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Vital Signs: Listeria Illnesses, Deaths, and Outbreaks — United States, 2009–2011
Vital Signs: Listeria Illnesses, Deaths, and Outbreaks — United States, 2009–2011
Source: Morbidity and Mortality Weekly Report (CDC)
Background: Older adults, pregnant women, and persons with immunocompromising conditions are at higher risk than others for invasive Listeria monocytogenes infection (listeriosis), a rare and preventable foodborne illness that can cause bacteremia, meningitis, fetal loss, and death.
Methods: This report summarizes data on 2009–2011 listeriosis cases and outbreaks reported to U.S. surveillance systems. The Listeria Initiative and PulseNet conduct nationwide surveillance to rapidly detect and respond to outbreaks, the Foodborne Diseases Active Surveillance Network (FoodNet) conducts active, sentinel population–based surveillance to track incidence trends, and the Foodborne Disease Outbreak Surveillance System (FDOSS) receives reports of investigated outbreaks to track foods and settings associated with outbreaks.
Results: Nationwide, 1,651 cases of listeriosis occurring during 2009–2011 were reported. The case-fatality rate was 21%. Most cases occurred among adults aged ≥65 years (950 [58%]), and 14% (227) were pregnancy-associated. At least 74% of nonpregnant patients aged <65 years had an immunocompromising condition, most commonly immunosuppressive therapy or malignancy. The average annual incidence was 0.29 cases per 100,000 population. Compared with the overall population, incidence was markedly higher among adults aged ≥65 years (1.3; relative rate [RR]: 4.4) and pregnant women (3.0; RR: 10.1). Twelve reported outbreaks affected 224 patients in 38 states. Five outbreak investigations implicated soft cheeses made from pasteurized milk that were likely contaminated during cheese-making (four implicated Mexican-style cheese, and one implicated two other types of cheese). Two outbreaks were linked to raw produce.
Conclusions: Almost all listeriosis occurs in persons in higher-risk groups. Soft cheeses were prominent vehicles, but other foods also caused recent outbreaks. Prevention targeting higher-risk groups and control of Listeria monocytogenes contamination in foods implicated by outbreak investigations will have the greatest impact on reducing the burden of listeriosis.
Implications for Public Health Practice: Careful attention to food safety is especially important to protect vulnerable populations. Surveillance for foodborne infections like listeriosis identifies food safety gaps that can be addressed by industry, regulatory authorities, food preparers, and consumers.
FDA releases new tool to help prevent intentional food contamination
FDA releases new tool to help prevent intentional food contamination
Source: U.S. Food and Drug Administration
The U.S. Food and Drug Administration has released a new tool to help bolster the food industry’s defense measures against an act of intentional food contamination. The Food Defense Plan Builder is a comprehensive, easy-to-use software program designed to help owners and operators of food facilities—ranging from primary production and manufacturing to retail and transportation—develop customized plans to minimize the risk of intentional contamination at their individual food facilities.
The FDA does not require food facilities to implement food defense plans, but many facilities have voluntarily put such plans into place to safeguard their products.
…
Cases of intentional contamination are infrequent but can entail serious adverse public health consequences. For example, in 2009, more than 40 people in Kansas became ill after disgruntled restaurant employees intentionally contaminated salsa with a pesticide. In 1996, 12 lab workers at a Texas medical facility became ill after eating pastries that were intentionally contaminated with a virulent strain of Shigellabacteria.The Food Defense Plan Builder is FDA’s latest effort to help owners and operators of food facilities take appropriate action to defend the food supply. In the years following the September 11, 2001 attacks, the FDA released a number of food defense tools and resources to aid the U.S. food industry, federal partners, state and local regulators, and the international community in protecting the food supply against biological, chemical and radiological attack.
The Food Defense Plan Builder guides users through a series of substantive questions about the user’s food facility and the food manufactured, processed, packed or held there to develop a comprehensive food defense plan for the facility, which includes a vulnerability assessment, broad and focused mitigation strategies, and an action plan.
