The U.S. Department of Health and Human Services (DHHS) and the U.S. Department of Agriculture (USDA) share the goal of bringing about a 50 percent reduction in the incidence of listeriosis by the year 2005.
Background: Food-borne illness
Food-borne illnesses occur in humans when infectious diseases are spread through food. Some common bacteria that cause food-borne illness include Escherichia coli O157:H7, Salmonella, Campylobacter, and Listeria. Listeria, for example, can be transmitted in soft cheeses, raw milk, and some meat and poultry products. Symptoms of illness include fever, chills, headache, backache, abdominal pain, and diarrhea. Although these flu-like symptoms may occur in healthy individuals, food-borne illnesses are particularly dangerous for particular at-risk populations. Individuals who have weakened immune systems, such as elderly persons, newborns, individuals with human immunodeficiency virus infection (HIV) or AIDS, and particularly pregnant women and their unborn babies, are especially susceptible.
Risk Assessment of Listeriosis
A listeriosis risk assessment was completed by two U.S. federal agencies that regulate food safety, USDA and DHHS, with the two agencies given directives that were similar but that varied somewhat. The directive of USDA included the completion of regulations and testing to ensure, among other things, that ready-to-eat products meet appropriate government standards. Components of the DHHS action plan included the preparation of guidance documents for processors and the preparation of labeling standards and control measures for foods that place individuals at risk for listeriosis. Collectively, the two agencies developed a joint action plan in accordance with the government's goal of a 50 percent reduction in the incidence of listeriosis by 2005. The action plan includes initiatives to enhance education efforts directed toward health care providers as well as consumers.
According to research conducted in 1999 and 2000 by the International Food Information Council (IFIC), physicians may not always provide adequate food safety information to patients. Recent focus group testing with pregnant women conducted by the USDA Food Safety and Inspection Service (FSIS) indicates that there is an urgent need for more consumer education materials on food safety from the primary health care provider, especially the obstetrician-gynecologist. The purpose of a listeriosis risk assessment is to evaluate currenly available data to systematically estimate the relative risk that a serious illness might occur when one consumes different types of ready-to-eat foods that may be contaminated with Listeria monocytogenes. A risk analysis of this type provides information necessary to determine the level of exposure to Listeria monocytogenes for certain at-risk populations as well as to relate that exposure to human health and safety risks. Three segments of the population were evaluated: the prenatal and neonatal population, including unborn fetuses and newborn infants from 16 weeks to 30 days after birth; elderly individuals, those consumers 60 years of age or older; and groups of intermediate age, which encompasses the entire remaining population.
Foods were categorized into various groups including seafood, produce, dairy, meats and combination foods. They were ranked on a scale of 1 to 20 according to laboratory data, with the ranking indicating whether a food has either a lower or a greater predicted relative risk of causing listeriosis. Other factors such as heating and reheating, consumption amounts, and contamination levels were also considered in the ranking system.
Several information gaps noted in the "Interpretive Summary: Draft Assessment of the Relative Risk to Public Health from Food-borne Listeria monocytogenes Among Selected Categories of Ready-to-Eat Foods" from the Food and Drug Administration (FDA) Center for Food Safety and Applied Nutrition, January 2001, included consumption information for several populations, retail pricing, the possible occurrence of cross-contamination at the retail level, and reheating processes.
Risk assessments like the listeriosis risk assessment have provided valuable scientific data that are beneficial in shaping public policy and ensuring the safety of U.S. consumers. At-risk individuals are especially vulnerable to food-borne diseases, and for this reason the federal agencies responsible for food safety have collectively adopted consumer messages and guidelines for older Americans, HIV/AIDS patients (immunocompromised individuals), and pregnant women. FSIS and FDA provide the following advice to all "at-risk" consumers:
- Do not eat hotdogs, luncheon meats or deli meats unless they are reheated until they are steaming hot.
- Do not eat soft cheeses such as feta, Brie, Camembert, blue-veined cheeses or Mexican-style cheeses such as queso blanco fresco. Hard cheeses, semisoft cheeses such as mozzarella, pasteurized processed cheese slices, and cottage cheese can be safely consumed.
- Do not eat refrigerated pâté or meat spreads. Canned or shelf-stable pâté and meat spreads can be eaten.
- Do not eat refrigerated smoked seafood unless it is an ingredient in a cooked dish such as a casserole. Canned fish such as canned salmon or canned tuna can be safely eaten.
- Lastly, do not drink raw (unpasteurized) milk or eat foods that contain unpasteurized milk.
Adherence to these food safety guidelines along with easy in-home Fight BAC!™ food safety tips, will allow the reduction and elimination of harmful bacteria:
- Clean: wash your hands and food preparation surfaces often;
- Separate: don't allow cross-contamination between raw and cooked foods;
- Cook: cook foods to proper temperatures (use a food thermometer); and
- Chill: refrigerate or freeze foods promptly.
