Ranking the Risks: The 10 Pathogen-Food Combinations with the Greatest Burden on Public Health

[draggonlaady]

Researchers at the University of Florida Emerging Pathogens Institute have attempted to identify the Top 10 riskiest combinations of foods and disease-causing microorganisms.

• Poultry contaminated with Campylobacter bacteria topped the list, sickening more than 600,000 Americans at a cost of $1.3 billion per year. Salmonella in poultry also ranks in the Top 10, with $700 million due to costs of illness. Infections with these microorganisms can cause acute illness such as vomiting but also can lead to hospitalization or death. Campylobacter infection can also cause paralysis and other neuromuscular problems. The report questions whether new safety standards announced by the USDA for young chickens and turkeys are sufficient, and recommends evaluating and tightening these standards over time.

• Salmonella is the leading disease-causing bug overall, causing more than $3 billion in disease burden annually. In addition to poultry, Salmonella-contaminated produce, eggs and multi-ingredient foods all rank in the Top 10. The report recommends that the FDA and USDA develop a joint Salmonella initiative that coordinates efforts in a number of foods.

• Four combinations in the Top 10 – Listeria in deli meats and soft cheeses, and Toxoplasma in pork and beef – pose serious risks to pregnant women and developing fetuses, causing stillbirth or infants born with irreversible mental and physical disabilities. The report recommends that agencies strengthen prevention programs for these pathogens and improve education efforts aimed at pregnant women.

• Norovirus is the most common food borne pathogen and is largely associated with multi-ingredient items that can become contaminated, often by service-industry workers who handle food. The researchers recommend strengthening state and local food safety programs through increased funding, training and adoption by states of the most recent FDA Food Code.

• The report lists E. coli O157:H7 as the sixth pathogen in overall burden, with the majority due to contaminated beef and produce. The report recommends federal agencies continue to target E. coli O157:H7, due to the particularly devastating injuries it causes in small children, including kidney failure, lifetime health complications, and death.

Campylobacter in poultry — costs $1.3 billion a year
Toxoplasma in pork — costs $1.2 billion a year
Listeria in deli meats — costs $1.1 billion a year
Salmonella in poultry — costs $700 million a year
Listeria in dairy products — costs $700 million a year
Salmonella in complex foods — costs $600 million a year
Norovirus in complex foods — costs $900 million a year
Salmonella in produce — costs $500 million a year
Toxoplasma in beef — costs $700 million a year
Salmonella in eggs — costs $400 million a year

(“Complex foods” is defined by the researchers as "a category created to capture outbreaks associated with non-meat dishes comprised of multiple ingredients, and for which a specific contaminated ingredient could not be identified. The nature of these outbreaks suggests an important role for contamination, cross-contamination, and other mistakes during handling, preparation, and cooking.")

I am a bit surprised by this list, as it is significantly different than the frequency of recalls. Almost all the recalls on the FDA list are produce or "complex foods", followed by fish and cheese... but then, most of those recalls are associated with no illness or few complaints. Interesting disparity, between the two lists, and makes me wonder how it is that so many potential produce contamination events occur but are caught, while so many meat and dairy contamination events slip through.

The researchers do point out that produce incidents are moving up the list, so maybe some of my skewed perception of incidence is from the short amount of time I've been paying attention?

Salmonellosis due to contaminated produce (tied for 8th) has been recognized by others as a growing problem (Lynch et al. 2009, Maki 2009). In an analysis of foodborne outbreaks from 1998 to 2008,we found that of those due to Salmonella in produce, more than half were associated with tomatoes, sprouts or cantaloupes.3 Salmonella in eggs (10th) remains a major concern, though risks have significantly declined over the last twenty years (Braden 2006).

Anyway; I guess I'll read more of the report later, for now I'm supposed to be working...

Comments

[fr33f0x.livejournal.com]

You got any numbers on how many peeps are actually hospitalised from this stuff (I mean, who get more than some puking and the runnies for a couple of days) and on how many peeps die from it?

[draggonlaady.livejournal.com]

Yes, pages 8 and 9 of the report have tables listing number of illnesses, hospitalizations, and deaths associated with each pathogen. It won't let me copy and paste or I'd drop them here, sorry. The link to the report is in the first line of the post though.

[fr33f0x.livejournal.com]

INteresting, innit? If I've been reading that correctly then these little critters kill every two years as many Americans as Al-Queda did on 9/11. On a ten-year scale this would be definitely the far more dangerous threat to the national security of the USA, wouldn't it? How much money is poored into combating this, then, compared to Homeland Security?

(On the other hand, I have lived for going on 3 years now more or less entirely amongst people for who milk comes from cows or more often goats, not cartons, and eggs are something you take out of nests, and meat more often than not still makes sounds, eats grass, and craps, when bought. Sure, some get sick, and being sick can be more dangerous than it is to those that I grew up with, but... I don't have the numbers, but I can't shake the feeling that if you stack traffic accidents, obesity, drug abuse (not just the illegal kind, too), and so on, against the salmonella, and middle ear infections, and infected wounds on the other... the industialised world comes out look less perfect than it likes to present itself.)

[draggonlaady.livejournal.com]

Damn near anything kills more people than terrorism, really. Terrorists are not efficient at anything except making people freak out. Which is why I make a point of not freaking out about anything terrorist related. :)

The industrialized world isn't perfect, no. However, we very rarely have thousands of people dying of dysentery any more (http://www.infoplease.com/cig/dangerous-diseases-epidemics/epidemic-dysentery.html). And as I posted a while back, the rates of infection with tuberculosis plummeted when we started selling pasteurized milk instead of unpasteurized. Incidentally--you can pasteurize your own milk at home, after you milk it out of your own cow. It's not something that has to be store-bought.