Incidence and Trends of Infection with Pathogens Transmitted Commonly Through Food — Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 1996–2012
Source: Morbidity and Mortality Weekly Report (CDC)
Foodborne diseases are an important public health problem in the United States. The Foodborne Diseases Active Surveillance Network* (FoodNet) conducts surveillance in 10 U.S. sites for all laboratory-confirmed infections caused by selected pathogens transmitted commonly through food to quantify them and monitor their incidence. This report summarizes 2012 preliminary surveillance data and describes trends since 1996. A total of 19,531 infections, 4,563 hospitalizations, and 68 deaths associated with foodborne diseases were reported in 2012. For most infections, incidence was highest among children aged <5 years; the percentage of persons hospitalized and the percentage who died were highest among persons aged ≥65 years. In 2012, compared with the 2006–2008 period, the overall incidence of infection† was unchanged, and the estimated incidence of infections caused by Campylobacter and Vibrio increased. These findings highlight the need for targeted action to address food safety gaps.
FoodNet conducts active, population-based surveillance for laboratory-confirmed infections caused by Campylobacter, Cryptosporidium, Cyclospora, Listeria, Salmonella, Shiga toxin–producing Escherichia coli (STEC) O157 and non-O157, Shigella, Vibrio, and Yersinia in 10 sites covering 15% of the U.S. population (48 million persons in 2011).§ FoodNet is a collaboration among CDC, 10 state health departments, the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS), and the Food and Drug Administration (FDA). Hospitalizations occurring within 7 days of specimen collection date are recorded, as is the patient’s vital status at hospital discharge, or at 7 days after the specimen collection date if the patient was not hospitalized. All hospitalizations and deaths that occurred within a 7-day window are attributed to the infection. Surveillance for physician-diagnosed postdiarrheal hemolytic uremic syndrome (HUS), a complication of STEC infection characterized by renal failure, is conducted through a network of nephrologists and infection preventionists and by hospital discharge data review. This report includes 2011 HUS data for persons aged <18 years.
Incidence was calculated by dividing the number of laboratory-confirmed infections in 2012 by U.S. Census estimates of the surveillance population area for 2011.¶ A negative binomial model with 95% confidence intervals (CIs) was used to estimate changes in incidence from 2006–2008 to 2012 and from 1996–1998 to 2012 (1). The overall incidence of infection with six key pathogens for which >50% of illnesses are estimated to be foodborne (Campylobacter, Listeria, Salmonella, STEC O157, Vibrio, and Yersinia) was calculated (2). Trends were not assessed for Cyclospora because data were sparse, or for STEC non-O157 because of changes in diagnostic practices. For HUS, changes in incidence from 2006–2008 to 2011 were estimated.
Bacterial Communities Associated with the Surfaces of Fresh Fruits and Vegetables
Bacterial Communities Associated with the Surfaces of Fresh Fruits and Vegetables
Source: PLoS ONE
Fresh fruits and vegetables can harbor large and diverse populations of bacteria. However, most of the work on produce-associated bacteria has focused on a relatively small number of pathogenic bacteria and, as a result, we know far less about the overall diversity and composition of those bacterial communities found on produce and how the structure of these communities varies across produce types. Moreover, we lack a comprehensive view of the potential effects of differing farming practices on the bacterial communities to which consumers are exposed. We addressed these knowledge gaps by assessing bacterial community structure on conventional and organic analogs of eleven store-bought produce types using a culture-independent approach, 16 S rRNA gene pyrosequencing. Our results demonstrated that the fruits and vegetables harbored diverse bacterial communities, and the communities on each produce type were significantly distinct from one another. However, certain produce types (i.e., sprouts, spinach, lettuce, tomatoes, peppers, and strawberries) tended to share more similar communities as they all had high relative abundances of taxa belonging to the family Enterobacteriaceae when compared to the other produce types (i.e., apples, peaches, grapes, and mushrooms) which were dominated by taxa belonging to the Actinobacteria, Bacteroidetes, Firmicutes, and Proteobacteria phyla. Although potentially driven by factors other than farming practice, we also observed significant differences in community composition between conventional and organic analogs within produce types. These differences were often attributable to distinctions in the relative abundances of Enterobacteriaceae taxa, which were generally less abundant in organically-grown produce. Taken together, our results suggest that humans are exposed to substantially different bacteria depending on the types of fresh produce they consume with differences between conventionally and organically farmed varieties contributing to this variation.
