CDC Food Safety Announcements
This page contains all CDC Food Safety announcements, organized by date. The most recent announcements are at the top. To sign up to receive email updates on Food Safety topics, enter your email address in the "Get email updates" box on the right side of this page.
February 2015: New Method for Attributing Foodborne Illness
Partners Develop New Method for Attributing Foodborne Illness
CDC, the U.S. Food and Drug Administration (FDA) and the USDA’s Food Safety and Inspection Service (FSIS) have developed an improved method for analyzing outbreak data to determine which foods are responsible for illnesses related to four major foodborne bacteria.
Today, the Interagency Food Safety Analytics Collaboration (IFSAC), a partnership among the three agencies, released a report entitled “Foodborne Illness Source Attribution Estimates for Salmonella, Escherichia coli O157 (E. coli O157), Listeria monocytogenes (Lm), and Campylobacter using Outbreak Surveillance Data”.
CDC estimates that, together, these four pathogens causes an estimated 1.9 million cases of foodborne illness in the United States each year.
IFSAC analyzed data from nearly 1,000 outbreaks that occurred from 1998 to 2012 to assess which categories of foods were most responsible for making people sick with Salmonella, E. coli O157, Listeria, and Campylobacter. IFSAC experts divided food into 17 categories for the analysis. The pathogens were chosen because of the frequency or severity of the illnesses they cause, and because targeted interventions can have a significant impact in reducing them.
The report presents the methods behind the results and provides details about the amount of uncertainty around the estimates. Some of the findings include:
- More than 80 percent of E. coli O157 illnesses were attributed to beef and vegetable row crops, such as leafy vegetables.
- Salmonella illnesses were broadly attributed across food commodities, with 77 percent of illnesses related to seeded vegetables (such as tomatoes), eggs, fruits, chicken, beef, sprouts and pork.
- Nearly 75 percent of Campylobacter illnesses were attributed to dairy (66 percent) and chicken (8 percent). Most of the dairy outbreaks used in the analysis were related to raw milk or cheese produced from raw milk, such as unpasteurized queso fresco.
- More than 80 percent of Listeria illnesses were attributed to fruit (50 percent) and dairy (31 percent). Data were sparse for Listeria, and the estimate for fruit reflects the impact of a single large outbreak linked to cantaloupes in 2011.
Due to limitations in outbreak data and uncertainty in the estimates, IFSAC recommends caution in interpreting certain findings, such as the estimates for Campylobacter in dairy and Listeria in fruits. IFSAC suggests that the results be used with other scientific data for risk-based decision making.
IFSAC will describe its methods at a public meeting today in Washington, D.C., as part of the overall federal efforts to improve foodborne illness source attribution. For more information on the IFSAC partnership, its goals and projects, please visit the partnership's website.
February 2015: Outbreaks from Raw Milk on the Rise
Outbreaks from raw milk on the rise
Outbreaks caused by raw milk increased over a six-year period, according to a newly released CDC study. The study reviewed outbreaks caused by raw milk--milk that has not been pasteurized to kill disease-causing germs--in the United States that were reported to CDC from 2007-2012. The study analyzed the number of outbreaks, the legal status of raw milk sales in each state, and the number of illnesses, hospitalizations, and deaths associated with these outbreaks.
More states are legalizing the sale of raw milk even though this leads to an increase in the number of outbreaks.
About the Raw Milk Study:
- 26 states reported:
- 81 outbreaks
- 979 illnesses
- 73 hospitalizations
- Outbreaks increased:
- 30 between 2007-2009
- 51 between 2010-2012
- Three germs caused the most outbreaks (2007-2012):
- Campylobacter - 81%
- Shiga toxin-producing E.coli - 17%
- Salmonella - 3%
Findings also showed that the number of states that have legalized the sale of raw milk has also increased. In 2004, there were 22 states where the sale of raw milk was legal in some form; however, this number increased to 30 in 2011. Eighty-one percent of outbreaks were reported in states where the sale of raw milk was legal.
Children were at the highest risk for illness from raw milk. About sixty percent of outbreaks involved at least one child younger than five years of age.
Raw milk is a risk for human health.
You cannot look at, smell, or taste raw milk to determine if it is safe. Cows and other animals can appear healthy and clean, but can still have germs, like Salmonella and E. coli, which can cause illnesses in humans.
Milk cannot be collected without introducing some bacteria—even under ideal conditions of cleanliness. Unless the milk is pasteurized, these bacteria can multiply.
Even raw milk supplied by "certified," "organic," or "local" dairies has no guarantee of being safe. Raw milk from grass-fed animals is not considered safe either.
How does milk get contaminated?
Milk contamination may occur from:
- Cow feces coming into direct contact with the milk
- Infection of the cow's udder (mastitis)
- Cow diseases (e.g., bovine tuberculosis)
- Bacteria that live on the skin of cows
- Environment (e.g., feces, dirt, processing equipment)
- Insects, rodents, and other animal vectors
- Humans, for example, by cross-contamination from soiled clothing and boots
Is it true that raw milk has more enzymes and nutrients than pasteurized milk?
While it’s true that the heating process of pasteurization does inactivate some enzymes in milk, the enzymes in raw animal milk are not thought to be important in human health. Some nutrients are somewhat reduced in pasteurized milk, but the United States diet generally has plenty of other sources of these nutrients. For example, vitamin C is reduced by pasteurization, but raw milk is not a major source of vitamin C. Read more about the raw milk study.
Learn more about raw milk:
January 2015: Public Meeting Notice: IFSAC Updates
Tri-Agencies to Update Public on Harmonized Foodborne Illness Attribution
CDC, the U.S. Food and Drug Administration (FDA), and USDA’s Food Safety and Inspection Service (FSIS) will hold a public meeting on Tuesday, February 24, 2015 to update stakeholders on the Interagency Food Safety Analytics Collaboration’s (IFSAC) work to improve foodborne illness source attribution. Specifically, IFSAC will provide updates on work to develop harmonized foodborne illness source attribution estimates, as well as other analyses IFSAC has undertaken since its formation in 2011. This work can inform food safety strategies. FSIS, FDA, and CDC are also interested in input from stakeholders regarding plans for future IFSAC endeavors.
- Tri-agency collaboration of
- Center for Disease Control and Prevention (CDC)
- U.S. Food and Drug Administration (FDA
- Food Safety and Inspection Service (FSIS) of the United States Department of Agriculture (USDA)
- Formed in 2011 with the goal to:
- Improve coordination of federal food safety analytics efforts
- Address cross-cutting priorities for food safety data collection, analysis, and use
- Current focus is foodborne illness source attribution
- Defined as process of estimating the most common food sources responsible for specific foodborne illnesses
- Projects and studies aim to identify foods that are important sources of illnesses
- Tuesday, February 24, 2015, 8:30 am – 5:00 pm EST
- Jefferson Auditorium in South Building, U.S. Department of Agriculture (USDA), 14th & Independence Avenue, SW, Washington, DC
- No fee to register
- Pre-registration is mandatory for participants attending both in-person and via webcast
- In-person attendees must check-in onsite the day of the meeting
- Non-USDA employees must enter through the Wing 4 entrance on Independence Avenue and show a photo ID to enter the building
- Only pre-registered attendees will be permitted to enter the building
How to Register:
- Visit the meeting event page to register or contact Courtney Treece at 704-258-4983 or email@example.com
- For general questions, to request an opportunity for an oral public comment, or for special accommodations due to a disability, contact Juanita Yates at 240-402-1731 or Juanita.firstname.lastname@example.org
Onsite registration will not be permitted. Early registration is recommended because seating is limited.
- Refer to the Federal Register Notice for details about the public meeting.(FSIS Agency ID: Docket Number FSIS-2015-0001; Document Number: 2015-01566)
- Learn more about IFSAC
- Download IFSAC meeting materials
Please note the following important dates:
- February 9, 2015: Closing date for request to make oral comment
- February 9, 2015: Closing date to request special accommodations due to a disability
- February 17, 2015: Closing date for registration
- April 30, 2015: Closing date to submit comments to Docket Clerk
December 2014: Holiday Food Safety Twitter Chat
CDC invites you to participate in our second annual Holiday Food Safety Twitter Chat. The Twitter chat this year is designed to address the importance of safe food handling, healthy tips for preparing holiday meal favorites, and healthy and safe meal planning and preparation during the Holidays. Our theme this year will be:
Holiday Food Safety: Food Safety Experts Share Lists of What’s Naughty & Nice
The event was a huge hit last year—the largest twitter chat of its kind at the time—reaching 3.8 million people. The success of the event was largely due to CDC’s collaboration with a number of food safety partner organizations, including FDA, USDA, foodsafety.gov, and a host of others.
