States Lag on Food Poisoning Surveillance

A number of issues are leaving Americans vulnerable to food poisoning outbreaks, including from the dangerous, sometimes deadly, Listeria monocytogenes, Salmonella, and E. coli pathogens. With a combined 12 multi-state outbreaks in 2011, the issue has left over 100 ill and 20 dead in a Listeria cantaloupe outbreak that is ongoing today.

Now, says, the Daily Herald, reporting of these illnesses is, at best, inconsistent, leaving most vulnerable before health officials can identify outbreaks and recall contaminated foods. Salmonella appears to be the most prevalent, comprising about 60% of the multi-state outbreaks that have been reported in the past five years by the U.S. Centers for Disease Control and Prevention (CDC). About 1 million people fall ill yearly with salmonellosis, the illness caused by Salmonella poisoning.

The Daily Herald reported that a News21 analysis of Salmonella reporting revealed that differences nationwide are putting residents living in the worst-performing states at increased risk and that these differences can mitigate national surveillance of foodborne illness outbreaks. For instance, noted the Daily Herald, in larger outbreaks, the worst performers adversely impact other states’ surveillance and end up relying on other states to catch what they’ve missed. Smaller outbreaks are often completely missed.

“There are multi-state outbreaks out there that we don’t recognize and we don’t know about,” said Tim Jones, state epidemiologist for the Tennessee Health Department, said the Daily Herald, which pointed out that national surveillance relies on 2,800 state and local health departments—utilizing some 50 different reporting requirements—to work together. The CDC, investigation coordinator in multi-state outbreaks, is only permitted to “provide guidelines and recommendations”, according to Ian Williams, chief of the agency’s outbreak response and prevention branch, said the Daily Herald.

Speed is critical in foodborne illness response; however, for instance, 10 states permit one week before reporting Listeria poisoning; 16 require one-day notification, noted the Daily Herald. While the CDC recommends reporting take place for 20 foodborne illnesses, less than half mandate reporting on all.

Prior outbreaks have revealed weaknesses in the system. In 2008, the massive jalapeño and Serrano pepper Salmonella poisoning outbreak brought 43 state surveillance measures to task, exposing their weakness, said the Daily Herald. That outbreak left 2 dead, 308 hospitalized, and 1,500 sick and seeking medical attention.

In related news, we recently wrote that, according to the U.S. Food and Drug Administration (FDA), in 2010, it rejected about 16,000 food shipments into the U.S. from the more than 10,000 million arriving in over 320 ports. Some feel this is not enough. And, as much as the FDA says it does do to ensure Americans are provided with safe foods, some, including the U.S. Government Accountability Office (GAO), say the FDA is not able to ensure food import safety. Even worse, said the GAO, food imports are on the rise, noting that 10 years ago, 6 million FDA-regulated food products passed through U.S. ports; 24 million shipments are expected in 2011.

Meanwhile, despite the rise in products coming into U.S. ports, the number of investigators at the FDA has remained virtually unchanged, with only about 1,800 covering the entire nation. In 2010, agency inspectors only reviewed 2.06% of all food-related imports; only about 1.59% are expected to be examined this year and next year should only see 1.47% inspected, said the Office of Regulatory Affairs.