When Good Food Goes Bad: Strengthening the US Response to Foodborne Disease Outbreaks
When Good Food Goes Bad: Strengthening the US Response to Foodborne Disease Outbreaks
Source: University of Pittsburgh Center for Biosecurity
Foodborne illness sickens or kills an extraordinary number of people each year. It also has great economic costs. Last year, an outbreak linked to contaminated cantaloupe in the United States sickened 146 and killed 30. In 2011, another outbreak in Germany that was eventually linked to contaminated sprouts, sickened more than 4,000 and caused at least 50 deaths. Foodborne disease outbreak response is a critical part of reducing the consequences of outbreaks that will occur in the future. If public health officials can more quickly recognize when a foodborne illness outbreak has occurred and identify the food causing the outbreak, lives can be saved and economic losses averted. The lessons learned from outbreak investigations can be used by industry and government to address the underlying causes of contamination that lead to illness, thus making food safer for everyone.
The Center for Biosecurity of UPMC produced this report to catalyze improvements in the country’s ability to respond to large foodborne disease outbreaks. We analyzed the existing data and studies on foodborne illness outbreak response, identified emerging trends, and interviewed dozens of federal and state level officials and experts from industry, professional organizations, academia, and relevant international organizations. The report puts forth a series of recommendations to accelerate and strengthen responses to foodborne illness outbreaks in the US.
Attribution of Foodborne Illnesses, Hospitalizations, and Deaths to Food Commodities by using Outbreak Data, Uni ted States, 1998–2008
Source: Emerging Infectious Diseases (CDC)
Each year, >9 million foodborne illnesses are estimated to be caused by major pathogens acquired in the United States. Preventing these illnesses is challenging because resources are limited and linking individual illnesses to a particular food is rarely possible except during an outbreak. We developed a method of attributing illnesses to food commodities that uses data from outbreaks associated with both simple and complex foods. Using data from outbreak-associated illnesses for 1998–2008, we estimated annual US foodborne illnesses, hospitalizations, and deaths attributable to each of 17 food commodities. We attributed 46% of illnesses to produce and found that more deaths were attributed to poultry than to any other commodity. To the extent that these estimates reflect the commodities causing all foodborne illness, they indicate that efforts are particularly needed to prevent contamination of produce and poultry. Methods to incorporate data from other sources are needed to improve attribution estimates for some commodities and agents.
Surveillance for Foodborne Disease Outbreaks — United States, 2009–2010
Surveillance for Foodborne Disease Outbreaks — United States, 2009–2010
Source: Morbidity and Mortality Weekly Report (CDC)
Known pathogens cause an estimated 9.4 million foodborne illnesses annually in the United States (1). CDC collects data on foodborne disease outbreaks submitted by all states, the District of Columbia, and Puerto Rico through CDC’s Foodborne Disease Outbreak Surveillance System. Data reported for each outbreak include the number of illnesses, hospitalizations, and deaths; the etiologic agent; the implicated food vehicle; and other factors involved in food preparation and consumption. During 2009–2010, a total of 1,527 foodborne disease outbreaks (675 in 2009 and 852 in 2010) were reported, resulting in 29,444 cases of illness, 1,184 hospitalizations, and 23 deaths. Among the 790 outbreaks with a single laboratory-confirmed etiologic agent, norovirus was the most commonly reported, accounting for 42% of outbreaks. Salmonella was second, accounting for 30% of outbreaks. Among the 299 outbreaks attributed to a food composed of ingredients from one of 17 predefined, mutually exclusive food commodities (2), those most often implicated were beef (13%), dairy (12%), fish (12%), and poultry (11%). The commodities in the 299 outbreaks associated with the most illnesses were eggs (27% of illnesses), beef (11%), and poultry (10%). Public health, regulatory, and food industry professionals can use this information when creating targeted control strategies along the farm-to-table continuum for specific agents, specific foods, and specific pairs of agents and foods. This information also supports efforts to promote safe food-handling practices among food workers and the public.
