by Marion Nestle
Dec 16 2010

CDC halves foodborne illness count. But why now?

Food politics in action: The CDC announced yesterday that its scientists had recalculated the extent of foodborne illnesses in the United States and cut the estimates by nearly half.

The old mantra (1999):

  • 76 million cases of illness
  • 325,000 hospitalizations
  • 5,000 deaths

The new mantra (2010):

  • 48 million illnesses
  • 128,000 hospitalizations
  • 3,000 deaths

But no, the new figures do not mean that the food supply is safer.  The reduction, says the CDC, is no cause for celebration.  Instead, it only means that tracking methods have improved.     As the editorial accompanying the CDC reports puts it,

Bottom line: with the exception of Vibrio spp., things don’t seem to be getting worse; however, after the initial decline since the USDA regulatory changes in 1995, one does not see evidence of sustained improvement.

The Politics

OK.  Very interesting.  The old estimates weren’t as good as the new estimates.  But why announce what appears to be a huge reduction in foodborne illness now, especially if it really isn’t a reduction?

Is the CDC unaware that a highly contentious food safety bill still lingers in Congress, with only days to go until the congressional term ends?

I sat in on the press conference call yesterday and heard CDC’s weak attempts to minimize the drop in numbers and maximize the fact that foodborne illnesses are still way too high (“one in six Americans”).

I’m not the only one concerned about the timing.  The headline and first sentence in Food Chemical News:

Lower CDC foodborne illness numbers could undercut food safety bill. Just as Congress seems to be on the edge of passing the biggest food safety bill in decades, the Centers for Disease Control and Prevention released today two new studies that reduce the previous estimates of people suffering from foodborne illness in the United States.

CDC officials must be worried.  I hear rumors that CDC press people are complaining to reporters who lead off their stories with the reduced numbers, as most did.

William Neuman in the New York Times, for example, correctly reported:

The federal government on Wednesday significantly cut its estimate of how many Americans get sick every year from tainted food.  But that does not mean that food poisoning is declining or that farms and factories are producing safer food. Instead, officials said, the government’s researchers are just getting better at calculating how much foodborne illness is out there.

And here is USA Today’s Beth Weise, also correctly:

Food isn’t making us as sick as we thought — almost 40% less, in fact. It’s not that the numbers of foodborne illnesses have suddenly decreased, but the Centers for Disease Control and Prevention says its methods for counting have become more precise.

Weise noted: “The new figures are long awaited in the food industry, which believed the previous numbers to be too high.”

Right.  That’s why the timing isn’t so good.

Why is the CDC doing this now?  Maybe this is just a matter of journal publication dates but it would be painfully ironic if CDC’s “better” numbers undercut enactment of the food safety bill.

The Science

That said, the CDC has done a splendid job of making the rationale for these estimates accessible on its main web page for this topic.  The page links to the two scientific papers, one on estimates of illnesses caused by  major pathogens, and the second on unspecified (unidentified) agents.

CDC also presents a detailed table comparing the 1999 and 2010 estimates.

But the 2010 estimates, like the 1999 estimates, are still guesses—just better ones based on methods that were not available in 1999.

Much remains uncertain about the extent of foodborne illness, because they are so difficult to  track:

  • Many pathogenic organisms cause foodborne illness; some are characterized, some not.
  • Gastrointestinal illness is not always due to food poisoning.
  • Most people with foodborne illnesses do not report them to doctors.
  • Doctors rarely take stool samples.
  • Laboratories test stool samples for only the most frequent pathogens.
  • Laboratory tests for pathogens are not always reliable.

Indeed, the CDC estimates that 80% of foodborne illnesses are due to unspecified causes, as are 56% of foodborne hospitalizations and deaths.

The CDC’s conclusion: the burden of foodborne illness is high and keeping pathogens out of the food system is still a good idea.

That, of course, is precisely why it is so important that Congress enact the food safety bill.   Its measures require preventive controls that should apply to pathogens, known and unknown.

