Foodborne Illness

1. Foodborne Illness An Age Old Problem Requiring Contemporary Solutions

2. Outline • Status/trends in foodborne illness • What is food irradiation? • Irradiation effect on microorganisms • Barriers to use/solutions • Estimated benefits • Conclusions

3. Status/Trends in Foodborne Illness

4. Estimates of Annual Disease Burden/Cost (USA) • 76 million illnesses • 5 thousand deaths • $7 billion in healthcare costs 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. Emerg Infect Dis. 1999 Sep-Oct;5(5):607-25

5. Estimated Disease Burden by Agent-2009 CDC. Preliminary FoodNet Data on the Incidence of Infection with Pathogens Transmitted Commonly Through Food---10 States, 2009. MMWR. 2010;59:418-422

6. Estimated Average Disease Incidence by Age-2009 CDC. Preliminary FoodNet Data on the Incidence of Infection with Pathogens Transmitted Commonly Through Food---10 States, 2009. MMWR. 2010;59:418-422

7. Additional Summary Information • ≥50 yo • Highest Overall Hospitalization Rate • Highest rate by agent – STEC O157 59.4% • Highest Overall Case Fatality Rate (CFR) • Highest rate by agent - Listeria at 17.5% CDC. Preliminary FoodNet Data on the Incidence of Infection with Pathogens Transmitted Commonly Through Food---10 States, 2009. MMWR. 2010;59:418-422

8. Foodborne Disease Outbreaks • Etiology confirmed in 49% • Of those • Norovirus – 54% • Salmonella – 18% • 11 Multistate outbreaks • 10 from bacteria • 11 Reported deaths • 10 from bacteria Centers for Disease Control and Prevention. Surveillance for Foodborne DiseaseOutbreaks – United States, 2006. MMWR. 2009;58(22):609-15

9. Foodborne Illness Trends • 1996-1998 compared to 2009 • Reduction • Shigella, Yersinia, STEC O157, Campylobacter, Listeria, and Salmonella • Increase • Vibrio • 2006-2008 compared to 2009 • Significant reduction in Shigella and STEC O157 CDC. Preliminary FoodNet Data on the Incidence of Infection with Pathogens Transmitted Commonly Through Food---10 States, 2009. MMWR. 2010;59:418-422

10. What is Food Irradiation?

11. What is Food Irradiation? • Exposure of food to ionizing radiation to • Reduce microbial loads • Destroy pathogens • Extend shelf life • Disinfestation produce Smith JS, Pillai S. Institute of Food Technologists' Expert Panel on Food Safety and Nutrition. Scientific Status Summary, Irradiation and Food Safety. Food Technology 2004;58(11):48-55.

12. What is Food Irradiation? • Sources of irradiation • Cobalt 60 • Cesium 137 • Accelerated electrons • X-rays U.S. Food and Drug Administration. Irradiation in the Production, Processing and Handling of Food. Federal Register.1997 Dec 3;62(232):64107-21.

13. Irradiation Effect on Microorganisms

14. Damage to DNA & cell structure • Direct • Breaking DNA bonds • Indirect • Irradiation of water molecules • Free radicals • Hydrogen peroxide Thayer DW. Irradiation of Food-Helping to Ensure Food Safety. N Engl J Med. 2004; 350(18):1811-2. Lewis SJ, Velasquez A, Cuppett SL, McKee SR. Effect of Electron Beam Irradiation on Poultry Meat Safety and Quality. Poultry Science. 2002;81:896-903.

15. Barriers to Use/Solutions

16. Barriers to Use - Opponents • Among issues raised by opponents • Unique radiolytic product • Degradation of nutrients • Mutagenic potential • Negative sensory changes Andress E, Delaplane K, Schuler G. Food Irradiation. Athens, GA: University of Georgia, Cooperative Extension Service.1998. Rao CV. Do Irradiated Foods Cause or Promote Colon Cancer? Nutrition and Cancer. 2003;44(2):107-9.

