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According to the CDC, incidence rates of E. coli O157:H7 decreased significantly in 2009 from recent averages, reaching the lowest level since 2004.

Moreover, for the first time, the number of reported cases actually fell below the federal 2010 Healthy People target of less than one case per 100,000 people.

As explained by Dr. David Goldman, assistant administrator of the FSIS Office of Public Health Science, the report “confirms our success in combating food-borne illness by setting an aggressive goal, designing an effective system to meet that goal, and [then] relentlessly implementing it.”

The most recent food-borne illness incidence data was collected and analyzed through FoodNet, a collaborative project including the CDC, USDA, FDA and various state health departments. FoodNet conducts active surveillance for nine pathogens, including Campylobacter, Cryptosporidium, Cyclospora, E. coli O157:H7, Listeria, Salmonella, Shigella, Vibrio and Yersinia. Click on the following link to learn how food-borne illnesses are tracked.

According to Dr. Chris Braden of the CDC, "the report indicates that there have been reductions in illness caused by many of these pathogens." Braden further explained that, “since FoodNet began surveillance in 1996, . . . [most] of the pathogens that we track have all declined."

And, while E. coli O157:H7 and shigella cases showed encouraging recent declines, the federal targets for Campylobacter, Listeria, Salmonella and Vibrio have not yet been met. Vibrio infections, for instance, increased by 85 percent compared with the first three years of surveillance, and Salmonella fell short of the goal.

Many Vibrio infections result from eating raw or undercooked shellfish, especially oysters. In turn, Salmonella is often difficult to combat because it can originate and spread from a wide variety of foods and environmental sources. In addition to foods, Salmonella has been associated with animals like baby chicks, small turtles, reptiles and frogs. And, as noted, while incidence levels for campylobacter and listeria continued to decline significantly, they still did not meet "Healthy People" targets.

In addition to the expected Senate passage of the Food Safety Modernization Act next month, the FDA is also moving forward with additional food safety initiatives aimed at decreasing food-borne illness. Dr. Jeff Farrar, the FDA’s associate commissioner for food protection, noted that the agency is still pursuing new requirements aimed at reducing the incidence of Salmonella during shell egg production. These initiatives are expected to become effective this summer, while FDA also works to develop a proposed rule which will likely include risk-based safety standards for produce.

If we are really serious about reducing food-borne illness, however, such initiatives and regulations are only one part of the overall equation. Much greater progress can likely be achieved – more quickly – if more consumers recognize the importance of properly handling and preparing raw animal foods. If all consumers can be educated to assume raw chicken, meat and eggs carry bacteria that can cause illness, to take additional precautions to avoid cross-contamination, and to cook all raw animal products to a safe temperature, consumers can significantly reduce their risk of becoming ill.

In this regard, better “Educated People” will more quickly and readily translate into far more “Healthy People.”

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The President's “Food Safety Working Group,” chaired by the Secretaries of the Department of Health and Human Services (Kathleen Sebelius) and the Department of Agriculture (Tom Vilsack), was conceived in March 2009 to help modernize our food safety system. In turn, Vice President Biden, Sebelius and Vilsack, have now announced key findings of the Group.

Following numerous meetings, and imput from key stakeholders, the Working Group has recommended a new approach to food safety based on three core principles: (1) prioritizing prevention; (2) strengthening surveillance and enforcement; and (3) improving response and recovery.

"There are few responsibilities more basic or more important for the government than making sure the food our families eat is safe," said Vice President Biden. "Our food safety system must be updated – 1 in 4 people get sick every year due to food-borne illness, and children and the elderly are more at risk. I applaud the Secretaries of HHS and the USDA for tackling this problem head-on, and coming up with key recommendations to ensure the health and safety of our food supply and, with it, the American people."

"Instead of spending their time trying to get kids to eat healthier food, too many parents and families are worrying about whether their food is safe in the first place," said Secretary Sebelius. "In just the past few months since we began work with the Food Safety Working Group, we have seen recalls on everything from spinach to peanut products to now even cookie dough.” According to Sebelius, the Administration believes “that the current system just isn’t working for America’s families, and under the President’s leadership, we are taking action to keep our food supply safe and prevent outbreaks that can impact millions of Americans."

"There isn’t a single American that isn’t impacted by our efforts to protect the food supply," said Secretary Vilsack. "We owe it to the American people to deliver on President Obama’s bold promise to greatly enhance our food safety system, moving our approach into the 21st century, employing the best surveillance techniques available, and ensuring that we are doing all we can to prevent illness before it occurs."

In its announcement, the Working Group outlined specific steps designed to advance its three core principles:

• HHS and USDA are targeting Salmonella contamination by developing tougher standards to protect the safety of eggs, poultry, and turkey.

• To fight the threat of E. coli, USDA is stepping up enforcement in beef facilities and the Food and Drug Administration (FDA) is developing new industry guidance improving protections for leafy greens, melons, and tomatoes.

• The Obama Administration is building a new national traceback and response system including clearer industry guidance, a new unified incident command system, and improved use of technology to deliver individual food safety alerts to consumers.

• Finally, the Administration announced a plan to strengthen the organization of federal food safety functions, including the creation of new positions at key food safety agencies and a continuing oversight role for the Food Safety Working Group.

The Food Safety Working Group is chaired by Secretaries Sebelius and Vilsack, and participating agencies include the FDA, the FSIS, the CDC, the Department of Homeland Security, the Department of Commerce, the Department of State, the Environmental Protection Agency, and several offices of the White House.

