Efforts to reduce the number of food-borne illnesses in the United States have stalled in the past three years, and some illnesses are on the upswing, giving new urgency to efforts to reform the nation's food safety system, the Centers for Disease Control and Prevention reported yesterday.

"We need greater effort at all stages of movement of food in the food chain from farm to table" to prevent bacterial contamination, said Robert Tauxe, deputy director of the CDC's Division of Foodborne, Bacterial and Mycotic Diseases.

Several factors are fueling the trend, including the intricacy of the U.S. food chain, the changing nature of the contaminating bacteria and the rise in imported food, Tauxe said. Bacteria that used to be associated mainly with meats and poultry have recently shown up in fresh produce, posing new risks, he said. Examples include E. coli 0157 in spinach and salmonella in peanuts and pistachios.

"It reflects the complexity of the problem, with many different foods becoming potentially contaminated, including more fresh produce. It reflects that fact that pathogens like E. coli 0157 and salmonella can spread in the environment and contaminate a number of different foods, some of which we have not seen in the past," Tauxe said. "And the food industry is also complicated and changing, with a variety of different arenas and components from all over the world."

Children younger than 4 are particularly vulnerable to food-borne bacteria, while adults older than 50 are the most likely to be hospitalized and die from bacterial exposure, the study found. Children can become infected simply by sitting in a shopping cart next to raw meat or, in non-food-related cases, from living with pet turtles or reptiles or from attending day-care facilities where other children or care providers have not adequately washed their hands after using the bathroom, Tauxe said.

The bacteria in question are generally found in the intestines and feces of animals. When consumed in food by humans, they can cause diarrhea and cramps. Most healthy adults recover within days, but the bacteria can cause serious and sometimes deadly illness in children, the elderly and those with compromised immune systems.

"We had been moving in the right direction. We had been reducing some of these key food-borne illnesses, and something potentially significant has stopped that progress or reversed that progress," said Erik D. Olson, director of food and consumer product safety at the Pew Charitable Trusts, which is advocating for tougher food safety requirements for industry and stepped-up oversight by government regulators. "In some cases, like salmonella, we're double the [2010] national objective. That says we've got a pretty serious issue here."

The CDC has been collecting data since 1996 from 10 states on the people with infections caused by eight bacteria and two parasites found in food. The study, reported in the CDC's Morbidity and Mortality Weekly Report, found that the rate of infection for several bacteria had been dropping until about 2004, when the numbers began rising again or leveled off. They include salmonella, vibrio, E. coli 0157, listeria and campylobacter.

Preliminary 2008 data show that infection rates for five food-borne illnesses currently exceed the national goals set by the CDC for 2010. The rate of salmonella infection was more than twice the national goal, and that data did not include the current national outbreak of salmonella illness linked to peanut products. That episode began in late 2008 and peaked in the early months of 2009, sickening nearly 700 people and killing nine.

The Food and Drug Administration, which is responsible for overseeing the safety of most food in this country, has been under fire for years on Capitol Hill and among health advocates for being too lax. The agency is widely considered to be understaffed and underfunded, deficiencies highlighted repeatedly by the Government Accountability Office.

As fresh produce increasingly became a new source of food-borne illnesses, the FDA provided little or no oversight, the GAO found in a report last year. The agency inspected less than 1 percent of the fresh produce imported between 2002 and 2007, it had no formal program devoted to fresh produce, and it had conducted no scientific work to understand contaminants such as E. coli 0157 because it did not have research money, the GAO found. In fiscal 2007, the agency spent about 3 percent of its food safety budget on fresh produce, the GAO reported.

The agency did not act even after an outbreak of E. coli 0157 illness from spinach decimated spinach growers and the leafy greens industry lobbied the FDA, asking regulators to require growers to take preventive measures to minimize bacterial contamination.

The crisis came to a head during the ongoing outbreak of salmonella illness linked to peanuts, which captured national attention and prompted a pledge by President Obama to elevate food safety and revamp the FDA. It also spurred about half a dozen bills now pending in Congress to reform food safety.

David Acheson, director of food safety and security at the FDA, said his agency is moving ahead with new tactics to try to prevent outbreaks and to react more quickly when they occur. "This has to be addressed with a proactive, dynamic approach to new strategies to protect American consumers," he said.

Among other things, the FDA is hiring more than 150 inspectors and scientists to boost its capabilities and is joining with public health officials in six states in a pilot project to create "rapid response" teams to speed investigations once an outbreak occurs, Acheson said.

Obama's nominee to head the agency, Margaret Hamburg, is awaiting Senate confirmation. Her deputy, Joshua Sharfstein, started work last month and has pushed a more aggressive posture in the way the agency is handling a new salmonella scare connected to pistachios.

www.washingtonpost.com/wp-dyn/content/article/2009/04/09/AR2009040902495_pf.html