E coli and Food Safety: It's a Jungle Out There

William F. Balistreri, MD


April 23, 2018

In This Article

Detection and Prevention

New detection modalities and improved understanding of the epidemiologic features of foodborne STEC infections can inform food safety and other prevention efforts.[27]

Polymerase chain reaction (PCR) and genome sequencing approaches facilitate surveillance and enhance the response to outbreaks of non-O157 STEC.[14]

Culture-independent diagnostic tests (CIDTs), which are increasingly used by clinical laboratories to detect enteric infections, provide timely information for clinical management of foodborne infections.[28] However, the increasing use of highly sensitive CIDTs creates logistical issues regarding interpretation of public health surveillance and monitoring data.[13,27,28] Ideally, CIDT-positive specimens should be reflex-cultured to obtain isolates for determining pathogen subtypes and antimicrobial resistance, to monitor trends, and to detect outbreaks.[13,27,28]

For the detection of both O157 and non-O157 STEC infections, clinical laboratories should test all stool specimens submitted for diagnosis of acute community-acquired diarrhea for O157 STEC and for Shiga toxin; isolates should be sent to a public health laboratory for serotyping and subtyping.[27]

The concept of prevention is not new, but there is an intensified federal focus on strategies to improve food safety and to reduce foodborne disease.

Regulations from the FDA and the USDA—the Food Safety Modernization Act (FSMA) are designed to reduce contamination of produce.[29,30] The FSMA granted the FDA power to improve the safe production and harvesting of produce by creating standards for environmental factors, including staff hygiene, microbial levels in agricultural water, uses of animal waste in growing foods, and equipment sanitation.[29,30] Produce regulations establish standards for growing, harvesting, packing, and storing produce on farms in the United States, including requirements for water quality, employee health and hygiene, and manure and compost use. In addition, under the FSMA, the FDA has the authority to recall a hazardous food product.

The Bottom Line

As in the days of The Jungle, a universal goal must be to provide safe, nutritious food. We are all accountable; individuals, families, schools, industry, and the government can do more to keep food safe and to act promptly to protect consumers' health.

The CDC offers common-sense tips for safe food handling in the home (eg, avoid ingestion of raw meat; cook products at proper temperatures; wash hands, work surfaces, and utensils). Food industries can prevent or limit the size of outbreaks by making food safety a core part of their culture; their goal must be to meet or exceed food safety regulations and standards.[30] Measures to improve food safety should include maintaining records to enable the rapid tracing of foods and the use of suppliers who apply best practices to food processing.

Let us not repeat the history of E coli tragedies.

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Detection and Prevention


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