William F. Balistreri, MD

Disclosures

February 08, 2016

In This Article

How Safe Is Our Food?

Contaminated-food recalls in 2015 were on pace to exceed those from 2014, with bacteria discovered in everything from ice cream to spinach.[10,13] Companies in the United States recalled 3.7 million food items in the first half of 2015 because of viral or bacterial contaminants, such as Listeria and Salmonella, compared with 5.03 million in all of 2014. The 2015 tally includes several high-profile cases, including the recall of Listeria monocytogenes-tainted ice cream from Blue Bell Creameries Inc. that was linked to the deaths of three people.[13]

Other prominent recent outbreaks include the following:

E coli. As of late December 2015, an outbreak of E coli O26 (one of several types of Shiga toxin-producing) linked to Chipotle Mexican Grill had spread to nine states, affecting a total of 52 people who presumably acquired the infection between mid-October and early November 2015.[14] Chipotle temporarily closed over 40 restaurants in the Northwest because of the E coli outbreak. The CDC remained unclear as to which food item was the cause; however, the widespread nature of the outbreak seemingly implicated an ingredient that was distributed nationally.

Salmonella. The CDC investigated an outbreak of Salmonella Poona infection that began in early July 2015 and was linked to cucumbers imported from Mexico.[15] By late November 2015, 838 people from 38 states had reportedly been infected with the outbreak strain of Salmonella; 165 people were hospitalized and four deaths were reported. Of those affected, 75% were 17 years old or younger.

Hepatitis A. US federal, state, and local public health officials investigated an outbreak of foodborne, symptomatic hepatitis A virus infections.[16] Of 165 patients identified from 10 states, 42% were admitted to the hospital, two developed fulminant hepatitis, and one underwent a liver transplant; none died. Hepatitis A virus genotype IB, uncommon in America, was recovered from the specimens of 117 of the patients. Imported frozen pomegranate arils were identified as the vehicle early in the investigation by combining epidemiology (with data from several sources), genetic analysis of patient samples, and product tracing. The implicated product was imported from Turkey, where genotype IB is common. Product recalls took place, and postexposure prophylaxis with both hepatitis A virus vaccine and immunoglobulin was provided.

The FDA Outbreaks: Investigation, Response & Evaluation, the United States Department of Agriculture (USDA) Food Safety and Inspection Service (FSIS), and Food Safety News report similar foodborne illness. In fact, Food Safety News recently compiled a list of the 10 most harmful US outbreaks of 2015.[17] While single-source outbreaks such as these are common, the majority do not generate the same degree of widespread publicity.

Where's the (Safe) Beef?

Ground beef can easily harbor dangerous bacteria and is a food item frequently implicated in foodborne illness. Serious outbreaks—such as the Jack in the Box cases in 1993, when 700 people were sickened and four children died after eating tainted hamburgers—changed perception and awareness of E coli O157.[18] Unfortunately, outbreaks continue to this day. Tons of ground beef and steak destined for restaurants and other food-service operations are recalled because of possible contamination with toxigenic E coli O157:H7.[19,20,21]

A recent Consumer Reports investigation found that between 2003 and 2012, 1144 individuals developed diarrheal illnesses after ingesting beef contaminated with E coli O157; 316 were hospitalized and five people died.[19,20] To test the current safety of our beef, Consumer Reports staff members went to 103 grocery, big-box, and natural food stores in 26 cities across the country to buy and test 458 pounds of ground beef (the equivalent of 1832 quarter-pounders). They sought the five common types of bacteria found on beef—Clostridium perfringens, E coli (including O157 and six other toxin-producing strains), Enterococcus, Salmonella, and Staphylococcus aureus. They found that all 458 pounds of beef examined contained bacteria that signified fecal contamination. Although the beef did not contain Shiga-toxin-producing E coli, Salmonella was present in 1% of the samples, approximately 20% of the meat contained C perfringens, and approximately 10% of the samples had a strain of S aureus bacteria. One of their most significant findings was that beef from conventionally raised cows was more likely to harbor pathogenic bacteria, as well as bacteria resistant to antibiotics, than beef from sustainably raised cows that spent their lives in a pasture.

The report states that the USDA performance standards regarding the level of contaminants considered safe are too lax. The USDA allows beef to have Salmonella in up to 7.5% of samples. Consumer Reports investigators propose that this level should be considered as an "adulterant," which would restrict it further. They also made a plea for industry to more stringently restrict the use of antibiotics for cattle, which contributes to development of antibiotic-resistant bacteria. The report concludes that, "until then, consumers should play it safe by making certain hamburgers are cooked to 160 degrees."[19,20]

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