By Raymond Formanek Jr.

Strict rules for egg producers and makers of fruit or vegetable juices, and consumption limits for pregnant women and women considering pregnancy on fish containing high levels of mercury highlight a comprehensive food safety package issued by the Food and Drug Administration.

The vast majority of fruit and vegetable juices sold in the United States are pasteurized to kill potentially harmful bacteria during the manufacturing process. Juice processors who don't pasteurize their products now must take other germ-killing steps such as an ultraviolet light treatment or specially treating peels before squeezing citrus fruit for juice, according to a rule issued in January by FDA's Center for Food Safety and Applied Nutrition (CFSAN).

Unpasteurized fruit and vegetable juices have posed serious public health risks in recent years. Seventy people--including a child who died--became ill in 1996 after drinking unpasteurized apple juice contaminated by a strain of Escherichia coli bacteria. In 1999 and 2000, unpasteurized orange juice contaminated with salmonella bacteria sickened hundreds of people in the United States and three Canadian provinces. The 1999 outbreak contributed to one death.

Under the new rule, juice processors are required to follow Hazard Analysis and Critical Control Point (HACCP) principles, a quality control system initially developed by NASA to prevent food-borne illnesses among astronauts. Manufacturers using HACCP systems conduct science-based analyses of food production processes, locate where the hazards can occur, take steps to prevent problems, and respond rapidly to problems. FDA inspectors will do spot-checks to ensure that the processors' HACCP systems are working.

Packaged unpasteurized juices produced and sold at retail establishments must carry a warning label under the new rule.

Large companies have a year from the publication of the regulation to implement HACCP programs. Small companies must comply within two years after publication, and roadside stands and other very small operations must comply within three years. The FDA estimates that between 16,000 and 48,000 juice-related illnesses occur in the United States each year. For more on juice safety, see the FDA news release at www.cfsan.fda.gov/~lrd/hhsjuic4.html.

Mercury, Fish and Pregnant Women

Pregnant women and women considering pregnancy should not eat shark, swordfish, king mackerel or tilefish because they could contain enough mercury to harm an unborn infant's nervous system, according to an FDA advisory.

The advisory says that young children and nursing women also should avoid those species of fish, which tend to live longer and have higher mercury concentrations in their tissues.

In its advisory, the FDA says that fish are an important source of protein and part of a healthful diet. Joseph Levitt, director of CFSAN, says pregnant women safely can eat 12 ounces of other types of cooked fish each week. Levitt says that it's important to eat a variety of other kinds of fish.

Mercury, a silvery element, occurs naturally. About half of environmental mercury occurs from vapors escaping from the earth's core. Most of the rest comes from smokestack emissions, which the Environmental Protection Agency (EPA) regulates under the Clean Air Act. The EPA estimates that solid-waste incinerators and coal-fired power plants are responsible for more than 80 percent of the man-made mercury emissions in the United States.

Bacteria in both fresh and salt water convert mercury into methylmercury, a toxic form that accumulates in fish. CFSAN plans a comprehensive education program to reach pregnant women, women of childbearing age who may become pregnant, and their health-care providers concerning the hazard posed by methylmercury to the unborn child. As one of its priorities for fiscal year 2001, the center also will develop a public health strategy for future regulation of methylmercury in commercial seafood.

For more on the FDA advisory on methylmercury in fish, check out the FDA Talk Paper at www.cfsan.fda.gov/~lrd/tphgfish.html.

Listeria

The bacterium Listeria monocytogenes can be found nearly everywhere--soil, dust, sewage, and even water. It's tough too. It can thrive in hot, salty or acidic environments that are deadly to many other bacterial strains.

Even cold temperatures don't stop listeria, which can cause a potentially life-threatening disease called listeriosis. The bacterium continues to multiply-albeit more slowly-until temperatures reach zero degrees Fahrenheit. Most other foodborne bacteria stop growing at 40 F.

Researchers have known since the early 1900s that listeria infects animals, including birds and fish. The bacterium was recognized as a human pathogen in 1929. However, scientists didn't know that listeria could be spread through food as well as by animal contact until the early 1980s.

Listeriosis causes an estimated 2,500 serious illnesses and 500 deaths in the United States each year. Foodborne illness caused by listeria in pregnant women can result in miscarriage, fetal death, and severe illness or death of a newborn infant. Others at risk for severe illness or death are older adults and those with weakened immune systems.

