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Telebriefing Transcript
Release of Preliminary Foodborne Illness Data for 2004

April 14, 2005

MS. MORCONE: Thank you all for joining us today. We've got some good news to share. Foodborne illnesses continue a downward trend, and today we have Dr. Rob Tauxe, chief of CDC's Foodborne and Diarrheal Diseases Branch who will start the call, followed by Dr. Robert Brackett, and that's Robert Brackett, PhD, director of FDA's Center for Food Safety and Applied Nutrition. And Dr. Merle Pierson, the acting undersecretary for Food Safety for USDA. And one clarification for all the reporters on the call. Pierson is spelled P-i-e-r-s-o-n. Our apologies at CDC for the error. Dr. Tauxe, please take it away.

DR. TAUXE: Well, thank you very much.

Foodborne infections are an important public health problem in the United States. There actually are a range of a number of different infections, many of which cause significant GI illness, with diarrhea, fever, and vomiting, and persons at high risk, including young children or the elderly, or people who are already sick with other conditions, it can be severe. Foodborne illness can even be fatal.

In 1999, we published estimates that 76 million Americans become ill each year, 325,000 are hospitalized, and 5,000 die. At that time, goals are set for reducing several infections by the year 2010, as part of a Healthy People 2010 goal-setting process.

Since 1996, we have tracked the frequency of infections that are typically transmitted through food with a network called FoodNet. FoodNet is a collaborative surveillance network conducted by CDC, sentinel sites in ten public health departments in states, and with our federal food safety partners, USDA and FDA.

Today, we are releasing the preliminary results for 2004. These results show important progress and I'll summarize these as three major findings.

First of all, there is continued, sustained decline in several major infections compared to the baseline when we first started surveillance. That's a 42 percent decline in E.coli O157 infections. A 40 percent decline in Listeria infections. A 31 percent decline in Campylobacter infections and an 8 percent decline in Salmonella infections.

Second, it's important that the decline in E. coli O157 infections, which we really first observed last year, continued this year, and for the first time we met the target for the 2010 Healthy People goal of only one infection per 100,000 people.

Third, there is now an observed decline in some infections, including some types of Salmonella, Shigella infections and Vibrio infections.

So we're very glad to see the sustained decline in E.coli O157. This occurs in association with changes in regulations, in meat industry practices, and consumer education, particularly around the issue of ground beef.

We anticipate even more progress is possible and that the infection rate for E.coli O157 could even be lower in the future if the contamination in live animals on the farm can be further reduced.

The decrease in Listeria infections that we observed this year occurs after an increase in last year's numbers, that is, the ones we reported last year for 2003, and that means we again are observing a significant decrease in Listeria infections from the baseline period.

Some important progress that we've made here with several foodborne diseases is reason to be very encouraged with our general progress in food safety. However, it's important to remember that prevention efforts underway now need to be continued and expanded to meet and to exceed our goals for protecting the health of all Americans.

MS. MORCONE: Thank you, Dr. Tauxe.

Dr. Brackett, please go ahead.

DR. BRACKETT: Thank you. Well, first off, I would like to echo Dr. Tauxe's sentiment, the fact that the numbers that we're seeing overall are quite encouraging and it shows that some of our activities are beginning to pay off, and we're very pleased to see this.

The one area, or actually two areas that FDA is particularly interested in pursuing, however, is in the area of Salmonella, first of all, the fact that Salmonella enteritidis, which is primarily associated with shell eggs, has not declined in the way that we would like to have seen, and so this again shows the importance of educating the consumers on handling those eggs and also the importance of having a farm-to-table approach to reducing the number of contaminated eggs that the consumers are exposed to, and so we are going to continue being aggressive in trying to promote that program.

The second issue that Dr. Tauxe brought up was the rise of illnesses associated with Vibrio species and this is something that FDA is concerned about, and we will be exploring some of the options that we can use to reduce the number of illnesses from these naturally-occurring bacteria, and as a first step, we're going to be working with very closely with the Interstate Shellfish Sanitation Conference and we'll be discussing some of the control options with this group at their conference this summer.

