Healthy People 2010 Focus Area 10: Food Safety Progress Review December 20, 2007
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Healthy People 2010 Focus Area 10:
Food Safety
Progress ReviewDecember 20, 2007
Edward J. Sondik National Center for Health
Statistics
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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-RelatedIllness and Death in the United States. Emerging Infectious Diseases 5(5):607-625. 1999.
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Foodborne Diseases Pyramid
Exposure in the general population
Person becomes ill
Person seeks care
Specimen obtained
Culture confirmed case
Reported to Health Department/CDC
Lab tests for organisms
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Food Safety Focus Area ObjectivesA Framework for Reducing Foodborne Illness
Through Prevention, Intervention and Response
Production
PreparationTransportation
Retail
Consumer
Processing
Regulations, Enforcement, and Guidance
Consumption
Distributionand
Storage
Illness
?
Obj 10-5
Objs 10-6, 7
Objs 10-1, 2,3, and 4
EducationTrainingSurveillanceResearch
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Highlighted Objectives
Getting worse10-1d Foodborne infections (Salmonella spp.)10-2a Foodborne outbreaks (E. coli O157:H7)10-4b Severe allergic reactions to food
10-1a-c,f Foodborne infections 10-2b Foodborne outbreaks (Salmonella)10-5 Food safety practices
Improving
Target met or exceeded10-3c,d Antimicrobial drug resistance
Little or no progress *10-3a,b Antimicrobial drug resistance
No tracking data10-6a-i Safe retail food preparation
* Percent of targeted progress achieved is between -10% and 10%, and/or not statistically significant.
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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.
0
1
2
3
4
5
1997 1998 1999 2000 2001 2002 2003 2004 2005
Rate per 100,000 population
Escherichia coli O157:H7
Listeria monocytogenes 2010Targets
HUS*
Objs. 10-1b,c, f
Major Foodborne Infections
Decrease desired
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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.
0
5
10
15
20
25
1997 1998 1999 2000 2001 2002 2003 2004 2005
Rate per 100,000 population
Campylobacter species
Salmonella species
Objs. 10-1a,d
Major Foodborne Infections
Decrease desired
2010Targets
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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.
0
5
10
15
20
25
1997 1998 1999 2000 2001 2002 2003 2004 2005
Rate per 100,000 population
Campylobacter speciesSalmonella species
Objs. 10-1a-d, f
Major Foodborne Infections
Escherichia coli O157:H7Listeria monocytogenes
HUS*
Estimated† percent oftotal foodborne deaths
Salmonella spp. 30.6 %Listeria monocytogenes 27.6%Campylobacter spp. 5.5%E. coli O157:H7 2.9%
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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.
Outbreaks of Infections Caused by Key Foodborne Bacteria
0
10
20
30
40
50
60
1997 1998 1999 2000 2001 2002 2003 2004 2005
Salmonella serotype Enteritidis
Number of outbreaks †
Objs. 10-2a, b
Decrease desired
Escherichia coli O157:H72010
Targets
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Human Samples of Non-Typhi Salmonella Resistant to Antibiotics
Notes: The target for 10-3a and 10-3b is zero (0). Source: National Antimicrobial Resistance Monitoring System: Enteric Bacteria-Salmonella (NARMS-EntericBacteria), CDC, NCID; FDA, CVM; USDA, FSIS, APHIS, and ARS; Foodborne Disease Active SurveillanceNetwork (FoodNet), CDC, FDA, USDA, and State agencies..
0
5
10
15
20
1997 1998 1999 2000 2001 2002 2003
Objs. 10-3a-d
Percent
Ampicillin
Gentamicin
Cephalosporins
Fluoroquinolones
2010Targets
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0
10
20
30
40
50
60
70
Severe Allergic Reactions† to Food in Persons With Allergies
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.
Percent
Decrease desired
2010 Target: 21 %
Obj. 10-4b
2001 2006
EducationGender
*Black High
SchoolTotal White Female Male Some
College60 +18-59
AgeRace
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Deaths From Severe Food Allergies
Source: National Vital Statistics System—Mortality (NVSS—M), CDC, NCHS;Food Safety Survey (FSS), FDA and USDA, FSIS. Obj. 10-4a
• 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
Developmental
Yocum, MW, and DA Khan. Assessment of patients who have experienced anaphylaxis: a 3-year survey.Mayo Clin. Proc. 1994; 69:16-23*
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Key Food Safety Practices
Obj. 10-5
1. Clean – wash hands and surfaces often
2. Separate – don’t cross-contaminate
3. Cook – cook to proper temperatures
4. Chill – refrigerate promptly
FightBAC Campaign R
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50
60
70
80
90
100
Consumer Food Safety Practices†
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
2010 Target: 79 %
Increase desired1998 2006
Black HighSchool
Total White Female Male SomeCollege
Less thanHigh School
Percent
EducationGenderRace
0
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Notes: Percent of employee behaviors and food preparation practices, directly related to foodborne illness risk, that areobserved to be in compliance during observational, non-regulatory inspections by FDA.Source: Retail Food Database of Foodborne Illness Risk Factors, FDA, CFSAN.
0 20 40 60 80 100
Seafood departments
Produce departments
Meat/Poultry departments
Deli departments
Full-service restaurants
Fast food restaurants
Elementary schools
Nursing homes
Hospitals
Percent
82
80
80
60
74
81
76
83
73
Objs. 10- 6a-i
Retail Food Establishment Compliance with FDA Guidelines, 1998
2010 Targets
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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.
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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
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Progress Review data and slides
can be accessed on the web at:
http://www.cdc.gov/nchs/hphome.htm