Abstract
Food safety remains a serious issue in public health. Foodborne disease is the main threat to public health. It occurs when food gets contaminated with pathogens and is then ingested into the body. Food contamination occurs when there is a flaw in the food handling process that allows food to get into contact with the pathogens. Many efforts have been made to deal with food contamination. However, the food industry still faces many challenges some of which are emerging challenges. The dairy sectors are one of the sectors in the food industries facing numerous challenges. Nevertheless, it is one of the sectors in which many efforts have been made to promote food safety. One of such efforts is the regulations that ban the selling of raw milk directly to farmers across states. This regulation has been in force for some time. However, there has been a recent push to change this law to allow farmers to sell raw milk directly to the consumers across the states. The proponents of this new push cite the nutritious content of raw milk compared to that of pasteurized milk and the perceived benefits such as the control of allergens to justify the push. On the other hand, the opponents of this push claim that raw milk is prone to contamination with microorganism such as Listeria that can cause a severe harm to the human being when ingested. Most of the arguments being advanced by the group pushing for the change in the regulations guiding the selling of raw milk are not supported by sound scientific evidence. Changing these regulations might increase the level of exposure of the members of the public to foodborne illnesses. Therefore, the regulations in question should remain in force.
Introduction
Food safety is one of the areas of great concern to the public health. A threat to food safety is a threat to the wellbeing of the public. As a matter of fact, a single flaw in the food handling, preparation, and storage processes can lead to an almost immediate life-threatening impact on a huge population. For instance, poor food handling practices can result in the introduction of pathogens into the food products. If the contaminated product is distributed to a large number of people, an epidemic of the disease associated with the pathogens may occur. Adding to the severity of the infection can be the difficulty of dealing with the surge in the number of people infected. In cases where the healthcare systems are not prepared to handle a large number of casualties, many fatalities may result. Therefore, there is the need to design a healthcare system to deal with emergencies of this nature. More importantly, the public health system should direct many efforts towards detecting any threat to food safety to prevent the outbreak in foodborne illnesses.
Foodborne infections result from the ingestion of disease-causing organisms such as bacteria, fungi, toxins, parasites, and other substances contained in food products that are harmful to the body. Bacteria are the some of the leading causes of foodborne diseases in the world. Some of the strains of bacteria responsible for various foodborne diseases are the following: Salmonella, campylobacter, Escherichia, clostridium, vibrio, listeria, and staphylococcus among others. Precisely, Campylobacter jejuni, Clostridium botulinum, Escherichia coli, Listeria monocytogenes, Streptococcus A, Clostridium perfringens, and Staphylococcus aureus are the major causes of most foodborne diseases locally and globally. For instance, according to Centers for Disease Control and Prevention (CDC) (2014, p.6), cases of Salmonella-related foodborne disease outbreak outnumbered all other foodborne diseases caused by bacteria in 2012. In this case, a total of 113 outbreaks related to Salmonella were reported (CDC, 2014, p.6). These outbreaks resulted in a total of 3,394 illnesses and 454 hospitalizations (CDC, 2014, p.6). Campylobacter recorded the second highest number of foodborne disease outbreaks in the same year. In this case, it caused a total of 37 outbreaks (CDC, 2014, p.6). These outbreaks resulted in a total of 476 illnesses and 29 hospitalizations (CDC, 2014, p.6). Vibrio strains reported the least number of foodborne diseases outbreaks in the same year making them the least common foodborne disease-causing bacteria in the United States in 2014. In this case, only one outbreak was reported resulting in a total of 3 illnesses and one hospitalization (CDC, 2014, p.6).
Background Information
Different strains of bacteria use different mechanisms to cause various symptoms after completing the incubation period following ingestion. Besides, they are found in different parts of the host. Furthermore, various bacteria occur in different places from where they are transmitted to the host. Salmonella, for example, is mainly found in animal feces and the intestinal tract of animals. Some strains of the bacteria are also found in eggs. Salmonella enteritidis, for instance, inhabits raw eggs. Even though various bacteria occur in various environments, it is common to find several strains of bacteria in the same environment. In other words, the environments suitable for the various strains of bacteria only vary slightly. The modes of transmission of different strains of bacteria also vary slightly. However, in general, most bacteria are introduced into the body through the ingestion of contaminated food and water. Symptoms of the toxins produced by bacteria also vary slightly depending on the strain of the bacteria ingested. The infection with Campylobacter jejuni, for instance, is associated with the following symptoms: a headache, muscle pain followed by diarrhea that is sometimes bloody, fever, and nausea. The infection with Escherichia coli, on the other hand, presents with the following symptoms: abdominal cramps, diarrhea that can sometimes be bloody, malaise, and nausea among other symptoms. For Staphylococcus aureus infection, symptoms such as abdominal cramps and severe nausea and vomiting are common.
