# Presentation: 723928

## Healthy People 2010 Focus Area 10:Food SafetyProgress ReviewDecember 20, 2007

**Healthy People 2010 ****Focus Area 10:****Food Safety****Progress Review****December 20, 2007**

- Edward J. Sondik
- National Center for Health Statistics

## 76 million illnesses
325,000 hospitalizations
5,000 deaths
$23 billion in costs

**76 million illnesses**
**325,000 hospitalizations**
**5,000 deaths**
**$23 billion in costs**

- Source: 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. Emerging Infectious Diseases 5(5):607-625. 1999.

## Foodborne Diseases Pyramid

**Exposure in the general population**

**Person becomes ill**

**Person seeks care**

**Specimen obtained**

**Culture **
**confirmed case**

**Reported to Health Department/CDC**

**Lab tests for organisms**

## Food Safety Focus Area Objectives

- A Framework for Reducing Foodborne Illness
- Through Prevention, Intervention and Response

**Education**
**Training**
**Surveillance**
**Research**

## Highlighted Objectives

**Getting worse**

**10-1d****	****  Foodborne infections (*****Salmonella***** spp.)**
**10-2a****	****  Foodborne outbreaks (*****E. coli***** O157:H7)**
**10-4b****	****  Severe allergic reactions to food**

**10-1a-c,f  Foodborne infections **
**10-2b****	****  Foodborne outbreaks (Salmonella)**
**10-5****	****  Food safety practices**

**Improving**

**Target met or exceeded**

**10-3c,d ****	****  Antimicrobial drug resistance**

**Little or no progress ***

**10-3a,b    Antimicrobial drug resistance**

**No tracking data**

**10-6a-i     Safe retail food preparation**

***** **Percent of targeted progress achieved is between -10% and 10%, and/or not statistically significant.**

## Major Foodborne Infections

- *Data for for postdiarrheal hemolytic uremic syndrome (HUS) (2000-2004) are for children under 5 years.
- Source: Foodborne Disease Active Surveillance Network (FoodNet), CDC, FDA, USDA, and State agencies.

- Rate per 100,000 population

***Escherichia coli***** O157:H7**

***Listeria monocytogenes***

**2010**
**Targets**

**HUS*******

**Objs. 10-1b,c, f**

## Major Foodborne Infections

- Source: Foodborne Disease Active Surveillance Network (FoodNet), CDC, FDA, USDA, and State agencies.

- Rate per 100,000 population

***Campylobacter***** species**

***Salmonella***** species**

**Objs. 10-1a,d**

**2010**
**Targets**

## Major Foodborne Infections

- Notes: Rates are the number of culture-confirmed cases of illness for all persons.  *Data for for postdiarrheal hemolytic uremic syndrome
- (HUS) (2000-2004) are for children under 5 years.  Source: Foodborne Disease Active Surveillance Network (FoodNet),
- CDC, FDA, USDA, and State agencies. †Source: 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. Emerging Infectious Diseases 5(5):607-625. 1999.

- Rate per 100,000 population

***Campylobacter***** species**

***Salmonella***** species**

**Objs. 10-1a-d, f**

***Escherichia coli***** O157:H7**

***Listeria monocytogenes***

**HUS*******

**Estimated****†**** percent of**
**total foodborne deaths**

***Salmonella *****spp*****.*****	****	****30.6 %**
***Listeria monocytogenes*****	****27.6%**
***Campylobacter***** spp.****	****	****  5.5%**
***E. coli***** O157:H7****	****	****  2.9%**

## Outbreaks of Infections Caused by 

-     from the ingestion of a common food, among the U.S. resident population and reported to CDC.
-     Source: Foodborne Disease Outbreak Surveillance System, CDC, NCID.

- Outbreaks of Infections Caused by
- Key Foodborne Bacteria

***Salmonella *****serotype Enteritidis**

- Number of outbreaks †

**Objs. 10-2a, b**

***Escherichia coli***** O157:H7**

**2010**
**Targets**

## Human Samples of Non-Typhi Salmonella Resistant to Antibiotics

- Notes: The target for 10-3a and 10-3b is zero (0).
- Source: National Antimicrobial Resistance Monitoring System: Enteric Bacteria-Salmonella (NARMS-Enteric
- Bacteria), CDC, NCID; FDA, CVM; USDA, FSIS, APHIS, and ARS; Foodborne Disease Active Surveillance
- Network (FoodNet), CDC, FDA, USDA, and State agencies..

