April 10/St. Louis Post-Dispatch -- Rates of food-borne illnesses have remained roughly level since 2004, the Centers for Disease Control and Prevention (CDC) reported, revealing what health officials and regulators say is an alarming lack of progress in reducing food safety risks.

The rate of illnesses from salmonella -- the bug that struck hundreds of Americans in recent outbreaks involving peanut butter and hot peppers -- is twice the level federal agencies had hoped to reach, according to the CDC. Meanwhile, produce-related food poisonings are on the rise.

"We need greater efforts along the food chain -- from farm to table," said Dr. Robert Tauxe of the CDC.

Faced with bigger, more complex food-poisoning outbreaks in recent years, government agencies have been forced to devote the bulk of their resources to reacting only after people became sick. Outbreaks also are becoming more difficult to investigate as more imported food pours into the U.S. and food distribution networks become more complex.

"As supply chains get longer and longer, there's more opportunity for contaminants," said Dr. Stephen F. Sundlof, director of the Food and Drug Administration's (FDA)Center for Food Safety. "One single ingredient can have a very wide distribution."

Investigators also have to cope with the emergence of new forms of illness. "Our pathogens have complicated ecologies that may be changing, and we have very little information about that," Tauxe said.

The CDC report focused on data collected from 10 states through a government surveillance network dubbed FoodNet. The network tracked food-borne pathogens dating back to 1996. The data showed declines in cases of several food-borne illnesses from 1996 to 2004, but those numbers have leveled off since.

In recent years, however, several prominent outbreaks have heightened awareness of food poisoning and triggered several bills in Congress that would overhaul the food safety system. President Barack Obama's administration has declared food safety a priority and last month established a Food Safety Working Group to address what the president called an unacceptable status quo.

"Our system of inspection and enforcement is spread out so widely among so many people that it's difficult for different parts of the government to share information, work together and solve problems," the president said in March.

The agencies responsible for food safety and responding to outbreaks are vast, unwieldy and often fail to communicate effectively, many critics and regulators say. Last year, when a cluster of salmonellosis cases appeared in Missouri's Jefferson County, inspectors and scientists from three federal agencies came to the area to oversee different parts of the investigation.

"We've dealt directly with the CDC, the FDA and the Department of Agriculture on some of these issues as most health departments have," said Dennis Diehl, the county's health director. "But because of the way the responsibilities are delegated to those different agencies, the FDA doesn't always know what Agriculture or what CDC is doing, and sometimes it's hard to get information."

Critics say the FDA, which oversees 80% of the food in the U.S., is overwhelmed and devotes more resources to drug oversight than food. Last year, however, the agency hired 150 more inspectors, and its plans to hire roughly 30 more scientists and consumer safety officers. The agency also has opened several international offices, in China, Latin America and India. "It's become very clear that preventative controls are critical," said David Acheson, associate commissioner for foods at the FDA. "FDA certainly needs to do more inspections."

Food safety experts generally agree that more inspections and more emphasis on prevention rather than reaction will be key to addresses food poisoning challenges.

One bill introduced in Congress would call for a single food safety agency to streamline the food safety system. Another calls for preventative controls in high-risk facilities and points along the food chain.

Michael Taylor, a professor at the George Washington School of Public Health and former deputy commissioner for policy at the FDA, agrees the country's food safety system needs to undergo a "paradigm shift."

"It has to shift from people getting sick to a framework of prevention where you clarify the industry's duty to implement modern preventative controls," Taylor said. "Also defining through government standards what's good enough, and following up with inspection and enforcement."

Taylor, as well as other food safety experts, say the time is ripe for substantial change, noting the reform theme of Obama's administration.

"You've got a visible presence for reform," Taylor said, "and that's an important part of this."

From the April 13, 2009, Prepared Foods E-dition