This year, we’re hoping to expand our reach and impact even further. CDC plans to partner with a number of guest food-smart connoisseurs, as well as local and national celebrity chefs and food bloggers to contribute their insight and expertise during the twitter chat. We hope your health department will join us for this important food safety awareness event for consumers on easy-to-remember tips for a safe and healthy season. Event details are below:
Date: Thursday, December 11, 2014
Time: 3:00 pm- 4:00 pm EST
To join, follow @CDC_eHealth on Twitter, and be sure to use the hashtag #CDCfoodchat when you participate in the chat.
November 2014: Raising Awareness About Antibiotic Resistance
Get Smart Week
November 17-23 was Get Smart About Antibiotics Week, an international observance to raise awareness about the threat of antibiotic resistance and the importance of appropriate prescribing and use. Get Smart Week is a key activity in CDC’s efforts to improve antibiotic stewardship in communities, health care facilities, and on farms in collaboration with other partners.
Earlier this year, the White House announced the National Strategy to Combat Antibiotic-Resistant Bacteria. To support this, CDC will focus on:
- Strengthening national surveillance efforts to track resistant bacteria,
- Advancing development of rapid diagnostic tests to identify and characterize resistant bacteria, and
- Improving international collaboration for antibiotic resistance prevention, surveillance, control, and antibiotic research and development.
To accomplish these goals, CDC has submitted a FY 2015 budget request for:
- 30 million for the Detect and Protect Against Antibiotic Resistance [PDF - 1 page] initiative to improve antibiotic prescribing practices and protect patients from drug resistant infections, and
- $14 million for the National Healthcare Safety Network (NHSN) to fully implement tracking of antibiotic use and antibiotic resistance threats in U.S. hospitals.
Did You Know?
- Each year, an estimated two million persons in the United States are infected with antibiotic-resistant bacteria, and approximately 23,000 die as a result.
- The rise of antibiotic resistance represents a serious threat to human and animal health, national security, and economies worldwide.
- The use of antibiotics is the single most important factor leading to antibiotic resistance around the world.
CDC partners with National Institute for Animal Agriculture:
The National Institute for Animal Agriculture (NIAA) hosted a three-day symposium (November 12-14) on antibiotic use and resistance, and moving forward through shared stewardship. The NIAA Antibiotics Symposium brought together academia, government researchers, public health experts, the scientific community and stakeholders within animal agriculture, human medicine and the environment.
CDC's Tom Chiller, Steve Solomon, and Rob Tauxe presented on the human-animal interface of antimicrobial resistance, and Chris Braden provided opening remarks on CDC’s efforts in antibiotic resistance and shared stewardship.
CDC and Partners "Get Smart" on Twitter
On November 18, CDC hosted an antibiotic-themed Twitter chat that coincided with Get Smart Week. The Twitter chat featured CDC experts Drs. Tom Chiller, Lauri Hicks, and Loria Pollack, who lent expertise on antibiotic resistance in animals and humans.
Several European countries, as well as Australia and Canada, also participated in a 24-hour global antibiotic resistance-themed Twitter chat.
Partners participating in the Twitter chat included American Academy of Pediatrics, NIAA, Perdue, and a host of others.
Twitter chat messages made more than 52.4 million impressions.
- Get Smart About Antibiotics Week digital press kit is filled with quotes, images, and related resources. Be sure to check out our additional resources:
- Learn about Antibiotic Resistance from the Farm to the Table [PDF - 1 page]
- Learn about Antibiotic Prescribing Rates by State Across the US (2012/13)
- Learn about How Antibiotic Resistance Happens
- Visit CDC’s Get Smart About Antibiotics Week website
October 2014: CDC Experts Respond to Ebola Outbreak
CDC Experts Respond to Ebola
Food safety leaders Drs. Chris Braden and Robert Tauxe, along with a number of other food safety staff, have been deployed to CDC's Emergency Operations Center (EOC) and in the field to offer their epidemiology, laboratory, and communications expertise to the Ebola response.
This is the largest outbreak of Ebola in recorded history, and we anticipate our staff being engaged in the response efforts for the foreseeable future.
As of October 25, 2014:
- Total Cases: 10,114
- Laboratory-Confirmed Cases: 5,666
- Total Deaths: 4,912
- Outbreak distribution map of areas most affected by Ebola in West Africa
- Infographic [PDF - 1 page]on how Ebola is spread
As of 10/23/2014, 54 staff from the Division of Foodborne, Waterborne and Environmental Diseases have responded to the epidemic, or are scheduled to deploy in the near future.
Quick Win in India
India estimates that 70% of illnesses and outbreaks are caused by acute diarrheal diseases. Understanding what comprises this significant disease burden is a national priority and the focus of a pilot project by India’s CDC (NCDC) in partnership with the Global Disease Detection Center (GDD) Regional Center.
CDC reference laboratory experts and communications staff traveled to India as part of a Global Health Security (GHS) "Quick Win" project to kick-start this work. The trip was the first phase of intensive training in two Indian states (Tamil Nadu and Gujarat) through four pilot sites. The goal of the pilot program was to accurately identify and characterize antibiotic susceptibility of enteric pathogens. These findings will help quantity the large burden of illness so that effective prevention measures can be implemented. Success in these pilot states will be reproduced throughout India. In September, the India trip was mentioned in the White House Meeting "Quick Win Report."
Recent Investigations of Foodborne Outbreaks Reported on CDC.gov:
CDC and federal, state, and local public health partners are continuing surveillance to identify and interview ill persons and to identify sources of infection. Read more about current outbreak investigations:
Final Update: Multistate Outbreak of Human Salmonella Infections (Announced October 21, 2014)
Cilantro Cyclosporiasis (Announced August 2014)
Nut Butter Salmonella (Announced August 2014)
Foodborne outbreak investigations go through several steps to ensure that the public, industry, and researchers have access to timely and accurate information. Learn more about the steps in investigating foodborne outbreaks.
CDC works closely with a number of partners to address foodborne infections from resistant bacteria. These partners include federal agencies, state and local health departments, the food industry, healthcare providers, and academia.
New and improved! CDC's Antimicrobial Resistance and Food Safety page is now live.
You can learn more about CDC's role in combating antibiotic resistance from the following resources:
- Medscape: Clinical Impact of Antibiotic-Resistant Salmonella
- CDC Feature: Be Food Safe: Protect Yourself from Food Poisoning
- CDC Website: Office of Antibiotic Resistance (OAR)
Collaboration on Food Safety and Antibiotic Resistance:
- FDA is reporting a 16% increase in the quantity of medically important antimicrobials sold for use in food animals from 2009-2012: FDA Annual Summary Report on Antimicrobials Sold or Distributed in 2012 for Use in Food-Producing Animals.
- Food Safety News: Overuse of Antibiotics Nearly Doubled Clostridium Difficile Infection Rate.
- The National Institute for Animal Agriculture (NIAA)is hosting a conference in Atlanta November 12-14 on antibiotic resistance through shared stewardship. CDC subject matter experts will be presenting at the conference on the importance of antimicrobial resistance and its impact on human and animal health.
Coming Next Month:
Spotlight on antimicrobial resistance and food and animal agriculture through shared partnerships
Spotlight on Botulism:
Marshall KM, Nowaczyk L 2nd, Raphael BH, Skinner GE, Rukma Reddy N. Identification and genetic characterization of Clostridium botulinum serotype A strains from commercially pasteurized carrot juice. Food Microbiol. 2014 Dec;44:149-55
Raphael BH, Shirey TB, Lúquez C, Maslanka SE. Distinguishing highly-related outbreak-associated Clostridium botulinum type A(B) strains. BMC Microbiol. 2014 Jul 16;14(1):192.
Raphael BH, Bradshaw M, Kalb SR, Joseph LA, Lúquez C, Barr JR, Johnson EA, Maslanka SE. Clostridium botulinum strains producing BoNT/F4 or BoNT/F5. Appl Environ Microbiol. 2014 May;80(10):3250-7.
Gonzalez-Escalona N, Timme R,Raphael BH, Zink D, Sharma SK. single-nucleotide-polymorphism analysis for discrimination of Clostridium botulinum group I strains. Appl Environ Microbiol. 2014 Apr;80(7):2125-32.
July 2014 Special Edition: Antibiotic Resistance in Foodborne Germs
Antibiotic Resistance in Foodborne Germs
CDC reports progress and problems in foodborne germs it tracks
Antibiotic resistance—when bacteria don’t respond to the drugs designed to kill them—threatens to return us to the time when simple infections were often fatal. Antibiotic resistance in foodborne germs showed both positive and troubling trends, according to National Antimicrobial Resistant Monitoring System (NARMS). CDC is the only source of national information on antibiotic resistance in people from foodborne pathogens.
