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April 30, 2002
Good afternoon, Mr. Chairmen and Members of the Subcommittees. I am Dr. Lester Crawford, Deputy Commissioner of the Food and Drug Administration (FDA or the Agency). I am accompanied today by Dr. Paul Mead who is Chief of the Outbreak Response and Surveillance Unit in the Centers for Disease Control and Prevention (CDC). Thank you for this opportunity to discuss the safety of Federal school lunches. Ensuring the safety of the food supply is a top priority for FDA, the Department of Health and Human Services (HHS), and the Administration. I am pleased to be here today with my colleague from the U.S. Department of Agriculture (USDA), Dr. Elsa Murano.
appreciate this opportunity to explain FDA's role with regard to the safety of Federal school lunches and the food supply in general. I would like to describe FDA's role in responding to reports of foodborne illness and our coordination with other Federal, State, and local agencies and to mention some of our recent food safety efforts that are directed toward children.
The Role of FDA
As you know, FDA has responsibility for all of the food supply, with the exception of meat, poultry, and egg products, which are regulated by USDA. FDA's jurisdiction covers approximately 80 percent of domestic and imported foods that are marketed in interstate commerce. The Agency seeks to ensure that these products are safe, nutritious, wholesome, and properly labeled. FDA has jurisdiction where food is produced, processed, packaged, stored, or sold. In addition to jurisdiction over food establishments, FDA's purview also includes approval and surveillance for new animal drugs, animal feeds, and all food additives that can become part of food.
USDA administers the Federal school lunch program. FDA is not involved in the procurement of foods for this program. However, FDA works closely with USDA and other Federal, State, and local agencies when reports of illnesses related to foods in the school lunch program are received. FDA's various food safety activities all help to ensure that the foods served in school are safe. Our food safety activities include research, risk assessment, outbreak response, the development of preventive controls, inspection of domestic and imported food, enforcement, and the development of educational materials for consumers, health officials, and industry.
FDA recognizes State and local governmental jurisdictions as having primary responsibility for the regulation of the retail segment of the food industry. FDA provides assistance to local, State, and Federal governmental bodies to ensure that the food that is provided to consumers by retail establishments is not a vehicle for transmitting foodborne illness. The Agency publishes a model Food Code that represents FDA's best advice for a uniform system of regulation to ensure that the food sold or offered for human consumption in retail outlets such as restaurants, grocery stores, and institutions (including schools and nursing homes) is safe, properly protected, and honestly presented. Many jurisdictions have adopted FDA's Food Code, or an amended version of it, as their regulatory standards. FDA, the Conference for Food Protection, and the Association of Food and Drug Officials (AFDO) are working together to promote adoption of the Food Code by all food safety agencies at the Federal, State, tribal nation, and local levels. According to a recent report by AFDO, a majority of the States and territories have adopted a version of the Food Code. Most of the remaining States and territories are actively pursuing Food Code adoption. Adoption of the Food Code represents a successful Federal/State/local partnership to improve food safety. Widespread adoption and implementation of the Food Code will help protect schoolchildren by ensuring that school food service managers and workers have up-to-date, science-based guidance on safe food preparation practices.
Outbreak Response and Coordination
Responsibility for responding to foodborne disease outbreaks is shared among local, State, and Federal governments. Local and State governments are often the first to detect the occurrence of an outbreak and initiate an investigation if appropriate. It is important to note that many episodes of foodborne illness are addressed exclusively at the local or State level. Local and State governments play a major role in outbreak surveillance and investigation.
The role of the Federal agencies in large or complex multi-state outbreaks is to assist the State and local agencies in preventing additional cases of illness from occurring. CDC, through its surveillance systems, detects and investigates outbreaks of foodborne illness. CDC also assists Federal, State, and local agencies in investigating outbreaks. FDA becomes involved when FDA-regulated food products may be implicated. FDA has stationed an employee at CDC in the Foodborne Diarrheal Diseases Group to assure seamless communication on foodborne outbreaks. FDA's objectives in outbreak investigation and response are verification of the association with a regulated product, identification of the source of the product and the extent of distribution, prevention of any further exposure to the contaminated product, and initiation of regulatory action if indicated. An additional critical role of outbreak investigation is to identify contributing factors in order to prevent any future outbreaks from a similar problem.
FDA has worked closely with USDA's Food and Nutrition Service and Food Safety and Inspection Service in responding to several school-related outbreaks, such as the one involving hepatitis A in frozen strawberries in 1997, one associated with burritos in 1998, and one involving burritos and tortillas in 1998. FDA also has provided laboratory analysis assistance to USDA.
In conjunction with activities related to the Food Code, FDA initiated a project to establish a baseline for the occurrence of the risk factors identified by CDC that contribute to foodborne illness in retail food establishments. A recent survey of risk-related conditions in food service covered nine different facility types, one of which was elementary schools. For the food service operations in elementary schools, an initial survey identified problems such as failure to ensure adequate handwashing and failure to maintain potentially hazardous foods at proper temperatures. This kind of information is useful in addressing risk factors and in measuring the success of new initiatives. CDC is currently working with the National Association of City and County Health Officials to develop a standardized inspection form that could be used by local health department inspectors to assess risks in schools. HHS and USDA are working toward the HHS Healthy People 2010 food safety objective of reducing the occurrence of the CDC-identified foodborne illness risk factors in institutional food service establishments (including schools), restaurants, and retail food stores by 25 percent by October 1, 2010.
To improve outbreak detection and response by the Agency and our State and local partners, FDA has developed several training courses. FDA's satellite training courses on food microbiology, foodborne disease epidemiology, and product traceback related to outbreak investigations, have been attended by thousands of government and industry representatives from around the country. FDA has also invited representatives of the governments of Canada and Mexico to attend these training sessions. In addition, FDA has conducted presentations at numerous conferences in the U.S., Mexico, and Latin America on foodborne outbreaks and tracebacks to determine the source of the outbreaks.