Different bacterial infections have different incubation periods. In some cases, the symptoms occur almost immediately after ingestions. However, in some infections, it takes days before the symptoms can emerge. Clostridium botulinum, another dangerous bacterium, is mainly associated with the symptoms such as trouble speaking and double vision. This bacterium mainly affects the nervous system, thus explains the unique nature of the associated symptoms. Botulinum is responsible for some of the worst foodborne disease outbreaks in the United States. In some infections, the symptoms can disappear even if the infected person does not take medication. However, in some infections, failure to take medications can result in serious and even life-threatening consequences. Therefore, it is highly recommended to seek medication in case of an infection. Different symptoms for various infections also appear at different stages of the progression of the infection. In most cases, the symptoms that appear at a later stage of the infection progression tend to be more severe than those that appear at the early stages.
Other than the bacteria, chemical toxins, parasites, and viruses are responsible for many cases of death and hospitalizations in the United States. As a matter of fact, in 2012, norovirus contributed to a larger number of outbreaks of foodborne illnesses than Salmonella (CDC, 2014, p.6). In this case, it recorded 287 outbreaks (CDC, 2014, p.6). These outbreaks resulted in 6,009 illnesses and 58 cases of hospitalizations (CDC, 2014, p.6). Some of the viral causes of foodborne illnesses are the following: astrovirus, and sapovirus. On the other hand, the toxic chemicals that commonly cause foodborne illnesses are mycotoxins, scombroid toxin/histamine, paralytic shellfish poison, and ciguatoxin (CDC, 2014, p.6). In this category of chemical toxins, scombroid toxin seems to be the most common cause of foodborne disease outbreak in the United States of America (CDC, 2014, p.6). According to CDC (2014, p.6), scombroid toxin reported a total of 19 cases of foodborne diseases in 2012. These outbreaks resulted in 55 illnesses. However, no hospitalization was reported from these outbreaks (CDC, 2014, p.6). According to CDC, Glardia reported the largest number of cases of foodborne illnesses since it recorded a total of 2 outbreaks in 2012 (CDC, 2014, p.6). The outbreaks resulted in 7 illnesses and 2 hospitalizations (CDC, 2014, p.6).
Foodborne illnesses bear a huge burden on the healthcare system in the United States. According to CDC (2014, CDC 2011 Estimates: Findings, para. 1), an estimate of 1 in every 6 Americans gets infected with foodborne diseases every year. This translates to 48 million people (CDC, 2014, CDC 2011 Estimates: Findings, para. 1). Out of this number, 128,000 people get hospitalized while 3,000 people die every year owing to foodborne infections (CDC, 2014, CDC 2011 Estimates: Findings, para. 1). Foodborne illness also has a significant impact on the healthcare expenditure. For instance, during outbreaks of foodborne diseases, the government through various departments incurs huge expenses in conducting investigations and catering for the hospitalization costs of some casualties. Many resources are also used to deploy staff to control the epidemic. In some cases, the outbreak of foodborne illnesses necessitates the suspension of operations in the public institutions. For instance, schools may be closed when a foodborne disease outbreak is detected. If the source of the outbreak is traced to a particular food processing plant, the plant’s operations are suspended at least temporarily while further investigations are carried out. The private businesses also incur huge losses due to the damage caused to their images.
Despite the efforts being made to promote food safety, many challenges keep emerging. Some of the problems that food safety efforts are facing in the United States are the following: changes in the food production and supply practices, new and different contaminated food products, and environmental changes that contribute to food contamination (CDC, 2015). These and other difficulties characterize many food processing industries across the United States. The dairy industry, in particular, is grappling with many food safety problems that the stakeholders are continuously seeking to address. Milk and milk products form a staple diet for many people throughout the world. Its richness in nutrients makes it a perfect source of nourishment for many people. However, it is also a suitable medium for the growth of various microorganisms. Indeed, if not handled and stored properly, milk can easily get contaminated. Once the milk is contaminated, the microbial growth takes place relatively faster because of the highly nutritious medium that milk provides. Due to the rapid growth rate of milk microorganisms, milk and dairy products go bad relatively faster. In general, milk can accommodate nearly all kinds of microorganisms. Other than being prone to contamination, milk also accounts for a significant number of cases of food allergy in the United States due to its protein content. Furthermore, milk and dairy products cause symptoms such as bloating and stomach cramps among other gastrointestinal symptoms when ingested by people with lactose intolerance. Lactose is the main carbohydrate found in milk.