Why is this information important?
- Each year, antibiotic-resistant infections from foodborne germs cause an estimated 440,000 illnesses in the United States. In severe cases, the right antibiotic can save lives.
- Understanding trends in antibiotic resistance helps doctors to prescribe effective treatment and public health officials to investigate outbreaks faster.
What’s in the report and on the web?
- The report from CDC NARMS compares resistance levels in human samples in 2012 to a baseline period of 2003-2007.
It introduces a Campylobacter data and includes links to online interactive graphs where users can choose an organism and an antibiotic and see the “bug-drug” trends from year-to-year in NARMS.
CDC is currently tracking three active outbreaks related to foodborne infections:
- Multistate Outbreak of Salmonella Infections Linked to Organic Sprouted Chia Powder –Salmonella Newport, Salmonella Hartford, and Salmonella Oranienburg
- Multistate Outbreak of Shiga toxin-producing Escherichia coli O121 Infections Linked to Raw Clover Sprouts
- Multistate Outbreak of Multidrug-Resistant Salmonella Heidelberg Infections Linked to Foster Farms Brand Chicken (See timeline of events in following image.)
Battling Antibiotic Resistance Together
Who's doing what
The fight against antibiotic resistance is huge...and, determined. Here's a snapshot of a few soldiers on the frontline and some of their battleplans.
- Centers for Disease Control and Prevention (CDC) researches, monitors, and reports antibiotic resistance threats in the United States.
- Read CDC's 2013 Threats Report that connects antibiotic resistance to foodborne and other enteric (intestinal) germs in animals, food, and humans.
- Food and Drug Administration (FDA) regulates antibiotics use in humans or animals, educates industry on medically-important antibiotics in food animals, and works to bring the therapeutic uses of such drugs under the oversight of licensed veterinarians.
- Interagency Task Force on Antimicrobial Resistance (ITFAR) coordinates the activities of multiple federal agencies in addressing antibiotic resistance.
- Read ITFAR's public health action plan to combat antibiotic resistance.
- National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS), a tri-agency group, tests bacteria and tracks antibiotic resistance in humans (CDC), retail meats (Food and Drug Administration), and food animals (U.S. Department of Agriculture).
- Read the 2012 NARMS Annual Report.
- Pew Charitable Trusts works to preserve the effectiveness of antibiotics by phasing out the overuse and misuse of the drugs in food animal production.
- United States Department of Agriculture (USDA) conducts and funds food safety research, including antibiotic resistance.
Bigger Issue Than Food
Antibiotic resistance in foodborne germs is part of a bigger problem
Called public health’s ticking time bomb, antibiotic resistance annually causes more than two million illnesses and 23,000 deaths nationwide. Of these, antibiotic resistance in foodborne germs cause about 440,000 illnesses. Tomorrow, if it continues on its current course, could be even worse.
The FY 2015 President’s Budget requests funding for CDC to improve early detection and tracking of multidrug resistant Salmonella and other urgent antibiotic resistance threats. The proposed initiative would increase CDC’s ability to test drug-resistant Salmonella [PDF - 1 page] by 20 times. With a $30 million annual funding level over five years, CDC estimates that it could achieve a 25 percent reduction in multidrug resistant Salmonella infections, as well as significant reductions in other resistant infections.
Click to see entire Pew infographic above: The Threat of Antibiotic Resistance.
- Multi-Locus Sequence Typing Confirms Wild birds as the Source of a Campylobacter Outbreak Associated with the Consumption of Raw Peas
- Improving Response to Foodborne Disease Outbreaks in the United States: Findings of the Foodborne Disease Centers for Outbreak Response Enhancement (FoodCORE), 2010-2012
- Outbreaks Attributed to Cheese: Differences Between Outbreaks Caused by Unpasteurized and Pasteurized Dairy Products, United States, 1998-2011
Good to Know
CDC’s National Center for Environmental Health has two new exciting food safety tools, and we need your help spreading the word.
- e-Learning on Environmental Assessment of Foodborne Illness Outbreaks
- Free interactive online course
- Prepares individuals for team investigations of foodborne illness outbreaks in restaurants and other food service areas
- Continuing education units (CEUs)
- National Voluntary Environmental Assessment Information System
- Surveillance system for jurisdictions that inspect and regulate restaurants and other food areas, such as banquet facilities, schools, and other institutions
- Captures underlying environmental assessment data that describes what happened and how events most likely led to a foodborne illness outbreak
- Access the full 2012 NARMS report [PDF - 88 pages], including links to interactive graphs.
- Find out more about CDC’s Role in NARMS.
- Read CDC’s FAQ About Antibiotic Resistance and Food Safety.
- Learn more about Antibiotic Use in Food-Producing Animals.
- Read the new report on Antibiotic Resistance Threats in the United States, 2013.
- Take the quiz: Get Smart About Antibiotics on the Farm.
May - June 2014: Latest findings on norovirus
New CDC Vital Signs Report
Norovirus often gets attention for outbreaks on cruise ships, but those account for only about 1% of all reported norovirus outbreaks. Norovirus is highly contagious and is the leading cause of disease outbreaks from contaminated food in the United States. Infected food workers are often the source.
June's CDC Vital Signs report presents CDC's latest findings on reported norovirus outbreaks from contaminated food and highlights key recommendations to help the food service industry prevent such outbreaks.
Get more information:
- Vital Signs MMWR: Foodborne Norovirus Outbreaks — United States, 2009–2012
- Vital Signs – Preventing Norovirus Outbreaks [PODCAST - 1:15 minutes]
- CDC Telebriefing and Transcript –How can we prevent norovirus outbreaks from contaminated food?
- CDC Digital Press Kit
- CDC: Norovirus
- Vital Signs - Cómo prevenir los brotes de norovirus (en Español)
- CDC Features: Prevent the Spread of Norovirus
Recent investigations of foodborne outbreaks reported on CDC.gov:
- Organic Sprouted Chia Powder – Salmonella Newport (Announced May 2014)
- Raw Clover Sprouts – E. coli O121 (Announced May 2014)
- Ground Beef – E. coli O157:H7 (Announced May 2014)
- Live Poultry – Salmonella Infantis and Newport (Announced May 2014)
Read how CDC investigates foodborne outbreaks.
Read full reports of CDC's Annual Summaries of Foodborne Outbreaks.
New data on foodborne disease outbreaks, norovirus, and E. coli
- Surveillance Summaries: Two new CDC reports for 2011 and 2012 help show the human impact of foodborne disease outbreaks.
- Norovirus: Vital Signs: Foodborne Norovirus Outbreaks — United States, 2009–2012
- E. coli: National Patterns of Escherichia coli O157 infections, United States, 1996–2011
New web site launched for tri-agency group, Interagency Food Safety Analytics Collaboration (IFSAC)
IFSAC is teaming across agencies to improve coordination of federal food safety analytic efforts and estimates of foodborne illness sources.
Recently, IFSAC--a partnership between Food and Drug Administration, and the Food Safety Inspection Service of the United States Department of Agriculture--expanded on the previously used food categories used to estimate attribution. The addition of more botanically correct categories better reflects production practices and postharvest handling systems, and more readily distinguishes FDA- and FSIS-regulated products.
Learn more about IFSAC.
Recent research shows that over half of reported foodborne outbreaks occur in restaurants.
Follow these four simple tips to prevent food poisoning when eating out.
1. Check inspection scores
2. Make sure the restaurant is clean
3. Check that your food is cooked thoroughly
4. Properly handle your leftovers
See CDC’s new “Protect Yourself When Eating Out [PDF - 1 page]” infographic to learn more about how you can protect yourself and your family from food poisoning.
April 2014 Special Edition: CDC’s Annual Food Safety Report Card
2013 Progress Report on Six Key Pathogens Compared to 2006-2008
Food safety grades show limited progress in 2013. More can be done.
The nation's food safety grades are out and the results are mixed.
CDC's annual report card, produced by FoodNet (see article below to learn more about FoodNet) shows some recent progress in reducing Salmonella. (See chart at right which shows short-term comparison of 2013 rates to 2010-2012.)
Other pathogens have not shown similar success either in the short or long term and we could be losing ground on past progress in E.coli reduction.
There is a critical need to implement more prevention measures and keep a close eye on these trends over the next year.
Highlights from the 2013 FoodNet report include a comparison of rates for different time periods. For the short term, we compared 2013 with the rates of the preceding three years, 2010-2012. For the longer term, we compared 2013 with the 2006-2008 baseline period. We can even go back to the beginning of FoodNet in 1996.
- Salmonella infections decreased by about nine percent in 2013 compared with the previous three years.