CDC defines a foodborne disease outbreak as the occurrence of two or more similar illnesses resulting from ingestion of a common food. State, local, tribal, and territorial health department officials voluntarily submit reports of outbreaks investigated by their agency to the Foodborne Disease Outbreak Surveillance System on a standard, Internet-based form.* This report analyzes outbreaks that were reported by August 2, 2012, in which the first illness occurred during 2009–2010. Data reported for each outbreak include the number of illnesses, hospitalizations, and deaths; the etiologic agent (confirmed or suspected†); the implicated food vehicle; factors contributing to food contamination; and the settings of food preparation and consumption. Foods were assigned to one of 17 commodities§ if a single contaminated ingredient was identified or if all ingredients belonged to that commodity (2). Outbreaks identifying foods that could not be assigned to one of the 17 commodities, or for which the report contained insufficient information for commodity assignment, were not attributed to any commodity. Population-based outbreak reporting rates were calculated for each state using U.S. Census estimates of the 2009 and 2010 state populations.¶
CRS — The Federal Food Safety System: A Primer
The Federal Food Safety System: A Primer (PDF)
Source: Congressional Research Service (via U.S. State Department Foreign Press Center)
Numerous federal, state, and local agencies share responsibilities for regulating the safety of the U.S. food supply. Federal responsibility for food safety rests primarily with the Food and Drug Administration (FDA) and the U.S. Department of Agriculture (USDA). FDA, an agency of the Department of Health and Human Services, is responsible for ensuring the safety of all domestic and imported food products (except for most meats and poultry). FDA also has oversight of all seafood, fish, and shellfish products. USDA’s Food Safety and Inspection Service (FSIS) regulates most meat and poultry and some egg products. State and local food safety authorities collaborate with federal agencies for inspection and other food safety functions, and they regulate retail food establishments.
The combined efforts of the food industry and government regulatory agencies often are credited with making the U.S. food supply among the safest in the world. However, critics view this system as lacking the organization, regulatory tools, and resources to adequately combat foodborne illness—as evidenced by a series of widely publicized food safety problems, including concerns about adulterated food and food ingredient imports, and illnesses linked to various types of fresh produce, to peanut products, and to some meat and poultry products. Some critics also note that the organizational complexity of the U.S. food safety system as well as trends in U.S. food markets—for example, increasing imports as a share of U.S. food consumptions and increasing consumption of fresh, often unprocessed, foods—pose ongoing challenges to ensuring food safety.
The 111 th Congress passed comprehensive food safety legislation with the FDA Food Safety Modernization Act (FSMA, P.L. 111-353). FSMA is the largest expansion of FDA’s food safety authorities since the 1930s. Although numerous agencies share responsibility for regulating food safety, FSMA focused on foods regulated by FDA and amended FDA’s existing structure and authorities, and did not directly address meat and poultry products under USDA’s jurisdiction. Beyond these changes, some in Congress continue to push for additional policy reforms to address other perceived concerns about the safety of the U.S. food supply.
After FSMA was signed into law in January 2011, concerns were voiced about whether there would be enough money to overhaul the U.S. food safety system and also whether expanded investment in this area is appropriate in the current budgetary climate. Although Congress authorized appropriations and new user fees for FDA when it enacted FSMA, it did not provide the full funding needed for FDA to perform these activities. FDA’s FY2012 budget for its foods program was $866 million, and FSIS’s FY2012 budget was $1.004 billion in appropriated funds, with some additional funding available from authorized user fees. Funding levels specific to food safety responsibilities at other federal and state agencies is not readily available.
Outbreaks of Acute Gastroenteritis Transmitted by Person-to-Person Contact — United States, 2009–2010
Source: Morbidity and Mortality Weekly Report (CDC)
Problem/Condition:
Approximately 179 million cases of acute gastroenteritis (AGE) occur in the United States each year, and outbreaks of AGE are a substantial public health problem. Although CDC has conducted national surveillance for waterborne and foodborne AGE outbreaks since 1971 and 1973, respectively, no national surveillance existed for AGE outbreaks resulting primarily from person-to-person transmission before implementation of the National Outbreak Reporting System (NORS) in 2009.Reporting Period:
2009–2010.Description of System:
