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
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
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
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
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: Thank you. With me, here, in Washington, D.C., is the acting
administrator for the Food Safety and Inspection Service, Dr. Barbara
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.
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
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
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
MODERATOR: And excuse me, Doctor, we actually just got three questions.
MS. MORCONE: Okay.
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
QUESTIONER: With respect to the E.coli infections, could you name
some measures, specific measures that you think might have led to this
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
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
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
MS. MORCONE: Thank you, sir.
DR. PIERSON: This is Merle Pierson, and I'll also comment relative to
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.
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
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