- Rates remained the same when compared to the longer term 2006-2008 baseline period
- Still well above the national goal for 2020 of 11.4 cases per 100,000 people
- Campylobacter infections have risen 13 percent since 2006-2008.
- Often linked to contaminated chicken
- Vibrio infections were at the highest level observed since active tracking began in 1996.
- Often linked to eating raw shellfish
- Rates of Vibrio vulnificus, the most severe strain, have remained steady.
- E.coli infections continue to inch up and the progress noted from previous years has stalled.
- Still about 30 % lower than our FoodNet baseline year of 1996-1998
- Rates of the other foodborne infections tracked have not changed since 2006-2008.
What is FoodNet and why do they track trends in foodborne infections?
"CDC data are essential to gauge how we're doing in our fight against foodborne illness. This year's data show some recent progress in reducing Salmonella rates and highlights that our work to reduce the burden of foodborne illness is far from over. To keep Salmonella on the decline, we need to work with the food industry and our federal, state, and local partners to implement strong actions to control known risks and to detect foodborne germs lurking in unexpected foods."
~Robert Tauxe, M.D., Deputy Director,
CDC's Division of Foodborne, Waterborne and Environmental Diseases
The Foodborne Diseases Active Surveillance Network (FoodNet) collects information to track rates and determine trends in laboratory-confirmed illnesses caused by nine pathogens transmitted commonly through food: Campylobacter, Cryptosporidium, Cyclospora, Listeria, Salmonella, STEC O157 and non-O157, Shigella, Vibrio, and Yersinia. Annual data are compared with data from a recent period (2006–2008) and with data from the preceding three years of surveillance (2010–2012) to measure progress.
FoodNet is a collaboration among CDC, ten state health departments, the US Department of Agriculture's Food Safety and Inspection Service, and the Food and Drug Administration. FoodNet surveillance covers 48 million people, encompassing about 15 percent of the US population. The ten health departments represent the FoodNet surveillance sites and include the states of Connecticut, Georgia, Maryland, Minnesota, New Mexico, Oregon, and Tennessee, and selected counties in California, Colorado, and New York.
Each year, FoodNet reports on the changes in the number of people in the United States sickened with foodborne infections that have been confirmed by laboratory tests. This annual report card also lets CDC, its partners, and policy makers know how much progress has made in reaching national goals for reducing foodborne illness.
The data behind this year's report card
February - April 2014: Spotlight on Global Health Security
This article, published in CDC's Morbidity and Mortality Weekly Report, is an annual summary of data collected by FoodNet to track rates and determine trends for nine infections.
FoodNet identifies all those infections that are diagnosed by laboratory testing of samples from patients, and also physician-diagnosed hemolytic uremic syndrome (HUS).
This report summarizes 2013 preliminary surveillance data and describes trends since 2006; the information contributes to our understanding of the human health impact of foodborne diseases.
Overall, in 2013, FoodNet logged just over 19,000 infections, 4,200 hospitalizations, and 80 deaths from the nine germs it tracks. Young children were the most affected group for seven of the nine germs that FoodNet tracks.
This information helps regulators, the food industry and consumers understand the progress we are making in preventing them.
Recent efforts and next steps
Most foodborne illnesses can be prevented. But continued efforts are needed to understand how contamination of fresh produce and processed foods occurs and to develop and implement measures that reduce it.
CDC is working with state health departments to develop and implement ways to detect and investigate outbreaks more quickly, so that the foods that cause outbreaks are identified quickly, and illnesses can be prevented. Farmers, the food industry, regulatory agencies, food service, consumers, and public health authorities all have a role to play in food safety.
What are some recent efforts to reduce foodborne illness?
- Establishment in 2011 of performance standards for Campylobacter contamination of whole broiler chickens in processing plants.
- Approval of more stringent time and temperature controls for oysters after harvest to prevent Vibrio vulnificus infections.
- The Food Safety Modernization Act of 2011: It gives FDA additional authority to regulate food facilities, establish standards for safe produce, recall contaminated foods, oversee imported foods, and which requires improvements in surveillance and response to outbreaks. It calls on CDC to strengthen surveillance and outbreak response.
USDA-FSIS' new strategies to address Salmonella contamination in meat and poultry: Salmonella Action Plan.
What are some next steps to reduce foodborne illness?
There are many partners in prevention of foodborne illness, including state and federal public health authorities, the federal food regulatory authorities, the food industry, consumer and patient advocacy groups, and consumers themselves.
Enhanced measures are needed to:
- Control or eliminate pathogens in domestic and imported food;
- Reduce or prevent contamination of food during growing, harvesting, and processing;
- Continue the education of all food-handlers, including restaurant workers and consumers, about risks and prevention measures; and
- Detect and protect against drug-resistant Salmonella. CDC's new initiative could increase our ability to test drug-resistant Salmonella infections 20-fold.
- Share this information with your members and partners.
- Check out the CDC webpage with quotes, graphics, and key links.
- Look for tweets about FoodNet from @CDCgov and @CDC_NCEZID and please consider retweeting.
- Incidence and Trends of Infection with Pathogens Transmitted Commonly Through Food — Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2006–2013
- Increase in Vibrio parahaemolyticus Infections Associated with Consumption of Atlantic Coast Shellfish — 2013
- Trends in Foodborne Illness in the United States, 2006-2013
- What is CDC is doing to fight antibiotic-resistance Salmonella infections?
February - April 2014: Spotlight on Global Health Security
Food, Water, & Air Connect Us Globally
"We are all connected by the food we eat, the water we drink, and the air we breathe. Stopping outbreaks where they start is the most effective and the least costly way to save lives." ~ Dr. Tom Frieden, director of the Centers for Disease Control and Prevention
Experts from CDC and across the world gathered (March 17-20) on the agency's main Atlanta campus to discuss global health security. CDC’s Center for Global Health, host of the meeting, “Prevent, Detect, and Respond: Leveraging CDC's Global Health Programs and Overseas Offices for a Safer US and a Safer World,” underscored that global health security was a CDC priority.
"counties are safer if they have the capacity to prevent, detect, and respond to common pathogens, which better prepares them for the uncommon ones"
a mutual theme shared by presenters at the 2014 Global Health Security meeting
Throughout the four-day meeting, experts discussed how concentrated efforts between CDC and its country partners could rapidly build and enhance capacities to prevent, rapidly detect, and effectively respond to infectious disease threats. By building and strengthening laboratory networks, information systems, and emergency operations centers, CDC and its partners showed how global health security can be accelerated.
Presenters discussed many examples of global food and water security projects at CDC, including:
- Republic of Georgia: site visits and focused training workshops to build capacity for laboratory based surveillance for foodborne pathogen detection.
- Uganda: implementation of rapid diagnostic testing for cholera.
- Kenya: staff training on a new multiplex bead assay system for serologic antibody surveillance at Kenya Medical Research Institute.
- Haiti: water quality survey of private water vendors in Port au Prince.
To learn more:
- View presentation on global health security demonstration projects in Vietnam and Uganda.
- Read about CDC's role in global food and water security.
- View CDC Foundation's dynamic infographic about global health security, A Health Threat Anywhere Impacts Business Everywhere.
CDC tracked multiple multistate outbreaks of foodborne illness during February-April, including:
- As of March 3, CDC received reports of 481 ill people, including 51 new cases since the last update on January 16.
- Cases appeared to return to baseline in January; however, ongoing surveillance identified in February that infections from two of the previously rare outbreak strains have again exceeded the number of infections expected to be reported to PulseNet during this time of year.
- This investigation continues.
- As of March 12, Maryland (seven) and California (one) reported eight cases, including one death. Five of the illnesses (two mother-newborn pairs and a newborn) were related to pregnancy
- Roos Foods issued an expanded and clarified recall on March 1. The US Food and Drug Administration suspended the food facility registration of Roos Foods on March 11.
- Media outlets covering the story include CBS News*, Food Poisoning Journal*, the Oregonian* and Food Quality News.
Detect and Protect against Antibiotic Resistance
CDC’s Initiative will fight foodborne infection
It’s been called public health’s ticking time bomb. Antibiotic resistance—when bacteria don’t respond to the drugs designed to kill them—threatens to return us to the time when simple infections were often fatal. Today, antibiotic resistance annually causes more than two million illnesses and 23,000 deaths in the United States. Tomorrow, if it continues on its current course, could be even worse.
We need to outsmart antibiotic resistance—now. The Detect and Protect Against Antibiotic Resistance Initiative (known as the AR Initiative) gives us a good head start. The 2015 President’s Budget requests $30 million annual funding level for 5 years for the AR Initiative—part of a broader CDC strategy to target investment to achieve measureable results in four core areas:
- Detect and track patterns of antibiotic resistance.
