Meat Eaters, Vegans - No One is Safe (Health)

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(And,yes, I concede those who raise all of their own food are at less risk, but not 100%) January 30, 2001 A World of Food Choices, and a World of Infectious Organisms By JANE E. BRODY -------------------------------------------------------------------------------- Robin Nelson for The New York Times Dr. Robert V. Tauxe, expert on food-borne illness, a U.S. disease-control chief, says new pathogens have overtaken salmonella as a threat.

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-------------------------------------------------------------------------------- Americans enjoy the safest and most varied and abundant food supply in the world. But this variety and availability, along with changes in food production, eating habits, people's age and overall health, and the food-borne organisms themselves, have resulted in a number of serious and sometimes fatal episodes of food poisoning in recent years.

It is not possible to say that food poisoning cases over all are on the rise. In years past, as now, most cases never came to official attention. But while salmonella was once the primary culprit, a number of troublesome new organisms have been identified in the last two decades and, experts say, the potential for widespread disaster has definitely expanded. Outbreaks have already occurred 3,000 miles from a single contaminated source of fresh produce in California.

Accurate statistics on food poisoning are hard to come by because most of those afflicted do not seek medical treatment, and if they do, laboratory tests are rarely done or, if tests are done, the results are rarely reported to the public health authorities. Even when victims die, the cause is identified in only slightly more than one-third of food poisoning cases. All told, according to a recent study by the Centers for Disease Control and Prevention in Atlanta, fewer than 5 percent of food-borne illnesses are ever reported to the authorities.

Nonetheless, based on the study, the centers estimated that food-borne illness accounts for a staggering 76 million illnesses, 323,914 hospitalizations and 5,194 deaths each year in the United States. The very young, the very old, pregnant women and those with compromised immune systems caused by disease or its treatment are the hardest hit.

Slightly more than a third of all cases of acute gastrointestinal illness — diarrhea with or without vomiting — are caused by food-borne organisms, according to the centers' data. The rest of cases that are commonly listed as "intestinal flu" are spread directly from person to person, not through food, though many of the same organisms are involved.

The all-too-frequent failure to properly diagnose food poisoning cases and identify their causes can seriously delay the recognition of new food-related threats and allow dangerous organisms to spread widely through the food supply before being reined in by the agencies charged with safeguarding the health of the nation.

In the last 20 years, according to Dr. Robert V. Tauxe, chief of the food-borne and diarrheal illnesses branch of the centers, at least a dozen pathogens have been newly recognized as serious food-borne hazards, including the sometimes lethal E. coli O157:H7, which can contaminate meats and produce, and Listeria monocytogenes, an organism that can kill adults and cause miscarriages. It can contaminate raw milk, soft-ripened cheeses and ready-to-eat meats, and thrives even in the refrigerator.

"Salmonella, which used to be the No. 1 cause of food-borne illness, is now a relatively minor culprit," Dr. Tauxe said. "In the last two decades, an increasing number of pathogens have been identified as transmitted through foods, and we predict there will be more in the future. We can expect more surprises."

Some new agents cause more than the usual gastrointestinal distress of nausea, vomiting and diarrhea. They have also resulted in reactive arthritis, autoimmune disorders, brain disorders, meningitis and blood infections, a team of public health specialists reported in the August 1999 issue of Postgraduate Medicine.

Previously recognized food-borne pathogens are also posing new problems, the specialists noted. "For example, we know that the increasing consumption of chicken in this country has been accompanied by an increased incidence of Campylobacter jejuni infection," which, they wrote, "now exceeds salmonella as the most common bacterial food-borne pathogen."

Further complicating the picture is the emergence of antibiotic-resistant forms of campylobacter, a result of the widespread use of antibiotics on chicken farms. One survey of retail poultry products identified antibiotic-resistant campylobacter in 20 percent of them.

Experts cite a number of other factors that have contributed to the recent rise in the severity of food-borne illnesses, which they say present a far greater threat to the health of Americans than pesticide residues and environmental contaminants.

In what seems like a supreme injustice, recent increases in the consumption of health-promoting fresh fruits and vegetables have resulted in "greater exposure to diseases like hepatitis A, shigellosis and salmonellosis" from contaminated produce, according to a report last summer in Patient Care magazine.

Along with a wide array of ethnic and exotic processed foods from all over the world, Americans can now enjoy an incredible variety of fresh produce year-round, thanks to imports from other countries, some of which are not as careful as they might be about agricultural hygiene.

"There's been an increase in food-borne disease in recent years because of the globalization of the food supply," said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University School of Medicine in Nashville. "With so much of our food imported, you no longer have to go south of the border to get turista."

During the last decade, food poisoning outbreaks have been caused by imported foods that include raspberries from Guatemala; carrots from Peru; mangoes from South America; strawberries, scallions and cantaloupes from Mexico; coconut milk from Thailand; canned mushrooms from China; a snack food from Israel; and alfalfa sprouts from several countries.

The Food and Drug Administration has warned the last two administrations that systems for assuring the safety of imported foods are inadequate and outdated, and the agency, along with the United States Department of Agriculture, is expanding efforts to increase the safety of food processes abroad.

