Food Protection Trends - February 2011 - (Page 84)

“REFLECTIONS” OF YOuR president ell, the New Year has started with a bang, with the release of the long awaited estimates on the burden of foodborne illness in the United States. The earlier estimates, produced by the U.S. Centers for Disease Control and Prevention (CDC), were published by Mead and colleagues in 1999. The new estimates (Scallan et al., 2011) are affectionately referred to by some as “daughter of Mead.” I suspect that Paul Mead and his co-authors never anticipated the amount of attention nor the number of citations their 1999 publication would generate. Even those unfamiliar with that work will probably recognize the following statement (or something like it) as the lead sentence in many of the last decade’s food safety publications: “Foodborne disease is responsible for 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths in the U.S. annually; a large proportion of these cases are caused by as yet uncharacterized agents (Mead et al., 1999).” The estimates produced by Mead et al. (1999) and Scallan et al. (2011) differ and direct comparisons between the two studies should be approached with caution for a number of reasons. More specifically, Mead’s initial work pointed out some notable data gaps and methodological limitations, some of which have improved over the last decade. For example, Scallan et al. (2011) used two modeling approaches: one based on laboratory-confirmed illnesses (using data obtained from FoodNet and the National Notifiable Disease Surveillance System, among others) and the other based on disease incidence data. Note that FoodNet was in its infancy when the Mead et al. (1999) work was underway. In addition, Scallan et al. (2011) took great care to characterize the uncertainty associated with their calculations, increasing the utility of the estimates for future risk and epidemiological attribution modeling. Also, the 2011 work used separate W although the differences between the findings are interesting. In this column, I would like to compare briefly the results of these two distinct works, pointing out what is new, what appears to have remained relatively unchanged, and concluding with my opinions about how these new disease burden estimates might influence food safety research and perhaps policy over the next decade. Comparing the Numbers • Burden of disease associated with “known” pathogens. Mead et al. (1999) estimated that 28 known pathogens were responsible for about 14 million illnesses, almost 61,000 hospitalizations, and 1,800 deaths. The Scallan et al. (2011) figures are lower, at 9.4 million cases, about 56,000 hospitalizations, and 1,351 deaths caused by 31 known pathogens. The newer work covers the same original pathogens but subdivides pathogenic vibrios in a different manner and includes two additional pathogens (sapoviruses and Mycobacterium bovis), both of which are relatively infrequent causes of disease. • Burden of disease associated with “unspecified” agents. Mead et al. (1999) estimated that unknown agents accounted for about 62 million illnesses, 265,000 hospitalizations, and 3,200 deaths annually in the U.S. Again, the Scallan et al. (2011) estimates are lower, with unspecified agents responsible for 38.4 million cases, close to 72,000 hospitalizations and 1,686 deaths. • Combined (“known” and “unspecified”pathogens) disease burden. The Mead et al. (1999) figures estimate an annual burden of foodborne disease of 76 million cases, while the combined totals for the By LEE-ANN JAYKUS PRESIDENT “It is very difficult to make major conclusions about how the burden of foodborne disease has changed over the past decade” multipliers to account for underreporting of laboratory-confirmed illnesses, under-diagnosis, and travelrelated cases, providing estimates specifically for domestically acquired incidents of foodborne disease. The earlier work was not able to provide such detailed resolution of the data. Because of these differences and others, it is very difficult to make major conclusions about how the burden of foodborne disease has changed over the past decade, 84 FOOD PROTECTION TRENDS | FEBRUARY 2011

Table of Contents for the Digital Edition of Food Protection Trends - February 2011

Food Protection Trends - February 2011
Contents
Sustaining Members
Reflections of Your President
Commentary from the Executive Director
An Outbreak of Escherichia coli O157:H7 Infection Linked to Unpasteurized Apple Cider in Oklahoma, 1999
Examining the Exam: Implications for Participants and Policy Makers of the Food Manager Certification Exam
General Interest Paper: Recipe Websites: A Novel Medium for Disseminating Food Safety and Origin Information
IAFP 2011–2012 Secretary Election
IAFP 2011 Award Nominations
New Members
What's Happening in Food Safety
Industry Products
Activities
General Information
Registration Form
Coming Events
Advertising Index
Journal of Food Protection Table of Contents
Booklet Order Form
Membership Application
Celebrating 100 Years of IAFP Journals: 1940s

Food Protection Trends - February 2011