Question

describe and review the conclusion and critique of Survelilance for Foodborne Disease outbreaks --United States, 2009-2015.

Answer 1

1)ans) The Foodborne Disease Outbreak Surveillance System( FDOSS) collects data on foodborne disease outbreaks, which are defined as the occurrence of two or more cases of a similar illness resulting from the ingestion of a common food. Since the early 1960s, foodborne outbreaks have been reported voluntarily to CDC by state, local, and territorial health departments using a standard form. Beginning in 2009, FDOSS reporting was made through the National Outbreak Reporting System, a web-based platform launched that year.

Approximately 800 foodborne disease outbreaks are reported in the United States each year, accounting for approximately 15,000 illnesses, 800 hospitalizations, and 20 deaths (1). Outbreak-associated foodborne illnesses are only a small subset of the estimated 9.4 million foodborne illnesses from known pathogens that occur annually in the United States (2). However, the food sources and exposure settings for illnesses that are not part of outbreaks can be determined only rarely. Outbreak investigations, on the other hand, often link etiologies with specific foods, allowing public health officials, regulatory agencies, and the food industry to investigate how foods become contaminated. Foodborne outbreak data also can be used to identify emerging food safety issues and to assess whether programs to prevent illnesses from particular foods are effective.

This report summarizes foodborne disease outbreaks reported in the United States in which the first illness occurred between January 1, 2009, and December 31, 2015. The report highlights a few large outbreaks as well as novel foods and food-pathogen pairs responsible for outbreaks during the reporting period.

Conclusion:

Foodborne disease outbreaks remain an important public health issue. Data collected during outbreak investigations provide insight into the foods and pathogens that cause illnesses and the settings and conditions in which they occur. Continued efforts must be made to track and to analyze the causes of foodborne illness to inform targeted prevention efforts. In particular, strengthening the capacity of state and local health departments to investigate and to report outbreaks will improve foodborne disease outbreak surveillance and could help decrease the burden of foodborne illness through identification of foods, etiologies, outbreak settings, and specific points of contamination, which can inform intervention efforts.

Results:

During 2009–2015, FDOSS received reports of 5,760 outbreaks that resulted in 100,939 illnesses, 5,699 hospitalizations, and 145 deaths. All 50 states, the District of Columbia, Puerto Rico, and CDC reported outbreaks. Among 2,953 outbreaks with a single confirmed etiology, norovirus was the most common cause of outbreaks (1,130 outbreaks [38%]) and outbreak-associated illnesses (27,623 illnesses [41%]), followed by Salmonella with 896 outbreaks (30%) and 23,662 illnesses (35%). Outbreaks caused by Listeria, Salmonella, and Shiga toxin-producing Escherichia coli (STEC) were responsible for 82% of all hospitalizations and 82% of deaths reported. Among 1,281 outbreaks in which the food reported could be classified into a single food category, fish were the most commonly implicated category (222 outbreaks [17%]), followed by dairy (136 [11%]) and chicken (123 [10%]). The food categories responsible for the most outbreak-associated illnesses were chicken (3,114 illnesses [12%]), pork (2,670 [10%]), and seeded vegetables (2,572 [10%]). Multistate outbreaks comprised only 3% of all outbreaks reported but accounted for 11% of illnesses, 34% of hospitalizations, and 54% of deaths.

Interpretation:  

Foodborne disease outbreaks provide information about the pathogens and foods responsible for illness. Norovirus remains the leading cause of foodborne disease outbreaks, highlighting the continued need for food safety improvements targeting worker health and hygiene in food service settings. Outbreaks caused by Listeria, Salmonella, and STEC are important targets for public health intervention efforts, and improving the safety of chicken, pork, and seeded vegetables should be a priority.

Public Health Action:

It causes of foodborne illness should continue to be tracked and analyzed to inform disease prevention policies and initiatives. Strengthening the capacity of state and local health departments to investigate and report outbreaks will assist with these efforts through identification of the foods, etiologies, and settings linked to these outbreaks.

Limitations:

The findings of this report are subject to at least four limitations. First, because CDC’s foodborne outbreak surveillance is dynamic and agencies can submit, update, or delete reports at any time, the results of this analysis might differ slightly from previous or future reports. Second, not all outbreaks are identified and the majority of foodborne illnesses occur outside the context of a recognized outbreak. The degree to which the food vehicles, etiologies, and locations implicated in outbreaks represent the vehicles, etiologies, and locations of sporadic foodborne illness is unknown. Third, some outbreaks have an unknown food vehicle, an unknown etiology, or both, and analyses and conclusions drawn from outbreaks with an identified food vehicle and confirmed etiology might not be representative of all outbreaks. Finally, pathogens that are not known to cause illness sometimes are reported as a confirmed or suspected etiology.