Foodborne Illnesses: United States, 1998–2008

New CDC publication and web materials: Attribution of Foodborne Illnesses, Hospitalizations, and Deaths to Food Commodities, United States, 1998–2008

CDC released its first estimates of the food sources of all foodborne illnesses acquired in the United States. A new CDC paper, “Attribution of Foodborne Illnesses, Hospitalizations, and Deaths to Food Commodities by using Outbreak Data, United States, 1998-2008” will be published in the March issue of the peer-reviewed journal Emerging Infectious Diseases with online release on January 29, 2013.

The paper provides a historical baseline of estimates that will be further refined over time with more data and improved methods.  The analysis is the logical extension of our prior analyses estimating the number of foodborne illnesses, hospitalizations and deaths in the US, published in 2011, that told us that about 48 million people (1 in 6) get sick each year from food. 

  

We have updated our Foodborne Illness Estimates website. Some changes you will notice include:

• New publication link: For additional information on this study, visithttp://www.cdc.gov/foodborneburden/index.html  with a special page devoted to the study, found here. 
• Setting the stage: A new page provides an overview of burden, trends and attribution of foodborne illness, with graphics.
• Foods causing illness: We added a new page on Attribution of Foodborne Illness that is a springboard for more work to come.
• Focus on partnerships: This site introduces the Interagency Food Safety Analytics Collaboration and provides select links and resources. 
• Updated trends: We updated our Trends page with FoodNet’s 2011 data and posted a new page,Trends in Foodborne Illness in the United States, 1996-2011 on FoodNet’s website.

Key CDC publications for food safety in January, 2013:

Antibiotic Resistance

• Azithromycin resistance gene found in Shigella outbreak. Division scientists partnered with the Los Angeles County Department of Health to characterize isolates from a 2012 California outbreak of shigellosis. Laboratory testing confirmed presence of a gene that reduces Shigella’s susceptibility to azithromycin, a commonly used antibiotic for shigellosis. 
  • Outbreak of Infections caused by Shigella sonnei with Reduced Susceptibility to Azithromycin, United States. Antimicrobial Agents and Chemotherapy. [Internet] 2012 Dec.

Attribution

• A study on the attribution of illnesses attributed to specific food commodities using a decade of outbreak data.  Produce accounted for nearly half of illnesses (46%) while meat and poultry accounted for fewer illnesses, but for 29% of deaths. 
  • Attribution of foodborne illnesses, hospitalizations, and deaths to food commodities by using outbreak data, United States, 1998–2008. Emerg Infect Dis [Internet]. 2013 Mar.

Bacterial Enteric Infections in Children

• Bacterial enteric infections cause many illnesses in US children. Compared with the general population, enteric illnesses among children <5 are="" be="" diagnosed="" likely="" more="" old="" strong="" to="" years="">. However, overall rates of illness remain higher in children after adjusting for under-diagnosis in both groups, story to come in Food Quality magazine.
  • Estimates of Illnesses, Hospitalizations, and Deaths Caused By Major Bacterial Enteric Pathogens in Young Children in the United States. Ped Infect Dis. 2012 Dec 17.

Botulism

• Commercially produced hot dog chili sauce caused type A botulism outbreak in 2007.
  • Sharing of epidemiologic and laboratory findings allowed for the rapid identification of implicated food items and swift removal of potentially deadly products from the market by US food regulatory authorities. National outbreak of type a foodborne botulism associated with a widely distributed commercially canned hot dog chili sauce. Clin. Infect. Dis. 2013 Feb;56(3):376-82.

E. coli

• Secondary cases of Shiga toxin producing Escherichia coli (STEC) infection, transmitted person‐to‐person through fecal shedding, account for an estimated 11% of infections. However, the two primary strategies for preventing secondary cases (careful hygiene practice and exclusion of infection persons from situations that may facilitate transmission) can be challenging to implement and burdensome.
  • Fecal shedding of Shiga toxin-producing Escherichia coli: What Should be Done to Prevent Secondary Cases? Clinical Infectious Diseases [Internet]. 2013 Jan.

Listeria

• Dose-response models are essential components of L. monocytogenes risk assessment.  Findings summarize strategies for modeling.
  • New data, strategies, and insights for Listeria monocytogenes dose-response models: summary of an interagency workshop, 2011. Risk Analysis [Internet] 2013 Jan.
• A recently published study on Listeria monocytogenes strains implicated in the 2011 cantaloupe outbreak reports that these strains comprised two new epidemic clones and one novel outbreak strain.
  •  Novel Epidemic Clones of Listeria monocytogenes, United States, 2011. Emerg. Infect. Dis.  2012. 19: 147-150.
• Contaminated diced celery caused a baffling outbreak of hospital-acquired listeriosis in 2010. This article reveals that PCR testing often failed to detect the pathogen, suggesting its reliability should be further evaluated.
  • Hospital-acquired listeriosis outbreak caused by contaminated diced celery--Texas, 2010. Clin. Infect. Dis. 2013 Jan;56(1):20-6.

Outbreaks

• The annual MMWR article on 2009-2010 surveillance for foodborne disease outbreaks reports that 1,527 outbreaks were reported, resulting in 29,444 illnesses, 1,184 hospitalizations, and 23 deaths.Norovirus (42%) and Salmonella (30%) were the most commonly reported pathogens that caused outbreaks.
  • Surveillance for Foodborne Disease Outbreaks — United States, 2009–2010. MMWR. Jan 2013:62(03);41-47.
  • See the CDC feature that highlights outbreak size, reporting mechanisms, current data, mishandling foods, and CDC’s role.

Salmonella

• Live baby poultry remain an important source of human salmonellosis, particularly among children. Preventing these infections requires comprehensive interventions at hatcheries and agricultural feed stores; pediatricians should inform patients of risks associated with live poultry contact.
  • Outbreak of Human Salmonella Typhimurium Infections Linked to Contact With Baby Poultry From a Single Agricultural Feed Store Chain and Mail-order Hatchery, 2009. The Pediatric infectious disease journal. 2013 Jan;32(1):8-12.
• A recent MMWR Notes from the Field reports that an outbreak of human Salmonella Typhimurium infections is linked to contact with pet hedgehogs. This outbreak strain is historically rare.
  • Notes from the Field: Multistate Outbreak of Human Salmonella Typhimurium Infections Linked to Contact with Pet Hedgehogs — United States, 2011–2013. MMWR. 62(04);73-73.

Shigella

• Most reported foodborne shigellosis outbreaks in the USA between 1998 and 2008 were restaurant-associated. Targeted efforts to reduce contamination during food handling 0could prevent many foodborne disease outbreaks and outbreak-related illnesses including those due to Shigella. Nygren BL, Schilling KA, Blanton EM, Silk BJ, Cole DJ, Mintz ED.
  • Foodborne outbreaks of shigellosis in the USA, 1998-2008. Epidemiology and infection. 2012 Feb 24:1-9.