Download Sidwa-FoodborneIllness - Texas Department of State Health Services

Foodborne Illness
An Age Old Problem Requiring
Contemporary Solutions
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Outline
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Status/trends in foodborne illness
What is food irradiation?
Irradiation effect on microorganisms
Barriers to use/solutions
Estimated benefits
Conclusions
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Status/Trends in Foodborne Illness
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Estimates of Annual Disease
Burden/Cost (USA)
 76
million illnesses
 5 thousand deaths
 $7 billion in healthcare costs
Mead PS, Slutsker L, Dietz V, McCaig LF, Bresee JS, Shapiro C, Griffin PM, Tauxe RV. Food-Related Illness and
Death in the United States. Emerg Infect Dis. 1999 Sep-Oct;5(5):607-25
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Estimated Disease Burden by Agent2009
Salmonella 40.3%
Campylobacter 34.5%
Shigella 10.6%
Cryptosporidium 7.6%
STEC 2.6%
STEC-non O157 1.5%
Vibrio 0.9%
Listeria 0.9%
Yersinia 0.9%
Cyclospora 0.2%
CDC. Preliminary FoodNet Data on the Incidence of Infection with Pathogens Transmitted Commonly Through
Food---10 States, 2009. MMWR. 2010;59:418-422
Estimated Average Disease Incidence
by Age-2009
12%
11%
<4 yo
4-11 yo
50%
9%
12-19 yo
20-49 yo
≥50 yo
18%
CDC. Preliminary FoodNet Data on the Incidence of Infection with Pathogens Transmitted Commonly
Through Food---10 States, 2009. MMWR. 2010;59:418-422
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Additional Summary Information
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≥50 yo
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Highest Overall Hospitalization Rate
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Highest rate by agent – STEC O157 59.4%
Highest Overall Case Fatality Rate
(CFR)
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Highest rate by agent - Listeria at 17.5%
CDC. Preliminary FoodNet Data on the Incidence of Infection with Pathogens Transmitted Commonly Through
Food---10 States, 2009. MMWR. 2010;59:418-422
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Foodborne Disease Outbreaks
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Etiology confirmed in 49%
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Of those
Norovirus – 54%
 Salmonella – 18%
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11 Multistate outbreaks
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10 from bacteria
11 Reported deaths
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10 from bacteria
Centers for Disease Control and Prevention. Surveillance for Foodborne Disease Outbreaks – United States, 2006.
MMWR. 2009;58(22):609-15
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Foodborne Illness Trends
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1996-1998 compared to 2009
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Reduction
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Increase
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Shigella, Yersinia, STEC O157,
Campylobacter, Listeria, and Salmonella
Vibrio
2006-2008 compared to 2009
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Significant reduction in Shigella and STEC
O157
CDC. Preliminary FoodNet Data on the Incidence of Infection with Pathogens Transmitted Commonly Through Food---10 States, 2009.
MMWR. 2010;59:418-422
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What is Food Irradiation?
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What is Food Irradiation?
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Exposure of food to ionizing
radiation to
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Reduce microbial loads
Destroy pathogens
Extend shelf life
Disinfestation produce
Smith JS, Pillai S. Institute of Food Technologists' Expert Panel on Food Safety and Nutrition. Scientific Status
Summary, Irradiation and Food Safety. Food Technology 2004;58(11):48-55.
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What is Food Irradiation?
 Sources
of irradiation
 Cobalt
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 Cesium 137
 Accelerated electrons
 X-rays
U.S. Food and Drug Administration. Irradiation in the Production, Processing and Handling of Food. Federal
Register.1997 Dec 3;62(232):64107-21.
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Irradiation Effect on Microorganisms
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Damage to DNA & cell structure
 Direct
 Breaking
 Indirect
DNA bonds
 Irradiation
 Free
of water molecules
radicals
 Hydrogen peroxide
Thayer DW. Irradiation of Food-Helping to Ensure Food Safety. N Engl J Med. 2004; 350(18):1811-2.
Lewis SJ, Velasquez A, Cuppett SL, McKee SR. Effect of Electron Beam Irradiation on Poultry Meat Safety and
Quality. Poultry Science. 2002;81:896-903.
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Barriers to Use/Solutions
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Barriers to Use - Opponents
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Among issues raised by opponents
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Unique radiolytic product
Degradation of nutrients
Mutagenic potential
Negative sensory changes
Andress E, Delaplane K, Schuler G. Food Irradiation. Athens, GA: University of Georgia, Cooperative Extension
Service.1998.