NORS is a national surveillance system launched in 2009 to support the reporting of all waterborne outbreaks and enteric disease outbreaks from foodborne, person-to-person, animal contact, environmental, and unknown modes of transmission. State and local public health agencies in the 50 U.S. states, the District of Columbia, five U.S. territories, and three Freely Associated States report these outbreaks to CDC via NORS using a standardized online data entry system. Data are collected on general outbreak characteristics (e.g., dates, number of illnesses, and locations), demographic characteristics of cases (e.g., age and sex), symptoms, case outcomes, and laboratory testing information and results. Only outbreaks reported in NORS with a primary mode of transmission of person-to-person contact are included in this report.Results:
During 2009–2010, a total of 2,259 person-to-person AGE outbreaks were reported in NORS from 42 states and the District of Columbia. These outbreaks resulted in 81,491 reported illnesses, 1,339 hospitalizations, and 136 deaths. No etiology was reported in approximately 40% (n = 840) of outbreaks. Of the remaining 1,419 outbreaks with a reported etiology, 1,270 (89%) were either suspected or confirmed to be caused solely by norovirus. Other reported etiologies included Shigella (n = 86), Salmonella (n = 16), Shiga toxin-producing Escherichia coli (STEC) (n = 11), and rotavirus (n = 10). Most (82%) of the 1,723 outbreaks caused by norovirus or an unknown etiology occurred during the winter months, and outbreaks caused by Shigella or another suspected or confirmed etiology most often occurred during the spring or summer months (62%, N = 53 and 60%, N = 38, respectively). A setting was reported for 1,187 (53%) of total outbreaks. Among these reported settings, nursing homes and other long-term–care facilities were most common (80%), followed by childcare centers (6%), hospitals (5%), and schools (5%).Interpretation:
NORS provides the first national data on AGE outbreaks spread primarily through person-to-person transmission and describes the frequency of this mode of transmission. Norovirus is the most commonly reported cause of these outbreaks and, on the basis of epidemiologic characteristics, likely accounts for a substantial portion of the reported outbreaks of unknown etiology. In the United States, sporadic and outbreak-associated norovirus causes an estimated 800 deaths and 70,000 hospitalizations annually, which could increase by an additional 50% during epidemic years. During 2009–2010, norovirus outbreaks accounted for the majority of deaths and health-care visits in person-to-person AGE outbreaks reported to NORS.Public Health Action:
Prevention and control of person-to-person AGE outbreaks depend primarily on appropriate hand hygiene and isolation of ill persons. NORS surveillance data can help identify the etiologic agents, settings, and populations most often involved in AGE outbreaks resulting primarily from person-to-person transmission and guide development of targeted interventions to avert these outbreaks or mitigate the spread of infection. Surveillance for person-to-person AGE outbreaks via NORS also might be important in clarifying the epidemiology and role of certain pathogens (e.g., STEC) that have been traditionally considered foodborne but can also be transmitted person-to-person. As ongoing improvements and enhancements to NORS are introduced, participation in NORS has the potential to increase, allowing for improved estimation of epidemic person-to-person AGE and its relative importance among other modes of transmission.
New From the GAO
New GAO Reports
Source: Government Accountability Office
1. Medicare: Higher Use of Advanced Imaging Services by Providers Who Self-Refer Costing Medicare Millions. GAO-12-966, September 28.
http://www.gao.gov/products/GAO-12-966
Highlights – http://www.gao.gov/assets/650/648989.pdf
2. Food Safety: FDA Can Better Oversee Food Imports by Assessing and Leveraging Other Countries’ Oversight Resources. GAO-12-933, September 28.
http://www.gao.gov/products/GAO-12-933
Highlights – http://www.gao.gov/assets/650/649011.pdf
3. Department of Homeland Security: Taking Further Action to Better Determine Causes of Morale Problems Would Assist in Targeting Action Plans. GAO-12-940, September 28.
http://www.gao.gov/products/GAO-12-940
Highlights – http://www.gao.gov/assets/650/648996.pdf
Botulism From Drinking Prison-Made Illicit Alcohol — Utah 2011
Botulism From Drinking Prison-Made Illicit Alcohol — Utah 2011
Source: Morbidity and Mortality Weekly Report (CDC)
Foodborne botulism is a rare, potentially fatal paralytic illness caused by eating food contaminated by Clostridium botulinum toxin. It occurs most often as a single case not linked to others by a common food source. As a result of improvements in food canning, when outbreaks do occur, they typically involve fewer than five persons. During October 2–4 2011, eight maximum security inmates at the Utah State Prison in Salt Lake County were diagnosed with foodborne botulism. An investigation by Salt Lake Valley Heath Department, Utah Department of Health, and CDC identified pruno, an illicit alcoholic brew, as the vehicle. The principal ingredients in pruno are fruit, sugar, and water. Many additional ingredients, including root vegetables, are sometimes added, depending on the availability of foods in prison. A baked potato saved from a meal served weeks earlier and added to the pruno was the suspected source of C. botulinum spores. Many of the affected inmates suffered severe morbidity, and some required prolonged hospitalizations. Knowing the link between pruno and botulism might help public health and correctional authorities prevent future outbreaks, respond quickly with appropriate health-care to inmates with acute descending paralysis and/or other symptoms, and reduce associated treatment costs to states.
