Conclusions

Food-borne disease in the industrialized world is shifting in its epidemiologic patterns of who, what, when, where, and why. Food is abundant and cheap, with less of household income being expended on it. Traditional pathogens like trichinosis, tuberculosis, and typhoid have been eliminated. Dietary changes are reflected in increases in less traditional pathogens, such as non-typhoidal salmo-nellae, and more produce-related illnesses. Immunocompromised persons now constitute significant proportions of the populations in industrialized countries. Nearly half of food expenditures are now on food consumed away from home, and imported foods are regularly available. New pathogens will be identified and others will re-emerge in different ecologic niches. In the global village, consumers in the industrialized countries now are directly connected to the health and environmental conditions of food producers in the developing world. Their food safety is less under their personal control, and increasingly is vested in a complex network of producers, distributors, processors, and retailers. Because the strength of such a network is measured by its weakest link, the future of food safety will be a greater emphasis on prevention and tighter control of the food supply. Regulation is the pact that society has with government to provide the safety net which markets do not provide. To keep pace with change, food safety regulations must evolve to become more science-based, have greater flexibility, and be more transparent, while society must choose the cost it is willing to pay for the benefits of improvements in public health.

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