Let’s hope Congress understands that foodborne illness is still a serious problem, does not misinterpret the CDC’s new numbers, and passes the legislation as its gift to the new year.

Comments

[...] This post was mentioned on Twitter by Pia Christensen, jranck, Marion Nestle, John McQuaid, Maryn McKenna and others. Maryn McKenna said: must-read! so smart. RT @marionnestle: CDC halves foodborne illness count. why now?: Food politics in action: http://bit.ly/guUcLU [...]

Thank you, Marion, for helping to make sense of this. I find the timing both curious and troubling. Either CDC did not consider the sensitive nature of releasing the data this week, which seems naive and out of touch, or they did it deliberately to undermine the bill, which makes no sense either. They are upset at reporters? That angle was pretty obvious, as long scientific disclaimers don’t make for scintillating news headlines. Maybe CDC is less politically savvy than I thought.

  • Nicole Johnson
  • December 16, 2010
  • 2:34 pm

Dr. Nestle,

According to Dr. Richard Raymond, former Under Secretary of Food Safety, “The new numbers have been getting “reviewed” for almost one year now. You will see them once the food safety bill is passed and we no longer need inflated numbers to create a sense of a crisis.” Dr. Raymond made this comment earlier this week in a response to an article published on Bill Marler’s Food Safety News about Raymond’s own recent blog entry entitled “76 million foodborne illnesses … really??”

We shouldn’t be asking why the CDC is releasing them now. We should be demanding to know why the CDC sat on this relevant information for almost a year! It appears that the publication of the CDC’s revised estimates were purposefully delayed in order to prevent the public from knowing that the food safety crisis was just a public relations stunt and to give the Food Safety Modernization Act time to pass.

Like the CDC, the Make Our Food Safe coalition also buried data indicating the Mead estimates were inflated. In October 2009, the Pew Charitable Trust, an integral part of the Make Our Food Safety political campaign, funded a survey that included the question: “In the past year, have you had a bout of food poisoning or gotten sick from eating what you believed to be contaminated food?” Data gathered during the survey reveals that the number of people who suffer from food borne illness each year is 1 in 10, a far cry from 1 in 4 ratio endlessly used by parties trying to justify the need for this unnecessary, unconstitutional, food control legislation. For more detailed information, see the section “Is Our Food Really that Unsafe?” in my article “Food Safety Reform and the Covert Continuation of the Enclosure Movement” at http://www.foodsafetynews.com/2010/05/food-safety-reform-and-the-enclosure-movement/

The CDC should have come out with the revised estimates as soon as they were available. Withholding the information from the pubic until after the expected passage of the legislation further undermines the agency’s credibility as a unbiased, scientific institution.

[...] casualties are pegged at at 48 million illnesses, 128,000 hospitalizations, and 3,000 fatalities. Link. Spread the [...]

  • Michael Bulger
  • December 16, 2010
  • 5:30 pm

@ Nicole

In order to ensure the most accurate numbers possible, scientific papers like this undergo extended review processes. Thankfully, they don’t just fly off of one persons desk to be considered as fact. They are checked, double-checked, and so on.

Further, the Pew data does not show how many people got sick from food, it shows how many people think they did. Big difference.

Michael Bulger’s response to Nicole Johnson’s excellent, valid question demonstrates his clear bias in favor of the FDA Food Safety Modernization Act (FSMA)…or whatever bill his mentors’ support.

As a confirmation of what Richard Raymond wrote, on 4-20-10, Caroline Smith DeWaal told me that the study was in peer review. She said something like, “You know don’t you that the CDC is revising Mead and it’s in peer review.”

Bulger and other apologists for the FSMA have screamed to high heaven about how S 510 was “stalled” for no good reason in the Senate when its task was many times as important and complex as the new guesstimate but they have no problem with the CDC delaying the issuance of a way overdue article for political reasons. What does that say about their actual commitment to science?

