Are we plateauing in the fight against foodborne illness?

In the 1990s, eating food in the United States was a bit more dangerous than it is today. A host of potential infections lurked within, though food borne illness rates were still quite low and certainly much lower than they had been at the height of contamination of the food supply in the early 20th century. When food went mass-produced and people moved into cities, it brought about a host of problems farms had never had to contend with — illness would spread beyond a single farm when it cropped up, close quarters made it easier for animals to get sick and spread illness, multiple sets of hands could provide multiple entry points for infectious organisms, poor handling and storage could pose problems like listeria in milk supplies.

The government made substantial process in regulating the food supply to keep outright adulterants out and crack down on food safety, protecting access to food that wouldn’t make you sick, or kill you. And by the 1990s, rates were much, much lower than they had been, suggesting that the CDC and the rest of the county might be on track for meeting the target rate for 2020. But then, something interesting started happening in the 2010s: We began stalling out, with infection rates remaining static or in some cases getting even worse.

In 2014, Camplyobactor (chicken), E. coli (some meats, fresh produce), and vibrio (seafood) infections all increased. Rates of listeriosis (raw dairy products) and salmonella (chicken) remained static. Infection rates on all of these things, I hasten to add, remain quite low. The United States is still registering significant gains when it comes to safety in the food supply. But these things are worrying trends, especially in light of the growing antibiotic resistance entering the food supply due to overuse of antibiotics and other medications in the agricultural industry.

The more we learn about what’s happening in the food chain, the more worried we should be. Frontline’s Trouble With Chicken‘ aired a year ago, highlighting the problems with chicken alone — and people are eating roughly 90 pounds of chicken annually, a number that’s steadily on the rise. One reason for that is the shift away from red meats in response to health concerns and social criticisms — some people are uneasy about eating beef, but chickens, not being mammals, seem more abstract. With so many consumers calling for chicken, there’s steady pressure on the supply side, which means raising as many chickens as possible as quickly as possible without regard for health or welfare, and that has consequences not just from an intrinsic animal rights perspective (whether you eat chicken or not) but also from a human health perspective. Our meat is making us sick, but so are other foods.

In 2015, Costco chicken salad carried E. coli to unwary consumers. Infamously, an outbreak at Chipotle spread across the country. Bluebell Ice Cream carried Listeria. Cucumbers and nut butters brought along some bacterial friends for the ride. Many of these foods were produced at centralised facilities with a mandate to generate uniform products for shipment all over the country, which makes it extremely easy for infectious organisms to hop across the country. Production lines often host multiple products (between brands) and may cover a wide territory, explaining why E. coli can show up in seemingly disparate locations — it’s not necessarily about the hygiene habits and controls at a given establishment, but about the products coming through the door, which spell doom before any employees open the packaging or put them out on the shelf.

When the media cover a lot of food borne illness, it can be tough to determine if the problem is growing, or if awareness is rising, because these are not necessarily the same thing. Name brands tend to attract more media attention, which can create an artificial sense that a problem is larger than it is. But looking at trends does seem to bear out the suspicion that in some cases, food borne illnesses are on the rise, while others aren’t really moving at all, which isn’t the desired goal — the CDC wants to be bringing these numbers further down, not watching them float around the same level. 3,000 people in the U.S. die of food borne illness every year, which isn’t a huge number statistically speaking, but that’s cold comfort to their friends and family members, particularly in light of the fact that at least some of these cases could be preventable.

Food is always going to carry some dangers, no matter where it’s produced and how it’s handled. There are, however, some reasonable steps the industry can take to reduce infection, and they’re under pressure from regulatory agency to take those steps — like knocking antibiotic use down, creating more room for animals, and so forth. Larger issues include subjects like paid sick leave for workers, who often bring infection to settings like produce fields (you don’t want to know what commercial strawberry fields look like, but you should), thus allowing it to spread into the food supply.

We’re likely not going to see a return to peak levels of food borne infection, thanks to aggressive reform and monitoring. But if we can’t get it together, we will backslide, and that’s going to be a problem, especially for people with increased vulnerability, like young children, older adults, and people with immunosuppression. While people laughed at the Chipotle outbreak and mocked people for eating mass-produced fast food, they ignored the systemic issues underlying both the food system and why people rely on sources like Chipotle for their diets.

Numbers on food borne illness in 2015 still aren’t solid yet. I wouldn’t be surprised to see an upward tick, not because of the media coverage, but because of trends in epidemiological surveys, and that’s a bad sign.

(The above chickens are happily living out their lives as members of the family and are not destined to become vectors of foodborne illness. One of them also really loves it when you pet her.)