Introduction of Hazards: Preparation, Consumption, and the Chain of Transmission Pathogen Reduction Dialogue Panel 1 May 6, 2002 Georgetown University Conference Center Robert V Tauxe, M.D., M.P.H. Foodborne and Diarrheal Diseases Branch, DBMD, NCID Centers for Disease Control and Prevention, Atlanta, GA
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Introduction of Hazards: Preparation, Consumption, and the Chain of Transmission Pathogen Reduction Dialogue Panel 1 May 6, 2002 Georgetown University.
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Introduction of Hazards:Preparation, Consumption, and the Chain of
Transmission
Pathogen Reduction DialoguePanel 1
May 6, 2002Georgetown University Conference Center
Robert V Tauxe, M.D., M.P.H.Foodborne and Diarrheal Diseases Branch,
DBMD, NCIDCenters for Disease Control and Prevention,
Atlanta, GA
Each year an estimated 76 million cases• 1 in four Americans gets a foodborne illness each year• 1 in 1000 Americans is hospitalized each year• $6.5 billion in medical and other costs
• Prevention depends on efforts from farm to table to reduce contamination of food
Public health burden of foodborne disease
Infection with a variety of different pathogens
Illness may occur in large focal outbreaksMost illness is “sporadic”: either individual cases or part of
unrecognized dispersed outbreaks
Reservoir: locus of sustained transmission and persistence• Some have a human reservoir: Shigella, hepatitis A, Norwalk virus
• Some have an animal reservoir: Salmonella, Campylobacter, E. coli O157:H7, Listeria, Vibrio, Yersinia, Toxoplasma
Often transmitted by several different pathways• Specific foods, water, direct contact with animals, direct contact with humans
Foodborne diseases
Major identified foodborne pathogens, United States – circa 2002
• Bacterial: Bacillus cereus Brucella Campylobacter* Clostridium botulinum Clostridium perfringens E. coli O157:H7* E. coli, non-O157 STEC* E. coli, other diarrheagenic* Listeria monocytogenes* Salmonella Typhi Salmonella non-typhoidal Shigella Staphylococcus Streptococcus Vibrio cholerae, toxigenic*
HACCP monitoring samples (FSIS data). Percent of ground beef samples yielding Salmonella, by size of
processing plant, and year Baseline
0
10
20
30
40
1998 1999 2000 2001
Per
cen
t p
osit
ive
Broilers Ground turkey Hogs
HACCP monitoring samples. Percent of broiler, ground turkey and hog samples yielding Salmonella,
by year, large processing plants (FSIS data)
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1996 1997 1998 1999 2000 2001
Rel
ativ
e R
ate
Salmonella Campylobacter Listeria Yersinia
Human illness data (CDC-FoodNet). Change in incidence of foodborne infections relative to 1996
15%25%31%49%
Decrease of
Some future prevention points for foodborne disease (with microbial
validation)
E,HW,SL
Production
Processing
Preparation
Land animals Plants
Seafood
Fish & shellfish
Meat, poultry, dairy,eggs
Fruit, nuts& vegetables
Distribution
Transport/ lairage
Consumption (and foodborne illness)
HACCP HACCP
QAP
Some future prevention points for foodborne disease (with microbial
validation)
E,HW,SL
Production
Processing
Preparation
Land animals Plants
Seafood
Fish & shellfish
Meat, poultry, dairy,eggs
Fruit, nuts& vegetables
Distribution
Transport/ lairage
Consumption (and foodborne illness)
HACCP HACCPHACCP
QAP
Foodborne pathogens enter food chain at multiple points Pathogen reduction approaches can reduce risk at each stepMicrobial monitoring can verify control measuresIn the kitchen:
• Educating the food preparers is important, so is• Handwashing• Keeping ill workers out of the kitchen, and• Decreasing contamination of food coming into the kitchen
Microbial standards in purchase contracts may helpFor high risk populations, using safer food products