Food: Latest Report shows EU Controls ensure our food is safe
Food: Latest Report shows EU Controls ensure our food is safe
A European Commission report published today shows that thanks to the EU’s Rapid Alert System for Food and Feed (RASFF) many food safety risks have been averted or mitigated and safety controls ensure our food is safe. RASFF plays a key role in ensuring safety from “farm to fork”, by triggering a rapid reaction when a food safety risk is detected. All members of the RASFF system1 are swiftly informed of serious risks found in food or feed so that together they can react to food safety threats in a coordinated way to protect the health of EU citizens.John Dalli, Commissioner in charge of Health and Consumer Policy, said: “European consumers enjoy the highest food safety standards in the world. The EU’s Rapid Alert System for Food and Feed is a key tool as it allows risks to be identified and removed from the European market. RASFF reinforces the confidence of our consumers in our food and feed safety system. In 2011, we dealt with a number of important crises such as the effects of the Fukushima nuclear incident, the dioxin and the E. coli crisis. The EU managed to tackle them and the lessons we all learnt will no doubt guide us to do even better in the future.”
See: FAQ: Rapid Alert System for Food and Feed (RASFF) – role and achievements
Food safety guides for groups most vulnerable to foodborne illness now available
Food safety guides for groups most vulnerable to foodborne illness now available
Source: U.S. Food and Drug Administration
The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) and the Department of Health and Human Services’ Food and Drug Administration (FDA) have partnered to create six booklets with food safety advice for populations that are most susceptible to foodborne illness. The booklets in this “at-risk series” are tailored to help older adults, transplant recipients, pregnant women, and people with cancer, diabetes or HIV/AIDS reduce their risk for foodborne illness.
“These booklets are a much needed resource for consumers who are at increased risk of getting sick from food,” said USDA Under Secretary for Food Safety Dr. Elisabeth Hagen. “The clear, understandable information in these booklets will help at-risk individuals feel confident about the safety of foods they prepare and eat. The booklets are also helpful to physicians and other health care providers for educating their at-risk patients about foodborne illnesses.”
Each of the booklets contains 24 pages of practical guidance on how to prevent foodborne illness. The information is presented in easy-to-read charts, illustrated how-tos, and straightforward descriptions of why each group is at higher risk for foodborne illness and symptoms that may mean trouble. The booklets contain three tear-out cards with quick-reference tips for grocery shopping, cooking to the right temperature, and eating at restaurants for times when taking along the entire booklet would be impractical.
“Everyone from farmers to food manufacturers to food preparers in the home has a role in food safety,” said FDA Deputy Commissioner for Foods Michael Taylor. “It is important that consumers, particularly those who are at higher risk of foodborne illness, have information they can use to do their part in preventing illness by properly selecting and preparing foods.”
While booklets on five of these topics were previously produced in 2006, the two agencies this year created a sixth booklet for pregnant women, who are at particular risk for the illness listeriosis. The six new booklets list food safety resources, such as http://www.foodsafety.gov, that have been made available since the earlier copies were printed. They also include revised safe cooking temperatures for meat and poultry: 145 °F for whole cuts of meat, followed by a three-minute rest time; 160 °F for ground meats; and 165 °F for all poultry and leftovers.
New From the GAO
New GAO Reports and Testimonies
Source: Government Accountability Office
+ Reports
1. Thrift Savings Plan: Adding a Socially Responsible Index Fund Presents Challenges. GAO-12-664, June 26.
http://www.gao.gov/products/GAO-12-664
Highlights – http://www.gao.gov/assets/600/591880.pdf
2. Chief Acquisition Officers: Appointments Generally Conform to Legislative Requirements, but Agencies Need to Clearly Define Roles and Responsibilities. GAO-12-792, July 26.
http://www.gao.gov/products/GAO-12-792
Highlights – http://www.gao.gov/assets/600/593076.pdf
3. IMF: Planning for Use of Gold Sales Profits Under Way, but No Decision Made for Using a Portion of the Profits. GAO-12-766R, July 26.
http://www.gao.gov/products/GAO-12-766R
4. Evolved Expendable Launch Vehicle: DOD Is Addressing Knowledge Gaps in Its New Acquisition Strategy. GAO-12-822, July 26.