- Respond to outbreaks involving antibiotic-resistant bacteria.
- Prevent infections from occurring and resistant bacteria from spreading.
- Discover new antibiotics and new diagnostic tests for resistant bacteria.
With a $30 million annual funding level over 5 years, CDC’s AR Initiative could achieve a 25-50% reduction in infections from nightmare bacteria that sicken or kill.
To learn more:
- Read how CDC's Initiative will fight foodborne infections [PDF - 1 page].
- Read the CDC's Initiative fact sheet [PDF - 2 page].
- Read the CDC's collaborative infographic [PDF - 1 page].
Select CDC food safety publications during February - April, including:
Poultry and Food Safety
- Evaluation of Musculoskeletal Disorders and Traumatic Injuries Among Employees at a Poultry Processing Plant [PDF - 52 pages]. The report, indicating that line speed is not a big problem in the new USDA poultry inspection overhaul, generated policy interest in Washington DC and media attention.
- Notes from the Field: Multistate Outbreak of Human Salmonella Infections Linked to Live Poultry from a Mail-Order Hatchery in Ohio — March–September 2013. This report notes that 30 states submitted cases of 158 persons infected with outbreak strains of four Salmonella serotypes.
- Clinical outcomes of nalidixic acid, ceftriaxone, and multidrug resistant nontyphoidal Salmonella infections compared with pansusceptible infections in FoodNet sites, 2006-2008. This study extends evidence that patients with antimicrobial-resistant nontyphoidal Salmonella infections have more severe outcomes.
- Notes from the Field: Multistate Outbreak of Listeriosis Linked to Soft-Ripened Cheese —United States, 2013. This report reviews a listerioris outbreak linked to soft cheeses that were likely contaminated during the cheese-making process.
Select food safety resources and news about CDC's partners
- Mapping genes to uncover food poisoning. Whole genome sequencing is the ultimate DNA fingerprint. Food safety experts broaden their arsenal for decoding the DNA of potentially deadly bacteria and viruses, reports the Associated Press.
- Everybody’s blogging! Did you know that FDA has its own blog? Last week Dr. Stephen Ostroff, former deputy director of the National Center for Infectious Diseases discussed his new position as Acting Chief Scientist at FDA and you can read his first blog.
- Need guidance? The Association of State and Territorial Health Officials (ASTHO) released it’s second set of food policy guides showcasing cross-sector partnerships.
- Age matters in the raw milk revolution: Washington Post reports that, despite warnings from public health officials, distrust of government and a thirst for raw milk have helped fuel the movement to do away with federal and state restrictions. CDC and FDA officials say 55 percent of the victims are younger than 18 and got the beverage from a parent or guardian. “When you give it to a young child who gets an E.coli infection, and their kidneys fail, they didn’t get to make that choice,” said Robert V. Tauxe, the CDC’s deputy director of food-borne, water-borne and environmental diseases.
- Rough, rugged, and raw. Food Safety News reports raw-milk cow-share bill falls flat on the House floor.
- Barfblog - it's not as gross as it sounds. It's a blog where Drs. Powell, Chapman, Hubbell, and assorted food safety friends offer evidence-based opinions on current food safety issues.
Update following the release of An Atlas of Salmonella in the United States, 1968-2011, CDC's hands-on, web accessible document providing 40 years of surveillance data on 32 Salmonella serotypes.
The Atlas is not new; it’s been published twice before in book and CD-Rom. But, how far can bound copies of a book or CD travel? What’s new is getting Salmonella data at everyone’s fingertips—providing hands-on web access for the public, the food industry, and researchers. Did it work? Yes! Within hours of the CDC’s press release (and the March 2014 GovD Special Edition) announcing the Atlas, global media paid attention and spread the word. Overnight, the metrics had shifted to show that 90% of viewers were now from the general public see graphs below).
CDC has seen a hunger for our data from more than public health departments.Under the Food Safety Modernization Act (FSMA), CDC is tasked to make our data accessible, but access does not guarantee engagement. There is an art to distribution that goes beyond posting a PDF [PDF - 248 pages]—it means getting people to explore your science. We found that the 200-page PDF was intimidating. So, we broke it down and added context, an explanation about the Importance of Serotyping and other pages: Salmonella Atlas, 32 Individual Serotypes Reports, and Snapshots of Serotypes.
If you build it they will come. The take-away from this is simple: present solid research in a format to those who can most benefit from accessing it. Enough said.
March 2014 Special Edition: Hands-On Access to Salmonella Data
New CDC Report: Hands-On Access to Salmonella Data
40 Years and 32 Serotypes of Salmonella Data Available Online
Fighting Salmonella: More Understanding = More Progress
An Atlas of Salmonella in the United States, 1968-2011 [PDF - 248 pages] is the first-of-its-kind report that charts over 40 years of laboratory-confirmed surveillance data on 32 Salmonella serotypes. The report includes analyses by age, sex, season, and geography, down to the county level. This is the first time CDC has posted these data online in a downloadable format. (CDC published two earlier versions of the Atlas as books.)
CDC estimates that Salmonella causes about 1.2 million illnesses each year in the United States, with about 23,000 hospitalizations and 450 deaths. Salmonella most often causes vomiting or diarrhea, sometimes severe. In rare cases, Salmonella can cause severe and life-threatening bloodstream infections. Read more about Salmonella.
"The more we understand Salmonella, the more we can make progress in fighting it all along the farm to table chain."
~Robert Tauxe, M.D., Deputy Director,
CDC's Division of Foodborne, Waterborne and Environmental Diseases
“Salmonella causes a huge amount of illness and suffering each year in the United States. We hope these data allow researchers and others to assess what has happened and to think more about how we can reduce Salmonella infections in the future,” said Robert Tauxe, M.D., deputy director of CDC’s Division of Foodborne, Waterborne and Environmental Diseases. “The more we understand Salmonella, the more we can make progress in fighting it all along the farm to table chain.”
The Atlas allows users to explore
- National Salmonella trends in reported cases over time.
- Problems in specific geographic areas.
- Sources of Salmonella.
- The connection between animal and human health.
Importance of the Atlas
- Permits comparison of different serotypes
- Allows analysis of trends over time
- Reports data from human, animal, and other environmental sources in one place
In addition to human infections, it also includes reports of Salmonella in animals in the environment and animal feeds, which can be sources of antibiotic resistant strains. Read more about the importance of the Atlas.
The data presented likely represent just the tip of the iceberg since many infections from Salmonella are not diagnosed and reported to the health department.
This may occur because
- The ill person does not seek medical care.
- The health care provider does not obtain a stool culture.
- The culture results are not reported to public health officials.
Salmonella, Serotypes, and Serotyping
Public health scientists use serotyping to find Salmonella outbreaks and track them to their sources.
Salmonella has more than 2,500 different serotypes, but fewer than 100 cause the vast majority of infections in people. What we learn about the more common serotypes can increase our understanding of illness and the natural history of all the Salmonella strains. Read more about Salmonella and serotypes.
Since the 1960s, public health scientists in the US have used serotyping to help find Salmonella outbreaks and track them to their sources. Laboratory experts serotype the Salmonella from infected people. When cases with one serotype increase, they suspect an outbreak and disease detectives start their investigation.
One of Salmonella's Nastiest Serotypes:
Imagine a healthy looking, but infected, chicken that can lay eggs with contaminated yolk. Frightening, but true. Salmonella Enteritidis [PDF - 15 pages], one of the most common serotypes of Salmonella reported worldwide, is often linked to eggs. If a fertile egg is contaminated with Salmonella Enteritidis, it infects the new chick. If the egg is for eating, and someone eats the egg raw, or undercooked, that unlucky person may be infected with Salmonella Enteritidis.
Since the 1990s, infection rates have decreased as the egg industry voluntarily placed controls on egg flocks and consumers have eaten fewer raw eggs. Still, large outbreaks have occurred. The US Food and Drug Administration (FDA) enacted the Egg Rule in 2010 to control Salmonella on egg farms; they also established safe handling and labeling requirements for shell eggs.
- To access the Atlas, please visit the CDC's Salmonella Atlas web page.
- For more information on Salmonella, please visit the CDC's Salmonella web page.
- For more information on food safety, please visit the FoodSafety.gov web site.
January - February 2014: CDC and Medscape-Content Delivery Partners
CDC and Medscape: A Partnership that Delivers
Healthcare content delivered to 100,000+ viewers
Launched during 2009’s H1N1 flu pandemic, Medscape and CDC teamed to deliver timely information and education to medical professionals using the Internet. Since then, their partnership has blossomed. CDC Expert Commentaries attracts thousands of clinician views with each new weekly posting.
