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Focus on Retail Food Safety
10-Year Tracking Report Highlights Areas for Improvement
SILVER SPRING, Md., Oct.
22 /PRNewswire-USNewswire/ -- The Food and Drug Administration called
today for stepped up efforts to improve food safety practices in retail
food establishments, specifically pointing to the need for the presence
of certified food safety managers to oversee safety practices. FDA pledged
to work closely with state and local governments and operators of restaurants,
grocery stores and other food service establishments to prevent illness
from contaminated food.
FDA Deputy Commissioner for
Foods Michael R. Taylor cited the retail food industry's recent progress
in key areas as well as room for improvement, based on the findings
released today from FDA's 10-year study tracking the retail industry's
efforts to reduce five key risk factors.
"In looking at the data,
it is quite clear that having a certified food protection manager on
the job makes a difference," Taylor said. "Some states and
localities require certified food protection managers already, and many
in the retail industry employ them voluntarily as a matter of good practice.
We think it should become common practice."
A component of the 10-year
study, the 2009 retail food report, found that the presence of a certified
food protection manager in four facility types was correlated with statistically
significant higher compliance levels with food safety practices and
behaviors than in facilities lacking a certified manager. For instance,
compliance in full service restaurants was 70 percent with a manager,
versus 58 percent without a manager. In delicatessens, compliance was
79 percent with a manager, versus 64 percent without. For seafood markets,
compliance with a manager was 88 percent, versus 82 percent without.
And in produce markets, compliance was 86 percent with a manager, versus
79 percent without.
In addition to calling for
certified food protection managers to be common practice, Taylor said
the FDA initiative will include:
. Increased efforts to encourage
widespread, uniform and complete adoption of the FDA Model Food Code
by state, local and tribal regulatory agencies that are responsible
for retail food safety standard setting and inspection. The Food Code
recommends standards for management and personnel, food operations and
equipment and facilities;
. Increased efforts for adoption
of FDA's National Retail Food Regulatory Program Standards by state,
local and tribal agencies that enforce the Food Code and other measures
to create an enhanced local regulatory environment for retail food operations.
"The key to food safety
is prevention at every step from farm to table. Food retail managers,
like growers and processors, have a responsibility to reduce the risk
of foodborne illness," Taylor said. "We want to build on past
progress through continued collaboration with the retail industry and
strengthened partnerships with state, local and tribal agencies in their
standard-setting and compliance efforts."
The 10-year study looked
at more than 800 retail food establishments in 1998, 2003 and 2008 and
five risk factors: food from unsafe sources, poor personal hygiene,
inadequate cooking, improper holding of food (time and temperature),
and contaminated food surfaces and equipment.
FDA found that overall compliance
improved in all nine categories of establishments. The improvements
were statistically significant in elementary schools, fast food restaurants,
full-service restaurants, meat and poultry markets and departments,
and produce markets and departments. Improvements, although not statistically
significant, were seen in hospitals, nursing homes, deli departments/stores
and seafood markets and departments.
However, according to FDA,
continued improvements are needed across the board, in regard to three
risk factors: poor personal hygiene, improper holding of food, and contaminated
food surfaces and equipment.
More than 3,000 state, local
and tribal agencies have primary responsibility to regulate the more
than 1 million food establishments in the United States. FDA assists
the regulatory agencies and the retail industry through the Food Code,
which contains prevention-oriented and science-based food safety guidance,
training, program evaluation and technical assistance.
makes marketing missteps
By Greg Johnson
Published on 10/22/2010 12:32PM
ORLANDO, Fla. . Criticism
was swift and should not have been surprising.
At an Oct. 15 news conference, just as the Produce Marketing Association¡¯s
Fresh Summit 2010 opened in Orlando, Fresh Express announced its new
produce wash technology, FreshRinse, it says kills microorganisms on
leafy greens using an acidic rinse better than traditional chlorine.
Cincinnati-based parent company Chiquita¡¯s chief executive officer Fernando
Aguirre didn¡¯t hold back superlatives, saying, ¡°Chlorine is the abacus,
and FreshRinse is the iPad. An abacus is what people use with the beads,
a great thing at the time, just like chlorine rinse was. We believe
FreshRinse sets a new standard in food safety.¡±
This kind of promotion violates the generally agreed upon, though nonbinding,
industry standard after the 2006 E. coli spinach outbreak that the produce
industry is in food safety together.
