Progress Toward Healthy People 2010 Targets

The following discussion highlights objectives that met or exceeded their 2010 targets; moved toward the targets, demonstrated no change, or moved away from the targets; and those that lacked data to assess progress. Progress is illustrated in the Progress Quotient bar chart (see Figure 10-1), which displays the percent of targeted change achieved for objectives and subobjectives with sufficient data to assess progress.

Data were available to measure progress for foodborne infections (10-1a through d, and f), outbreaks of foodborne infections (10-2a and b), antimicrobial resistance of Salmonella species (10-3a through d), and consumer food safety practices (10-5). One objective moved toward its target. The remaining three objectives demonstrated mixed progress toward or away from their targets based on individual subobjectives. Two subobjectives within these three objectives met their targets, and another four subobjectives made progress toward their targets. Five subobjectives moved away from their targets, and two objectives could not be assessed.

Objectives that met or exceeded their targets. Two subobjectives met their targets at baseline and continued to improve. Between 1997 and 2002, the percentage of human isolates of non-Typhi Salmonella species exhibiting resistance to gentamicin (10-3c) declined from 3 percent to 1 percent. The percentage of human isolates of non-Typhi Salmonella species displaying resistance to ampicillin (10-3d) declined from 18 percent to 13 percent. Decreased resistance to these antimicrobial drugs may be due, in part, to the development of prudent and judicious antimicrobial drug use programs by the American Veterinary Medical Association and FDA. These programs assist veterinarians and producers in making sound decisions about the use of such products in food animals.⁶

Objectives that moved toward their targets. Reductions in infections caused by Campylobacter species (10-1a), E. coli O157:H7 (10-1b), and L. monocytogenes (10-1c) showed progress toward their respective targets of 50 percent reductions from the baseline levels. Between 1997 and 2002, Campylobacter species infections (10-1a) declined from 24.6 cases per 100,000 population to 13.3 cases per 100,000 population, achieving 92 percent of the targeted change. During the same period, L. monocytogenes infections (10-1c) declined from 0.47 cases per 100,000 population to 0.26 cases per 100,000 population, achieving 91 percent of the targeted change. E. coli O157:H7 infections (10-1b) decreased from 2.1 cases per 100,000 population in 1997 to 1.7 per 100,000 population in 2002, achieving 36 percent of the targeted change. Outbreaks of infection from Salmonella serotypes enteritidis (10-2b) declined from 44 outbreaks per year in 1997 to 29 outbreaks in 2002, achieving 68 percent of the targeted change. General food safety practices among consumers aged 18 years and older (10-5) improved from 73 percent in 1998 to 75 percent in 2001, attaining 33 percent of the targeted change.

Objectives that moved away from their targets. Five subobjectives moved away from their targets: foodborne infections caused by Salmonella species (10-1d), postdiarrheal HUS among persons under 5 years of age (10-1f), outbreaks of foodborne infections from E. coli O157:H7 (10-2a), and percentage of human isolates of non-Typhi Salmonella exhibiting resistance to fluoroquinolones or third-generation cephalosporins (10-3a and b).

Three years of HUS data showed little change, with 1.80, 1.44, and 1.91 new cases per 100,000 population each year in 2000, 2001, and 2002, respectively.

The decrease in the number of cases and increase in the number of outbreaks of E. coli O157:H7 may signal either a real increase in number of outbreaks, perhaps associated with wider distribution of meats and produce, or the improved ability to group cases into outbreaks. Pulsed field gel electrophoresis (PFGE) methods allow differentiation of E. coli O157:H7 strains. The PulseNet linking of laboratories permits identification of widespread outbreaks that previously might have been considered sporadic cases.

The targets of 0.0 percent of non-Typhi Salmonella species exhibiting resistance to fluoroquinolones (10-3a) and third-generation cephalosporins (10-3b) were met at baseline. However, between the 1997 baseline and 2002, these percentages increased from 0.0 to 0.1 percent for fluoroquinolones and 0.2 percent for third-generation cephalosporins. These changes may be a result of the increasing use of these new antibiotics. Additional years of NARMS data will improve knowledge of the trends.³ Non-Typhi Salmonella is the third most commonly reported cause of foodborne illness in the United States.¹ A comprehensive farm-to-table approach to food safety is necessary for control.⁷

Objectives that could not be assessed. Data were unavailable to assess progress for 11 subobjectives. As previously noted, 1 objective and 14 subobjectives were deleted. Data sources have been identified for two formerly developmental objectives and subobjectives: deaths and illness from severe food allergies (10-4a and b) and safe food preparation practices in retail food establishments (10-6a through i).

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