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Food Safety Progress Review

A comprehensive review of food safety progress from Healthy People 2010 focus area 10. This report covers the estimated burden of foodborne diseases, major infections, outbreaks, and objectives for prevention and response. It highlights areas of improvement, challenges, and targets for reducing foodborne illnesses.

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Food Safety Progress Review

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  1. Healthy People 2010 Focus Area 10:Food SafetyProgress ReviewDecember 20, 2007 • Edward J. Sondik • National Center for Health Statistics

  2. Estimated Annual Burden ofFoodborne Disease • 76 million illnesses • 325,000 hospitalizations • 5,000 deaths • $23 billion in costs Source: 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. Emerging Infectious Diseases 5(5):607-625. 1999.

  3. Foodborne Diseases Pyramid Reported to Health Department/CDC Culture confirmed case Lab tests for organisms Specimen obtained Person seeks care Person becomes ill Exposure in the general population

  4. Food Safety Focus Area Objectives A Framework for Reducing Foodborne Illness Through Prevention, Intervention and Response Production Obj 10-5 Consumer Transportation Preparation Processing Retail Distribution and Storage Objs 10-6, 7 Consumption ? Regulations, Enforcement, and Guidance Illness Objs 10-1, 2, 3, and 4 Education Training Surveillance Research

  5. Highlighted Objectives Target met or exceeded 10-3c,d Antimicrobial drug resistance Improving 10-1a-c,f Foodborne infections 10-2b Foodborne outbreaks (Salmonella) 10-5 Food safety practices Getting worse 10-1d Foodborne infections (Salmonella spp.) 10-2a Foodborne outbreaks (E. coli O157:H7) 10-4b Severe allergic reactions to food Little or no progress * 10-3a,b Antimicrobial drug resistance No tracking data 10-6a-i Safe retail food preparation *Percent of targeted progress achieved is between -10% and 10%, and/or not statistically significant.

  6. Major Foodborne Infections Decrease desired Rate per 100,000 population Escherichia coli O157:H7 HUS* 2010 Targets Listeria monocytogenes Notes: Rates are the number of culture-confirmed cases of illness for all persons. *Data for for postdiarrheal hemolytic uremic syndrome (HUS) (2000-2004) are for children under 5 years. Source: Foodborne Disease Active Surveillance Network (FoodNet), CDC, FDA, USDA, and State agencies. Objs. 10-1b,c, f

  7. Major Foodborne Infections Decrease desired Rate per 100,000 population Campylobacter species Salmonella species 2010 Targets Notes: Rates are the number of culture-confirmed cases of illness for all persons. Source: Foodborne Disease Active Surveillance Network (FoodNet), CDC, FDA, USDA, and State agencies. Objs. 10-1a,d

  8. Major Foodborne Infections Estimated† percent of total foodborne deaths Rate per 100,000 population Salmonella spp. 30.6 % Listeria monocytogenes 27.6% Campylobacter spp. 5.5% E. coli O157:H7 2.9% Campylobacter species Salmonella species Listeria monocytogenes HUS* Escherichia coli O157:H7 Notes: Rates are the number of culture-confirmed cases of illness for all persons. *Data for for postdiarrheal hemolytic uremic syndrome (HUS) (2000-2004) are for children under 5 years. Source: Foodborne Disease Active Surveillance Network (FoodNet), CDC, FDA, USDA, and State agencies. †Source: 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. Emerging Infectious Diseases 5(5):607-625. 1999. Objs. 10-1a-d, f

  9. Outbreaks of Infections Caused by Key Foodborne Bacteria Decrease desired Number of outbreaks † Salmonella serotype Enteritidis 2010 Targets Escherichia coli O157:H7 Notes: † A foodborne disease outbreak is defined as the occurrence of two or more cases of a similar illness resulting from the ingestion of a common food, among the U.S. resident population and reported to CDC. Source: Foodborne Disease Outbreak Surveillance System, CDC, NCID. Objs. 10-2a, b

  10. Human Samples of Non-Typhi Salmonella Resistant to Antibiotics Percent Ampicillin 2010 Targets Fluoroquinolones Gentamicin Cephalosporins Notes: The target for 10-3a and 10-3b is zero (0). Source: National Antimicrobial Resistance Monitoring System: Enteric Bacteria-Salmonella (NARMS-Enteric Bacteria), CDC, NCID; FDA, CVM; USDA, FSIS, APHIS, and ARS; Foodborne Disease Active Surveillance Network (FoodNet), CDC, FDA, USDA, and State agencies.. Objs. 10-3a-d

  11. Severe Allergic Reactions† to Food in Persons With Allergies 2006 2001 Decrease desired Percent 2010 Target: 21 % * Some College Total Female Male High School 18-59 60 + Black White Gender Race Age Education Notes: † Persons 18 years and older with doctor-diagnosed food allergies who report an allergic reaction within the last 5 years and who report that the allergic reaction was severe (required the use of epinephrine, or treatment in a hospital or doctor’s office, or an overnight stay in a hospital). * Data are statistically unreliable and are suppressed. Source: Food Safety Survey (FSS), FDA and USDA, FSIS. Obj. 10-4b

  12. Deaths From Severe Food Allergies Developmental • ICD-10 codes for food-induced anaphylaxis were developed but do not necessarily reflect all allergen-related deaths. • Research indicates expected number of deaths to be around 125 annually* • Death certificates currently show about 20 deaths annually * Yocum, MW, and DA Khan. Assessment of patients who have experienced anaphylaxis: a 3-year survey. Mayo Clin. Proc. 1994; 69:16-23 Source:National Vital Statistics System—Mortality (NVSS—M), CDC, NCHS; Food Safety Survey (FSS), FDA and USDA, FSIS. Obj. 10-4a

  13. Key Food Safety Practices R • Clean – wash hands and surfaces often • Separate – don’t cross-contaminate • Cook – cook to proper temperatures • Chill – refrigerate promptly Obj. 10-5 FightBAC Campaign

  14. Consumer Food Safety Practices† Increase desired 1998 2006 Percent 2010 Target: 79 % 0 High School Some College Total Black White Less than High School Female Male Gender Race Education Notes: † The percents of consumers over 18 years of age who report they follow each of 4 key food safety practices, Clean, separate, cook, and chill, among the U.S. civilian non-institutionalized population. Source: Food Safety Survey (FSS), FDA and USDA, FSIS. Obj. 10-5

  15. Retail Food Establishment Compliance with FDA Guidelines, 1998 2010 Targets 80 82 80 74 60 73 81 76 83 Percent Notes: Percent of employee behaviors and food preparation practices, directly related to foodborne illness risk, that are observed to be in compliance during observational, non-regulatory inspections by FDA. Source: Retail Food Database of Foodborne Illness Risk Factors, FDA, CFSAN. Objs. 10- 6a-i

  16. Status of Food Safety Objectives Target met or exceeded Improving Getting worse Little or no progress* No tracking data Dropped at midcourse Retained as developmental 2 6 3 2 9 15 1 *Percent of targeted progress achieved is between -10% and 10%, and/or not statistically significant.

  17. Contributors: • Elisa Elliot, FDA Sara Fein, FDA • Delila Parham, USDA Katherine Vierk, FDA • Holly McPeak, ODPHP Glenda Lewis, FDA • Elizabeth Jackson, CDC Olga Henao, CDC • Jeffrey Pearcy, CDC Ellis Davis, ODPHP

  18. Progress Review data and slides can be accessed on the web at: http://www.cdc.gov/nchs/hphome.htm

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