Of course this complaint is unsurprising. Throughout this process, according to the Make Our Food Safe coalition (MOFS) and almost all apologists for the FSMA, everything that has occurred has further justified the immediate passage of the current version of FSMA. Again and again, they ignored what the event actually demonstrated. No better example exists than the Wright Country Egg/Hillandale Farms salmonella outbreak. A scofflaw had never been inspected despite the FDA’s having had the clear authority AND responsibility for doing so for over a dozen years. And over 200,000,000 eggs recalled after the new FDA Final Shell Egg Rule went into effect. And a new FDA rule that took 19 years to write and implement and was out of date on the day it was promulgated.

But, best of all, I’m laughing out loud at how Bulger can’t even understand that his correct statement about the Pew data (“Further, the Pew data does not show how many people got sick from food, it shows how many people think they did. Big difference.”) shows that the Pew’s poll (which generates a less than 9% incidence rate for foodborne illness) mean that the Pew’s poll OVERSTATES the problem. Bulger apparently didn’t understand that means the Pew would need to LOWER the incidence rate!

So thank you, Michael Bulger, for actually supporting Nicole Johnson’s contentions!

Dr. Nestle,

I’m confused. Aren’t you an ardent advocate for the uniform application of science to food safety? Haven’t you argued for the same regulations for every grower, packer, processor, storage facility and distributor, regardless of how many businesses have to close because they can’t afford the financial cost of those regulations?

The scientific method I’m used to says, “Share what you come up with no later than after it has been adequately peer reviewed.” It says, “Now is the time to share the information not later.”

Yet, in this case, despite a peer review that Richard Raymond, MD, former Under Secretary for Food at the USDA (i.e., head of the Food Safety Inspection Service) says has taken “almost one year now” and a publishing date that was clearly intended to occur AFTER the FDA Food Safety Modernization Act (FSMA) had passed and the 111th Congress adjourned and the CDC’s supposedly only interest being good science and not politics, you have questioned the “timing” of its release. You have questioned the CDC’s political judgment.

To me that clearly shows your bias in favor of the FSMA,

And, thank you for the quote from the editorial that clearly shows to what lengths the CDC tried to downplay the fact that its numbers definitely show that the many years of prevention oriented efforts to improve the safety of food by reducing and removing pathogen contamination through out the entire food chain are working. The industrial food system deserves to be applauded for its efforts and, I, its frequent critic, am happy to do so.

Best of all, you and I finally agree on something important. As you said, “But the 2010 estimates, like the 1999 estimates, are still guesses.” “Guesses.” What a foolish driver for huge legislative changes in the FSMA.

Finally, Dr. Nestle, my answer to your title’s query is, “Because the CDC couldn’t keep it under wraps any longer.”

  • Michael Bulger
  • December 17, 2010
  • 8:40 am

Dr. Chris Braden of the FDA has been quoted as saying they had “no control over the timing.”

The CDC submitted the report for publication over a year ago. Dr. Nestle was correct in her surmising this might be an issue of journal publication dates. Indeed, it appears to be the combination of the journal’s lengthy peer-review process, as well as set publication dates which the CDC does not control.

As to the Pew data, somehow the communication is not working. My original point was that the Pew survey measured how many people THINK they suffered from food poisoning at some point during the year.

It’s not measuring how many people became ill. It’s measuring how many people think food was to blame. Lowering incidence rates based solely on anecdotal testimony from layperson subjects would be irresponsible.

[...] CDC halves foodborne illness count. But why now? <<I’m calling BS of the week on the CDC, not Marion Nestle. First off, WTF? Second, I’m still horrified that 1 of 6 people gets food poisoning each year, even if that’s better than the supposed 1 of 3. (Food Politics) [...]

[...] Marler on Huffington Post. Baltimore Sun. Finally, the best article on this topic goes to….Dr. Marion Nestle’s account & analysis. Its a must [...]

[...] said the new bill will give the FDA the tools and authority it needs to help prevent the CDC’s new estimates of the annual burden of foodborne illness: 48 million cases,  180,000 hospitalizations, and [...]

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