Once companies say they¡¯re safer than others, consumers can infer that
some produce is less safe or worse, unsafe, and they stop buying.
That sort of thing upsets many people in the industry.
¡°It¡¯s grossly irresponsible what Aguirre said,¡± said Tim York, president
of Markon Cooperative, Salinas, Calif.
York has been a point man on food safety, including being chairman of
the Center for Produce Safety.
He said chlorine-based washes keep fresh produce safe.
York also said the timing was opportunistic, as it was picked up by
several mainstream news groups, The New York Times, Wall Street Journal
and USA Today during Fresh Summit weekend.
He said it reminded him of the October 2006 USA Today story timed with
Fresh Summit that year about Fresh Express ¡°leading the pack¡± on food
Both produce industry trade groups were understandingly reluctant to
get in the middle of this controversy, because all companies involved
¡°Food safety should never be a competitive advantage,¡± said Tom Stenzel,
president and CEO of the United Fresh Produce Association. ¡°If a new
product improves food safety, we should share it with the whole industry.¡±
Bryan Silbermann, president and CEO of PMA, said PMA hadn¡¯t evaluated
Fresh Express¡¯ product claims, so he couldn¡¯t address them, but that
¡°Innovation to enhance produce safety is always desirable.¡±
Ed Loyd, director of corporate communications for Chiquita, said the
company isn¡¯t marketing its method as safer than others because it¡¯s
offering FreshRinse technology to competitors.
Let scientists verify
So about the product claims¡¦
I have no food science background, so I¡¯m not qualified to say whether
FreshRinse is better than chlorine-based systems on the market.
I¡¯d like to leave that to experts and scientists to qualify. That¡¯s
Several competitors say Fresh Express¡¯ claims about its new wash are
exaggerated or flat-out false, and they have not been verified by any
Loyd said FreshRinse was reviewed by the National Center for Food Safety
and Technology, and by the end of the year, the results should be published
in a peer-reviewed journal.
Todd Wichmann, president and CEO of Cincinnati-based HealthPro, which
markets Fit fruit and vegetable wash, said Fresh Express¡¯ process is
not new, and its performance claims do not make it statistically better
Chiquita officials cited research showing that in testing, FreshRinse
reduced E. coli O157:H7 and salmonella on romaine lettuce and spinach
by factors of nine and up compared to chlorine washes.
Wichmann said that is less than one log different than chlorine, which
means it¡¯s a statistically insignificant improvement.
Another competitor, Bruce Taylor, president and CEO of Taylor Fresh
Foods, Salinas, said tests have shown Smartwash, a chlorine-based wash
system marketed by Taylor subsidiary New Leaf Food Safety Solutions,
is very effective in killing bacteria, so Fresh Express¡¯ contention
that chlorine is inferior is false.
In fact, Taylor said on its dedicated processing line in Salinas, the
company¡¯s scientists tested Smartwash versus FreshRinse, and found Smartwash
was superior in killing pathogens.
He said Smartwash has been third-party certified by the U.S. Department
of Agriculture and the Center for Produce Safety and peer reviewed in
It¡¯s true Fresh Express cited some third-party testing, with the national
center, and several well-known food scientists.
So why not well-known industry partner CPS. Any why not in a peer-reviewed
Going on their own
In the end, whether Fresh Express has a better food safety program than
competitors isn¡¯t the big issue.
Whoever has the safest system should share it with the industry.
The fact that Fresh Express did not work with United Fresh or PMA, CPS
or have its claims peer-reviewed just feeds detractors.
I have no doubt some marketers, all along the vertical produce industry,
tell their customers that their product is safer than their competitors.
And that¡¯s bad for the industry.
But they don¡¯t do it quite as openly and to consumers via consumer media
the way Fresh Express has done.
That justifiably rubbed people the wrong way.
Research Shows Food Safety Managers Have Impact
by Helena Bottemiller | Oct 25, 2010
Having a designated food
safety manager matters, according to research released by the U.S. Food
and Drug Administration Friday. FDA called for increased efforts to
improve food safety practices in retail food establishments, specifically
ensuring the presence of food safety managers. The agency pledged to
work closely with state and local governments and the restaurant industry
as well as grocery stores and other food service establishments to improve
food safety conditions and prevent illness.
