department of Agriculture, underscored that the Vital Signs report “demonstrates that we’ve made great progress. However, far too many people still get sick from the food they eat, so we have more work to do. That is why we are looking at all options, from farm to table, in-order to make food safer and prevent illnesses from E. coli, Salmonella, and other harmful pathogens.”
As of today, the new national health objectives target a 25 percent reduction in Salmonella infections by 2020 and 25 percent – 50 percent reductions for five other infections and HUS. The CDC projects that “[a]chieving the targets could prevent an estimated 4.6 million illnesses, 68,000 hospitalizations, and 1,470 deaths by 2020. It also could save $421 million in direct medical costs associated with Salmonella infection alone.”
FDA Deputy Commissioner for Foods Michael R. Taylor is hopeful that the implementation of FDA’s new shell egg safety requirements will aid in reducing illnesses caused by Salmonella enteritidis in eggs. Moreover, he believes that FDA’s expanded regulatory authorities under the recently enacted Food Safety Modernization Act will allow for “a comprehensive approach to preventing illnesses from many types of Salmonella and a wide range of other contaminants that can make people sick.”
Second Image Source: Centers for Disease Control and Prevention