GAINESVILLE, Fla. – University of Florida Emerging Pathogens Institute researchers have identified the Top 10 riskiest combinations of foods and disease-causing microorganisms. Titled “Ranking the Risks: The 10 Pathogen-Food Combinations with the Greatest Burden on Public Health,” the study lists the number of illnesses, costs and overall public health burden of specific microbes in particular types of food – such asSalmonellain poultry and
Listeriain deli meat.

This is the first comprehensive ranking of pathogen-food combinations that has been computed for the United States. The study was supported by a grant from the Robert Wood Johnson Foundation.

The following are the top-10 pathogen-food combinations identified in the study that cause the greatest burden to public health:

1.Campylobacterin poultry costs $1.3 billion and causes a loss of 9,500 quality-adjusted life years (QALYs), which is a measure of disease burden.
2.Toxoplasmain pork costs $1.2 billion and causes a loss of 4,500 QALYs.
3.Listeriain deli meats costs $1.1 billion and causes a loss of 4,000 QALYs.
4.Salmonellain poultry costs $700 million and causes a loss of 3,600 QALYs.
5.Listeriain dairy products costs $700 million and causes a loss of 2,600 QALYs.
6.Salmonellain complex foods costs $600 million and causes a loss of 3,200 QALYs.
7.Norovirusincomplex foods costs $900 million and causes a loss of 2300 QALYs.
8.Salmonella in produce costs $500 million and causes a loss of 2800 QALYs.
9.Toxoplasmain beef costs $700 million and causes a loss of 2,500 QALYs.
10.Salmonellain Eggs costs $400 million and causes a loss of 1,900 QALYs.

UF researchers were quick to say, however, people should not use this study as a top 10 list of foods to avoid, but as a reminder that many of the foods eaten every day can become contaminated. While some food-safety risks are outside of consumers’ control, the researchers add that effective food-safety practices – such as making sure hands are washed frequently and using separate cutting boards and knives for meat and produce – can help to keep a family safe from foodborne illness.

While millions of Americans get food poisoning each year, thousands die. Although federal agencies, such as the Food and Drug Administration, US Department of Agriculture and more than 3,000 state and local governments are charged with protecting consumers from these risks, their efforts often are fragmented and uncoordinated, stated a press release on the study.

“The number of hazards and scale of the food system make for a critical challenge for consumers and government alike,” said Michael Batz, lead author of the report and head of Food Safety Programs at the Emerging Pathogens Institute. “Government agencies must work together to effectively target their efforts. If we don’t identify which pairs of foods and microbes present the greatest burden, we’ll waste time and resources and put even more people at risk.”

When asked if the study authors felt there should be only one government agency overseeing food safety, Batz told “The report does not recommend a single food agency, so I can speak only for myself. If we were designing a food-safety system from scratch, I would advocate strongly for a single agency, but we’re not and so I don’t. The agencies have gotten much better over the last decade at talking with one another, and I think they are working more closely today than at any point in recent memory.”

There is still much room for improvement, though, he added. “While I think it would ultimately be beneficial to have a single person ultimately responsible for the federal government’s food-safety efforts, there is plenty that can be done to improve coordination and communication between federal agencies, state and local agencies, businesses and the public,” he said.

The new study concludes five leading bugs –Campylobacter,Salmonella,Listeriamonocytogenes,Toxoplasma gondii and norovirus – result in $12.7 billion in annual economic loss – with the Top 10 pathogen-food combinations responsible for more than $8 billion. This burden includes the cost of medical care and lost productivity from employee sick days, as well as the expense of serious complications or chronic disabilities that result from the acute illness or sometimes strike after acute illness goes away.

Other key study findings and recommendations for food-safety officials include:

• Poultry contaminated with Camplylobacter bacteria topped the list, sickening more than 600,000 Americans at a cost of $1.3 billion per year. Salmonella in poultry also ranks in the Top 10, with $700 million due to costs of illness. Campylobacter infection can also cause paralysis and other neuromuscular problems. The study questions whether new safety standards announced by the USDA for young chickens and turkeys are sufficient and recommends evaluating and tightening these standards over time.

• Salmonella is the leading disease-causing bug overall, causing more than $3 billion in disease burden annually. In addition to poultry, Salmonella-contaminated produce, eggs and multi-ingredient foods all rank in the Top 10. The report recommends that the FDA and USDA develop a joint Salmonella initiative that coordinates efforts in a number of foods.

• Four combinations in the Top 10 – Listeria in deli meats and soft cheeses, and Toxoplasma in pork and beef – pose serious risks to pregnant women and developing fetuses, causing stillbirth or infants born with irreversible mental and physical disabilities. The report recommends that agencies strengthen prevention programs for these pathogens and improve education efforts aimed at pregnant women.

• Norovirus is the most common foodborne pathogen and is largely associated with multi-ingredient items that can become contaminated, often by service-industry workers who handle food. The researchers recommend strengthening state and local food safety programs through increased funding, training and adoption by states of the most recent FDA Food Code.

• E. coli O157:H7 is the sixth pathogen in overall burden, with the majority due to contaminated beef and produce. The study recommends federal agencies continue to target E. coli O157:H7, due to the particularly devastating injuries it causes in small children, including kidney failure, lifetime health complications, and death.

Batz told food safety is a shared responsibility. Contamination can enter the system or be amplified all along the chain from the farm to the kitchen. It’s not just the responsibility of meat and poultry processors, he said.

“That said, I think the practice of ‘biomapping’ or collecting microbial data throughout the processing line, holds a lot of promise,” he added. “Biomapping can identify potential leverage points throughout processing and is very much in line with a data-driven, risk-based approach to problem solving.”

There is also a growing body of evidence that supports improved food-safety cultures within organizations, Batz said. Frank Yiannis and Doug Powell have both made strong cases for how to do this and presented some data to back it up, he added.

“Lastly, I think meat and poultry processors, particularly those of beef and lamb, should pay more attention to Toxoplasma gondii,” Batz said. “While toxo isn’t a well-known pathogen, our analysis suggests it is a silent killer. Toxo doesn’t cause outbreaks, but infections that manifest themselves later in life when people become immunocompromised. Likewise, pregnant women exposed to toxo may have miscarriages or children born with permanent physical and mental disabilities. CDC estimates over 300 foodborne deaths annually, making it the second-deadliest foodborne pathogen overall. Clearly, more must be done to understand the true burden of toxo, and we need better information on which foods are serving as vehicles.”

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