U.S. Food Safety No Longer Improving, Data Show

Source of Article:  http://www.nytimes.com/2009/04/10/health/policy/10food.html?ref=health

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Published: April 9, 2009

WASHINGTON — After decades of steady progress, the safety of the nation’s food supply is no longer improving. And in the case of salmonella — the dangerous bacteria recently found in peanuts and pistachios — infections may be creeping upward, the government reported Thursday.

In 2008, 16 out of 100,000 people in the United States had laboratory-confirmed cases of salmonella infections, according to the Centers for Disease Control and Prevention. That translates into about 48,000 serious illnesses, since individual stool samples are sent to labs generally only when someone is suffering a severe bout. In 2005, the figure was 14 people per 100,000 — or about 42,000 cases of laboratory-confirmed salmonella infections.

The apparent increase in salmonella is not statistically significant and could be a statistical fluke, according to the disease centers. Across a range of different food-borne illnesses, there has been no statistically significant change over the past three years in the share of the nation’s population that has been severely sickened by food.

But health experts said the lack of improvement was disheartening. And in the case of salmonella, the numbers mean that the nation is unlikely to meet goals created in 2000 under the government’s “Healthy People 2010” program to reduce the incidence of salmonella infections to about half its current level.

“This highlights the urgent need to overhaul our food-safety system,” said Erik D. Olson, director of food and consumer product safety at the Pew Charitable Trusts. “In some cases, there are early indications that progress may be reversing for some diseases. The children and elderly in our families are most at risk, and it is our duty to better safeguard them.”

Roughly 76 million people in the United States suffer food-borne illnesses each year, 300,000 are hospitalized and 5,000 die, according to estimates by the disease centers. Children younger than 4 are sickened by food more than those in any other age group, but adults over age 50 suffer more hospitalizations and death as a result of food-related infections.

Because food-related illnesses are so common, measuring whether food is getting safer or more dangerous is critical to public health, but it is also a daunting challenge. The disease control agency uses three very different methods to routinely track sickness caused by food. Of these, FoodNet — whose most recent data was made public Thursday — is the most reliable because government epidemiologists routinely survey more than 650 clinical laboratories that serve about 46 million people in 10 states. Such active surveillance tends to be more accurate than other tools that rely on voluntary, and generally spotty, reporting by doctors and hospitals.

Even so, FoodNet captures only a tiny slice of all those sickened by food. For a case to be included in FoodNet, someone must become sick enough to see a doctor, the doctor must be concerned or well-trained enough to ask for and get a stool sample, and the laboratory to which the doctor sends the sample must be part of the government’s system.

Since 1996, when the system began, the burden of illness from campylobacter, listeria, shigella, E. coli 0157 and Yersinia has decreased, although all of that decrease occurred before 2004. There has been no statistically significant change in the incidence of salmonella and cryptosporidium and there has been a marked increase in cases of vibrio, a relatively rare disease mostly associated with raw oysters.

There are unexplained variations in infection rates among the 10 states in the FoodNet system. The incidence of campylobacter, for instance, is highest in California while salmonella infections are highest in New Mexico and Georgia. Geographic differences in diet may be the cause, officials said.

“The lack of recent progress toward the national health objective targets and the occurrence of large multistate outbreaks point to gaps in the current food safety system and the need to continue to develop and evaluate food safety practices as food moves from the farm to the table,” disease center epidemiologists wrote in a note accompanying the release of FoodNet’s latest data.

Dr. Tim Jones, state epidemiologist in Tennessee, said that many of the easy improvements in the nation’s food-safety system had been made.

“You can only tell people so much to wash their cutting boards and wash their hands,” Dr. Jones said. “I think we’re running out of things to do to make dramatic improvements.”



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