Rao CV. Do Irradiated Foods Cause or Promote Colon Cancer? Nutrition and Cancer. 2003;44(2):107-9.
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Solutions - Answering Opponents
Concerns
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FDA approval
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Criteria assessed
Nutritional adequacy
 Toxicological hazard
 Microbiological hazard
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U.S. Food and Drug Administration. Irradiation in the Production, Processing and Handling of Food. Federal
Register.1997 Dec 3;62(232):64107-21.
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Solutions - Answering Opponents
Concerns
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FDA approval
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Nutritional adequacy
Reduction of some vitamins
 Macronutrients conserved
 Minerals unaffected
 Overall – no adverse impact on diet as a
whole
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U.S. Food and Drug Administration. Irradiation in the Production, Processing and Handling of Food. Federal
Register.1997 Dec 3;62(232):64107-21.
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Solutions - Answering Opponents
Concerns
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FDA approval
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Toxicological hazard
WHO data considered
 Repeated review of available data
 Finding of no toxicological hazard
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Included mutagenic potential
Included teratogenic potential
U.S. Food and Drug Administration. Irradiation in the Production, Processing and Handling of Food. Federal
Register.1997 Dec 3;62(232):64107-21.
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Solutions - Answering Opponents
Concerns
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FDA approval
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Microbiological hazard
Special emphasis on Clostridium
botulinum
 Spoilage organisms compete with
pathogens
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Food obviously “spoiled” before risk
Finding of no microbiological hazard
U.S. Food and Drug Administration. Irradiation in the Production, Processing and Handling of Food. Federal
Register.1997 Dec 3;62(232):64107-21.
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Solutions - Answering Opponents
Concerns
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Controlling Unwanted Effects
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Unwanted Effect
Vitamin losses
 Off flavors, odors
 Chemical changes
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Control for all
Use lowest effective dose
 Low Oxygen environment
 Maintain low product temperatures
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U.S. Food and Drug Administration. Irradiation in the Production, Processing and Handling of Food. Federal
Register.1997 Dec 3;62(232):64107-21.
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Barriers to Use – Lack of Consumer
Demand
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Influence by opponents
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Opponents very vocal and messages
are alarming
Irradiation minimally utilized
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Industry awaits consumer demand
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Investment (e.g. facilities, promotion)
Andress E, Delaplane K, Schuler G. Food Irradiation. Athens, GA: University of Georgia, Cooperative Extension
Service.1998.
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Solutions - Increasing Consumer
Demand
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Education
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Frequent messages
Credible and trustworthy sources
Broad range of media/outreach
Food Safety and Inspection Service, U.S. Department of Agriculture. The Food Safety Educator. 1996;1(3).
Brady JT, Li P, Brown D. Consumer Perception of Food-Borne Illness Risks Before and After the 2006 E.Coli
Events. Family and Consumer Sciences Research Journal. 2009;37(4):456-65.
Reicks J, Bosch A, Herman M, Krinke UB. Effectiveness of a Food Safety Teaching Strategy Promoting Critical
Thinking. Journal of Nutritional Education. 1994;26:97-100.
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Solutions - Increasing Consumer
Demand
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Education
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Blend of technical and social process
approaches
Opportunity to try product
Sapp, SG. A Comparison of Alternative Theoretical Explanations of Consumer Food Safety Assessments.
International Journal of Consumer Studies. 2003; 27(1):34-9.
Cardello AV. Consumer Concerns and Expectations about Novel Food Processing Technologies: Effects on Product
Liking. Appetite. 2003;40:217-33.
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Estimated Benefits
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Estimated Benefit
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Assumption
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50% of poultry, ground beef, pork, and
processed meat irradiated
50% of foodborne illness due to E. coli
O157, Campylobacter, Salmonella,
Listeria, and Toxoplasmosis
Tauxe RV. Food Safety and Irradiation: Protecting the Public from Foodborne Infections. Emerg Infect Dis.2001
June;7(3):516-21.
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Estimated Benefit
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Annually
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900,000 fewer cases
8,500 fewer hospitalizations
350 fewer deaths
Tauxe RV. Food Safety and Irradiation: Protecting the Public from Foodborne Infections. Emerg Infect Dis.2001
June;7(3):516-21.
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Conclusions
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Progress in reducing foodborne
illness has reach a plateau
Intervention throughout continuum
Irradiation is long tested and
underutilized
On balance…benefits far outweigh
risk
Consumer demand is imperative
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