CDC acts to expedite foodborne data
Source of Article: http://www.cidrap.umn.edu/cidrap/content/fs/food-disease/news/jul0709fooddata.html
Jul 7, 2009 (CIDRAP News) – At the same time that the
Obama Administration inaugurates new safety and enforcement standards for
the agencies overseeing food production in the United States, one of those
agencies—the Centers for Disease Control and Prevention (CDC)—is taking
steps to improve the flow of data revealing food-safety problems.
Last month, the CDC released one of its periodic
reports disclosing statistics on foodborne disease outbreaks in the United
States. But in a break from agency tradition, the report did not summarize
and compare 2 or more years' worth of numbers.
Instead, it presented just 1 year's worth, for 2006,
in an unusually granular breakdown of outbreaks by disease-causing organism—the
first step in a program to push outbreak analysis out more quickly, said
CDC scientist Ian Williams, PhD.
"Our hope is to get data out there for people to
actually use it," said Williams, chief of the OutbreakNet team in the
CDC's Division of Foodborne, Bacterial and Mycotic Diseases. "In
reporting systems, there is always a lag time because data has to be
aggregated, cleaned, and verified—but for any year we hope to have something
out by the following fall."
Data for 2007 and then 2008 will be published soon,
The report, titled "Surveillance for Foodborne
Disease Outbreaks—United States, 2006," and published in the CDC's
bulletin Morbidity and Mortality Weekly Report (MMWR), points
up vulnerabilities in the food-safety system that may be more visible
because they are not contrasted with other years' data. Among them: by
etiology, a high percentage of outbreaks caused by norovirus (54%) followed
by Salmonella (18%); and by food, a high percentage traced to leafy
vegetables and fruits and nuts (17% for leafy vegetables and 16% for fruits
and nuts, or 33% all told).
Such single-point reporting may be a weakness of the
new system, because it cannot establish trends in the way that multi-year
analyses do, said prominent food-safety attorney Bill Marler of Seattle.
"It you looked just at 2006, you would think that produce is a
terrible risk, but in 2007 and 2008 there were fewer outbreaks in produce
and many more in meat," he said.
Marler and other food-safety advocates, though,
applauded the move to get data out to the field more quickly.
"We have been asking for years to get this kind
of data out more succinctly and earlier," said Donna Rosenbaum,
executive director of the nonprofit organization Safe Tables Our Priority
(STOP). "To put out a single-year data set is a move in the right
The greatest hole in the safety net exposed by the
report, though, is the large number of outbreaks for which there are no
data. In 2006, 48 states reported 1,270 outbreaks (defined as two or more
cases of similar illnesses linked to a common food).
But among those 1,270 outbreaks, officials could
confirm a causative agent for only 621 (49%), and a causative food in only
528 (42%). In an additional 263 outbreaks (21%), an organism or chemical
was suspected, but not confirmed.
The new analysis confirming those percentages
"will help us get a sense of where there are holes in the system and
where we need to put more effort," Williams said.
In addition to two states that reported no foodborne
outbreaks at all, 12 reported none due to viral illnesses, despite the
sharp rise in norovirus cases in other areas—findings that the CDC
acknowledged are due to the differences in funding, lab resources, and
other public-health infrastructure from state to state. (In 2006, for
instance, a number of state laboratories began receiving materials that
allowed them to perform diagnostic tests for the presence of norovirus.)
The data show other holes as well: chief among them,
the vast number of foodborne illnesses that are presumed to happen in the
United States each year but are never reported in a manner that allows them
to be analyzed. Up to 76 million Americans are believed to suffer foodborne
illness each year, according to previous CDC estimates; the 2006 data,
though, cover only 27,634 cases among the 1,270 outbreaks that year.
"It is very concerning to us how few cases are
identified and analyzed," Rosenbaum said. "Some people do suffer
transient illness and get well quickly, but others suffer long-term
consequences and tremendous economic loss, and have no one to hold
"Even when people do seek care and attempt to
get a (lab) culture confirmation for their illness, unless there is a
second, third or fourth case in the community, it is very unlikely there is
going to be an investigation."
Slow progress in reducing foodborne illness was a
theme in the administration announcements Tuesday, covering sweeping
changes to egg safety rules. And it has been touched on in earlier CDC
reports, such as an April 10 MMWR disclosing that "fundamental
problems with bacterial and parasitic contamination are not being
That paper, from a sister CDC project to OutbreakNet
known as FoodNet, found that for certain disease organisms, improvements in
foodborne illness plateaued in 2004, and predicted that the United States
would not hit 2010 goals for reducing those illnesses.
Some smaller outbreaks are never analyzed by public
health, and some illnesses that look like individual cases may be part of
larger or multi-state outbreaks that are not recognized, the CDC's June
Surveillance for foodborne disease outbreaks—United States, 2006. MMWR.
2009 Jun 12;58(22):609-15 [Full text]
FoodNet data on the incidence of infection with pathogens transmitted
commonly through food—10 states, 2008. MMWR 2009 Apr 10;58(13):333-7 [Full text]