As an outbreak of a food illness commonly linked to imported fruits and vegetables is spreading in Texas and 13 other states, the federal government released proposed rules Friday aimed at making such imports safer.
For the first time, the Food and Drug Administration would require U.S. businesses that import foods to verify that they are as safe as those grown or processed domestically. In addition, the rules establish an auditing and certification process to help determine whether to allow foods into the country that the FDA has flagged as potentially risky.
Food imports have quadrupled in a decade and now come from 150 countries, although the FDA inspects only about 2 percent of those foods at U.S. borders and ports. Imports make up 15 percent of the U.S. food supply, including about 50 percent of the fresh fruits and 20 percent of the fresh vegetables that Americans eat, the FDA says. Americans increasingly demand access to their favorite fruits and vegetables year-round, and imports make them available when they out of season in this country.
Each year, about 1 in 6 Americans — 48 million people — get sick from a food-borne illness; 128,000 are hospitalized and 3,000 die, according to the U.S. Centers for Disease Control and Prevention. The cost of those illnesses from imported food is estimated at $1.2 billion, more than one-fifth of the entire cost of food-borne sickness in the U.S., according to the FDA.
Right now, Texas is among 14 states and one city — New York — grappling with an outbreak of cyclospora infection, called cyclosporiasis, the CDC said. It is caused by a single-celled parasite linked in past outbreaks to imported produce, but investigators haven’t yet determined the source of this one.
Cyclospora infection is caused by ingesting food or water contaminated by feces. The infection is “pretty rare,” said state health department spokeswoman Christine Mann. Between 2001 and 2010, there were just 35 cases in Texas.
Texas reported 101 cyclospora infection cases Friday afternoon, while the CDC reported 321 cases around the country as of 5 p.m. Thursday.
The illness causes diarrhea that can last for weeks or months, in addition to appetite loss, nausea and severe fatigue. It isn’t believed to be transmitted from person to person. People at the highest risk of serious illness are those with compromised immune systems, including cancer patients and people who have had transplants.
In Texas, the highest number of cases are in Dallas, Collin and Tarrant counties. Travis County was next with six cases; Williamson County had two, according to the Department of State Health Services.
No deaths have been reported, although seven people in Texas were said to be hospitalized, Mann said.
On July 16, the state health department notified Texas doctors of the outbreak, asking them to test for cyclospora infection, a test that isn’t commonly done.
Health officials said they recommend carefully washing fruits and vegetables, although the microscopic cyclospora parasite can be difficult to wash off, even with soap, Mann said. Cooking vegetables should kill the parasite, Mann said.
Most healthy people will recover without treatment, but relapse isn’t uncommon. Some cases of diarrhea have been reported to last up to 70 days, according the state health department’s website.
The CDC website says it isn’t yet clear whether all of the cases are part of the same outbreak. Some people could have acquired the illness while traveling internationally, the CDC said.
Although the U.S. is doing a better job of detecting food illnesses, said Sandra Eskin, director of the Food Safety Campaign at the Pew Charitable Trusts, most people who are sickened by food stay home a day or two and never see a doctor. Consequently “a minuscule percentage are captured in outbreaks,” Eskin said.
The rules released Friday were long-awaited and are part of the Food Safety Modernization Act that Congress passed in 2010. The cost to industry is estimated to be up to $492 million a year.
“We believe this new rule is going to better assure the safety of imported foods,” Eskin said.
However, the rules will undergo a four-month comment period and could be changed.
“The rules on paper could be wonderful, but the FDA must have the resources to enforce the law … and that is critical,” Eskin said. “The FDA has received additional appropriations, but they are going to need significantly more, and what they are able to get will determine how robust the oversight and enforcement can be.”
Cause: Parasite from infected feces contaminates food or water.
Main symptom: Profuse diarrhea lasting weeks or months; may recur.
Other possible symptoms: Loss of appetite, fatigue, weight loss, abdominal cramps, bloating, nausea, vomiting and low-grade fever.
Timing: Symptoms appear within two days to two weeks of consuming contaminated food or water.
Treatment: Drinking plenty of fluids and antibiotics, when prescribed by a doctor.
Prevention: Thoroughly clean fruits and vegetables before eating, although that might not work.
Source: Texas Department of State Health Services
CORRECTION: This story has been corrected to reflect that cooking vegetables should kill the cyclospora parasite.