What started with one "test" video commentary has blossomed into a robust content partnership that now includes: video commentaries, text commentaries, Q&A expert interviews, slide shows, targeted mailers, one-on-one interviews, and peer-to-peer discussions.
To date, CDC and Medscape have partnered to produce:
- 170+ video and text commentaries
- 1.8 million views of interviews
- 100,000+ views of slideshows
The CDC Expert Commentary series includes participants from every CDC Center as well as CDC partners: Dr. Regina Benjamin, US Surgeon General, HHS; Dr. Neil Fishman, SHEA; and Dr. William Schaffner, IDSA.
Medscape commentaries for CDC's Division of Foodborne, Waterborne, and Environmental Diseases comprise almost one-third of total Medscape views and include content from all Divison topic areas: food safety, healthy water, fungus, and healthy pets and people.
CDC's enteric disease experts provide food-related commentaries on topics ranging from specific pathogens to major outbreaks, as well as tips for Healthy Pets, Healthy People. The table below highlights select food-safety commentaries from 2012 to the present. More food safety commentaries will be produced during 2014.
Select CDC Food Safety Publications
Key CDC publications during January-February include:
Surveillance of Foodborne Diseases
Food safety experts, Dr. Rob Tauxe and Dr. John Besser, examine the limitations, uses, and future of surveillance in public health for the Encyclopedia of Food Safety, Volume 4.
- Tauxe, R. V. and J. M. Besser (2014). Public Health Measures: Surveillance of Foodborne Diseases. Encyclopedia of Food Safety. Y. Motarjemi. Waltham, Academic Press: 77-88.
After receiving reports of gastrointestinal illness from attendees at a church festival, the local health department investigated and confirmed a foodborne outbreak linked to pulled pork prepared in a private home and sold at the event.
- Outbreak of Salmonellosis Associated with Consumption of Pulled Pork at a Church Festival — Hamilton County, Ohio, 2010. MMWR Volume 62, Number 51, January 4, 2014.
Salmonella enterica serotype Typhimurium
In this study, the authors examined whether the characterization of blaCMY plasmids, along with additional information, can help to identify potential sources of infection by Salmonella, and used serotype Typhimurium as a model.
- Characterization of blaCMY Plasmids and Their Possible Role in Source Attribution of Salmonella enterica Serotype Typhimurium Infections. Foodborne Pathog Dis. 2014 Jan 31. [Epub ahead of print]
Two publications document outbreaks and infections of non-O157 Shiga toxin-producing Esherichia coli.
- Outbreaks of non-O157 Shiga toxin-producing Escherichia coli infection: USA. Epidemiology and Infection. 2014 Jan 7.
- Multiple-Aetiology Enteric Infections Involving Non-O157 Shiga Toxin-Producing Escherichia coli - FoodNet, 2001-2010. Zoonoses and Public Health. 2014 Feb 1.
CDC tracked several multistate outbreaks of foodborne illness during January and February, including:
As of January 24, Tennessee reported nine cases to CDC. Tyson Brand initiated a recall of approximately 33,840 pounds of mechanically-separated chicken products, the USDA's Food Safety and Inspection Service (FSIS) announced. This outbreak of Salmonella Heidelberg infections is not related to the multistate outbreak of multidrug-resistant Salmonella Heidelberg infections linked to Foster Farms brand chicken.
Multistate Outbreak of Salmonella Stanley Infections Linked to Raw Cashew Cheese (outbreak appears to be over)
As of January 31, California (15), Nevada (1), and Wyoming (1) reported17 illnesses to CDC. The Cultured Kitchen, producers of the raw cashew cheese, issued a voluntarily recall due to a risk of contamination with Salmonella.
Multistate Outbreak of Salmonella Heidelberg Infections Linked to Foster Farms Brand Chicken (outbreak appears to be over; however, investigation continues)
The number of reported infections from the outbreak strains of Salmonella Heidelberg has returned to baseline levels indicating that this particular outbreak appears to be over. But, not before 23 states and Puerto Rico reported 430 illnesses to CDC. California reported the most illnesses (74%).
New Web Resources
Year-Round Food Safe Buffets
Every year, Americans have a food fest on Super Bowl Sunday. And, for many, that means hosting a buffet for friends and family. But any gathering at any time of the year can be an opportunity to share food--and, unfortunately, food poisoning, Make sure that germs are a "no-show" at your next buffet by following these six tips to avoid food poisoning. (Download our infographic [PDF - 1 page] for your kitchen as a reminder of preparing food-safe buffets.)
- Shout-out to our partners at Pew Charitable Trust for their Superbug Showdown infographic pitting Team Antibiotic against Team Superbug. And, a nod of the hat to FDA for their feature on Serving up Safe Buffets. Check them both out!
Public Health Practices
CDC has released the 2013 Prevention Status Reports (PSRs) highlighting the status of state-level policies and practices designed to prevent 10 important public health problems, including Food Safety.
Assisting the Disease Detectives
Did you know you can help disease detectives detect and solve foodborne disease outbreaks? Learn some ways you can help protect others from getting sick. You Can Help CDC Detect and Solve Foodborne Outbreaks.
We Are Better Prepared!
The Center for Infectious Disease Research and Policy (CIDRAP) reports several success stories that highlight states' preparedness.
Prepared by CDC's Office of Public Health Preparedness and Response, the National Snapshot of Public Health Preparedness covers activities between 2012 and 2013 and notes improvements for tracking and reporting E.coli and Listeria.
- Escherichia coli-positive tests analyzed and entered into PulseNet increased within four working days from 90% to 94%.
- More timely testing and reporting of Listeria-positive results from 88% to 92%.
The complete report and individual sections of the report are available for downloading as separate PDF files.
Medscape Update to Pets and Pet Food Slideshow.
An update is now available to the Risks from Pets and Pet Food slideshow featuring information on outbreak investigations in 2012 and 2013.
Food Safety Partners
Trans Fats: Moving Off the Label Webcast
Tue, Feb 11, 2014 2:00 PM CST
Join BestFoodFacts.org for a webcast that will break down the confusion about trans fats with straight talk and humor from four food system professionals who love to talk about food.
Progress toward Attribution of Foodborne Illness
The Interagency Food Safety Analytics Collaboration (IFSAC) recently held its second webinar to discuss progress toward attributing foodborne illnesses to food sources. The tri-agency collaboration (FDA, CDC, and USDA’s Food Safety and Inspection Service) also discussed the group's most recent activities.
Presenters shared an analysis comparing the characteristics of illnesses associated with foodborne outbreaks with those that are not linked to outbreaks.
Information on the first webinar is now available online. Information on the second webinar will be posted soon.
Listeria & Advanced Molecular Detection Work: One of CDC's 2013 Accomplishments
A Digital Press Kit highlighting 2013 accomplishments, including work on Listeria & Advanced Molecular Detection, has been updated with details about our important collaboration with the Food and Drug Administration (FDA) and the National Center for Biotechnology Information.
Coordinating Crisis Response: FDA’s Joint Information Center (JIC) Handbook [PDF - 298 pages] is now available. The handbook, that augments the FDA Emergency Operations Plan (EOP), enhances the agency’s ability to coordinate public communication during emergency responses.
November - December 2013
Food Safety Never Takes a Holiday
Just before holiday food-fests were in full swing, CDC and guest foodies gathered for a Twitter chat on being "food safe and food smart." And, we served up the number #1 chat at CDC… EVER.
With food safety and nutrition on the menu
- Our audience extended 2,550 tweets--about twice the average rate of people potentially reached through CDC’s monthly chats.
We learned that there are many food myths out there.
- Diverse participants—dairy and produce farmers, public health departments, media outlets, small and large companies, advocates, and individual consumers—swapped questions and expertise in real-time and in one virtual place.
People are eager to engage when food safety and nutrition are at the same party.
- CDC Director, Dr. Tom Frieden, tweeted introductions and thanks.
- Agency “foodie” programs joined as one-CDC voice: Traveler’s Health; Global Health; Nutrition, Physical Activity, & Obesity; Environmental Health; and Public Health Preparedness and Response.
- Beyond CDC, external co-hosts USDA, FDA, the Center for Food Integrity, Foodsafety.gov and the International Food Information Council (IFIC), provided extensive acumen on food safety, nutrition, and consumer education.
After the Chat
The sharing continued with retweets, blogs, features, and more, including:
- CDC Shares Food Safety Tips Via Twitter
- CDC makes merry with food safety chat
- Don’t Toss Your Cookies: Twitter Chat Offers Food Safety and Nutrition Insights for the Holidays
- #CDCchat About Holiday Food Safety
Thanks to everyone who participated!