http://www.gao.gov/products/GAO-12-822
Highlights – http://www.gao.gov/assets/600/593049.pdf
5. Veterans Paralympics Program: Improved Reporting Needed to Ensure Grant Accountability. GAO-12-703, July 26.
http://www.gao.gov/products/GAO-12-703
Highlights – http://www.gao.gov/assets/600/593041.pdf
6. Electronic Health Records: Number and Characteristics of Providers Awarded Medicare Incentive Payments for 2011. GAO-12-778R, July 26.
http://www.gao.gov/products/GAO-12-778R
7. Food Safety: FDA’s Food Advisory and Recall Process Needs Strengthening. GAO-12-589, July 26.
http://www.gao.gov/products/GAO-12-589
Highlights – http://www.gao.gov/assets/600/593032.pdf
8. Refugee Resettlement: Greater Consultation with Community Stakeholders Could Strengthen Program. GAO-12-729, July 25.
http://www.gao.gov/products/GAO-12-729
Highlights – http://www.gao.gov/assets/600/592977.pdf
9. Management Report: Improvements Are Needed to Strengthen the American Battle Monuments Commission’s Internal Controls and Accounting Procedures. GAO-12-830R, July 26.
http://www.gao.gov/products/GAO-12-830R
+ Testimonies
1. Critical Infrastructure Protection: DHS Is Taking Action to Better Manage Its Chemical Security Program, but It Is Too Early to Assess Results, by Stephen L. Caldwell, director, homeland security and justice, before the Subcommittee on Homeland Security, House Committee on Appropriations. GAO-12-515T, July 26.
http://www.gao.gov/products/GAO-12-515T
Highlights – http://www.gao.gov/assets/600/593021.pdf
2. Combating Nuclear Smuggling: DHS has Developed Plans for Its Global Nuclear Detection Architecture, but Challenges Remain in Deploying Equipment, by David C. Maurer, director, homeland security and justice, and Gene Aloise, director, natural resources and environment, before the Subcommittee on Cybersecurity, Infrastructure Protection, and Security Technologies, House Committee on Homeland Security. GAO-12-941T, July 26.
http://www.gao.gov/products/GAO-12-941T
3. DOD Civilian Workforce: Observations on DOD’s Efforts to Plan for Civilian Workforce Requirements, by Brenda S. Farrell, director, defense capabilities and management, before the Subcommittee on Readiness, House Committee on Armed Services. GAO-12-962T, July 26.
http://www.gao.gov/products/GAO-12-962T
Highlights – http://www.gao.gov/assets/600/593010.pdf
Bad Bug Book 2nd Edition — Foodborne Pathogenic Microorganisms and Natural Toxins Handbook
Bad Bug Book 2nd Edition — Foodborne Pathogenic Microorganisms and Natural Toxins Handbook
Source: U.S. Food and Drug Administration
The second edition of the Bad Bug Book, published by the Center for Food Safety and Applied Nutrition, of the Food and Drug Administration (FDA), U.S. Department of Health and Human Services, provides current information about the major known agents that cause foodborne illness. The information provided in this handbook is abbreviated and general in nature, and is intended for practical use. It is not intended to be a comprehensive scientific or clinical reference. Each chapter in this book is about a pathogen – a bacterium, virus, or parasite – or a natural toxin that can contaminate food and cause illness. The book contains scientific and technical information about the major pathogens that cause these kinds of illnesses. A separate “consumer box” in each chapter provides non-technical information, in everyday language. The boxes describe plainly what can make you sick and, more important, how to prevent it.
+ Full Document (PDF)
Hat tip: PW
Assessing the potential impacts of climate change on food- and waterborne diseases in Europe
Assessing the potential impacts of climate change on food- and waterborne diseases in Europe
Source: European Centre for Disease Prevention and Control
After a structured and systematic review of published literature on food- and waterborne pathogens and how they are influenced by meteorological and climate variables, a team of scientists from the University of Bonn developed a computerised interface to access the findings of this literature review. The resulting knowledge base allows users to quickly explore relationships between environmental variables and food- and waterborne pathogens.