Listeria often may pass through the digestive systems of healthy people, causing only mild, flu-like symptoms or without causing any symptoms at all.

The FDA and the U.S. Department of Agriculture's Food Safety and Inspection Service have released a draft risk assessment of the potential risks of listeriosis from eating certain ready-to-eat foods and an action plan designed to reduce the risk of foodborne illness caused by listeria.

The government advises that consumers can reduce their risk of listeriosis by:

• Using perishable items that are precooked or ready-to-eat as soon as possible
• Cleaning refrigerators regularly
• Using a refrigerator thermometer to ensure that temperatures remain at 40 F or lower

The FDA and USDA say that pregnant women, older people, and those with weakened immune systems should take the following steps to avoid listeriosis:

• Do not eat hot dogs or luncheon meats unless they are reheated until steaming hot.
• Do not eat soft cheeses such as feta, brie or Camembert, blue-veined cheeses or Mexican-style cheeses such as queso blanco fresco. Hard cheeses, semi-soft cheeses such as mozzarella, pasteurized processed cheeses, cream cheese, and cottage cheese may be eaten.
• Do not eat refrigerated patés or meat spreads. Canned or shelf-stable patés and meat spreads may be eaten.
• Do not eat refrigerated smoked seafood, unless it is part of a cooked dish, such as a casserole. Refrigerated smoked seafood--such as salmon, trout, whitefish, cod, tuna or mackerel--most often is labeled as "nova-style," "lox," "kippered," "smoked," or "jerky." The products are found in the refrigerator section or sold at deli counters of grocery stores or delicatessens. Canned or shelf-stable smoked seafood may be eaten.
• Do not drink raw (unpasteurized) milk or eat foods that contain raw milk.

Final action on the listeria draft risk assessment and the action plan will be taken after consideration of comments submitted by March 20, 2001. For more information on listeria and foodborne illness, see the news release on the Internet at www.hhs.gov/news/press/2001pres/20010118c.html.

Safety of Imported Foods

The FDA has developed new procedures that target "bad actor" importers who violate the rules and undermine the country's food-handling system by bringing unsafe food into U.S. markets.

The procedures now require that food shipments from "suspect" importers be held in a secure storage facility at the importer's expense until released by the FDA. Those who falsify documents or otherwise try to elude customs procedures also may be subject to fines up to the total value of the merchandise.

Some importers attempt to get around FDA regulations by "port shopping," a tactic in which the importer seeks admittance through another U.S. port when attempts at a first port have failed. In a bid to thwart the practice, FDA has proposed a rule that would require marking food shipments refused for safety reasons to indicate that the product had been previously denied entry into the United States.

In addition, FDA is developing a proposed rule that would establish standards for importers and others who use sample-collection services or private laboratories to demonstrate compliance with FDA law.

The procedures and proposals were developed in response to a July 1999 presidential directive to the secretaries of Health and Human Services and Treasury to work together to address the movement of unsafe food into the United States.

For more on the effort to tighten the rules on imported foods, read the FDA Talk Paper available on the Internet at www.cfsan.fda.gov/~lrd/tpimport.html.

Egg Safety

You may like them sunny side up or over easy, but it's safer to eat eggs that are cooked well. The FDA has issued a final regulation that soon will require shell egg cartons to bear the following statement:

"SAFE HANDLING INSTRUCTIONS: To prevent illness from bacteria: keep eggs refrigerated, cook eggs until yolks are firm, and cook foods containing eggs thoroughly."

In addition, the rule requires that eggs be promptly refrigerated at 45 degrees Fahrenheit or lower upon delivery at food-preparation establishments, including supermarkets, restaurants, delicatessens, caterers, vending operations, hospitals, nursing homes, and schools.

The new rule aims to prevent foodborne illnesses from the bacterium Salmonella enteritidis, which has been associated with undercooked eggs and foods containing undercooked eggs. Refrigerating eggs at 45 F or cooler slows the growth of the bacteria.

It's estimated that about one in 20,000 eggs produced in the United States is contaminated with salmonella. Persons infected with salmonella may experience diarrhea, fever, abdominal cramps, headache, nausea, and vomiting. Children, older people, and those with weakened immune systems may develop severe or even life-threatening illnesses.

FDA's new egg safety rule is part of a larger egg safety action plan, a joint effort between FDA and the U.S. Department of Agriculture that seeks to eliminate egg-associated salmonella illnesses by 2010. For more information on egg safety efforts, see the FDA Talk Paper at www.cfsan.fda.gov.