It appears from the data that we've seen, that most of the illnesses are due to Vibrio parahaemolyticus, and at this time we're really not sure what is accounting for the rise, but FDA is nearing completion of a risk assessment on this organism, on Vibrio parahaemolyticus, and once that is complete, we're hoping that that will give us more insight into what perhaps is leading to the rise.

But it is nevertheless a concern to us and we do plan to put forth a Vibrio parahaemolyticus illness reduction plan later on in this year, after discussing the options with the seafood industry.

In the meantime, the one message we would like consumers to remember is that they can do a lot to protect themselves and the best way that consumers can protect themselves from Vibrio parahaemolyticus exposure, as all the Vibrios, is to make sure that they thoroughly cook their seafood, particularly with oysters. So together with consumers doing what they can to protect themselves and some of the activities that we'll be embarking on, hopefully we will see a reduction in coming years.

MS. MORCONE: Great. Thank you, sir.

Dr. Pierson.

DR. PIERSON: Thank you. With me, here, in Washington, D.C., is the acting administrator for the Food Safety and Inspection Service, Dr. Barbara Masters.

We want to thank the CDC for holding this briefing and for working so closely with us to help prevent foodborne illness. We at USDA are very encouraged with the sustained good news on the food safety front, which tells us that our science-based policies are making a difference in the safety of meat, poultry and egg products.

Illnesses from E.coli O157:H7, as stated, are 42 percent lower than the baseline and for the first time, according to our good friends at CDC, the U.S. is now below the Healthy People 2010 goal of one case per 100,000 persons. This is a remarkable national achievement.

In part, the reductions in illnesses from Listeria monocytogenes, Campylobacter and Salmonella [inaudible] typically associated meat and poultry, were also noted.

We saw an 8 percent reduction in Salmonella, and we're very, very committed to further addressing a reduction, a very significant reduction in Salmonella, and are working on specific programs in that regard.

While these data, which are consistent with the results of FSI as regulatory testing, are encouraging, we know there are continuing challenges and there's more that needs to be done.

USDA will continue to dedicate resources to identifying and responding to the greatest risks to public health. We are committed to continuous improvement of our policies, our training, and our enforcement to make the products we regulate even more safe for our families and our children.

Thank you.

MS. MORCONE: Thank you, sir. Laura, we're now ready for Q/A.

MODERATOR: Thank you, and at this time, if you would like to ask a question, please press star followed by one on your touchtone phone. To withdraw your request, you may press star two.

Once again, to ask a question please press star followed by one. One moment for the first question.

Thank you. Our first question comes from Elizabeth Weise with USA Today.

QUESTION: Hi. This is a question for Dr. Brackett. I have a question about Salmonella in eggs and you talked about farm to table. What is FDA looking at --and it's always been a little unclear to me if it was FDA or USDA that was in charge of shell eggs--and secondly, what is FDA's and/or USDA's purview in terms of what farmers were--egg farmers do on the farm?

Can you actually go in and tell them what they need to do, or are you only in charge of it once it gets to a processing plant?

DR. BRACKETT: Thanks for that question. In fact FDA is responsible for the shell life on the farm and what we have done in this last year is actually issued a proposed rule to specifically address that issue and it would require egg farms to do such activities such as making sure that they have proper rodent control, that they source their hens from Salmonella enteritidis-free chicks, that they have proper cleaning and disinfection as well as biosecurity, that is, keeping individuals or other illnesses from coming into the poultry facility, in addition to some of the other recommendations that we would have such as refrigeration, and this is meant to work in tandem with USDA for egg products where similar sorts of controls would be made, and I'll let Dr. Pierson talk about that.

But the important difference between Salmonella enteritidis as opposed to some of these others is this organism actually contaminates the food as the shell is being formed within the hen. So it's not enough just to try to wash the shells off to eliminate it.

The best strategy is to actually prevent it from becoming contaminated in the first place.

Once it is contaminated, the only thing one can do is thoroughly cook or pasteurize the product itself.

MR. MORCONE: Dr. Pierson, would you like to add anything?

DR. PIERSON: Yes. What I'll do is I'll let Dr. Masters summarize our current status for--our risk assessment and other related activities for Salmonella.

