by Marion Nestle

Currently browsing posts about: CDC(Centers for Disease Control)

Aug 8 2018

CDC’s latest stats on foodborne illness

The CDC has issued its counts for the extent and cause of illnesses and deaths caused by eating contaminated food for the years 2009-2015.

For starters, outbreaks of foodborne illness increased during this period.

The figure above is a bar chart showing by year the number of foodborne disease outbreaks in the United States for 2009–2015 as reported to CDC’s Foodborne Disease Outbreak Surveillance System.

From 2009–2015, the CDC reports:

  • 5,760 outbreaks (more than one person becoming ill from the same source)
  • 100,939 illnesses
  • 5,699 hospitalizations
  • 145 deaths

Every US state and territory reported at least one outbreak.

Multistate outbreaks were particularly serious.  They accounted for only 3% of all outbreaks, but were responsible for:

  • 11% of illnesses
  • 34% of hospitalizations
  • 54% of deaths.

What organisms caused the outbreaks?  Of the 2,953 outbreaks in which the cause could be pinned to one organism, the top two causes were:

  • Norovirus (1,130 outbreaks, accounting for 41% of the illnesses)
  • Salmonella (896, accounting for 35%)

ListeriaSalmonella, and Shiga toxin-producing Escherichia coli (STEC) accounted for 82% of all reported hospitalizations and 82% of the deaths.

What foods were associated with the outbreaks?  Of the 1,281 outbreaks in which the contaminated food could be identified, the top carriers were:

  • Fish (222 outbreaks),
  • Dairy (136)
  • Chicken (123)

Looking at illnesses, the most frequent associated foods were:

  • Chicken (3,114 illnesses)
  • Pork (2,670)
  • Seeded vegetables, meaning tomatoes and beans (2572)
  • Eggs (2470)
  • Fruits (2420)
  • Beef (1934)

What does all this mean?

Foodborne illnesses remain a serious public health problem, not least because it is so difficult to trace illnesses back to a specific source.  The contaminated food could only be identified in about one-fifth of total outbreaks.

Although foods of animal origin were leading carriers of illness, plant foods are also at risk.

All of these illnesses are preventable.  We have laws requiring food producers and handlers to follow food safety procedures.  When they do, the risk of foodborne illness is greatly diminished.

These procedures were designed originally to prevent astronauts from getting sick in outer space under conditions of zero gravity (you don’t even want to think about the consequences of foodborne illness in a space capsule).

If the methods worse in outer space, they ought to work on earth—but only if they are designed and used appropriately.

These data argue for stronger food safety regulation.

May 8 2018

Don’t eat romaine lettuce until this outbreak ends

I’ve been following the E. coli 0157:H7 outbreak caused by eating romaine lettuce grown in Yuma, Arizona.

The CDC says the body count so far is:

  • Cases = 121
  • Hospitalizations = 52
  • Deaths = 1

Where the cases have been found:

Map of United States - People infected with the outbreak strain of E. coli, by state of residence, as of May 1, 2018

 

What the “epi curve” looks like:

Epi curve of people infected with the outbreak strain of E. coli, by date of illness onset, as of May 1, 2018

What’s happening with the FDA’s investigation:

The FDA has identified one farm [Harrison Farms of Yuma, Arizona] as the source of the whole-head romaine lettuce that sickened several people at a correctional facility in Alaska. However, the agency has not determined where in the supply chain the contamination occurred…All of the lettuce in question from this farm was harvested during March 5-16 and is past its 21-day shelf life. Because the growing season in the Yuma region is at its end, the farm is not growing any lettuce at this time.

Most of the illnesses in this outbreak are not linked to romaine lettuce from this farm, and are associated with chopped romaine lettuce. The agency is investigating dozens of other fields as potential sources of the chopped romaine lettuce and will share information as it becomes available.

Some interesting aspects of this and other leafy green outbreaks:

In the meantime, the CDC’s advice to you:

  • Do not eat or buy romaine lettuce unless you are sure it was not grown anywhere near Yuma.
  • Do not eat or buy romaine lettuce if you cannot tell where it was grown.
  • Do not eat salad mixes unless you are sure it is free of romaine lettuce.
  • This applies to romaine lettuce in any form: heads, hearts, chopped, baby, organic, in salads or salad mixes.

But Consumer Reports says to avoid romaine lettuce entirely.

Seems like good advice until this one gets figured out.

Dec 18 2017

A contest: Use all 7 of CDC’s forbidden words in one sentence!

You have no doubt heard by now that the Trump administration has instructed CDC policy analysts that they are not to use any of the following words in documents they prepare for next year’s budget:

  • Vulnerable
  • Entitlement
  • Diversity
  • Transgender
  • Fetus
  • Evidence-based
  • Science-based

No, I am not making this up.

Hence: the contest.

The Journal of Public Health Policy (I’m on the editorial board) says:

Please write a sentence using every one of the newly banned words-and post it on JPHP’s Facebook page and/or send it to us in the next few days at jphp@umb.edu.

The prize?  Fame.  They will post the results.
In the meantime, Brenda Fitzgerald, the head of CDC, denies the whole thing, at least on Twitter.
 
