Kentucky and 13 other states received a failing grade from a national consumer advocacy organization for the way food-borne illnesses are handled.
The seven states that received an A had the highest number of incidents of food-borne illness, such as salmonella, said The Center for Science in the Public Interest report, which was released Wednesday.
"While it may seem counter intuitive to give the best grades to the states with the most outbreaks, those states are the most likely to have robust detection and reporting systems," the report states.
The study also noted most states that received an F — Arizona, Arkansas, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, New Mexico, Oklahoma, South Carolina, Texas and West Virginia — are "Southern states with climates most conducive to pathogen growth."
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States with the highest grade are Florida, Hawaii, Maryland, Minnesota, Oregon, Washington and Wyoming.
The report examined data provided to the Centers for Disease Control and Prevention for a decade ending in 2007.
Kentucky reported a total of 25 outbreaks during that time with 193 people becoming ill. The report said 75 percent of the outbreaks involved 26 to 50 people. The numbers are not news to Dr. William Hacker, Kentucky's Commissioner for the Department for Public Health.
But, he said, significant changes have been made in the past five years in how food-borne illnesses are handled in Kentucky.
"We have done a better job than what the data would suggest," he said. "I believe the report doesn't actively reflect what is happening in Kentucky."
For one thing, he said, the state has hired 18 epidemiologists who work in the field to help prevent and investigate outbreaks. And, he said, last year the state law dealing with food safety was changed significantly for the first time in 20 years.
Those changes are starting to have positive results, he said. Last summer, Kentucky health officials were the first to discover a salmonella outbreak in Mexican-style restaurants that spread to several other states, he said. Kentucky's early detection made it possible for other states to limit the public's exposure to the tainted food, he said.
Gwenda Bond, a spokeswoman for the health department, said the illnesses reported in Kentucky represent about 1 percent of the national total. That is in line with Kentucky's percentage of the national population.
"Come back in another five years, and you will see an even better trend," she said.
It's important for individuals to be part of the solution, said Jessica Cobb, manager of environmental health and protection for the Lexington-Fayette County Health Department.
Consumers should pay attention to health violations at restaurants and grocery stores. They should return food at restaurants not served at the correct temperature. Also, consumers should see a physician if they start having symptoms of a food-related illness and report it to the local health department, she said.
Investigators can then go to the restaurant or grocery store to make sure other potentially tainted foods aren't sold to others.
But, she said, "it's hard to encourage people to do that." Many ride out their symptoms without even seeing a doctor, and that can lead to underreporting, she said.