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Foodborne Illness

An Age Old Problem Requiring Contemporary Solutions

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Outline

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

Estimated Disease Burden by Agent-2009

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

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Estimated Average Disease Incidence by Age-2009

50%

18%

9%

11%

12%

<4 yo

4-11 yo

12-19 yo

20-49 yo

≥50 yo

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

≥50 yo Highest Overall Hospitalization Rate

Highest rate by agent – STEC O157 59.4% Highest Overall Case Fatality Rate

(CFR) 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

Etiology confirmed in 49% Of those

Norovirus – 54% Salmonella – 18%

11 Multistate outbreaks 10 from bacteria

11 Reported deaths 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

1996-1998 compared to 2009 Reduction

Shigella, Yersinia, STEC O157, Campylobacter, Listeria, and Salmonella

Increase Vibrio

2006-2008 compared to 2009 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?

Exposure of food to ionizing radiation to 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 irradiationCobalt 60Cesium 137Accelerated electronsX-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

DirectBreaking DNA bonds

IndirectIrradiation of water molecules

Free radicalsHydrogen 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

Among issues raised by opponents 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

FDA approval Criteria assessed

Nutritional adequacy Toxicological hazard 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

FDA approval Nutritional adequacy

Reduction of some vitamins Macronutrients conserved Minerals unaffected Overall – no adverse impact on diet as a

whole

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

FDA approval Toxicological hazard

WHO data considered Repeated review of available data Finding of no toxicological hazard

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

FDA approval Microbiological hazard

Special emphasis on Clostridium botulinum

Spoilage organisms compete with pathogens

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

Controlling Unwanted Effects Unwanted Effect

Vitamin losses Off flavors, odors Chemical changes

Control for all Use lowest effective dose Low Oxygen environment Maintain low product temperatures

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

Influence by opponents Opponents very vocal and messages

are alarming Irradiation minimally utilized

Industry awaits consumer demand 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

Education 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

Education 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

Assumption 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

Annually 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

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