1997 Richard J. Duma/NFID Annual Press Conference and Symposium on Infectious Diseases

Contact: Terry LaMotte
(301) 656-0003

Embargoed for Release: April 16, 1997, 12:00 p.m.

Infectious Diseases Threats Increasing. Recent Food-Borne Outbreaks and Antimicrobial Resistance are Increasing Global Threats.

WASHINGTON, D.C.--A contaminated food supply and life-threatening diseases caused by microbes resistant to antibiotics are predicted in the near future by health experts unless prevention measures are taken immediately. Microbial agents are not only infiltrating our food supply, living in our homes and causing problems in hospitals, but they are becoming much more difficult to treat due to drug-resistant strains, health officials warned today at a news conference sponsored by the National Foundation for Infectious Diseases (NFID).

Global Economy Heightens Food Safety Concerns

According to Michael T. Osterholm, Ph.D., M.P.H., the state epidemiologist, Minnesota Department of Health, recent outbreaks, such as the hepatitis A scare, will only increase if steps are not taken to protect our food supply. "We believe that terminal pasteurization, including the use of irradiation, pulsed, high-intensity light, increased atmospheric pressure treatment or other such pathogen elimination methods, will be necessary on a wide-scale basis if we are to realize a safer food supply in the United States and throughout the world." He added that this is necessary "since food and vegetable washing does not appear to decrease the risk of infectious disease transmission."

It is important to implement treatment of foods as close to the end of the food preparation process as possible to ensure no further contamination. Osterholm believes that this will help reduce the risk of food-borne diseases.

Other factors that affect our food supply are consumers' dietary requirements and commercial sources for particular food products, he said. For example, the increased demand for fresh fruits and vegetables as part of a heart-healthy American diet has led to increased consumption of these items from foreign countries. "Seasonally, more than 75 percent of some fresh fruits and vegetables are harvested outside the United States, particularly in developing countries," Osterholm said. "These are the same fruits and vegetables that, when consumed in those developing countries, pose an increased risk of acquiring travelers' diarrhea." Improperly cooked domestic meats and other products also pose a health risk.

His view was echoed by Daniel L. Engeljohn, Ph.D., chief of the Standards Development Branch, Food Safety and Inspection Service with the U.S. Department of Agriculture (USDA). However, Engeljohn added that it is important for irradiated food products to be properly labeled so that consumers can make educated food-purchasing decisions.

Joseph M. Madden, Ph.D., strategic manager for microbiology, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration (FDA), said that food irradiation has already been approved for limited uses, but the FDA is currently reviewing petitions for expanded uses.

Mold Cleanup After Flooding Recommended

Pulmonary hemorrhage among infants in Cleveland was associated with toxic molds in leaky basements, according to Ruth A. Etzel, M.D., Ph.D. Etzel is a pediatrician and epidemiologist at the Centers for Disease Control and Prevention (CDC). In 1994, she led the team which made the discovery that infants in Cleveland with pulmonary hemorrhage, a life-threatening disease where infants cough up blood, were being exposed to toxigenic molds in their homes.

She discovered that the homes had suffered water damage as a result of flooding or plumbing problems which in turn promoted the growth of several molds, including the toxigenic Stachybotrys atra. This mold is known to cause gastrointestinal hemorrhage in farm animals eating moldy grain. Infants in Cleveland may have been affected by breathing airborne mold spores.

Appropriate mold cleanup should be emphasized following the recent flooding in the Midwest and Northwest. She suggests that any water-damaged items such as wet carpets should be replaced, and a bleach solution should be used to disinfect moldy areas to reduce the risks of toxigenic molds.

Drug-Resistant Pneumococcus Poses Health Threat

Streptococcus pneumoniae, commonly called pneumococcus, is the leading cause of community-acquired bacterial pneumonia, bloodstream infections and ear infections, said Benjamin Schwartz, M.D., chief of the Childhood and Vaccine Preventable Diseases Epidemiology Section at the CDC. This bacteria, which during the past decade has become resistant to many antibiotics, is posing a health threat, he added. "Pneumococcal infections cause about 20,000 deaths annually among persons of all ages in the United States and over one million deaths among children worldwide.

"In order to decrease, halt or reverse the spread of pneumococcal resistance, we must decrease the unnecessary use of antibiotic agents," Schwartz added. To accomplish this goal, he suggests educating both the public and the medical establishment to these problems. Patients that expect to receive antibiotics for treatment and physicians that are unsure of the diagnosis are major reasons for antibiotic overuse, he said. "The paradigm must change from one where antibiotics are expected and prescribed just to be safe,' to one where the safest course of action is not providing an antibiotic unnecessarily."

Health Care Systems Should Address Antimicrobial Resistance

Antimicrobial resistance is also a growing problem for hospital patients, said John E. McGowan, Jr., M.D., professor of epidemiology and pathology and medicine at Emory University in Atlanta. In the past, drug-resistant bacteria were mainly seen in hospital intensive care units. "Today, however, newly resistant organisms may appear at any location of the health system, and the distinction between hospital and community resistance is blurring," McGowan said.

To study this problem, McGowan is a co-director of Project ICARE (Intensive Care Antimicrobial Resistance Epidemiology), a joint project between CDC and the Rollins School of Public Health of Emory University to measure antibiotic resistance and antibiotic use in hospitals participating in CDC's National Nosocomial Infection Surveillance System (NNIS). A major goal of this study is to develop and improve mechanisms for the surveillance and control of antibiotic resistance. Some of the study's findings to date indicate that antimicrobial use and resistance are usually, but not always linked, he said.

McGowan suggests that health care systems should focus on more appropriate antimicrobial use and careful infection control practices to help combat drug-resistant bacteria in hospital settings.

About the Press Conference

The 2nd Richard J. Duma/NFID Annual Press Conference and Symposium on Infectious Diseases was sponsored by NFID and was supported in part through unrestricted educational grants from Bayer Corporation Pharmaceutical Division, Merck Vaccine Business, Pfizer Inc., RhÏne-Poulenc Rorer Inc., Roche Laboratories, Inc., SmithKline Beecham and Zeneca Pharmaceuticals. This event was named for former NFID President and Executive Director Richard J. Duma, M.D., Ph.D., director of infectious diseases at Halifax Medical Center in Daytona Beach, FL. Duma is an internationally renowned infectious disease expert.

NFID is a national, nonprofit public foundation established in 1973, to support infectious diseases research, to sponsor public and professional education programs and to aid in the prevention of infectious diseases.