But some of the largest and most serious food poisoning outbreaks have resulted from food safety violations within American borders. For example, in the mid-1990's a nationwide outbreak of salmonellosis that afflicted an estimated 224,000 people stemmed from a single source: a batch of Schwan's ice cream that became tainted with Salmonella enteritidis when the pasteurized ice cream premix was transported in tanker trailers previously used to carry unpasteurized liquid eggs.

Another outbreak that sickened 61 people in Illinois, Connecticut and New York with the potential killer E. coli O157:H7, including 21 people who required hospitalization and a 3-year-old child who spent 11 weeks in intensive care, was traced to a small lettuce farm in California, thousands of miles from the victims. Intensive investigations eventually implicated packaged mixed baby lettuce that was most likely contaminated by feces from nearby cows and was not properly washed by the producer.

In 1996, shortcuts taken by a California producer of fresh-squeezed unpasteurized juices resulted in the death of a 16-month- old toddler in Colorado and the hospitalization of 13 other children sickened by the same virulent strain of E. coli. And, in the most infamous case, in 1993 contaminated hamburgers from Jack-in-the-Box restaurants in the Northwest resulted in the deaths of four children, who were among hundreds sickened by burgers containing E. coli O157:H7.

The disease-control centers estimate that E. coli O157:H7, which was unknown as a cause of food poisoning before 1980, now infects as many as 20,000 Americans a year and kills up to 500. In addition to packaged lettuce, ground beef and unpasteurized apple juice, the organism has been identified in alfalfa sprouts and deer jerky.

Thus far, Americans have been spared the European scourge of mad cow disease, a fatal neurological disorder transmitted by contaminated beef.

Changing eating habits have increased the scope of food-borne disease so that huge numbers of people can now become ill from a single slip in food hygiene.

"More and more people are eating outside their homes," Dr. Tauxe said. "Restaurants and the deli trade are becoming a prime source of food." In addition, many supermarkets now have salad bars and deli counters that provide precut and prepared foods that are not cooked or heated by the consumer, and mishandling of these foods could easily sicken hundreds of customers.

"Another very important factor," the report in Postgraduate Medicine noted, "is the growth of high-risk population groups, particularly the elderly." Older people, those with serious chronic illnesses and especially those with immune systems compromised by chemotherapy, steroidal drug treatments or H.I.V. infection are more likely to become seriously, even fatally, ill from a food-borne infection.

"During the next 25 years, the baby- boomer generation is expected to create an explosion of potentially immunocompromised persons," the report stated. "The infectious disease implications for these population shifts are obvious, with both the incidence and the severity of food-borne disease steadily rising."

On the domestic front, state and federal government agencies responsible for public health are working with limited resources to beef up surveillance of food-borne problems and improve safety techniques. One strategy called H.A.C.C.P., for hazard analysis critical control point, identifies links in the production chain where trouble can occur and introduces preventive measures. A second involves pasteurization of all juice and milk products. The Food and Drug Administration, for example, is considering a ban on cheeses made from raw milk.

A third, and perhaps the most effective measure for many foods, especially ground beef and poultry, is the use of ionizing radiation. Though approved by both the F.D.A. and Department of Agriculture, irradiation of foods has been slow in coming, largely because producers fear knee-jerk opposition from consumers. But countless studies have shown that irradiation does not cause harmful changes in food and does not make food radioactive. Rather, it kills food poisoning organisms, reduces spoilage and increases shelf life.

However, irradiation does have a possible downside. If irradiated food is subsequently mishandled and becomes contaminated with a disease-causing organism, the food would lack competing beneficial organisms that could inhibit its growth. Which brings the matter of food safety full circle: safety measures have to be in place and routinely observed at every point in the food chain, from farm to stomach.



-- Ken S. in WC TN (scharabo@aol.com), February 09, 2001

Answers

Ken thanks for this it was very interesting reading. So many good points on the subject of food handling and the problems that result.

I would like to add this comment. I recently read a report about Americans being to germ free. We use antibiotics constantly never letting our bodies fight infections on their own to build up tolerance. Antibacterial hand soap, dish soap, disinfectant for our food, rooms, clothes and bodies. When we do come in contact with the smallest germ, our systems can't handle it.

Our food storage and use is much more cautious then other countries. For instance we refrigerate eggs and many countries do not. Poultry is left to hang in the windows of markets for extended periods of time. A friend of mine took a trip over seas and the delacacy of the area was fermented duck eggs. Yep you crack open the egg and there is alittle baby duck that has been rotting in the sand until it reaches perfection. Asian countries even eat food that if not cooked properly will kill them.

I can't imagine living like that, but perhaps there is something to the theory. I was given such large doses of penicillin when i was young that it no longer works on me.

-- Shau Marie (shau@centurytel.net), February 09, 2001.


To see what some of your fellow forum participants eat, go to the category of Country Kitchen and look for the post on Unusual Cultural Foods.

-- Ken S. in WC TN (scharabo@aol.com), February 09, 2001.

Is it a coincidence that we started experimenting in the early seventies with genetic engineering, using coliform bacteria as our guinea pigs?

We were "told" that all the experiments would be done in "secure" labs. Couple of years ago, my niece was doing these experiments in her middle school classroom

JOJ

-- jumpoffjoe (jumpoff@echweeb.net), February 09, 2001.


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