Initially, milk was the main cause of foodborne illnesses in the United States. Indeed, in 1938, disease outbreaks attributed to milk consumption accounted for 25% of all food and waterborne disease outbreaks (Knechtges, 2012, p.8; Hwang & Huang, 2010, p.85). This situation prompted various stakeholders in the dairy industry and food regulatory agencies to act. As a result, many measures have been established to regulate the production, processing, distribution, and all processes involved in the handling of milk and milk products. These actions have partly contributed to the reduction in disease outbreaks that are attributed to milk and dairy products. Indeed, it is estimated that milk-borne disease outbreaks in the United States account for less than 1% currently from the 25% reported in 1938 (Knechtges, P. L., 2012, p.8). Therefore, milk is currently considered one of the safest foods in the United States.
The efforts for promoting milk safety have not been confined to the control of pathogens only. Instead, they have been extended to incorporate the controlling of allergen and lactose intolerance. Besides, such efforts are also extended to the supplier to ensure that the suppliers abide by certain standards to minimize the contamination of milk. Despite the many approaches being made to maintain and improve food safety in the dairy industry, the industry still faces many challenges. One of the main food safety concerns that have affected the dairy industry for long is biofilms. A biofilm is a group of microorganisms embedded in a matrix made of a polymeric substance. With biofilms, bacteria and other microorganisms can withstand harsh conditions such as heat induced during processing. Therefore, it biofilms has been a serious challenge in the dairy processing industry for long.
Pasteurization is one of the methods widely used to promote food safety in the dairy industry. This method has been in use for many years. Indeed, it is one of the oldest food treatment methods. The debate on whether to loosen the restrictions on the sale of raw milk has been going on for a while in the United States of America. The regulations requiring the sale of pasteurized milk began in 1987 with the Food and Drug Administration (FDA) making it mandatory that milk sold across states must be pasteurized to kill bacteria (Petrie, 2012, p.19). The debate on whether to loosen the regulations on the interstate sale of milk comes at a time when the dairy industry and other food industries are facing more food safety challenges. However, given the current challenges, the regulations on the interstate sales of raw milk and milk products should remain intact.
Opinions on the Issue
Milk distribution in the United States is guided by The Code of Federal Regulations, which mandates that all the milk and dairy products intended for direct human consumption must be pasteurized. The calls to loosen these regulations have intensified in the recent years with many bills being introduced in the parliament. The proponents of the proposal site various benefits that they perceive are tied to raw milk. According to BerryBottom of Form (2016, Halting the Raw Milk Movement, para. 2), the proponents of this proposal argue that pasteurization destroys essential nutrients, functional compounds, and factors that boost immunity. On the other hand, raw milk contains these substances but loses them during pasteurization. Therefore, they feel that the restricting of the sales of raw milk directly to consumers between states denies the consumers the accessibility to a rich source of nutrients, immunity factors, and functional compounds.
Proponents of the proposal to allow the interstate sales of raw milk directly to the consumers also argue that raw milk tastes better than the pasteurized milk (BerryBottom of Form, 2016, Halting the Raw Milk Movement, para. 2). Therefore, the restrictions on the interstate sales of raw milk have made people do with the taste that may not be pleasant to them. According to the proponents, there is the need to increase the availability of raw milk to all consumers so that the consumers can have the opportunity to consume raw milk if they like it. Another argument that the proponents of this proposal advance is that a regular consumption of raw milk helps reduce allergies and weight loss (BerryBottom of Form, 2016, Halting the Raw Milk Movement, para. 2).
The proposal to loosen the regulations guiding the sale of raw milk across states has also received opposition from many organizations. For instance, Cary Frye, the vice president of regulatory and scientific affairs at International Dairy Foods Association (I.D.F.A), is opposed to the idea of loosening the regulations of the interstate raw milk sales to consumers (BerryBottom of Form, 2016, Halting the Raw Milk Movement, para. 5). Other organizations opposed to the selling of raw milk to consumers are the American Academy of Pediatrics and the American Medical Association (Berry,Bottom of FormBottom of Form 2016, Halting the Raw Milk Movement, para. 5). These opponents of the idea mainly cite the safety concerns as the reason for their opposition to the selling of raw milk. For instance, in an interview with Food Business News, Cary Frye explained that even though raw milk from cows, sheep, or goats is rich in nutrients, it can harbor bacteria that can be ingested into the body of anyone who consumes it (personal communication, n.d.). She states that bacteria such as Salmonella and Listeria are usually found in raw milk (personal communication, n.d.). These bacteria cause many foodborne illnesses. Besides, they are very harmful to people with weakened immune systems, pregnant women, and children (personal communication, n.d.).
Another reason cited for the opposition to the sale of raw milk directly to consumers is that it would be difficult to control and monitor the level of safety of the milk for consumption. Consequently, it would increase the risk of foodborne disease breakout. The proponents of the ban on interstate sale of raw milk argue that pasteurization is scientifically proven to be an effective method of eliminating microorganisms in milk. They stress that pasteurized milk is safe for consumption unlike raw milk. Therefore, according to them, the ban on interstate sale of raw milk to consumers should not be lifted. Rather, the ban should be expanded to cover the sale of raw milk within states. However, some of them advise that if one prefers raw milk, one should ensure that one is fully aware of the source of the milk and how the milk is handled before reaching the consumers.