"In looking at the data, it is quite clear that having a certified
food protection manager on the job makes a difference," said FDA's
deputy commissioner for foods Michael Taylor, citing the agency's 10-year
study that tracked the retail industry. "Some states and localities
require certified food protection managers already, and many in the
retail industry employ them voluntarily as a matter of good practice.
We think it should become common practice."
FDA found that the presence of a certified food protection manager in
four types of facilities was correlated with significantly higher food
safety compliance. For example, compliance in full service restaurants,
was 70 percent with a manager and 58 percent without a manager. In delis,
compliance was 79 percent with a manager, compared to 64 percent without.
In seafood markets, compliance with a manager was 88 percent, versus
82 percent without; in produce markets, compliance was 86 percent with
a manager, while 79 percent without.
The 10-year study, which looked at over 800 retail food establishments
in 1998, 2003 and 2008, found that compliance improved in all nine types
of establishments studied, including elementary schools, fast food restaurants,
full-service restaurants, and meat and poultry departments.
In addition to pushing for designated food safety management on the
retail level, Taylor said the agency would encourage uniform adoption
of the FDA Model Food Code by state, local and tribal regulatory agencies
that are responsible for retail food safety standard setting and inspection.
"The key to food safety is prevention at every step from farm to
table. Food retail managers, like growers and processors, have a responsibility
to reduce the risk of foodborne illness," Taylor said. "We
want to build on past progress through continued collaboration with
the retail industry and strengthened partnerships with state, local
and tribal agencies in their standard-setting and compliance efforts."
FDA's Trend Analysis Report from 1998 to 2008 can be viewed online.
Recall in Ruskin
Food (Safety) Fight
By: Richard Raymond
I was doing a little research on USDA¡¯s Food Safety and Inspection Service
(FSIS) web site today to get data for a presentation I will be making
down the road.
Specifically, I was looking to see how many recalls had taken place
from 2008 to present, and how many were linked to human illness vs.
product testing. To find that information, you must click on each recall
notice and read it.
This web site has links to ¡°active¡± recalls, and ¡°archived¡± recalls.
To get the total picture, you need to access both locations. When you
click on the link for ¡°active¡± recalls the site says: ¡°This page contains
summary data on active recall cases. After a recall is completed, it
will be removed from this listing.¡±
Pretty straight forward and easy to understand, I thought. Until I clicked
on the active recall notice issued November 17, 2009, for ground beef
produced on November 16. That one jogged the memory more than just a
little bit, and it caused many questions about how FSIS conducts and
This recall was from Fairbury Steaks, located in Fairbury, Nebraska.
Now this is a small town, and a very small plant, both located in a
state with a relatively small population base, and a very small Public
The recall itself was very small. It consisted of just 90 pounds of
ground beef packaged in nine 10-pound packages. It was all sold to a
very, very small restaurant in the very, very small town of Ruskin,
Nebraska, population 190, located about 30 miles down highway 136 from
The USDA home web page now describes FSIS as ¡°the public health agency
in the USDA¡±. If there was a recall on November 17 of meat produced
on November 16 that was endangering the public¡¯s health, shouldn¡¯t one
public health agency have called another public health agency with responsibility
for the health of persons living in or near Ruskin.
Instead, FSIS issued the recall notice on the web. I happen to know
this because last November I called the local and state authorities
in Nebraska just to check: They had no clue that lives were endangered.
Well, that was all a year ago and could be seen as water under the bridge,
until I noticed something the other day while trying to compile that
accurate list of recalls for my presentation..
The real surprise came when I saw the Fairbury recall was still listed
as in an active phase -- eleven months later. Remember, ¡°After a recall
is completed, it will be removed from this listing.¡± That¡¯s 90 pounds,
nine packages, 30 miles down the road, in a very small restaurant and
the only eating establishment in town. Surely that recall is not still
Clearly leaving it on the ¡°active¡± list was a simple mistake. But those
kinds of mistakes call into question the way USDA is implementing its
recall system, its effectiveness in protecting the public¡¯s health and
the accuracy of the information it is presenting relative to that system..
My hope is that FSIS will always personally notify local authorities
when their charges are in danger, so they can educate and act and assure
that adulterated meat is being destroyed. This would not require an
increase in appropriations, nor require new statutes or regs . it just
requires common sense.