+ Full Report (PDF)
Chicken as Reservoir for Extraintestinal Pathogenic Escherichia coli in Humans, Canada
We previously described how retail meat, particularly chicken, might be a reservoir for extraintestinal pathogenic Escherichia coli (ExPEC) causing urinary tract infections (UTIs) in humans. To rule out retail beef and pork as potential reservoirs, we tested 320 additional E. coli isolates from these meats. Isolates from beef and pork were significantly less likely than those from chicken to be genetically related to isolates from humans with UTIs. We then tested whether the reservoir for ExPEC in humans could be food animals themselves by comparing geographically and temporally matched E. coli isolates from 475 humans with UTIs and from cecal contents of 349 slaughtered animals. We found genetic similarities between E. coli from animals in abattoirs, principally chickens, and ExPEC causing UTIs in humans. ExPEC transmission from food animals could be responsible for human infections, and chickens are the most probable reservoir.
Antibiotic-resistant Bacteria Sickened 167, Hospitalized 47 in 2011
Antibiotic-resistant Bacteria Sickened 167, Hospitalized 47 in 2011
Source: Center for Science in the Public Interest
Rampant use of antibiotics in animal agriculture means foodborne illnesses are likely to become longer, more serious, and harder to treat, according to the nonprofit Center for Science in the Public Interest.
In three major outbreaks of antibiotic-resistant foodborne illness in 2011, 167 Americans became sick, 47 were hospitalized, and one died, according to a white paper released by the group today. Two of those outbreaks were connected to ground turkey, one contaminated with Salmonella Hadar and one with Salmonella Heidelberg, and one outbreak was connected to ground beef contaminated with Salmonella Typhimurium. All of those bacteria were resistant to treatment from several antibiotics that are critically important to human medicine, including drugs in the penicillin, cephalosporin, and tetracycline families.
+ White Paper (PDF)
New From the GAO
New GAO Reports
Source: Government Accountability Office
+ Reports
1. Food Safety: Preslaughter Interventions Could Reduce E. coli in Cattle. GAO-12-257, March 9.
http://www.gao.gov/products/GAO-12-257
Highlights - http://www.gao.gov/assets/590/589162.pdf
2. Interagency Collaboration: State and Army Personnel Rotation Programs Can Build on Positive Results with Additional Preparation and Evaluation. GAO-12-386, March 9.
http://www.gao.gov/products/GAO-12-386
Highlights - http://www.gao.gov/assets/590/589171.pdf
3. Interagency Collaboration: Survey Results of State and Army Personnel Rotation Program Participants and Their Host-Agency Supervisors, an E-supplement to GAO-12-386. GAO-12-387SP, March 9.
http://www.gao.gov/special.pubs/gao-12-110sp/index.htm
+ Reissued
1. Nursing Home Quality: CMS Should Improve Efforts to Monitor Implementation of the Quality Indicator Survey. GAO-12-214, February 1.
http://www.gao.gov/products/GAO-12-214
Highlights - http://www.gao.gov/assets/590/588160.pdf
MRSA in Conventional and Alternative Retail Pork Products
MRSA in Conventional and Alternative Retail Pork Products
Source: PLoS ONE
In order to examine the prevalence of Staphylococcus aureus on retail pork, three hundred ninety-five pork samples were collected from a total of 36 stores in Iowa, Minnesota, and New Jersey. S. aureus was isolated from 256 samples (64.8%, 95% confidence interval [CI] 59.9%–69.5%). S. aureus was isolated from 67.3% (202/300) of conventional pork samples and from 56.8% (54/95) of alternative pork samples (labeled “raised without antibiotics” or “raised without antibiotic growth promotants”). Two hundred and thirty samples (58.2%, 95% CI 53.2%–63.1%) were found to carry methicillin-sensitive S. aureus (MSSA). MSSA was isolated from 61.0% (183/300) of conventional samples and from 49.5% (47/95) of alternative samples. Twenty-six pork samples (6.6%, 95% CI 4.3%–9.5%) carried methicillin-resistant S. aureus (MRSA). No statistically significant differences were observed for the prevalence of S. aureus in general, or MSSA or MRSA specifically, when comparing pork products from conventionally raised swine and swine raised without antibiotics, a finding that contrasts with a prior study from the Netherlands examining both conventional and “biologic” meat products. In our study spa types associated with “livestock-associated” ST398 (t034, t011) were found in 26.9% of the MRSA isolates, while 46.2% were spa types t002 and t008—common human types of MRSA that also have been found in live swine. The study represents the largest sampling of raw meat products for MRSA contamination to date in the U.S. MRSA prevalence on pork products was higher than in previous U.S.-conducted studies, although similar to that in Canadian studies.
See: High Levels of MRSA Bacteria in U.S. Retail Meat Products, Study Suggests (Science Daily)