In 1998, FDA initiated an effort known as the National Food Safety System Project to improve coordination and communication among public health and food regulatory officials at all levels of government, particularly in connection with foodborne illness outbreaks. This project is a collaboration of FDA, CDC, USDA, the Environmental Protection Agency, and State and local officials from health, agriculture, and environment agencies. Five workgroups were formed to generate ideas for action that would promote an integrated food safety system. One of the groups, the Outbreak Coordination and Investigation Workgroup, produced guidelines last year for improving coordination and communication during multi-state foodborne outbreak investigations. These guidelines provide a framework for local, State, and Federal agencies to effectively respond to multi-state foodborne outbreaks. The concepts, principles, and checklists in the guidelines can also be used to recognize and respond to public health emergencies associated with other foodborne hazards.
Enhanced surveillance systems are also important tools for improving the response to outbreaks. For example, PulseNet, developed by CDC, enables a national network of public health laboratories to "fingerprint" bacteria that may be foodborne and compare results through an electronic database maintained by CDC. Now a collaborative effort among CDC, FDA, USDA, and participating State and local public health laboratories, PulseNet can help public health authorities recognize that cases of foodborne illness occurring at the same time in geographically separate locales are caused by the same strain of bacteria and may be due to a common exposure. PulseNet has been key in rapidly detecting and containing numerous outbreaks of foodborne illness, including multi-state outbreaks. For example, PulseNet aided in the identification of a multi-state outbreak of Salmonella Agona infections linked to toasted oats cereal. Since the illnesses were dispersed among 20 States, the comparative matching of the disease-causing organisms made possible via PulseNet facilitated the epidemiological investigation that led to the recall of two million pounds of contaminated product. Without PulseNet, it is unlikely that these cases would have been identified as coming from the same source. Similar systems are now under development for viruses and parasitic agents that are associated with foodborne illness.
Another system, which was proposed by some workgroups of the National Food Safety System Project, is the electronic Laboratory Exchange Network (eLEXNET). It is the nation's first Internet-based, interagency food testing reporting system developed to provide access to critical food testing data in Federal, State, and local food safety laboratories. eLEXNET has not only facilitated data information sharing and communication, but has also provided a means for collaboration among food safety experts. At present, 36 laboratories in 24 States are participating in eLEXNET. FDA is working to expand the system to include at least two laboratories from each State -- a public health lab and an agriculture lab. The system includes data on Escherichia coli O157:H7, all Salmonella species, Listeria monocytogenes, and Campylobacter jejuni.
Thanks to all the efforts described above, the response to outbreaks is faster and better coordinated than ever before. A rapid response is critical in containing an outbreak and preventing further illnesses from occurring.
FDA Activities for Schoolchildren
FDA is involved in numerous food safety activities that are specifically aimed at reducing the incidence of foodborne illness among schoolchildren. For example, FDA has been working with USDA's Food and Nutrition Service on its project with the National Food Service Management Institute of the University of Mississippi to revise the "Serving It Safe: A Manager's Tool Kit." This information is designed to help school food service managers achieve adherence with the safe food preparation practices in the Food Code.
FDA has also been participating with CDC in the National Coalition for Food-Safe Schools. This coalition includes school administrators, school nurses, educators, sanitarians, State representatives, FDA, USDA, and others working together to develop a comprehensive school health program. The coalition has just produced a draft Food-Safe Schools Action Guide that provides a coordinated framework of identifying and monitoring school food safety policies, programs, and practices to reduce the incidence of foodborne illness.
In a partnership to educate students themselves about food safety, FDA and the National Science Teachers Association (NSTA), developed a curriculum for middle and high school students. This program, "Science and Our Food Supply," teaches the scientific principles of all aspects of food safety, from the farm to the dinner table, and introduces students to the wide variety of careers in food science. Students learn about bacterial growth and how pathogens pose a risk of causing illness; how practices on the farm, such as safe composting, can lead to safer crops; how food processing technologies, such as ultra-high temperature pasteurization, are leading to new products; and how safe food handling practices in restaurants and at home can reduce foodborne illness.
This year, FDA and NSTA will be hosting their third conference to train teachers in the curriculum. At each conference, 50 middle and high school teachers are trained. Each of these teachers agrees to train other teachers in their States during the following school year. We expect that this curriculum will help reduce the incidence of illness by teaching students safe food preparation habits they can practice throughout their lives. As more high school students are employed in restaurants than in any other industry, this training will help ensure that food served in restaurants is safely prepared.
A video that was developed as part of this curriculum won an Emmy Award from the National Academy of Television Arts and Sciences Mid-Atlantic Region last year. "Dr. X and the Quest for Food Safety" introduces and reinforces the science concepts of food safety from the farm to the table. The "Science and Our Food Supply" education kit that includes the video is available free of charge to middle and high school teachers through NSTA.
As part of the Food-Safe Schools initiative, FDA is also participating in other working groups to improve school food safety, such as the advisory committee for the national non-governmental organizations funded by CDC which include the National Association of County and City Health Officials, the American Nurses Foundation, and the American School Food Service Association.
In my statement today, I have described just a few of the many food safety activities FDA is pursuing. We are working closely with our Federal, State, and local partners, as well as with industry, consumer organizations, and academia to reduce the incidence of foodborne illness for school children and the general population to the greatest extent possible.
Thank you for the opportunity to discuss FDA's food safety activities. We look forward to working with both subcommittees on ways to continue to improve the safety of the nation's food supply. I would be happy to answer any questions.
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Last revised: May 6, 2002