Select CDC Food Safety Publications
Key CDC publications during November - December include:
- Salmonellosis and Meat Purchased at Live-Bird and Animal-Slaughter Markets, United States, 2007-2012. This report reviews multiple salmonellosis outbreaks linked to meat purchased at markets, where live poultry and livestock are sold for onsite slaughter. Check out the CDC feature on Staying Safe from Salmonella Germs at Live Animal and Live Bird Markets!
- Multistate Outbreak of Salmonella Chester Infections Associated with Frozen Meals — United States, 2010. Many frozen meals are not "heat and serve" items but are "not-ready-to-eat" (NRTE) products that require full cooking before eating. This report and the CDC Podcast, “Make it Well Done,” describes findings during the outbreak investigation of Salmonella Chester associated with frozen meals.
- International Outbreak of Escherichia coli O104:H4 Infections Associated with Sprout Consumption— Europe and North America, May–July, 2011. This report describes surveillance conducted in the United States, which involved active case-finding, use of laboratory testing protocols specific to non-O157 STEC, interviews to identify potential exposures of interest, and documentation of clinical courses.
- Notes from the Field: Escherichia coli O157:H7 Outbreak Associated with Seasonal Consumption of Raw Ground Beef — Wisconsin, December 2012–January 2013. This publication summarizes an E. coli O157:H7 outbreak linked to eating raw ground beef and crackers, a traditional winter holiday specialty in certain regions of the upper Midwest.
Outbreak of Staphylococcal Food Poisoning from a Military Unit Lunch Party – United States, July 2012. This MMWR describes 22 cases of staphylococcal intoxication associated with eating perlo (a chicken, sausage and rice dish) following a military lunch party. Identification of staphylococcal enterotoxin A and isolation of S. aureus in perlo confirmed the cause of illness. Future outbreaks of staphylococcal food poisoning can be prevented by following the food safety practices suggested.
Restaurants and Food Workers
Over half of all foodborne disease outbreaks reported to the CDC are associated with eating in restaurants or delicatessens. New Environmental Health Specialists Network (EHS-Net) publications on restaurant food handling practices linked with foodborne illness provide findings for developing effective interventions and improving food safety in restaurants.
- Frequency of inadequate chicken cross contamination prevention and cooking practices in restaurants [PDF - 5 pages].
- Ground beef handling and cooking practices in restaurants in eight states [PDF - 9 pages].
- Food worker experiences with and beliefs about working while ill.
- Handling practices of fresh leafy greens in restaurants: receiving and training.
- Explaining the Risk of Foodborne Illness Associated with Restaurants: The Environmental Health Specialists Network (EHS-Net) [PDF - 2 pages].
Safe and Healthy
Because we work with food on a microscopic level, it’s really easy to forget the bigger picture of food safety in CDC’s overall work.
- The National Center for Chronic Disease published a supplement to a 2011 MMWR discussing access to healthier food retailers.
CDC tracked several multistate outbreaks of foodborne illness during November - December, including:
- Multistate Outbreak of Salmonella Heidelberg Infections Linked to Foster Farms Brand Chicken; Investigation ongoing: as of December 19, a total of 415 ill people have been reported to CDC. (Click case count map, shown above, for the latest information.)
More reporting on Salmonella and chicken:
- Pew Charitable Trusts released a report calling for more aggressive recalls of contaminated meat.
- Consumer Reports released an investigative piece on the prevalence of potentially harmful bacteria that lurk in store-bought chicken.
- Multistate Outbreak of Shiga Toxin-producing Escherichia coli O157:H7 Infections Linked to Ready-to-Eat Salads; Investigation closed on December 11: a total of 33 ill people were reported to CDC and the outbreak investigation led to the recall of numerous ready-to-eat salad and wrap products.
Botulism investigation: A home-made pickled vegetable dish known as turshi was linked to four cases of botulism in Amarillo, Texas. Health officials in Amarillo, Texas, working with CDC EIS officers and botulism experts cracked the case on this puzzling, yet limited outbreak. News Channel 10 in Amarillo, TX and Food Safety News reported about the outbreak.
- Food Safety News reports on a partnership with CDC, FDA, and the National Center for Biotechnology Information to conduct whole genome sequencing of Listeria monocytogenes collected from reported human illness cases in the United States.
- InFORM 2013 Conference (Integrated Foodborne Outbreak Response and Management)--a combined meeting of PulseNet, OutbreakNet and EHS-Net--drew over 400 laboratorians, epidemiologists, and environmental health professionals from the US and 8 other countries. Participants represented federal, state and local public health, food and environmental regulatory agencies. Read more from APHL, including conference proceedings.
New web resources
- New medscape video for clinicians by Division Director, Chris Braden, on the clinical impact of Antibiotic-Resistant Salmonella.
- Check out the Holiday Food Safety Feature providing helpful food safety tips for mothers-to-be.
- A new fact sheet [PDF - 1 page] about how to safely handle food in an easy to read—and remember—format.
- A new fact sheet [PDF - 2 pages] about the Palantir System for Enteric Disease Response, Investigation, and Coordination (SEDRIC) explains what it is and how it assists CDC and others in investigating enteric disease outbreaks.
Solve the outbreak!
- Training for future Disease Detectives. If you haven’t heard, CDC released an iPad app earlier this year that allows players a fun way to learn about epidemiology by playing Disease Detectives. This app is available on the iPad with plans to expand to additional platforms.
Upcoming Webinar: Progress toward Attribution of Foodborne Illness
Webinar: Are Outbreak Illnesses Representative of Sporadic Illnesses?
Friday, January 10, 2014, 2 PM to 3 PM ET
Join FDA, CDC, and USDA’s Food Safety and Inspection Service as they discuss progress toward attributing foodborne illnesses to food sources and the most recent activities of their tri-agency partnership, Interagency Food Safety Analytics Collaboration (IFSAC).
Presenters will share an analysis comparing the characteristics of illnesses associated with foodborne outbreaks with those that are not linked to outbreaks.
The webinar is open to the public at no charge.
December 2013 Special Edition
CDC Food Safety Twitter Chat
This Holiday, Don't Toss Your Cookies Be Food-Smart and Food-Safe
Chefs and home cooks bring their best goodies to the table during the holidays. But no one wants a bout of food poisoning to dampen their spirit. Join us for a lively Twitter chat with questions and answers about holiday food safety.
From finger foods to turkey and dressing, there is never a time of year when food is more of a focus. Join food safety experts (CDC, US Department of Agriculture, US Food and Drug Administration, International Food Information Council Foundation) and guest foodies for a Twitter chat with easy-to-remember tips for a safer and healthier holiday season.
Topics to expect:
- Food safety during the holidays: Holiday Entertaining: party giver or guest? Stay clear of “Buffet Bandits”—food hazards that can rob your holiday enjoyment. Learn how to be the host of the season by practicing safe and healthy food preparation.
- Foods and germs: fact and fiction: Raw cookie dough and some eggnog recipes are yummy holiday treats that may contain raw eggs [PDF - 1 page]. But, eating and drinking raw eggs can lead to food poisoning. Learn about this, other foods and germs, and what’s fact and fiction.
- Who’s at risk? Pregnant women, children under five years old, older adults, and people with weakened immune systems are particularly at-risk from germs that cause food poisoning.
- Simple steps, big rewards. Don’t make your holiday party ground zero for an outbreak! Remember these simple steps [PDF - 1 page]: wash hands and surfaces often, avoid cross-contamination, cook foods to proper temperatures, and refrigerate promptly.
- Holiday tips for safer eating. People in vulnerable stages and ages of life should not eat soft cheeses such as feta, brie, and queso fresco unless they have labels that say they are pasteurized. Unpasteurized products can contain harmful bacteria and can cause infections such as listeriosis. Check the facts [PDF - 1 page] and join the chat for more recommendations that everyone can use.
Wait—What’s a Twitter Chat?
Twitter chats are scheduled gatherings of people on Twitter to discuss anything that interests them, using a #hashtag to keep track of the conversation. There are chats for everything from blogging on art to agriculture to, yes, health!
Twitter chats offer participants a great way to network and share knowledge. It’s similar to a chat room in that it’s a topic-driven conversation happening in real time; it just happens to take place on Twitter.
Not using Twitter? No problem. Just visit https://twitter.com/CDCgov and click “Sign Up” to get started.
How to Participate in the Twitter Chat
The chat will be held Wednesday, December 3:00 PM - 4:00 PM ET. Mark your calendar!
To join, follow @CDCgov on Twitter, and be sure to use the hashtag #CDCchat when you participate in the chat.
- Sign in by 2:45 PM.
- You may also use a third-party service such as Tweetchat. Be sure to use #CDCchat.
