The Senate is about to vote on S.510 the "FDA Food Safety Modernization Act." This has been a heavily discussed issue by Pew Charitable Trusts and a great number of other organizations. The simple fact is that we need the legislation. You don't need much of a memory jolt to recall the peanut butter and egg food scares. Nor to recall that at least in these two cases the problems were from companies that had long histories of poor safety management that some might characterize as criminal. The new law gives the FDA the powers common sense would have assumed they already possessed, but did not. What gets lost in the discussion of the Act are the sheer numbers of foodborne illness cases in the U.S.
The Centers for Disease Control and Prevention (CDC) has estimated, albeit data perhaps 10 years old, the following:
To better quantify the impact of foodborne diseases on health in the United States, we compiled and analyzed information from multiple surveillance systems and other sources. We estimate that foodborne diseases cause approximately 76 million illnesses, 325,000 hospitalizations and 5,000 deaths in the United States each year. Known pathogens account for an estimated 14 million illnesses, 60,000 hospitalizations, and 1,800 deaths. Three pathogens: Salmonella, Listeria, and Toxoplasma, are responsible for 1,500 deaths each year, more than 75 percent of those caused by known pathogens, while unknown agents account for the remaining 62 million illnesses, 265,000 hospitalizations, and 3,200 deaths. Overall, foodborne diseases appear to cause more illnesses but fewer deaths than previously estimated.
To put these figures in perspective consider the UK. In 2007 the UK had about 1 million foodborne cases or a weekly rate of 36 per 100,000 population versus the U.S. figure of between 90 and 540 per 100,000 depending if you are using the CDC's 76 million case figure or the lower 14 million pathogen figure. Either way the U.S. compares unfavorably with the UK.
While finding this startling, it pales in comparison to the incidence rates for foodborne diseases for children. Children are the BIGGEST victims of foodborne illness. The Foodborne Diseases Active Surveillance Network (FoodNet) is the principal foodborne disease data collection program for the CDC's Emerging Infections Program (EIP). The CDC, using FoodNet data, estimated that in 2007 the incidence of laboratory-confirmed infections caused by specific bacterial and parasitic pathogens was about 38 per 100,000. Yet, the highest incidence of infection with multiple pathogens occurred among children less than one year of age: 173 cases/100,000 population versus about 20 cases per 100,000 for age groups above age 10.
FoodNet only covers about 15 percent of the country. It is a reporting tool not a census of the U.S. The CDC estimate of 76 million cases is based on old data which many feel like an over estimate. Does any of this negate the general conclusion that we are far behind the UK in foodborne illness control and have placed our children in the greatest danger? No. It does indicate that our data collection is insufficient. CDC and FDA have done what they can with their limited budgets and outdated Congressional mandates. It is not enough.
I am going to assume the Senate will approve the Act. While FDA's new enforcement capabilities are long overdue, I would hope that ultimately there will be better data to assess our food safety.
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