Food safety and irradiation: protecting the public from foodborne infections.

Early in the 20th century, when food safety was a major concern to the public, two technologies, milk pasteurization and retort canning, were developed, promoted, and virtually canonized as prevention measures against foodborne diseases. Fear of contracting typhoid fever from watered milk and outbreaks of botulism from commercially canned products are now part of the distant past, controlled by these food industry processes in many countries. Nonetheless, at the beginning of the 21st century, foodborne disease remains a major threat to public health, as new pathogens and products have emerged (1). Many of these threats can be controlled by applying new technologies, when we as a society are willing to use them. In the United States, foodborne infections cause an estimated 76 million cases of illness and 325,000 hospitalizations annually— more than 1 in 1,000 are hospitalized each year (2). The economic burden is substantial, estimated at up to $6.7 billion annually in patient-related costs for treatment of bacterial infections alone (3). Five pathogens account for much of the most severe illness: Salmonella, Escherichia coli O157 and other Shiga toxin-producing E. coli, Campylobacter, Listeria, and Toxoplas-ma cause an estimated 3.5 million infections, 33,000 hospitalizations, and 1,600 deaths each year (2). In the early 1990s, large and devastating foodborne outbreaks of E. coli O157:H7 infections heightened public concern about foodborne diseases (4). Efforts to improve food safety were intensified in industry and regulatory agencies and supported by the National Food Safety Initiative (5). As a result of these efforts, the process control strategy of the Hazard Analysis-Critical Control Point (HACCP) is becoming the norm to use for producing many foods. In slaughter inspection it is replacing manual and visual carcass-by-carcass inspections. An expanded focus on regulating sanitation and hygiene with good manufacturing and agricultural practices means that food would be produced under cleaner conditions. In restaurants and home kitchens, new attempts have been made to educate food preparers in the basic principles of food safety, though paid sick leave for foodhandlers is still the exception, and handwashing is intermittent. These developments may collectively help explain a decline in the reported incidence of Salmonella and Campylobacter infections that was observed in active surveillance by FoodNet between 1996 and 2000 (6). However, we are still far from the public health goals established for 2010. These goals include reducing the national incidence of infections with Salmonella, E. coli O157, Campylobacter, and Listeria to 50% …