DR. MASTERS: Thank you, Dr. Pierson. Our agency did conduct a very comprehensive risk assessment for Salmonella enteritidis in eggs. We presented that at a public meeting in October of 2004. We're working to review comments that we received based on that public meeting and that very comprehensive risk assessment, with the eye towards either rule making, a proposed rule making, as well as guidance material as an outcome of that public process, and how we can move more quickly and thoughtfully as to the next steps that we should take as an agency.

MS. MORCONE: Thank you both very much. Next question, Laura.

MODERATOR: Thank you. Once again, as a reminder, if you would like to ask a question, please press star one on your touchtone phone. One moment for the next question.

We are showing no further questions at this time.

MS. MORCONE: Okay. I think this might be a record short briefing. Would any of our speakers like to make a closing statement. Dr. Tauxe, would you like to repeat the main points we've covered today?

DR. TAUXE: Well, perhaps I could say just a little bit more about Salmonella. Overall, the infections dropped 8 percent but the decrease was just in one of the five most common strains, the Typhimurium strain, and other strains that did not decrease, and even one of them that's been increasing, deserve some specific attention.

Different Salmonella strains are found in a variety of animal hosts and different geographic locations, and further efforts are needed to better understand why some strains tend to contaminate produce, for example, the tomato problems that we had last summer, during production and harvest, and to better control foodborne pathogens in animals and plants, prevention is going to need to be implemented across the farm-to-table continuum.

I think that we have some real progress that we're documenting here. It represents the efforts of a lot of people throughout several agencies, many agencies, through the industry and the consumers themselves, and I want to thank everybody who has exerted and extended themselves in the food safety process as we hope to make continued progress.

I'd also like to thank everybody that joined us today for the phone call and we're very glad for your interest in foodborne disease and foodborne disease prevention.

MODERATOR: And excuse me, Doctor, we actually just got three questions.


MODERATOR: Thank you. Your next question comes from Miranda Hitti with WebMD. Please go ahead.

QUESTION: Hi. I just wanted to ask with Vibrio infections, are those just transmitted through seafood?

DR. TAUXE: Perhaps I'll answer that first. Vibrio infections are typically associated with salt water and most often are transmitted through seafoods. That's not the only way to get them.

Sometimes people who have wounds, who have cuts or abrasions on their skin, and that's exposed to seawater, they can also get the infection that way, but the most common source is seafood.

MS. MORCONE: Next question, please.

MODERATOR: Thank you. John Lauerman with Bloomberg News, you may ask your question.

QUESTIONER: With respect to the E.coli infections, could you name some measures, specific measures that you think might have led to this reduction?

DR. TAUXE: I think several--there may be several answers to that here. We're seeing this reduction especially visible in the last two years. It's really become noticeable in the last two years, and particularly associated we think with a reduction in infections related to ground beef. There obviously are a number of different ways one can get E.coli O157, from petting zoos or from ciders or fresh juices that are unpasteurized, and there's been attention in a number of areas including improving juice safety, but I think a lot of the reduction must be related to a decrease in the risk associated with ground beef, but let me encourage USDA and FDA to comment.

DR. PIERSON: This is Merle Pierson, and certainly I would like to comment. We, a little over two years ago, instituted a [inaudible] alert with very drastic policies that specifically addressed E.coli O157:H7. One of the things that we did is to encourage producers of fresh meats that were going to ground beef, as well as ground beef producers, to develop, implement and maintain valid, validated interventions, and in addition, required all producers to reassess their HASIP plans in regards to E.coli O157:H7.

As a result of this, we had I believe approximately 2,900 plants to do so. These plants then--plans were then audited or reviewed by our trained inspectors. We found over 60 percent of them had instituted new procedures and bolstered their procedures for control.

We also found that many of these companies were doing their own in-house verification testing prior to sale or distribution of the products. So we also have conducted very targeted testing, more at the fabrication level, or I should say the--in such things as not just at the end product, but in beef trim and other related products, to further assure that you don't get the wide distribution of the microorganism.

So we've taken a number of, I think, aggressive steps. The industry has been very responsive in implementing aggressive control measures, and we are actually seeing a very substantial reduction in our regulatory compliance sample positives. So this very much parallels the results we're getting from our compliance sampling too, the drop in illnesses. It's a good drop. We will continue these measures and we expect continued success.

MS. MORCONE: Thank you, sir.

