A Healthier Future for West Virginia - Healthy People 2010

10 - Food Safety

Objectives | References

Background

The number of illnesses due to common and emerging food-borne pathogens reported annually is on the rise. The Centers for Disease Control and Prevention (CDC) receive confirmed reports of thousands of food-borne illnesses each year, including many deaths. However, it is estimated that tens of millions of individuals become ill from consuming contaminated food, and of these thousands die. West Virginia is no different than the rest of the nation. While the number of illnesses reported annually in the state is only in the hundreds, it is recognized that only a small percentage of the cases is actually reported.

For most individuals, a case of food-borne illness may mean only minor symptoms, inconvenience, and a couple days away from work or school. These people may never seek medical attention and never receive a diagnosis nor have this illness reported. For others, more severe symptoms may lead them to their family doctor or the local emergency department. There a diagnosis may be provided, but without laboratory specimens and results no report is ever made. In West Virginia, while strides are being made, accessibility to health care may contribute to a lower reporting rate.

While normally healthy individuals may fall victim to foodborne illness from heavily contaminated foods, some individuals may be stricken by foods contaminated to a lesser degree. The very young, the elderly, and the immuno-compromised are at a higher risk of illnesses from all sources, including foodstuff. As West Virginia's population ages, and chronic diseases continue their prevalence, foodborne illness is likely to grow as a concern.

Many factors combine to make food- borne illness a growing problem in West Virginia and across the nation. As noted above, an increased number of people are at greater risk due to increased age and compromised immune systems for other reasons. The general population is less likely to follow safe food preparation practices in the home. This may be due to a belief that the United States food supply is innately safe and/or the lack of training in safe food preparation practices in school and at home. There is an increasingly diverse food industry. Employees of the food service industry are a large and very diverse group. There is generally a high turnover rate and there may be language barriers and literacy issues. In addition, there is no standard system for worker training or certification among states or even across counties in the State of West Virginia. Food supplies are no longer only locally grown and produced. Many foods found in the grocery store are just as likely to have been produced outside the country as within. Growing methods and food handling practices, as well as illness in food handlers, increases the chances of food contamination. We are also seeing new and emerging pathogens. As microorganisms grow, they adapt and evolve in their environments. Organisms not previously known to cause illness in humans are now identified as the cause of illnesses and outbreaks. We are also seeing unexpected organisms in foods that may be resistant to previously effective antibiotics.

Food-borne illness is a result of many factors coming together at one point in time. If no pathogens are present in food, then subjecting that food to temperatures favorable to organism growth and toxin production will not result in illness. However, just because pathogenic organisms are present does not mean illness is inevitable. If food is handled properly; kept refrigerated to prevent pathogen growth, cooked to destroy pathogens, and separated to prevent contamination of other foods, food-borne illness is unlikely. But each pathogen is different. Some require large numbers of organisms to cause illness, while others require only small numbers. Just as people differ in their susceptibility to illness, organisms differ in their ability to cause illness. Preventing food-borne illnesses requires due diligence on everyone's part. Proper food handling can reduce contamination, prevent pathogen growth, and prevent toxin production, thereby preventing food-borne illness.

The Objectives

FLAGSHIP OBJECTIVE
OBJECTIVE 10.1. Reduce by 20% for bacteria and 10% for parasites the number of illnesses/infections caused by common and emerging human food-borne pathogens including the following: (Note: Toxoplasma gondii is not reportable in West Virginia; therefore it is not included in the state objective.)
10.1a. Salmonella species
10.1b. Campylobacter jejuni
10.1c. Escherichia coli O157:H7*
10.1d. Cryptosporidium parvum*
10.1e. Cyclospora cayetanensis*

* These diseases did not become officially reportable until August 3, 1998.

Data Sources: West Virginia Bureau for Public Health (WVBPH), Office of Epidemiology and Health Promotion (OEHP), Division of Surveillance and Disease Control (DSDC)

OBJECTIVE 10.2. Maintain the number of deaths due to infections from Listeria monocytogenes at or below one per year. (Baseline: 1 from 1994-98)

Data Source: WVBPH, OEHP, Health Statistics Center (HSC)

OBJECTIVE 10.3. Reduce the number of food-borne outbreaks of Hepatitis A and Norwalk virus. (Note: Norwalk virus is not reportable in West Virginia; therefore our only data on this pathogen would be from investigations of outbreaks of illness.) (Baseline: 9 cases of Hepatitis A in 1998)

Data Source: WVBPH, OEHP, DSDC

OBJECTIVE 10.4. (Developmental) Reduce the occurrences of the following factors in retail food establishments:
10.4a. improper holding
temperatures;
10.4b. inadequate cooking;
10.4c. poor personal hygiene;
10.4d. contaminated equipment, and
10.4e. foods from unsafe sources.
(Baseline data available in 2000)

Data Sources: Local health department inspection reports; WVBPH - Division of Public Health Sanitation food surveys conducted at local health departments. (The current inspection system would not separate improper holding temperatures and inadequate cooking; in fact, inadequate cooking would most likely not be documented. However, the 2000 legislature is expected to consider and pass the adoption of the 1999 FDA model Food Code that would provide this information.)

OBJECTIVE 10.5. Maintain the number of deaths from food-induced anaphylaxis at or below one per year. (Baseline: 1 in 1997)

Data Source: WVBPH, OEHP, HSC

Meeting the Objectives

Health Promotion Channels for Achieving Objectives:

• Worksites
• Schools
• Public Health Programs
• Networks
• Health Care System
• Higher Education

In order to reduce the incidence of food-borne illness, all food handlers, whether producers, wholesalers, or retailers, must understand and employ proper food-handling and preparation practices. Regulators and the food industry must work together to educate workers about proper methods of growing, harvesting, preparing, and packaging foods to prevent contamination. We must insure that workers entering the food industry have knowledge of safe food handling techniques and practices. Outbreaks of illness may spread rapidly if no action is taken to halt them, and action requires timely information. Health care providers must understand the importance of reporting suspected and confirmed cases of food-borne illness quickly.

Many agencies are involved in insuring safe food for consumers. The West Virginia Departments of Health and Human Resources and Agriculture are lead agencies. In addition, the West Virginia University (WVU) Extension Service can provide educational information to both industry and consumers. Our schools, both K-12 and higher education institutions, can provide food industry workers who enter the job market with knowledge and skills necessary to help insure safe food.

Work Group Members

Karol Wallingford, Work Group Leader, Kanawha-Charleston Health Department
Linda Jones, Public Health Sanitation Division
Stanley Mills, Cabell-Huntington Health Department
Judi Rice, Jefferson County Health Department
Jan Charminski, West Virginia Department of Agriculture, Meat and Poultry Division
Mary Dooley, Concerned citizen
Sally Summers, WVU Extension Service
Paul Saab, Shepherd College
Darlene Kestner, Aramark Thomas Memorial
Sue Ellen Ensign, Olive Garden Restaurant

References/Resources

CDC. Healthy People 2010 Objectives: Draft for Public Comment. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, 1998.

United States Food and Drug Administration. 1999 Food Code.

For More Information

Kanawha-Charleston Health Department
108 Lee Street East
Charleston, WV 25301
Phone: (304) 348-8050; Fax: (304) 348-8054

This page was last updated June 13, 2001.
For additional information about HP2010, contact Chuck Thayer at (304) 558-0644 or Chuck.E.Thayer@wv.gov