It¡¯s also my hope that someone at FSIS is tasked with completing the
online ¡°paperwork¡± by making sure.. when a recall is complete, that
recall is ¡°archived.¡±
October 25, 2010
E. coli, salmonella
Last Updated: Tuesday, October 26, 2010 | 12:44 PM ET
By Emily Chung, CBC News
A cholera outbreak in Haiti has killed almost 260 people and sickened
more than 3,340. (Ramon Espinosa/Associated Press)
Cholera bacteria are deadly
to other bacteria that cause gastrointestinal illness . a finding that
may provide clues about how cholera survives between epidemics.
Cholera, a gastrointestinal
disease transmitted through unclean water, often strikes in the wake
of natural disasters.
An outbreak of cholera in
Haiti had killed 259 people and sickened 3,342 people by Monday, according
to the Haitian Health Ministry, although the situation appeared to be
stabilizing. Worldwide, the disease kills 120,000 a year, the World
Health Organization reported in 2005.
But new research by University
of Alberta microbiologists shows cholerae, the bacterium that causes
cholera, doesn't just kill people . it is also an effective killer of
E. coli (Escherichia coli, responsible for the Walkerton, Ont., tainted
water deaths in 2000), Salmonella typhimurium (which affects mice, but
is related to the bacteria that cause salmonella food poisoning), and
other bacteria that cause symptoms such as diarrhea.
The findings published Monday
in the Proceedings of the National Academy of Sciences, help explain
how outbreaks of cholera may sometimes recur six months or a year after
the last reported case of the disease.
Cholera bacteria usually
need a human host. But by killing other bacteria that compete with it
for resources such as food, cholera may have a better chance at surviving
in the harsh world outside the human body, said Dana MacIntyre, lead
author of a paper.
"In areas with limited
nutrient supplies, it creates a niche for itself where it's the only
MacIntyre made the discoveries
about Vibrio cholerae in collaboration with Sarah Miyata, Maya Kitaoka
and Stefan Pukatzki, a microbiology professor at the University of Alberta.
In the case of E. coli, its
population fell up to 100,000-fold when it was grown with cholera bacteria,
the study reported.
The researchers aren't sure
exactly how cholera kills the other bacteria, but they found it necessary
that cholera bacteria have a functioning "secretion system."
"Basically, you can
compare it to a needle to the surface of the cell that would make contact
with the target cell," said MacIntyre, who conducted the research
for her undergraduate thesis project.
The researchers don't know
if the bacteria injects a toxic protein or just kills through the act
of puncturing another cell. But they do know it's not as simple as secreting
a toxic substance into the environment . killing requires contact between
the cholera bacteria and their prey.
About 80 other bacteria have
similar secretion systems, including some that aren't harmful to humans,
In the future, humans might
be able to make use of this bacteria-killing method by harnessing harmless
bacteria to get rid of harmful bacteria such as E. coli on medical equipment,
However, this possibility
is still a long way off, she cautioned.
Pukatzki, the microbiology
professor, and his lab are working on research to figure out the method
used by Vibrio cholerae to kill other bacteria. Meanwhile, MacIntyre
has graduated and is preparing to apply for medical school next year.
The researchers began looking
into whether cholera could kill other bacteria after noting that its
secretion system contained proteins similar to those found in bacteriophages,
viruses that attack bacteria. Bacteriophages have a tail spike that
punctures bacteria and injects viral genetic material. The proteins
on the tip of the spike are similar to those found in V. cholerae's
Read more: http://www.cbc.ca/technology/story/2010/10/25/cholera-antibiotic-ecoli.html#ixzz13gGC2OF1
Study and Texas Celery Outbreak Highlight The Danger
Posted on October 25, 2010 by Colin Caywood
Given the recent SanGar chopped
celery listeria outbreak in Texas, in which at least 4 people have died,
today's report on new listeria research from a Purdue University study
could not be more timely.
The study sheds light on
how even low doses of listeria, once ingested by humans, can enter into
a person's intestinal wall and exit out to the bloodstream, thus causing
Arun Bhunia, a professor
of food science, and Kristin Burkholder, a former Purdue graduate student
who is now a postdoctoral researcher in microbiology and immunology
at the University of Michigan Medical School, found that listeria, even
in low doses, somehow triggers intestinal cells to express a new protein,
heat shock protein 60, that acts as a receptor for listeria. This may
allow the bacteria to enter the cells in the intestinal wall and exit
into a person's bloodstream. Bhunia and Burkholder's findings were published
in the early online version of the journal Infection and Immunity.
