Food-borne Illness
Food-borne Illness

In the same way that international travel by people can lead to the exposure and transmission of infectious diseases, infectious agents can also be “imported” into the United States through the food trade. This issue is growing in importance thanks to a vast increase in the international food trade. From 1999 to 2011, for example, food imports to the U.S. increased from $41 billion in 1997 to more than $105 billion in 2012) (USDA Economic Research Services, 2013). This increase is partly due to consumer preferences, cheaper foreign production and the increased access to foreign markets because of trade agreements.

The globalization of food supplies raises questions about safety standards for food production and processing. Many other countries, especially developing ones (where much of the new food imports originate), do not possess the same health and sanitary safeguards that some developed countries have. This raises the potential for the transmission of goods infected with pathogenic microorganisms into more developes states.

In 1996, a shipment of strawberries from Guatemala that was infected with cyclospora bacteria led to an outbreak of illness in the United States that sickened more than 2,000 people. The infection was believed to have originated in the fields of Guatemala, where the picked fruit was sprayed with contaminated water.

A decade earlier, Guatemala had never grown strawberries – for either domestic consumption or for export – and the cyclospora bacteria had almost never been seen in the United States. Strawberry production was introduced to Guatemala during the 1980s by the U.S. Agency for International Development, as an assistance project aimed at helping subsistence farmers. In addition, to help ensure access to the benefits of global trade, the Reagan Administration’s Caribbean Basin Initiative helped cut or eliminate tariffs on many imports from the region. These factors helped establish Guatemala as a significant strawberry producer and exporter to the United States.

However, the Guatemalan producers contest the allegation that they were the source of the bacterial contamination in the incident. Tests by the U.S. Center for Disease Control of their facilities failed to show any sign of cyclospora. A leading Guatemalan exporter charged, “We find a tremendous possibility that people in California are using this as a very dangerous tool for protectionism. Protectionist forces find bugs or whatever to protect their market. It’s a commercial war.”

A food safety official in the United States countered, “Where we see a safety issue, they see a trade issue.” (Source: New York Times and other articles)

Concerns about foreign foods are not confined to developing countries, of course. The outbreak of Bovine Spongiform Encephalopathy (BSE), or “mad cow disease,” led to a mass slaughter of cattle in Britain and cost the British beef industry between $10 and $40 billion. Other EU countries declined to import cattle from Britain over a period of almost two years as a result of the BSE. (The damage was not limited to the economy either: criticism over the handling of the crisis helped contribute to the fall of the government of then British Prime Minister John Major.)

Aside from concerns about foreign foods, the mass processing and distribution of food has itself provided new outlets for the transmission of harmful microbes. Massive outbreaks of salmonella and e.coli bacteria, for instance, have been linked to central food processing centers.  These processing centers, in turn, could never have affected so many people without mass distribution capabilities. Public health officials discovered a strain of salmonella (Salmonella Enteritidis) that was linked to the consumption of eggs. Starting in May 2010 and continuing until November, approximately 1,939 people were reportedly sickened by a salmonellosis outbreak (Centers for Disease Control, 2010).

The spring of 2008 witnessed a salmonellosis outbreak, linked to the consumption of certain types of red raw tomatoes and serrano peppers, as well as fresh cilantro (or certain products containing said vegetables). The New York Times reports that “in the months since the outbreak was first detected in April, the agency [CDC] has identified 1,017 people who were infected with the same strain, Salmonella Saintpaul.”

The Center for Disease Control notes that food borne illness outbreaks are on the rise. From 2005 to 2010, there were 39 outbreaks and 2,348 illnesses linked to imported food from 15 countries. In 2010, the U.S. enacted the Food Safety Modernization Act (Walsh, 2012).  This act gives the Food and Drug Administration (FDA) the ability to order mandatory recalls if the food is tainted or contaminated, a power that the agency did not previously possess (Walsh, 2010).

Of course, imports of food and the development of sophisticated food distribution networks is a very positive thing for most consumers. Prior to increases in transportation capabilities and refrigeration technology, people living in cooler climates (such as the northern two-thirds of the United States) were unable to eat fresh fruits and vegetables in winter months. Consequently, at certain times of the year, more than 75 percent of the fresh produce that is sold in stores and restaurants within the United States originates overseas.

Fifty years ago, the average grocery store stocked about 200 items, of which 70 percent were grown, produced or processed within 100 miles of where they were eventually purchased.

Today, the average supermarket stocks close to 39,000 food items (FMI, n.d.).  By some estimates, the food Americans eat has traveled, on average, 1,500 miles before it is consumed (DeWeerdt, n.d.) 

One hundred years ago, people living in northern climates considered an orange or an apple as a Christmas present to be an exotic and prized gift. Today, Americans expect to see groceries stores fully stocked with fresh fruits—many of which come from the Southern Hemisphere—at all times of the year.

Compounding the problems of increased mobility of people and food-borne illnesses is a nexus between these two concerns within the United States. Within the food service industry in the United States, a high percentage of food preparation tasks are carried out by immigrants from developing countries where intestinal infections are endemic, and the new jobs immigrants hold often provide low wages, and little or no health insurance or paid sick leave. This encourages them to continue working even, even when they are sick.

While less than 0.5 percent of the general population in the United States harbor intestinal parasites, studies of employees of restaurants known to have been involved in outbreaks of food borne illness have found that as many as 18 percent of workers were carrying intestinal infections.

Questions for Discussion:

If the movement of people, food, and manufactured goods can have such a negative impact on public health, should steps be taken to reduce these flows? What other options are there for lowering the spread of global diseases?

How does increased trade in food lead to the spread of food-borne illnesses? What measures can be taken to reduce the incidence of these diseases?

* Picture Source: Wikimedia

Click here for more information on food-borne illnesses: Globalization and Food Safety.


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