CSPI Finds a Troubling Decline in Foodborne Outbreak Investigations by State Health Officials
December 23, 2009
WASHINGTON—In a troubling trend, state health departments completed fewer foodborne outbreak investigations in 2007 than in the previous decade, according to the Center for Science in the Public Interest.
"The decline in fully-investigated outbreaks could reflect a serious gap in state public health spending," said CSPI food safety director Caroline Smith DeWaal. "Fewer outbreaks were fully investigated by state public health departments in 2007 than in any of the previous 10 years—and a smaller percentage of outbreaks were fully characterized than in any of the previous 7 years."
The trend showed up in the latest Outbreak Alert! report by CSPI. It found that states reported 33 percent fewer fully investigated outbreaks to the Centers for Disease Control and Prevention (CDC) in 2007 than in 2002. This doesn't mean that outbreaks aren't occurring, DeWaal stressed. Nearly 1,100 outbreaks were reported in 2007 to CDC, but in only 378 cases did states identify both a food and the pathogen (the mark of a complete investigation).
Outbreaks are first investigated at the local and state level. To provide the most useful data for controlling food safety problems, those investigators need to identify both the pathogen and the specific food responsible for the outbreak, and then state departments of health need to report the outbreaks to CDC. Fewer completed investigations mean that less information is available to the CDC and other federal health agencies—affecting their ability to identify problems in the food safety system or issue recalls to protect the public.
CSPI has been tracking foodborne outbreak reports for over 10 years and publishing the data in its Outbreak Alert! report and on its website. CSPI analyzes state reports compiled by CDC, sorts them by food category, and makes the aggregated data available to federal policymakers to guide priority setting, to the industry to address production problems, and to the public.
CSPI says that a food safety bill passed several months ago by the U.S. House of Representatives and another bill that is pending in the Senate would greatly enhance the government’s surveillance systems and ensure better coordination between state officials and the CDC. Most important, the legislation would create a food-safety system focused on preventing contamination in the first place, by requiring food processors to prepare food safety plans and requiring the FDA to inspect food processing facilities more frequently.
"Congress should pass legislation to dramatically reduce the numbers of needless deaths and expensive hospitalizations caused by contaminated food," said CSPI senior staff attorney David Plunkett. "Americans deserve food safety legislation early in the new year."
CSPI analyzed a total of 4,638 outbreaks of illness linked to specific foods, involving 117,136 individual illnesses that occurred between 1998 and 2007. An "outbreak" involves two or more people sickened by the same food. The food categories (other than "multi-ingredient") most commonly linked to outbreaks during this ten-year period were:
- Seafood: 838 outbreaks involving 7,298 cases of illness
- Produce: 684 outbreaks involving 26,735 cases of illness
- Poultry: 538 outbreaks involving 13,498 cases of illness
- Beef: 428 outbreaks involving 9,824 cases of illness
- Pork: 200 outbreaks involving 4,934 cases of illness
Foods regulated by the FDA, such as seafood, produce, eggs, and dairy products, were associated with more than twice as many outbreaks as foods regulated by the U.S. Department of Agriculture, which oversees meats and poultry. The data also show several changes in food trends. For instance, in this 10-year analysis of the data, eggs dropped out of the top five causes of outbreaks, probably due to the implementation of safety programs by egg producers, programs recently made mandatory by FDA. Also, dairy outbreaks increased dramatically after 2004 due to the increased availability of unpasteurized dairy products.
The outbreaks in CSPI's database represent just the tip of a much larger problem. The CDC estimates that contaminated foods kill thousands and sicken up to 76 million Americans each year. The vast majority of foodborne illnesses are undiagnosed and most are never reported to state officials. For those that come to their attention, state officials may lack the resources to track down the cause of most illnesses and outbreaks, and are not required to report foodborne illness outbreaks to CDC.