"It's possible that
host cells generate more of these proteins in order to protect themselves
during a stressful event such as infection," Burkholder said. "Our
data suggest that listeria may benefit from this by actually using those
proteins as receptors to enhance infection."
Listeria monocytogenes is a foodborne bacteria that can cause fever,
muscle aches, nausea and diarrhea, as well as headaches, stiff neck,
confusion, loss of balance and convulsions if it spreads to the nervous
system. According to the U.S. Centers for Disease Control and Prevention,
it sickens about 2,500 and kills 500 people each year in the United
States and primarily affects pregnant women, newborns, older adults
and those with weakened immune systems.
The findings suggest that
listeria may pass between intestinal cells to sort of seep out of the
intestines and into the bloodstream to cause infection.
"That can expedite the
infection," Bhunia said.
Measurable increases of the
heat shock 60 protein were detected when listeria was introduced to
cultured intestinal cells.
Bhunia and Burkholder also
introduced listeria to intestinal cells in the upper half of a dual-chamber
container and counted the number of bacteria that passed through the
cells and appeared in the lower chamber.
The bacteria moved to the
lower chamber faster than it is known to do when moving through cells,
and did so even when a mutant form of the bacteria that do not invade
the intestinal cells was used. This suggests the bacteria are moving
around the cells, Bhunia said.
"The infective dose
is very low. Even 100 to 1,000 listeria cells can cause infection,"
Bhunia said. "We believe that these mechanisms are what allow listeria
to cause infections at such low levels."
Bhunia said he next would
try to understand how listeria and the heat shock 60 protein interact
and work to develop methods to protect intestinal cells from the bacteria.
The Center for Food Safety Engineering at Purdue funded part of the
Needs $5 Billion for Food Safety
by Helena Bottemiller | Oct 28, 2010
The U.S. Food and Drug Administration
needs substantially more resources to effectively monitor the food supply,
a former food safety official said Wednesday.
"I firmly believe that FDA probably needs about $5 billion dollars
to do its job well, not $1 [billion]," said David Acheson, former
FDA Associate Commissioner of Foods, told an audience of food safety
experts at the American Conference Institute's 4th National Forum on
Foodborne Illness Litigation in Chicago.
"But where's that money going to come from." lamented Acheson,
well aware of the budgetary realities in the current political landscape.
Although FDA won't be getting a substantial increase in funding any
time soon, Acheson believes the pending food safety bill will be a boon
to public health.
"I think this legislation is needed simply because it sets a bar
and that way everybody can work around that bar and, as the regulations
get written, engage with the regulators so that the legislation turns
into good (italic) regulation," said Acheson.
"I'm a believer--I was as a regulator and now in the private sector--that
our food supply is one of the safest on the planet. The safest. Maybe
not, but one of the safest," he said. "[But] consumers are
now at a point where they want food year round and they want every type
of food to be available. They want the food to be safe. They have zero
tolerance for unsafe food, and I don't think that's an unreasonable
With or without the food safety legislation, or a large increase in
funding, the FDA is still improving its handle on food safety, according
"I think the agency believes, and I suspect probably rightly, that
there's a lot of things they can do with the authority they already
have and are going full speed ahead, assuming the legislation will pass.
There is much greater focus on imported goods, ramping up inspections,
opening up foreign offices and the use of more sophisticated information
technologies," he said.
Food Safety News was a media partner for the conference, which was also
sponsored by the National Meat Association and the Midwest Food Processors
from crayfish, frogs described at IDSA
Robert Roos News Editor
Oct 22, 2010 (CIDRAP News) . Reports presented at the Infectious Diseases
Society of America's (IDSA's) annual conference today revealed that
contaminated crayfish can cause severe illness and looked at the risk
of contracting Salmonella infections from pet frogs, among other findings.
A press conference on foodborne disease included a report on four illnesses,
two of them severe, caused by Vibrio mimicus infections in people who
had eaten cooked crayfish. The presentation also included a report on
113 cases of salmonellosis, mostly in children, linked to pet frogs,
which was described as the first multistate Salmonella outbreak linked
In another study, researchers from the Centers for Disease Control and
Prevention (CDC) found that black children were about twice as likely
as white children to contract salmonellosis, including severe cases.
