The incidence of foodborne infections in the U.S. from Campylobacter, Salmonella, and other virulent pathogens increased sharply last year, creating a major public health problem, according to CDC. Among its many consequences is a growing strain on the ability of federal, state, and local government agencies to identify and mitigate potential food safety concerns.
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Partly in response, FDA in April announced a “Blueprint for a New Era of Smarter Food Safety,” in which government and industry would cooperate to leverage advances in digital technologies such as blockchain to enhance product traceability; artificial intelligence and machine learning to facilitate food import inspections; and new packaging and transportation approaches to help modernize the food industry and meet the growing demands of e-commerce.
While the Food Safety Modernization Act (FSMA) has enhanced oversight of the nation’s food supply, “we recognize that it’s time to look to the future of food safety once again with a view that builds on the progress we’re making with our regulatory framework, but also leverages the use of new and emerging technologies to create a more digital, traceable, and safer system,” said acting FDA Commissioner Norman “Ned” Sharpless, MD, and Deputy Commissioner Frank Yiannas in a recent joint statement.
Toward this end, FDA this year will hold a public meeting and gather stakeholder input on “smarter food safety.” The agency will also launch a pilot project using artificial intelligence to enhance its ability to review imports at ports of entry to ensure they meet U.S. food safety requirements. In addition, FDA will tap into its existing programs related to tracking the drug supply chain to see whether similar approaches might be adapted to tracking the nation’s food supply.
“When you look at how other industries digitally track the movement of planes, ride sharing, and delivery of packaged goods, it becomes clear that we must explore how these types of technologies could improve tracking when it comes to food,” Dr. Sharpless and Yiannas explained.
Pathogens on the Rise
The incidence of foodborne infections increased in 2018 compared to 2015-17, according to CDC’s latest Foodborne Diseases Active Surveillance Network (FoodNet) report, released in April. Surveillance from labs in 10 states confirmed more than 25,600 infections, nearly 5,900 hospitalizations, and 120 deaths that were caused by eight enteric pathogens commonly transmitted through food.
As in previous years, Campylobacter was the most prevalent, being responsible for 9,723 illnesses, 1,811 hospitalizations, and 30 deaths. This was followed by Salmonella with 9,084 illnesses, 2,416 hospitalizations, and 36 deaths. Campylobacter is commonly associated with consumption of raw or undercooked poultry and meat, while Salmonella is an issue in many types of food, including eggs, meat, poultry, fruits, vegetables, spices, and nuts.
Both bacteria can cause mild to severe illness, from uncomplicated diarrhea to severe systemic infections, such as Guillain-Barré syndrome (Campylobacter), an autoimmune disease that can cause paralysis, and reactive arthritis (Salmonella), which can cause acute, debilitating joint pain.
Other bacterial pathogens included Shiga toxin-producing E. coli (with 2,925 illnesses), Shigella (2,414 illnesses), Vibrio (537), Yersinia (465), and Listeria (126). While Listeria caused the fewest number of cases, it was also the most virulent, hospitalizing 96 percent of its victims and killing 21 percent of them.
Compared to 2015-17, incidences per 100,000 population increased by 12 percent for Campylobacter and 9 percent for Salmonella. Incidences skyrocketed for the parasite Cyclospora (399 percent), followed by the bacteria Vibrio (109 percent), Yersinia (58 percent), and Shiga-producing E. coli (26 percent).
Nationwide, the actual number of cases are much greater. This is because FoodNet collects data from public health departments in only 10 states, covering just 15 percent of the U.S. population. Additionally, the true number of foodborne illnesses always exceeds the reported number because many people who get sick do not seek, or necessarily require, medical treatment.