How to Help Protect Patients From Foodborne Illness

The number of food recalls this year has some people questioning the safety of our food supply and wondering if there is more we can do to protect ourselves from foodborne illnesses.

Foodborne illness and infections, commonly called food poisoning, are caused by bacteria, parasites, viruses, or other toxins in foods. The Centers for Disease Control and Prevention (CDC) has identified over 250 different types of foodborne illnesses, which they estimate sicken 48 million people, and kill 3000 people in the United States each year.¹

The Most Common Foodborne Illnesses

The majority of foodborne illnesses are caused by the 5 types of pathogens listed in the table below.¹

Other less common pathogens include¹:

• Clostridium botulinum (botulism)
• Listeria
• Escherichia coli (E. coli), and
• Vibrio

These pathogens are more likely to result in hospitalization and/or death. Symptoms can take several days or even weeks to appear, making them difficult to trace back to the contaminated source.

Prevalence of Foodborne Illness

According to the CDC, the incidence of transmitted infections in food “has remained largely unchanged for many years.”² New technologies, including better detection methods, tracking, and reporting, are making it easier to identify pathogens, resulting in higher incidence rates of contaminated food items.

Additionally, increases in imported produce and seafood contribute to the growing number of outbreaks.³ Gould and colleagues determined that a total of 195 cases of foodborne outbreaks identified between 1996 and 2016 were caused by imported foods. The greatest percentage of outbreaks were caused by contaminated fish or seafood (55%) followed by produce (33%). Foods from Latin America (especially Mexico), the Caribbean, and Asia were most frequently implicated.³

Reports of foodborne illnesses tend to rise during the summer months due to environmental factors, such as warmer temperatures, and increases in the preparation and consumption of food outside, such as barbeques.⁴ As of September 2018, there were widespread outbreaks of E. coli from romaine lettuce that affected 210 people in 36 states,⁵ Salmonella detected in cut melons that affected 77 people in 9 states,⁶ and Cyclospora from fresh vegetable trays that affected 250 people in 4 states.⁷ As of mid-September, McDonald stopped selling salads which have been linked to nearly 511 cases of Cyclosporiosis infection in 15 states.⁸

Next Page: How to Prevent Foodborne Illness

Current Food Industry Preventive Measures

In 2011, the Food Safety Modernization Act (FSMA) was signed into law, which put into place more strict guidelines, science-backed standards and regulations for food manufacturing facilities, farms, and inspection programs for imported food.⁹ The FSMA also includes an “enhanced system of tracking and record-keeping of food products throughout the food chain.”⁹  In addition, the CDC has several surveillance systems in place to monitor and detect foodborne illness outbreaks to minimize their spread.

Additional Steps Consumers Can Take

Even though the food industry has extensive safety measures in place, consumers should still be aware of potential risks and take the following steps to minimize them:

• Be extra cautious of imported foods, especially seafood and produce. Buy from reputable stores that adhere to food safety standards.
• Note how food is packaged, stored, and served at grocery stores and restaurants.¹⁰ Speak up or shop elsewhere if a food establishment seems dirty, has signs of insects, packages are dented, damaged, or opened, refrigerators or freezers do not seem cold enough, or staff serving food do not engage in proper food handling hygiene.
• Be aware that raw produce, salads, fish, and cold cuts, handled extensively presents a greater risk for contamination. Whenever possible, skip packaged and precut fruits and vegetables. Buy whole produce, such as melons, and wash and prepare them yourself at home. Also, make sure any prepared hot foods are refrigerated as soon as possible if not consumed immediately.
• If possible, shop from local farms and purchase less processed foods. The fewer steps involved in getting food from the farm to the kitchen, the lower the risk of contamination along the way.¹¹
• Practice food safety at home.¹²This includes cleaning all cooking surfaces and hands with hot, soapy water, separating raw and cooked foods, cooking foods to the correct temperature and refrigerating them within 2 hours after cooking.

By becoming more aware of which foods present the greatest risks for food borne illnesses, and taking steps to minimize, consumers can greatly reduce their risk of catching these diseases.

Contributed by Anne Danahy MS RDN

References:

1. Foodborne illnesses and germs. Centers for Disease Control and Prevention website. https://www.cdc.gov/foodsafety/foodborne-germs.html. Updated Feb 16, 2018. Accessed July 26, 2018.
2. Marder, MPH EP, Griffin PM, et al. Preliminary incidence and trends of infections with pathogens transmitted commonly through food — Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2006–2017. MMWR Morb Mortal Wkly Rep. 2018;67(11):324-328.
3. Gould, LH, Kline J, Monahan C, Vierk K. Outbreaks of disease associated with food imported into the United States, 1996–2014. Emerg Infect Diseases. 2017;23(3): 525-28.
4. Foodborne illness peaks in summer -what can you do to prevent it? United States Department of Agriculture website. Updated June 19, 2018. https://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-fact-sheets/foodborne-illness-and-disease/foodborne-illness-peaks-in-summer/. Accessed July 26, 2018.
5. Multistate outbreak of E. coli O157:H7 infections linked to romaine lettuce. Centers for Disease Control and Prevention website. Updated July 28, 2018. https://www.cdc.gov/ecoli/2018e/o157h7-04-18/index.html. Accessed November 11, 2018.
6. Multistate outbreak of Salmonella Adelaide infections linked to pre-cut melon. Centers for Disease Control and Prevention website. Updated July 28, 2018. https://www.cdc.gov/salmonella/adelaide-06-18/index.html. Accessed November 11, 2018.
7. Multistate outbreak of Cyclosporiasis linked to Del Monte Fresh produce vegetable trays — United States, 2018. Centers for Disease Control and Prevention website. Updated September 6, 2018. https://www.cdc.gov/foodsafety/outbreaks/multistate-outbreaks/outbreaks-list.html. Accessed November 11, 2018.
8. Multistate outbreak of Cyclosporiasis linked to Fresh Express salad mix sold at McDonald’s restaurants — United States, 201 Centers for Disease Control and Prevention website. Updated September 12, 2018. https://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2018/b-071318/index.html. Accessed November 11, 201
9. Doyle MP, Erickson MC, Alali W, et al. The food industry's current and future role in preventing microbial foodborne illness within the United States. Clin Infect Dis. 2015;61(2):252-59.
10. Start at the store: 7 ways to prevent foodborne illness. US Food and Drug Administration website. Updated November 24, 1017. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm094535.htm. Accessed July 26, 2018
11. How food gets contaminated: The food production chain. Centers for Disease Control and Prevention website. Reviewed September 5, 2017. https://www.cdc.gov/foodsafety/production-chain.html. Accessed December 15, 2018.
12. Four steps to food safety. Centers for Disease Control and Prevention website. Updated April 19, 2018. https://www.cdc.gov/foodsafety/keep-food-safe.html. Accessed November 11, 2018.