17. Solutions - Answering Opponents Concerns • FDA approval • Criteria assessed • Nutritional adequacy • Toxicological hazard • Microbiological hazard U.S. Food and Drug Administration. Irradiation in the Production, Processing and Handling of Food. Federal Register.1997 Dec 3;62(232):64107-21.

18. Solutions - Answering Opponents Concerns • FDA approval • Nutritional adequacy • Reduction of some vitamins • Macronutrients conserved • Minerals unaffected • Overall – no adverse impact on diet as a whole U.S. Food and Drug Administration. Irradiation in the Production, Processing and Handling of Food. Federal Register.1997 Dec 3;62(232):64107-21.

19. Solutions - Answering Opponents Concerns • FDA approval • Toxicological hazard • WHO data considered • Repeated review of available data • Finding of no toxicological hazard • Included mutagenic potential • Included teratogenic potential U.S. Food and Drug Administration. Irradiation in the Production, Processing and Handling of Food. Federal Register.1997 Dec 3;62(232):64107-21.

20. Solutions - Answering Opponents Concerns • FDA approval • Microbiological hazard • Special emphasis on Clostridium botulinum • Spoilage organisms compete with pathogens • Food obviously “spoiled” before risk • Finding of no microbiological hazard U.S. Food and Drug Administration. Irradiation in the Production, Processing and Handling of Food. Federal Register.1997 Dec 3;62(232):64107-21.

21. Solutions - Answering Opponents Concerns • Controlling Unwanted Effects • Unwanted Effect • Vitamin losses • Off flavors, odors • Chemical changes • Control for all • Use lowest effective dose • Low Oxygen environment • Maintain low product temperatures U.S. Food and Drug Administration. Irradiation in the Production, Processing and Handling of Food. Federal Register.1997 Dec 3;62(232):64107-21.

22. Barriers to Use – Lack of Consumer Demand • Influence by opponents • Opponents very vocal and messages are alarming • Irradiation minimally utilized • Industry awaits consumer demand • Investment (e.g. facilities, promotion) Andress E, Delaplane K, Schuler G. Food Irradiation. Athens, GA: University of Georgia, Cooperative Extension Service.1998.

23. Solutions - Increasing Consumer Demand • Education • Frequent messages • Credible and trustworthy sources • Broad range of media/outreach Food Safety and Inspection Service, U.S. Department of Agriculture. The Food Safety Educator. 1996;1(3). Brady JT, Li P, Brown D. Consumer Perception of Food-Borne Illness Risks Before and After the 2006 E.Coli Events. Family and Consumer Sciences Research Journal. 2009;37(4):456-65. Reicks J, Bosch A, Herman M, Krinke UB. Effectiveness of a Food Safety Teaching Strategy Promoting Critical Thinking. Journal of Nutritional Education. 1994;26:97-100.

24. Solutions - Increasing Consumer Demand • Education • Blend of technical and social process approaches • Opportunity to try product Sapp, SG. A Comparison of Alternative Theoretical Explanations of Consumer Food Safety Assessments. International Journal of Consumer Studies. 2003; 27(1):34-9. Cardello AV. Consumer Concerns and Expectations about Novel Food Processing Technologies: Effects on Product Liking. Appetite. 2003;40:217-33.

25. Estimated Benefits

26. Estimated Benefit • Assumption • 50% of poultry, ground beef, pork, and processed meat irradiated • 50% of foodborne illness due to E. coli O157, Campylobacter, Salmonella, Listeria, and Toxoplasmosis Tauxe RV. Food Safety and Irradiation: Protecting the Public from Foodborne Infections. Emerg Infect Dis.2001 June;7(3):516-21.

27. Estimated Benefit • Annually • 900,000 fewer cases • 8,500 fewer hospitalizations • 350 fewer deaths Tauxe RV. Food Safety and Irradiation: Protecting the Public from Foodborne Infections. Emerg Infect Dis.2001 June;7(3):516-21.

28. Conclusions • Progress in reducing foodborne illness has reach a plateau • Intervention throughout continuum • Irradiation is long tested and underutilized • On balance…benefits far outweigh risk • Consumer demand is imperative