Are Foodborne Illnesses Increasing, Or Are Detection Methods Better?
ACROSS AMERICA — Food is still making Americans sick at a rate of about 48 million foodborne illnesses a year, with little progress in controlling common infections — a dismal sign that public education programs aren’t reaching the right people, federal health officials said in a new report.
The Centers for Disease Control and Prevention report did note that three common infections — listeriosis, salmonellosis and shigellosis — remained stable in 2023. Five other common infections — campylobacteriosis, Shiga toxin-producing Escherichia coli (STEC) infection, yersiniosis, vibriosis, and cyclosporiasis — saw an increase.
The safety of the nation’s food supply has come under intense scrutiny, with documentaries such as Netflix’s 2023 “Poisoned: The Dirty Truth About Your Food,” which disputes claims America’s food system is the “safest food in the world.”
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“The truth is, our food is nowhere near as safe as it should be,” Sarah Sorscher, the director of regulatory affairs for the Center for Science in the Public Interest, wrote on a blog about the documentary. “Regulators and the food industry have not done enough to mitigate deadly pathogens like STEC-E. Coli and salmonella, and consumers remain ill-prepared to manage food poisoning risks in our kitchens.
“We continue to be sickened and die at unacceptably high rates due to contaminated foods as a result,” she wrote.
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2024 has been fraught with product recalls related to the “big three” bacterial villains. Earlier this year, 11 states reported illnesses in a deadly outbreak of listeria, a hardy germ that can continue to grow while refrigerated. It is the leading cause of death from foodborne illness, killing about 260 people a year, according to the CDC. Even with antibiotic treatment, the disease has a high mortality rate of 20 percent to 30 percent, according to the Food and Drug Administration.
E. coli bacteria normally live in the guts of most healthy people and animals and cause relatively few problems. But some strains like E. coli 0157:H7, sometimes called enterohemorrhagic E. coli, can be considerably more serious, causing severe stomach cramps, bloody diarrhea and vomiting, with more serious complications in young children and older adults. People usually get it from contaminated water or food, especially raw vegetables and undercooked ground beef. E. coli outbreaks reported this year have been traced to ground beef, nuts, cheese, herbs and other products.
Salmonella outbreaks were reported in cantaloupe, cucumbers, cashews and a host of other products. Salmonella is rarely fatal but can be deadly if the bacteria spreads to other parts of the body or causes sepsis.
More Illnesses Or Better Tracking?
In its report, the CDC emphasized that tracking and reducing foodborne illnesses is a complex issue, and the rise in infections could be attributed to better detection methods.
Keith Schneider, a professor of food safety at the University of Florida who wasn’t involved in producing the report, thinks it’s the latter.
“I don’t completely agree we’re failing at food safety,” he told Patch in a telephone interview Wednesday.
Whole genome sequencing and other epidemiological advances have made it possible to isolate the source of foodborne illness outbreaks to a single field and its possible exposure to untreated livestock manure, or to an individual who may have been ill and shed the bacteria. Genetic changes that occur as the bacteria pass from one organism to another help scientists understand bacterial strains can change, including by becoming more dangerous or deadly, because of it.
“The old methods were limited. With our ability to — we call it ‘see inside a tomato’ — we can find things we weren’t able to before,” Schneider said.
That alone can account for increases in the number of foodborne illnesses reported to public health officials, Schneider said.
“I don’t necessarily things are worse. We could be doing better. We have the rules in place to better address where we were in the 1900s and [Lewis] Sinclair’s ‘Jungle,’” he said. “We are much cleaner and much safer. We are producing safer food and better at identifying outbreaks.”
Food can be exposed to pathogens at various points along the production chain, whether pre-harvest or during post-harvest from the packing house to the grocery store, where customers may leave their germs behind on food, Schneider said.
“How many times have you picked up a tomato, decided you don’t like it, and picked up another?” he said. “Is it the grocer’s fault that people don’t wash their hands?”
Some food safety issues are inherent in outdoor food production and aren’t a reflection of how farmers produce or retailers handle the food, Schneider said.
“There’s no way to hermetically seal the great outdoors,” Schneider said. “Insects, animals and birds all have access. Nature can be cruel. Food is exposed to specific pathogens while it’s being produced.”
One example of that occurred earlier this year when some of the nation’s dairy herds were infected with bird flu, and particles of the H5N1 avian influenza virus were later found in milk sold at grocery stores. In its most recent update on the situation, the FDA said recent studies provide reassurance that people who consume pasteurized milk and cheese products face little risk of being infected.
Thirteen states have reported outbreaks of the highly pathogenic avian flu in dairy cows, with 163 cases reported as of Thursday, according to the CDC. Four human cases have been reported.
It’s almost impossible to control those variables short of moving all food production indoors, Schneider said.
In many cases, changes in consumer behavior can greatly reduce the risk of food poisoning, he said, noting, “No one should get sick from chicken or hamburger if it’s cooked properly.”
Foodborne illnesses that aren’t tied to an outbreak typically result from mistakes made while cooking, such as undercooking meat or chopping lettuce and the same cutting board used to cut meat, or leaving leftovers at room temperature for too long, Schneider said.
“People do make mistakes. We have 330 million people eating three times a day 365 days a year,” he said.
The Problem With Lettuce
It is more difficult for consumers to protect themselves from E. coli in lettuce and other foods that are consumed raw. Studies show washing lettuce before eating doesn’t significantly reduce the bacteria.
The FDA determined a giant cattle-feeding operation was responsible for a 2018 E. coli outbreak that killed five people who had eaten romaine lettuce grown on 36 lettuce fields on 23 farms in Yuma County, Arizona. With the advancements in tracking technology, investigators were able to determine the exact strain of E. coli (STEC) on the lettuce was also found in an irrigation canal near the feedlot.
Another outbreak of E. coli that sickened 10 people and killed one in 2021 was linked to contaminated leafy greens, including kale and spinach, was the same strain as the 2018 outbreak, although the FDA did not specifically tie it to the feeding operation.
Before those outbreaks, Congress in 2021 had directed the FDA to develop standards for irrigation water sprayed on crops. The first rule was issued in 2015 and included enforceable periodic testing, but a revised rule proposed in 2022 gave farms the option of whether to include tests in their “water assessments.”
A CDC study said those voluntary efforts aren’t working.
The nonprofit Environmental Working Group said in a report earlier this year that the lack of enforceable regulations threatens the safety of thousands of acres of leafy greens grown in the United States during the colder months.
“The risk of contamination to food grown in the U.S. will continue unless farmers face stricter regulations to conduct tests of their irrigation water, management of manure from industrial agriculture is more rigorously monitored, and the FDA enforces its regulations more aggressively,” the organization said.
The CDC report also emphasized the need for targeted prevention efforts to reduce the incidence of foodborne diseases.
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