The nation’s annual food safety report card, issued by the CDC, is out. It shows that 2012 rates of infections from two germs spread commonly through food have increased significantly when compared to a baseline period of 2006-2008, while rates of most others have not changed during the same period. Infections from campylobacter -- which is linked to many foods, including poultry, raw milk and produce – has risen 14 percent in 2012 compared to 2006-2008. Vibrio infections as a whole were up 43 percent when compared with the rates observed in 2006-2008. Foodborne vibrio infections are most often associated with eating raw shellfish.
Every year the CDC estimates that about 48 million Americans, that would be one in six people in the United States, get sick from eating contaminated food. Overall in 2012, FoodNet, a collaboration among the CDC, ten state health departments, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS), and the FDA, reported 19,531 illnesses, 4,563 hospitalizations and 68 deaths from nine germs commonly spread through foods. FoodNet surveys just 15% of the US population. Salmonella was the most commonly diagnosed and reported cause of infection among those that are tracked. The frequency of Salmonella infections in general in the population that FoodNet follows has remained constant over time since 1996.
The second most common infection is caused by the bacteria Campylobacter. Campylobacter is associated with eating raw or undercooked poultry, raw milk dairy products, contaminated produce and contaminated water. It is also acquired through contact with infected animals. Campylobacteriosis is an infectious disease caused by bacteria of the genus Campylobacter. Most people who become ill with campylobacteriosis get diarrhea, cramping, abdominal pain, and fever within two to five days after exposure to the organism. The diarrhea may be bloody and can be accompanied by nausea and vomiting. The illness typically lasts about one week. Some infected persons do not have any symptoms. In persons with compromised immune systems, Campylobacter occasionally spreads to the bloodstream and causes a serious life-threatening infection.
Determining the root cause of a Campylobacter infection, a process known as “attribution,” can be difficult, so the report does not offer an explanation for the rise in the number of cases. Campylobacter is an illness that is rarely documented through outbreaks. The FSIS gets information about the food products that lead to illnesses through outbreak investigations. Because there is this relative lack of outbreak data on campylobacter, it is quite a challenge to determine what leads to this second most common bacterial cause of foodborne illness.
Vibrio infections, which are quite rare, also increased when compared with 2006 to 2008. Vibrio lives naturally in sea water and foodborne vibrio infection is most often linked to eating raw oysters. Vibrio vulnificus is a bacterium in the same family as those that cause cholera. It normally lives in warm seawater and is part of a group of vibrios that are called "halophilic" because they require salt. V. vulnificus can cause disease in those who eat contaminated seafood or have an open wound that is exposed to seawater.
Among healthy people, ingestion of V. vulnificus can cause vomiting, diarrhea, and abdominal pain. In immunocompromised persons, particularly those with chronic liver disease, V. vulnificus can infect the bloodstream, causing a severe and life-threatening illness characterized by fever and chills, decreased blood pressure (septic shock), and blistering skin lesions. V. vulnificus bloodstream infections are fatal about 50% of the time.
V. vulnificus can cause an infection of the skin when open wounds are exposed to warm seawater; these infections may lead to skin breakdown and ulceration. Persons who are immunocompromised are at higher risk for invasion of the organism into the bloodstream and potentially fatal complications.
In 2011, the FSIS implemented new and revised industry performance standards for campylobacter and salmonella, respectively, to decrease the presence of these pathogens in broiler chickens and turkeys. Meeting the standards may prevent as many as 25,000 illnesses per year from both Salmonella and Campylobacter combined.
The levels of E.coli 0157 in 2012 are similar to those that were observed in 2006-2008. New industry performance standards targeting ground beef has reduced the E. coli incidence to 2006-2008 levels.
At greatest risk for severe illness are children less than five years old and older people over the age of 65. People who want to reduce their risk of foodborne illness should assume raw chicken and other meat carry bacteria that can cause illness, and should not allow these foods to cross-contaminate surfaces and other foods. People should also cook chicken and other meat well, avoid consuming unpasteurized milk and unpasteurized soft cheeses. It is always best to cook seafood thoroughly. People at greater risk for foodborne illness with the most severe outcomes, such as pregnant women or people with weakened immune systems, should not eat raw or partially cooked seafood, including oysters that have been treated after harvest.
See the CDC Announcement
See the Transcript of the CDC Press Briefing
See the CDC’s Campylobacter site
See the CDC’s Vibrio vulnificus site
See also Medical Law Perspectives, July 2012 Report: Foodborne Illness: When Grabbing a Bite Can Be Deadly