FSMA, Part One: Unacceptable Levels of Foodborne Illness

According to Dr. Roy Betts in a recent review article on the Food Safety Modernization Act,¹ every year approximately 48 million people– or one in six– experience foodborne illness in the United States alone. Of these, 128,000 require hospitalization, and for 3,000 Americans, foodborne illness proves fatal each year.²

The major culprits in these instances and outbreaks include:^1,3

Pathogen	Incidence	Hospitalization Rate	Fatality Rate
Campylobacter	6,486	17%	0.2%
Listeria	118	92%	15.3%
Salmonella	7,452	29%	0.4%
Shigella	2,801	20%	0.1%
Shiga Toxin producing Escherichia coli (STEC) O157:H7	445	35%	0.7%
STEC non-O157:H7	690	15%	0%

The US has seen some high profile outbreaks of foodborne illness in recent years. In 2014-2015 these included:⁴

Salmonella outbreaks in cucumbers (275 cases), bean sprouts (115 cases), frozen raw tuna (65 cases), sprouted chia powder (31 cases), raw cashew cheese (17 cases), and nut butter (6 cases)
Listeria monocytogenes outbreaks in caramel apples (35 cases, 7 deaths), ice cream (10 cases, 3 deaths), cheese (8 cases, 1 death), sprouted seeds (5 cases, 2 deaths)
Cyclospora outbreak in cilantro/coriander (8 cases, 1 death)
E. coli outbreaks in clover sprouts (19 cases) and ground beef (12 cases)

As part of the Department of Health and Human Services “Healthy People 2020 initiative” launched in December 2010, the Centers for Disease Control (CDC) includes a benchmark target rate in its annual foodborne illness progress report for the purpose of decreasing current infection rates as compared with previous years (2006-2008).

The 2014 progress report is rather stark with rates for many foodborne pathogens still well above the CDC targets. For instance:^1,5

Pathogen	Target Rate	Actual Rate	Change since 2006-2008
Campylobacter	8.5%	13.45%	13% increase
E. coli O157:H7	0.6%	0.92%	32% decrease
Listeria	0.2%	0.24%	no change
Salmonella	11.4%	15.45%	no change

Furthermore, the numbers of reported cases of foodborne illness vastly underestimate the actual incidences of infection by foodborne pathogens since many go unreported. Taken together, this data regarding foodborne infection – and levels of illness considered unacceptable – influenced the biggest policy change in the food industry in 70 years: the Food Safety Modernization Act (FSMA).

Learn more about this landmark legislation in part two of this three-blog series or read the full article, The Food Safety Modernization Act — Global Impacts for Microbiological Food Safety.

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References:

1 Betts, Roy. (2016) ‘The Food Safety Modernization Act — Global Impacts for Microbiological Food Safety.‘ Culture 36 (1).

2 Centers for Disease Control and Prevention (CDC). (2015) Morbidity and Mortality Weekly Report. Vol. 64 / No. 18 http://www.cdc.gov/mmwr/preview/ mmwrhtml/mm6418a4.htm.

3 Centers for Disease Control and Prevention (CDC). (2014) Estimates of Foodborne Illness in the United States. http://www.cdc.gov/foodborneburden/.

4 Control and Prevention (CDC). (2015) List of Selected Multistate Foodborne Outbreak Investigations. http://www.cdc.gov/foodsafety/outbreaks/multistate-outbreaks/outbreaks-list.html.

5 Centers for Disease Control and Prevention (CDC). (2014) 2014 Food Safety Progress Report. http://www.cdc.gov/foodnet/pdfs/progress-report-2014-508c.pdf.