Any more questions, Laura?

MODERATOR: Thank you. Our next question comes from Carol Sugarman with the Food Chemical News.

QUESTIONER: Yeah. I wanted to get some more details about why you all think Salmonella has not declined as much as some of these other pathogens, and if USDA or FDA has any specific plans to deal with the serotypes that have actually increased, which would be the Salmonella Newport and Javiana, I believe?

DR. TAUXE: This is Robert Tauxe at CDC. I'll just take a word first. I think that Salmonella, as I say, is more than one story, and there is progress with one particular type of Salmonella, the most common type, typhimurium, and in the past there has been progress with the second Salmonella enteritidis, the egg-associated one, which that progress seems to have plateaued more recently, which is why we're not seeing change now.

Each of these Salmonella infections are related to different hosts. I think Salmonella Newport and some of the typhimurium may have meat animal reservoirs. This new one, Salmonella Javiana, is the one that really burst on the national scene last year in relation to Roma tomatoes, illustrating the range of issues that we have to think about with Salmonella. And I think it is both an animal and a plant problem, the different Salmonellas, and we're particularly concerned about some of the antibiotic resistant strains of Salmonella that have not been declining.

MS. MORCONE: Would another speaker want to continue?

DR. BRACKETT: This is Bob Brackett from the FDA, and I'll respond also to what Dr. Tauxe said, specifically addressing Salmonella Javiana but others as well.

What we have done in the pats years is specifically instituted a produce safety action plan which is meant to address not only that specific species of Salmonella, but also other pathogens that might contaminate fresh produce as well. This--the past efforts in produce safety has primarily focused on good agricultural practices and sort of on-farm controls.

This is a broader issue that is meant not only to address the on-farm controls but also the role that processors, since much of the food is being processed and pre-cut these days, transportation, as well as the food servers can also do to prevent either contamination of the product, per se, or cross-contamination to or from other types of foods. It would address options that the farmers could use to change their farming practices to reduce the chance for contamination. But having to realize that fresh produce is a raw agricultural commodity that's grown out in the natural environment, it is subject to contamination from sometimes wildlife or other animals that might be out there.

So we're also interested in encouraging the implementation of actions that might reduce the possibility that if it is contaminated that it would be either increased in population through mishandling or that it might otherwise lead to more infection of more products.

And as I mentioned, part of the problem is not knowing quite where this organism necessarily is coming from and how it's being transmitted within the plants. So we are also encouraging specific types of research that would answer the questions that we need. This is meant to be a very comprehensive program and we are working very closely with the industry to solve this problem.

MS. MORCONE: Thank you, sir.

DR. PIERSON: This is Merle Pierson, and I'll also comment relative to Salmonella.

Certainly we are very much dedicated to implementing policies and working towards reduction of foodborne illness related to Salmonella. We very much appreciate the information that is provided to us by CDC because that helps us to target our resources to target those areas of concern.

I might point out one thing that is relative to Salmonella Newport. Yes, it's still above the baseline, but if you notice, there's been substantial reductions over the past two years. This has paralleled actually the reductions that we've seen in E.coli O157:H7, and we hope that this--the actions taken so far combined with additional attention to the issue will further lead to a decline in the incidence of this microorganism.

Overall for Salmonella, we continue now to pay attention to specific target areas of concern. We, for example, have been working with the poultry industry on strategies for reducing the level and incidence of Salmonella in, for example, fresh broilers. We have challenged the industry to implement interventions. Likewise, we are working towards a more--a comprehensive policy to address Salmonella specifically.

Thank you.

MS. MORCONE: Thank you, sir.

Any more questions, Laura?

MODERATOR: Thank you. Our next question comes from Elizabeth Weise with the USA Today.

MS. MORCONE: No. Actually that must have been the previous one. Never mind.

MODERATOR: Thank you. We have no further questions at this time.

MS. MORCONE: Well, thank you, everyone, for joining today. We've just issued the press statement. If you did not receive it or you would like to receive it, please call the CDC press office at 404-639-3286. The transcript for this call will also be posted on the CDC website.

Again, any further questions for either agency, feel free to call CDC and I'll refer you to the right place. Thanks everyone for joining us today. 

Listen to the telebriefing

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