Food safety & infection - EFR 6-9

The public is scared by AIDS and cancer, but the article below lends credence to the idea that food safety concerns will continue to be a real problem around the world.

Excerpted from FOOD CHEMICAL NEWS, January 22, 1996, pp. 15-16

An editorial in the January 17, 1996 issue of Journal of the American Medical Association raised the concern that foodborne diseases have contributed to the rise in infectious diseases in the United States. AIDS, Hantavirus, Escherichia coli 0157:H7 and Cryptosporidium have all contributed to the rise, but the smaller numbers of the foodborne diseases keep them from showing up in overall vital statistics. The lack of reporting is related to less funding for those federal agencies charged with epidemiological surveillance for infectious diseases, according to author of the editorial, Joshua Lederberg, a 1958 Nobel Prize winner for work on genetic research. The editorial was a response to a Centers for Disease Control and Prevention (CDC) study which found an overall 58 percent increase (from 1980 to 1992) in the death rate of infectious disease-related cases.

Lederberg noted that environmental, sociological and socioeconomic factors have combined to create "a tinderbox" in which the world's population has "never been more vulnerable" to the dangers of new and reemerging infections.

CDC's Robert Pinner noted, "Despite historical predictions that infectious diseases would wane in the United States, these data show that infectious disease mortality has actually been increasing in recent years." And Pinner pointed out that the report "reflects only a portion of the burden, since infectious diseases often result in substantial morbidity (disease) or disability without causing death."

The American Medical Association's Council on Scientific Affairs gave a different view in a report, "Epidemic Infectious Disease Risks: Striving for Perspective." They stated that the people should not think that there is a greater danger today then there has been in the past.

"This conclusion [by the CDC] is far from the truth," said the Council's report. "Through application of sound public health practices, cooperative planning and implementation and advances in technology, remarkable achievements have been accomplished in the control of many epidemic infectious diseases in this century, not just in the United States but worldwide."

The AMA's council did state that the threats of foodborne disease caused by E. coli 0157.H7 are "real and must be monitored, evaluated and aggressively managed."

In the editorial, Lederberg proposed five ways to combat infectious diseases:

(1) concerted global and domestic surveillance and diagnosis of disease outbreaks and endemic occurrence

(2) vector (nonhuman to human transmission of an infectious agent) management and monitoring and enforcement of safe water and food supplies

(3) public and professional education

(4) scientific research on disease causes, pathogenic mechanisms, bodily defenses, vaccines and antibiotics

(5) "cultivating the technical fruits of such research, with the full involvement of the pharmaceutical industry, and a public understanding of the regulatory and incentive structures needed to optimize the outcomes."