**Objs. 10-3a-d**

- Percent

- Ampicillin

- Gentamicin

- Cephalosporins

- Fluoroquinolones

**2010**
**Targets**

## Severe Allergic Reactions† to Food 

- Severe Allergic Reactions† to Food
- in Persons With Allergies

- Notes: † Persons 18 years and older with doctor-diagnosed food allergies who report an allergic reaction within the last
- 5 years and who report that the allergic reaction was severe (required the use of epinephrine, or treatment in a hospital or
- doctor’s office, or an overnight stay in a hospital).  * Data are statistically unreliable and are suppressed.
- Source: Food Safety Survey (FSS), FDA and USDA, FSIS.

**Percent **

**2010 Target: 21 %**

**Obj. 10-4b**

**Education**

**Gender**

*****

**Black**

**High**
**School**

**Total**

**White**

**Female**

**Male**

**Some**
**College**

**60 +**

**18-59**

**Age**

**Race**

## Deaths From Severe Food Allergies

- Source: National Vital Statistics System—Mortality (NVSS—M), CDC, NCHS;
- Food Safety Survey (FSS), FDA and USDA, FSIS.

**Obj. 10-4a**

- ICD-10 codes for food-induced anaphylaxis were developed but do not necessarily reflect all allergen-related deaths.
- Research indicates expected number of deaths to be around 125 annually*
- Death certificates currently show about 20 deaths annually

- _Developmental_

- Yocum, MW, and DA Khan.  Assessment of patients who have experienced anaphylaxis: a 3-year survey.
- Mayo Clin. Proc. 1994; 69:16-23

*****

## Key Food Safety Practices

**Obj. 10-5**

- Clean – wash hands and surfaces often
- Separate – don’t cross-contaminate
- Cook – cook to proper temperatures
- Chill – refrigerate promptly

**FightBAC Campaign**

## Consumer Food Safety Practices†

- Consumer Food Safety Practices†

- Notes: †  The percents of consumers over 18 years of age who report they follow each of 4 key food safety practices,
- Clean, separate, cook, and chill, among the U.S. civilian non-institutionalized population.
- Source: Food Safety Survey (FSS), FDA and USDA, FSIS.

**Obj. 10-5**

**2010 Target: 79 %**

**Black**

**High**
**School**

**Total**

**White**

**Female**

**Male**

**Some**
**College**

**Less than**
**High School**

**Percent**

**Education**

**Gender**

**Race**

**0**

## Retail Food Establishment Compliance 

- observed to be in compliance during observational, non-regulatory inspections by FDA.
- Source: Retail Food Database of Foodborne Illness Risk Factors, FDA, CFSAN.

- Percent

- 82

- 80

- 80

- 60

- 74

- 81

- 76

- 83

- 73

**Objs. 10- 6a-i**

- Retail Food Establishment Compliance
- with FDA Guidelines, 1998

- 2010 Targets

## Target met or exceeded
Improving
Getting worse
Little or no progress*
No tracking data
Dropped at midcourse
Retained as developmental

- Target met or exceeded
- Improving
- Getting worse
- Little or no progress*
- No tracking data
- Dropped at midcourse
- Retained as developmental

- 2
- 6
- 3
- 2
- 9
- 15
- 1

***** **Percent of targeted progress achieved is between -10% and 10%, and/or not statistically significant.**

**Notes:**
No objective that can be assessed is moving in the wrong direction.

## Contributors:

_**Contributors:**_
**Elisa Elliot, FDA  ****	****	****Sara Fein, FDA **
**Delila Parham, USDA ****	****	****Katherine Vierk, FDA**
**Holly McPeak, ODPHP****	****Glenda Lewis, FDA**
**Elizabeth Jackson, CDC ****	****Olga Henao, CDC**
**Jeffrey Pearcy, CDC****	****	****Ellis Davis, ODPHP **

## Progress Review data and slides 

**can be accessed on the web at:**
**http://www.cdc.gov/nchs/hphome.htm**