Nov 22 2016

Some good news: childhood obesity declines in low-income children–a bit

The CDC and USDA are collaborating to track the prevalence of obesity in children ages 2 – 4 who participate in the Special Supplemental Program for Women, Infants, and Children (WIC).

In a new report, the agencies find obesity prevalence to have increased from 14% in 2000 to 15.9% in 2010.   But here’s the good news:  it dropped to 14.5% in 2014.

More good news: it decreased significantly among toddlers in these groups:

  • Non-Hispanic whites
  • Non-Hispanic blacks
  • Hispanics
  • American Indian/Alaska Natives and Asians/Pacific Islanders
  • 61% of the 56 agencies in states, DC, and US territories

The not-so-good news is that obesity in WIC kids is still higher than the national average among kids 2 – 5 years (8.9%), but this trend is in the right direction.

What accounts for it?  The report lists several possibilities:

Let’s keep doing more of the same and keep that trend heading downward.

Feb 5 2013

USDA proposes rules for “competitive” snack foods

At long last, the USDA announced that it has released its proposed rules governing the nutritional content of snacks, sodas, and meals sold in competition with federally subsidized school breakfasts and lunches.

As soon as the rules get published in the Federal Register, which is supposed to happen this week, people will have 60 days to file comments.  Although USDA has not said when it will issue final rules, it did say that it will give schools another year to implement them.

The rules apply to foods sold outside the school meals in vending machines and a la carte lines.  They will not apply to fundraisers.  They set minimum standards.  States and localities that want stricter standards may do so.  A recent CDC analysis says states are already doing this (see Competitive Foods and Beverages in U.S. Schools: A State Policy Analysis).

Under the proposed rules, schools must provide:

  • Potable water at no charge [this alone is cause for celebration].
  • Real foods that are either something recognizable as a food or something that naturally contains 10% of the Daily Value in calcium, potassium, vitamin D, or fiber.
  • Snacks with less than 200 mg sodium per serving.
  • Desserts with less than 35% of calories from sugars or less than 35% of weight as sugars.
  • Beverages with no more than 40 or 50 calories per 8-ounce serving.

There are plenty of exceptions.   I can only guess that the exemption for sweetened yogurt—30 grams of sugars in 8 ounces—has something to do with dairy lobbying.

My immediate reaction: these rules are a big improvement and deserve much support.

Applause to USDA for this one!

Apr 19 2011

The politics of contaminated meat

By this time, you must have heard about the study in Clinical Infectious Diseases sponsored by the Pew Charitable Trusts.  The study found nearly half of supermarket meat and poultry samples to be contaminated with Staphylococcus aureus. Half of the contaminated samples were resistant to multiple antibiotics.

Staph causes awful infections.  When I was a child, my mother had a Staph infection that kept her out of commission for what seemed like months in that pre-antibiotic era.  Antibiotics can keep Staph under control, but not if the Staph are antibiotic-resistant.   Staph resistant to multiple drugs are a clear-and-present danger.  No wonder this study got so much attention.

The study provides strong support for the idea that we ought to be reducing use of antibiotics as growth promoters in farm animals, an idea strongly supported by the CDC.

Even though 80% of U.S. antibiotic use is for farm animals, the meat industry strong opposes any proposal to change its practices.

The National Cattleman’s Beef Association responds by attacking the science:

Calling into question the safety of U.S. beef without conclusive scientific evidence is careless and misleads consumers. Pew Charitable Trusts, an agenda-driven organization on this issue, funded this study, which concludes that its extremely small sample size was ‘insufficient to accurately estimate prevalence rates’ and that ‘public health relevance of this finding is unclear.’ The study’s authors clearly call into question the validity of their own study. The bottom-line is U.S. beef is safe and is part of a healthy, well-balanced diet.

The American Meat Institute reassures the public that meat is safe.  After all, you are going to cook your meat, aren’t you?  In any case, the responsibility rests with you.

While the study claims that the many of the bacteria found were antibiotic resistant, it does note that they are not heat resistant.  These bacteria are destroyed through normal cooking procedures, which may account for the small percentage of foodborne illnesses linked to these bacteria.

As with any raw agricultural product, it is important to follow federal safe handling recommendations included on every meat and poultry package that urge consumers to wash hands and surfaces when handling raw meat and poultry and to separate raw from cooked foods to ensure that food is safe when served.

These sound like the arguments that the meat industry has made for years for Salmonella and E. coli O157:H7.

I see this study as another reason why we need better food safety regulation, and the sooner the better.

Postscript: Bill Marler reports that he had 100 samples of chicken tested from Seattle markets:

IEH Labs found S. aurea [sic], or staph, in 42 percent of the samples overall and Campylobacter in 65 percent. The supermarket chicken was contaminated with other pathogens as well: 19 percent of the samples tested positive for Salmonella, one tested positive for Listeria, and 10 percent showed the presence of the methicillin-resistant S. aureus (MRSA). In an unusual finding, one of the chicken samples tested positive for E. coli 0126, Shiga-toxin producing E. coli (STEC) bacteria more likely to be a contaminant of beef than poultry. Organic Chicken proved to be slightly less contaminated than nonorganic with 7 of the 13 (54%) testing positive for harmful bacteria.

As I said….