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Not surprisingly, as our ability to detect food-borne illness outbreaks continues to improve (as a result of increased awareness, better surveillance and more precise testing), we are detecting more outbreaks. The increase, in my view, is a result of our enhanced ability to identify those illnesses which, in years past, simply slipped “under the radar.”

Although some suggest broadly that outbreaks are increasing because today’s food companies (as opposed to yesterday’s food companies) don’t care about food safety, the theory is a bit hard to swallow. Given the incredible media and regulatory attention directed in recent years to food safety, most large companies have devoted incredible resources to improve the safety of their products. And, I personally believe, we’re doing better than ever.

It is also hard, frankly, to overlook that fact that an increasing number of outbreaks are being detected in other parts of the world as well.

Beginning in 2005, for instance, the European Food Safety Authority ("EFSA") began collecting, analyzing and publishing outbreak data submitted by its 22 member states.  The data confirmed that, in 2007, the EU experienced a total of 5,609 reported food-borne illness outbreaks. Although down only slightly from 2006, this actually represented a significant increase from just a few years earlier (when the number was zero), because data wasn’t being collected and reports weren’t being generated. Click on the following link to view a copy of the 2007 Community Summary Report on Food-borne Outbreaks.

The results of the the 2007 Community Report is also interesting. In the EU (like here in the US) Salmonella continues to be one of the most frequent causes of food-borne illness outbreaks. Of the total reported outbreaks in 2007, Salmonella accounted for 2,201 outbreaks, or four out of every ten.

In turn, viruses (such as Norovirus) were reported to be the second most frequent cause of outbreaks in the EU. Altogether, viruses accounted for 668 outbreaks, and sources were reported to include crustaceans, shellfish, molluscs and buffets.

Campylobacter was next in line, causing 461 outbreaks. Common sources included broiler and other meats.

In turn, bacterial toxins, such as those produced by Bacillus Cereus, Clostridium Perfringens and Staphylococcus, caused 458 outbreaks. Numerous outbreaks involving other bacteria, such as Listeria and E. coli O157:H7 were reported as well.

Does this mean that, suddenly, European companies have collectively decided to give up on food safety? Unlikely. Rather, it merely demonstrates that, wherever you live, as food-borne illness outbreak surveillance improves, we will begin to see outbreaks that would otherwise have been missed.

Indeed, even the EFSA concedes that the numbers of total reported outbreaks in the EU are expected to increase. This is because the "reporting systems" in the 22 member states vary significantly and, as a result, are simply not capturing every outbreak. In those member states with more effective national monitoring systems (like Germany), however, the reported number of outbreaks were expectedly much higher.

In any event, as reporting and surveillance continue to improve throughout the EU, we will likely see (just like here at home) the total number of reported outbreaks increase significantly.  And, while the increasing numbers of outbreaks, coupled with resulting media coverage, will continue to motivate entire industries to "do better," such results should not suggest that most food companies (whether based in New York or Paris) are simply failing to do anything at all.

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The answer, I suppose, depends upon who you ask.

With increased population, improved governmental outbreak surveillance, expanding media coverage, more public awareness, better attentiveness by healthcare professionals and increased frequency (along with substantial improvements) in testing, we might be justified to expect that the numbers of confirmed food-borne illnesses would be climbing like an uncontrolled fever. Nevertheless, according to a recent report issued by the CDC, the incidence of food-borne illnesses over the last three years has actually hit a “plateau.”

The findings are from 2008 data reported by FoodNet, a collaborative project of CDC, FSIS, the FDA and 10 separate states. Click on the following link for a copy of the CDC Report. According to CDC findings, incidence rates in 2008 for Campylobacter, Listeria, E. coli O157:H7, Salmonella, Shigella and other pathogens did not change significantly when compared to the previous three years (2005-2007). Moreover, significant declines since 1996 were reported in the incidence rates involving numerous, other food-borne infections.

Despite these findings, Robert Tauxe, deputy director of CDC's Division of Food-borne, Bacterial and Mycotic Diseases, suggested that we may have “reached a plateau in the prevention of food-borne disease.” In turn, David Goldman, assistant administrator of FSIS, indicated he was “concerned about the lack of progress in reducing the incidence of food-borne illness."  Click on the following link to learn how food-borne illnesses are tracked.

Has prevention really hit a plateau? Or, could the total number of illnesses be falling? Despite dozens of feverish outbreaks (and thousands of reported illnesses) recently associated with a long list of previously never-mentioned foods (such as produce, pot pies and peanut butter), the numbers of most food-borne illnesses (according to the CDC) have been holding firm. Although it might be easy to interpret such studies at face value, the real answer (lurking somewhere in the report’s constituent ingredients) might be far more complex.

Many will admit that, in years past, given considerable limitations in surveillance, testing and reporting, a large percentage of total illnesses simply went unreported. Given better public awareness and recent strides in our ability to detect and identify a greater number of food-borne illnesses and outbreaks, the lack of any perceivable increase in the CDC numbers could actually – in my humble view – represent a decline in total cases.

So, are food-borne illnesses declining, increasing or holding firm? While I doubt (and, there is no evidence) that the incidence rates for food-borne illness are on the rise, there are plenty of reasons to believe that we may have started – at the very least – to get this fever under control.

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