Foodborne Illness in Anchorage

Foodborne Illness: A disease that is carried or transmitted to humans by food containing harmful substances.¹

The true number of cases of foodborne illness in Anchorage is unknown, since most people do not identify or report foodborne illness. Cases of reported foodborne illness are tracked by the Anchorage Department of Health and Human Services. The State of Alaska reports confirmed foodborne outbreaks to the Centers for Disease Control and Prevention (CDC).

What is known is, as is true nationally, the incidence of foodborne illness in Anchorage is significantly higher than the data suggests—from 20 to 100 times greater. 2 There is no evidence to suggest that Anchorage or Alaska is different from the nation with respect to the incidence or causes of foodborne illness.

Most cases of foodborne illness in healthy adults are self-limiting and of short duration. Diarrhea, cramps and vomiting are the most common acute symptoms. Foodborne illnesses range from mild to severe and may cause death. Illness can occur from 30 minutes to 2 weeks after eating contaminated food.3 This time delay before the onset of symptoms is the major reason why many people think they have the 24-hour flu, not a foodborne illness.

Most cases of food-related illness can be prevented if consumers recognized they play an important role in ensuring the safety of the foods they eat.8

America’s food supply is among the safest in the world.⁹ Even so, there are between 6.5 million and 81 million cases of foodborne illness a year.¹⁰ This means that in 1998, at least 17,000 and maybe as many as 221,000 people suffered from a foodborne illness in the U.S. every day. Each year, 9,100 persons are believed to die from foodborne illnesses.¹¹

The exact number of foodborne illnesses is difficult to know because most cases go unreported. The CDC estimates that for every one reported illness, 20 to a 100 go unreported, which is the reason for the broad estimate range.¹²

Preventing foodborne illness has become a national priority in recent years due to new safety concerns regarding food. Demo-graphic, consumer lifestyle, and environmental changes have affected the way Americans purchase, prepare, and store food, including those listed below:

• Emerging foodborne pathogens require new control techniques. For example, three of the four pathogens that CDC rates as the most serious sources of foodborne illness were not recognized as causes of foodborne disease 20 years ago.¹³
• Bacteria which cause foodborne illness have found new modes of transmission. For example, Salmonella enteritidis, which once only contaminated the outside of egg shells, is now found inside many eggs, making raw and undercooked eggs unsafe to eat.¹⁴
• The food supply has become global with many different countries supplying food products to the U.S.
• The U.S trend toward smaller-sized families, a larger share of single-headed households, and more two-working parent families has resulted in: ¹⁵

1. Families having less time for food shopping & preparation.
2. More children preparing food for themselves during the increasing time-span when no adult is home.
3. More children and young adults growing up without proper instruction on food preparation, resulting in a generation of consumers with inadequate knowledge about how to prevent foodborne illness.
4. More food being prepared and consumed away from home. Estimates are that consumers spend 43 cents of every food dollar eating out.16

At the same time, declining numbers of Americans believe food safety is their responsibility (see indicator Foodborne Illness: Whose Responsibility).

Foodborne illness is caused by four sources: disease-causing bacteria, viruses, parasites and toxins. They are transmitted through contaminated food, contaminated water or person-to-person contact.

Certain types of germs produce toxins as they grow in food. In this case, it is the toxin that causes the illness when the food is eaten, not the living germs. Other illnesses are caused by food contaminated with living germs. The germs, even if present in small numbers, have the potential to establish and multiply in the digestive tract to cause the "infection." Yet other illnesses are caused when large numbers of living germs are eaten and then die in the digestive tract, releasing toxin(s) that cause the "toxico-infection."¹⁷

The following factors are known to contribute to foodborne illness:¹⁸

1. Improper cooling/refrigeration
2. Poor hygiene/handwashing
3. Inadequate hot-holding
4. Cross-contamination
5. Ill food handler
6. Cooking and serving later
7. Inadequate cooking/reheating

Foodborne illnesses are most likely to occur when food is cooked and then transported away from home, e.g. picnics.

State, local, and federal government plays a critical role by regulating food safety. The first public health initiative to prevent foodborne illness was instituted in 1923 to control typhoid fever and infantile diarrhea due to milkborne outbreaks.¹⁹ Since then, public health initiatives have expanded to prevent other foodborne illness.

The U.S. Department of Agriculture inspects meat, poultry, and egg processing plants, while the U.S. Food and Drug Administration oversees the safety of most other foods. State and local governments regulate food storage, transportation, processing, preparation and service facilities to verify compliance with food safety laws.

At risk groups are of special concern including children in child care centers. The Alaska Department of Environmental Conservation changed the Alaska Food Code in 1997 to include regulation of food facilities in commercial child care centers. The Municipality is updating the local food code to bring it into compliance with the Alaska Code. If adopted, the Municipality will regulate food service in commercial child care centers. Additionally, Environmental Sanitarians will act as consultants and advocates for food service personnel and the children they serve. Their joint efforts will surely reduce the risks associated with foodborne illness in childcare centers.