My Stand on the Issue
The two groups' arguments are not entirely accurate. For instance, the proponents of the ban on the regulations guiding the interstate sale of raw milk argue that raw milk helps in the reduction of allergy. This claim has not been proven scientifically. Therefore, it cannot be relied on. Besides, this group claims that destroys nutrients. While the claim is true, it does not matter because the nutrients that are destroyed during pasteurization process are those nutrients in which milk is not rich. For instance, milk is not a rich source of vitamin C that is destroyed during pasteurization. Therefore, the vitamin can be obtained from other sources such as lemon or oranges. The other argument that pasteurization destroys immunity factors does not justify the need replace it with raw milk. The immunity factors in milk are only important to babies. Indeed, the passage of immunity through milk only applies if the baby consuming the milk is the same member of species as the mother from whom the milk is obtained. Lastly, the claim by the proponents of the ban on raw milk sale that raw milk helps in weight loss has not been proven scientifically either.
The group opposing the proposal to lift the ban on the sale of raw milk to consumers is right in arguing that pasteurization is scientifically proven to be effective in promoting the safety of milk for direct human consumption. However, they fail to acknowledge that even pasteurized milk can be contaminated if not handled properly after pasteurization. Nonetheless, this group’s claim is supported by sound scientific evidence.
Based on the arguments presented by the two groups, I conclude that the regulations of the interstate sale of raw milk to consumers should remain intact. Though some arguments by the proponents of these regulations are valid, removing these regulations will expose the public to a high risk of foodborne diseases. Besides, most of the claims of this group are not backed with scientific evidence.
Food safety is important to the public health because foodborne illnesses affect many people whenever there is a breakout. Despite the challenges facing various food industry, the US government, through the United States Department of Agriculture (USDA) and the US Food and Drug Administration (USFDA), is managing the changes in food safety adequately. The government continues to conduct inspection of the both local and imported food products to ensure that food safety in the country is guaranteed. Besides, risk assessment and educating the public about the importance of food safety are areas that the government exploits to protect consumers from foodborne diseases.
This experience gave me many insights into the problems facing the US citizens concerning food safety, how the government is responding to the problem, and how the community is reacting to it. The experience has also broadened my understanding of the community health nursing. For instance, I have learned that it is important to consider the perception of the members of the community concerning a problem facing the community to advocate for the community well. Based this experience, the views of the public will play an important role in informing my decisions.
Letter
Senator, Texas
P.O. BOX
Dear sir or madam
I hereby write to request for your help in advancing the interest of the public concerning the controversy surrounding the current regulations guiding the interstate sale of raw milk.
I am a public health nurse currently working in Texas. I have noted with concern that the current push by some senators for the change in the Code of Federal Regulations to allow interstate sale of raw milk to the consumers directly is not informed by scientific evidence. The available evidence suggests that raw milk is more prone to contamination than pasteurized milk. Besides, removing the current regulations will make it difficult to monitor the production and distribution of milk. This will compromise efforts to protect members of the public from foodborne disease outbreak. Therefore, I request for your support in defending the current regulations guiding the interstate sale of raw milk.
I look forward to your positive response. Thank you.
References
Berry, D.Bottom of Form (February 24, 2016). Halting the raw milk movement. Food Business News. Retrieved from < http://www.foodbusinessnews.net/articles/news_home/Regulatory_News/2016/02/Halting_the_raw_milk_movement.aspx?ID={79D73493-BB81-4C03-9BD0-75AE93B14D85}>
Centers for Disease Control and Prevention (CDC). (2014). Surveillance for Foodborne Disease Outbreaks, United States, 2012, Annual Report. Atlanta, Georgia: US Department of Health and Human Services, CDC. Retrieved from http://www.cdc.gov/foodsafety/pdfs/foodborne-disease-outbreaks-annual-report-2012-508c.pdf
Centers for Disease Control and Prevention (CDC). (2014, January 8). CDC 2011 Estimates: Findings. Retrieved from http://www.cdc.gov/foodborneburden/2011-foodborne-estimates.html
Centers for Disease Control and Prevention (CDC). (August 31, 2015). Challenges in Food Safety. Retrieved from http://www.cdc.gov/foodsafety/challenges/index.htmlTop of FormTop of Form
Hwang, A., & Huang, L. (Eds.). (2010). Ready-to-eat foods: microbial concerns and control measures. CRC Press.
Knechtges, P. L. (2012). Food safety: Theory and practice. Burlington, MA: Jones & Bartlett Learning.
Petrie, K. (2012). Food safety: Avoiding hidden dangers. Edina, Minn: ABDO Pub. Co.