The IDSA's 48th annual meeting is being held in Vancouver, B.C.
Emily J.Cartwright, MD, of the CDC reported on the investigation that
ensued when Spokane, Wash., health officials were notified of two people
hospitalized with V mimicus infections in June of this year. The pathogen,
rare in the United States, can cause a severely dehydrating diarrheal
illness resembling cholera, she said.
The probe led to a cohort study of 22 people who had attended a "crayfish
boil" on Jun 19, 2010, or had eaten leftover crayfish the next
day. Four of eight people who ate the leftover crayfish got sick, whereas
none of those who ate only the freshly cooked crayfish fell ill. No
other food items or environmental exposures were linked to the illnesses.
Cartwright said an interview with the cook at the event revealed that
the crayfish had been boiled for 20 minutes but then were placed in
the same container where the raw crayfish had been stored. Afterward
the leftovers were refrigerated for 20 hours. "We believe that
it became contaminated in that container and exposed to juices from
the raw crayfish," she said.
She added that the contamination in the container wasn't enough to sicken
people who ate the crayfish when still hot, but the cold-tolerant pathogen
became more of a threat after the leftovers were refrigerated for hours.
She said the crayfish were ordered from an online seafood company, but
the original source was not traced.
Two of the four ill patients required intensive care for severe dehydration
and kidney failure, but they fully recovered with treatment. The other
two patients had only a mild diarrheal illness and recovered without
treatment, Cartwright said.
"People should be aware that improperly handled crayfish can be
a source of Vibrio mimicus infection and it's important to wash hands
after handling raw crayfish," she said. (Cartwright abstract)
Salmonella from pet frogs
Shauna L. Mettee, MSN, MPH, of the CDC reported on the salmonellosis
outbreak traced to pet frogs. Although reptiles and amphibians are known
Salmonella carriers, no multistate outbreak linked to amphibians had
been reported previously, says the abstract of her report. (The outbreak
was detailed in a Morbidity and Mortality Weekly Report article earlier
Investigation of the outbreak began in the fall of 2009. The CDC found
113 cases of Salmonella Typhimurium from 31 states with illness onset
between Apr 1, 2009, and Mar 31, 2010, including 18 cases that required
hospitalization. The median age of patients was 5 years, and 77% were
younger than 10.
A CDC case-control study showed that cases were significantly associated
with exposure to frogs. Only 21 case-patients knew what type of frog
they'd been exposed to, and most said it was the African dwarf frog,
which is sold in pet stores and marketed toward children, Mettee said.
Environmental samples from aquariums in patients' homes yielded Salmonella
isolates matching the outbreak strain.
A traceback investigation led to one frog breeder in California, and
the outbreak strain was found at the breeder's facility, Mettee reported.
There is no federal regulation of aquatic frog sales, she said, but
officials advised the breeder on various steps to reduce Salmonella
loads and improve monitoring and surveillance, she said. She commented
that the outbreak may still be continuing.
The CDC recommends that families who have children under age 5 or elderly
or immunocompromised members should not keep pet frogs, Mettee said.
Also, those who have pet frogs should wash their hands thoroughly after
any contact with them and should consider their habitat and water to
be contaminated. (Mettee abstract)
Racial disparities in infant salmonellosis
Patricia M. Griffin, MD, a CDC expert on enteric disease epidemiology,
reported that an analysis of 12 years worth of data from the CDC's FoodNet
surveillance system showed a higher rate of salmonellosis in black infants
than in white or Asian infants. The FoodNet surveillance system covers
10 states with about 15% of the US population.
Griffin said infants in general are about 10 times as likely as older
people to have salmonellosis and are also much more likely to have severe
"What we found was that black infants were about twice as likely
as white infants to have Salmonella infections and to have severe Salmonella
infections," she said.
The analysis included 6,179 salmonellosis cases in babies less than
a year old, about 61% of whom were white, 30% black, 6% Asian, and 4%
other. The CDC used census figures to calculate average annual incidence
per 100,000 population and came up with 163 for black infants, 114 for
Asians, and 84 for whites, according to the report abstract.
Black infants also were more likely than white infants to have invasive
disease: 9% versus 4% of cases, the report says. (Report abstract)
IDSA press conference information with links to abstracts
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