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June 2, 1993

Foodborne Illness in the 1990s

Author Affiliations

The Johns Hopkins School of Medicine Baltimore, Md

JAMA. 1993;269(21):2737. doi:10.1001/jama.1993.03500210037023

To the Editor.  —The December 9, 1992, issue contains an enlightening report on a recent cheese-related Salmonella outbreak affecting four states.1The report underscores the fact that there is an emerging health crisis in the United States. From 1985 through 1990, a total of 46 deaths were reported among 10253 cases of Salmonella enteritidis infection recorded by the CDC.2The authors correctly call for increased awareness of the potential pathogenicity of cheese items and a greater commitment to addressing this problem. But state and local governmental agencies must not limit themselves to the cheese and dairy industry, since there are many others equally culpable.The spread of the Salmonella scourge to the fast-food restaurant industry is a case in point.3 Because federal surveillance data do not differentiate between poisoning due to fast-food establishments from those of other eating facilities, the exact number of poisonings attributed to fast-food