Opportunities and Challenges

Surveillance, outbreak investigation, research, risk assessment, regulation, guidance, enforcement, coordination, and education are the broad strategies that Federal and State agencies, academia, the food industry, and trade organizations are using to focus efforts to decrease the number of foodborne illnesses, including decreasing the number and size of foodborne illness outbreaks. Surveillance systems, both passive and active, alert States, the Centers for Disease Control and Prevention (CDC), FDA, and FSIS to cases and increases of foodborne illness. Disease surveillance and epidemiologic investigations provide information for analyzing outbreaks and identifying tracebacks to food products, or to facilities, so that the remaining products can be removed from the market and other corrections or interventions can be made.

When outbreaks are tied to specific products, research can focus on the source of contamination and effective intervention. With the use of PFGE, phage-typing, and other methods of analysis, strains can be differentiated, for example, among E. coli O157:H7, L. monocytogenes, and Salmonella species. Public health officials are able to identify outbreaks that might otherwise have been considered sporadic cases and possibly limit their impact. FDA, FSIS, and others have developed microbiologic risk assessments on particular organisms to target prevention efforts on the riskiest products and procedures or steps in the farm-to-fork continuum.

Multiple educational initiatives have been implemented to reduce the number of outbreaks and individual cases of foodborne infections in general and specific populations. FDA and FSIS each develop and distribute consumer materials on food safety such as the importance of cooking foods to safe temperatures; how to ensure safe temperatures in refrigerators and freezers; details on foodborne illness associated with raw and undercooked meat, poultry, eggs, and seafood; and special issues associated with highly susceptible populations, including older adults, immunocompromised individuals, pregnant women, and young children.

Another important program to educate the public about food safety is the "Fight BAC!^®" campaign, a national initiative that unites FDA, FSIS, and the Partnership for Food Safety Education (PFSE).⁸ This program, which is the basis of the consumer food practices objective (10-5), reduces foodborne illness by stressing the four key food safety measures—clean, separate, chill, and cook—mentioned earlier. Also, for the annual National Food Safety Education Month^® every September, planning guides of consumer educational materials are issued to health educators.⁹ To further ensure that food safety messages reach consumers, FSIS introduced the Food Safety Mobile in 2003 to deliver food safety education messages to consumers, educators, and other interested partners at the local level.¹⁰

Cooking foods to safe temperatures is the "Fight BAC!^®" message that needs the most improvement among all consumer groups. "Thermy™" is a national food safety education campaign launched in 2000 by FSIS in cooperation with PFSE, the Food Temperature Indicator Association, and a number of grocery chains and thermometer companies across the country.¹¹ The campaign promotes the use of food thermometers when cooking meat, poultry, and egg products. In 2005, FSIS launched another national campaign, called "Is it done yet? You can't tell by looking. Use a food thermometer to be sure." to target families with young children and high-risk populations.¹²

In 2004, the National Coalition for Food Safe Schools released The Food-Safe Schools Action Guide. This guide reflects the state-of-the-science in school-based foodborne illness prevention.¹³

Since 2001, educational programs about the risks of listeriosis and the importance of a refrigerator thermometer have been delivered through the media, grocery stores, health professional organizations, and authors of books on pregnancy. These programs have targeted at-risk groups, including older adults and pregnant women. For pregnant women, FDA has developed a food safety educational program, Food Safety for Moms-to-Be, available in Spanish and English.¹⁴ FSIS produced a plain language flyer, Protect Your Baby and Yourself from Listeriosis, in Spanish and English, featuring information about foods suitable for pregnant women to eat to avoid contracting listeriosis.¹⁵ Information about L. monocytogenes was distributed by a segment aired nationwide through a television program aimed at young Hispanic mothers and pregnant women.

Efforts to reduce enteric infections caused by Salmonella species (10-1d and 10-3b) are under way. For example, in addition to its continuing consumer and food service personnel campaigns on the safe handling of shell eggs, FDA has proposed rules to assist in preventing S. enteritidis during egg production.^16,17,18

The Food Code is the foundation document of FDA's National Retail Food Program. The code represents the agency's policies and best science-based advice for a uniform system of provisions that address the safety and protection of food offered in the retail industry and in food service establishments. Having a regulatory foundation such as the Food Code in place is a key component of the FDA National Retail Food Program—the development of the Voluntary National Retail Food Regulatory Program Standards—aimed at decreasing foodborne illness.¹⁹ These standards provide nationally recognized criteria as a framework for public health administrators to assess their retail food protection program. They identify essential food safety program performance measurements; establish program priorities and intervention strategies; assess the design, structure, and delivery of program services; and allocate resources to programs providing the most significant public health benefits. As of 2005, 185 State, Tribal, and local food regulatory jurisdictions had enrolled in the program standards.

For improvement in food safety in retail establishments (10-6), regulators and the retail industry must focus on the following three risk factors for foodborne illness: food-holding times and temperatures, poor personal hygiene, and contaminated equipment. Progress toward safe food preparation depends on food service workers' understanding and practicing effective safe food preparation techniques. Training and technical assistance must be made available to program operators. Furthermore, education and training materials must be provided in wordless or multilanguage formats to accommodate a diverse workforce.

For certain individuals, the presence of allergens in food can be life threatening. Currently no cure for food allergy is available. The only successful method of managing a food allergy is to avoid foods containing the allergen. Formulated foods present a separate challenge because the individual relies on accurate ingredient labeling.²⁰ For progress to occur in reducing the number of severe food allergic reactions and deaths, food manufacturers must comply with the Food Allergen Labeling and Consumer Protection Act (FALCPA). Enacted in 2004, FALCPA amends the Federal Food, Drug, and Cosmetic Act to require that food packages be labeled in consumer-friendly terms and provide information on any major food allergen used as an ingredient in the food. FALCPA also calls for inspections of facilities to ensure that they comply with practices that reduce cross-contact of a food with residues of major food allergens. Continuing outreach efforts, such as FDA's Guidance for Industry on FALCPA,²¹ are necessary to educate food manufacturers on the specific requirements of the law to ensure appropriate implementation. FALCPA's implementation is expected to help reduce severe allergic reactions to food by helping consumers avoid foods to which they are sensitive.

In addition, progress in reducing the number of severe food allergic reactions and deaths depends on the adoption of the Food Code, which addresses food allergen concerns at the retail level. Through the Conference for Food Protection (CFP), States have endorsed revision of the Food Code to provide additional information on food allergens and symptoms of allergic reactions to food. Updates to the Food Code also require that managers of food establishments be knowledgeable about the major food allergens and the symptoms of allergic reactions to them. For the past several years, FDA, together with the CFP Allergen Committee, has provided the Food Code with new allergen information.²² Forty-eight of the 56 (86 percent) States and U.S. Territories have adopted codes patterned after the Food Code.²³ These 48 jurisdictions represent 79 percent of the U.S. population. Furthermore, 35 of 334 Tribes with food service establishments have adopted a version of the code.

<<  Previous—Progress Toward Healthy People 2010 Targets   |   Table of Contents  |   Next—Emerging Issues  >>