- This chat is broken into topics, designated T1, T2, etc.: foods and germs; holiday food safety; healthy eating; simple steps, big rewards all year round; and more.
- You can participate in the chat and help us to spread the word.
Before the Twitter Chat, Test Your Food Safety Knowledge
- Outbreaks caused by which pathogen typically peak following Thanksgiving?
- What safe minimum internal temperature is recommended for cooking turkey?
- No one wants to spend Christmas running to the bathroom because the ham was bad. Once cooked, what temperature should you keep hot food at or above (all temperatures in °F)?
- Mmmm… leftovers. How long can you safely freeze turkey leftovers ? (Pieces, not whole turkey.)
- Which US president reportedly died from food poisoning? Bonus: What food reportedly was implicated?
- What online tool lets you search for outbreaks in each state?
We invite you to participate in the Twitter chat to get the answers to our food safety quiz and learn other food-safe and food-smart tips. But, if you can't wait, the answers are shown below.
- ABC Food Safety Twitter Chat: Pass the Potato Salad
- CDC: Foodborne Illness
- USDA: Food Safety Education
- FDA: Food Safety
- The International Food Information Council Foundation: IFIC Foundation
- Vital Signs: Recipe for Food Safety
- MediaPlanet: Food Safety: When Food Bites Back
November 2013 Special Edition
Turkey Tidbits to Share
Holidays are times we share the kitchen with family and friends. Make it a goal this year to also share good food safety practices. Visit the CDC Features: It's Turkey Time: Safely Prepare Your Holiday Meal web page for simple tips that all cooks in the kitchen can follow this holiday season for preparing a delicious and safe turkey.
Did You Know?
- Clostridium perfringens is the second most common bacterial cause of food poisoning.
- Outbreaks from Clostridium perfringens occur most often in November and December.
- Meat and poultry accounted for 92% of Clostridium perfringens outbreaks with an identified single food source.
- Refrigerate leftovers at 40°F or below as soon as possible and within two hours of preparation to prevent food poisoning.
- Talking turkey? Make sure you safely thaw, prepare, stuff, and cook this #thanksgiving http://go.usa.gov/W7bH
- Thanksgiving turkey’s two hour rule #turkeytime #thanksgiving http://go.usa.gov/W7bH
- Which foodborne outbreaks occur most in November and December? #holiday #thanksgiving Find out http://go.usa.gov/W7DC #outbreaks
- Think FOOD http://go.usa.gov/W7Qh and keep it safe http://go.usa.gov/W7bH #outbreaks
Learn more about how CDC and states track and report foodborne outbreaks at the CDC's Foodborne Outbreak Tracking and Reporting web site.
September - October 2013
Absence Makes the Heart Grow Fonder
An excerpt from a letter to returning furloughed workers from Dr. Chris Braden (Director for the Division of Foodborne, Waterborne, and Environmental Diseases/National Center for Emerging and Zoonotic Diseases at the Centers for Disease Control and Prevention).
"Along with most of the federal government, the furlough curtailed the efforts of those who work to keep America healthy. For 16 days, there was a disturbing quiet in CDC's offices, labs, and hallways. Our furloughed staff were forced to cancel meetings, trainings, and walk away from critical work battling food, water, and environmental diseases.
I was impressed by the dedication and commitment of the staff that stayed through the furlough, often doing the jobs of many others. And, I was impressed by the attitude of people after the furlough. You returned enthusiastically, picked up your work quickly, and moved forward. It is great to see and wonderful to feel that buzz of energy in our Division again.
I was not the only one who missed you. The media published a steady stream of news stories ranging from worry over gaps in surveillance for influenza and foodborne outbreaks to an article highlighting non-furloughed laboratory staff who quietly worked behind the scenes (photo on left: Dr. Collette Fitzgerald Leaumont, team lead, Enteric Reference Laboratory).
There is certainly nothing "non-essential" about our work.
Thank you and carry on."
Christopher R. Braden, M.D., CAPT USPHS
CDC tracked five multistate outbreaks of foodborne illness during September - October:
- Salmonella Heidelberg. In a multistate outbreak linked to Foster Farms brand chicken, seven outbreak strains of the bacteria Salmonella Heidelberg have sickened over 300 people—40% of whom were hospitalized.
- Vibrio parahaemolyticus. CDC and state and federal partners in 13 states are monitoring an increase in vibriosis since May 2013. Vibrio bacteria live in saltwater. People can get vibriosis after eating raw or undercooked shellfish, particularly oysters. Several species of Vibrio, including Vibrio parahaemolyticus, can cause illness.
- Cyclospora. An Outbreak of Cyclosporiasis in the United States appears to be over.*
- Hepatitis A. The multistate outbreak of hepatitis A linked to pomegranate seeds from Turkey** appears to be over.
- Listeria. An outbreak strain of Listeria monocytogenes linked to Crave Brothers cheeses, appears to be over.
* This outbreak falls under the jurisdiction of CDC's Division of Parasitic Diseases and Malaria.
** This outbreak falls under the jurisdiction of CDC's Division of Viral Hepatitis.
Select CDC Food Safety Publications
Key CDC publications during September - October include:
Antibiotic Resistance Threats Report and Foodborne Germs
- Each year, millions of people in the United States become sick from foodborne and other enteric (gastrointestinal) infections. While many of these infections are mild and do not require treatment, antibiotics can be lifesaving in severe infections. Antibiotic resistance compromises our ability to treat these infections and is a serious threat to public health. CDC's Antibiotic Resistance Threats in the United States, 2013 report [PDF - 76 pages] connects antibiotic resistance to foodborne and other enteric germs in animals, food, and humans.
- Over half of all foodborne disease outbreaks reported to the CDC are associated with eating in restaurants or delicatessens. Using data on restaurant-associated foodborne disease outbreaks reported by sites participating in the Foodborne Diseases Active Surveillance Network (FoodNet), CDC analysts characterized contributing factors and the levels of evidence used to determine them.
- Gould LH, Rosenblum I, Nicholas D, Phan Q, and Jones TF. Contributing Factors in Restaurant-Associated Foodborne Disease Outbreaks, FoodNet Sites, 2006-2007. Journal of Food Protection, Vol. 76, No. 11, 2013, Pages 1824–1828, doi:10.4315/0362-028X.JFP-13-037.
On the Web
Voluntary Guidelines for Food Establishments during a Foodborne Illness Outbreak Investigation
CIFOR--the Council to Improve Foodborne Outbreak Response-is a partnership of food industry and public health professionals working to reduce the burden of foodborne illness in the United States.
CIFOR's Guidelines for Foodborne Outbreak and Response [PDF - 80 pages] (2009-2012) are recommendations for owners, operators, and managers of retail food establishments during a foodborne illness outbreak investigation. The document provides step-by-step approaches to outbreak response.
On the Road
CDC experts saw first-hand, the progress in food safety from labs in China to fields in California.
- China has made tremendous progress since 2006 in testing for Salmonella in Shanghai, Guangdong, Henan, and Jiangsu provinces. Started from scratch, laboratories in these provinces can now successfully conduct Pulsed-field Gel Electrophoresis (PFGE) analysis to detect foodborne outbreaks from Salmonella.
“Detecting outbreaks is the first step towards prevention”, says CDC foodborne expert, Dr. Robert Tauxe. Read more in:Laboratory-Based Surveillance of Non-typhoidal Salmonella Infections in Guangdong Province, China [PDF - 9 pages].
- CDC joined 23 federal partners from FDA, USDA, EPA, Department of State, Department of Interior, International Trade Commission, Fish and Wildlife Service, and the Executive Office for a one-week educational exchange examining key California agricultural issues from trade to food safety.
The theme, “Technology of the Future in Use Today,” covered priorities around water (supply, quality, flooding), air, labor, food safety, pest exclusion, crop protection, trade, conservation resources, and environmental issues. This is the 32nd class of fellows. See video clip and local story: Federal regulators receive hands-on ag lessons.
CDC tracked three multistate outbreaks of foodborne illness during August-September:
- Cyclospora. Investigation of an Outbreak of Cyclosporiasis in the United States (ongoing)*
- Hepatitis A. The multistate outbreak of hepatitis A linked to pomegranate seeds from Turkey** (ongoing)
- Listeria. Outbreak strain of Listeria monocytogenes linked to Crave Brothers cheeses; includes the use of whole genome sequencing (ongoing)
* This outbreak falls under the jurisdiction of CDC's Division of Parasitic Diseases and Malaria.
** This outbreak falls under the jurisdiction of CDC's Division of Viral Hepatitis.
Select CDC Food Safety Publications
This chapter, authored by CDC food safety experts, surveys emerging trends in surveillance, analyses, antimicrobial resistance, pathogen subtyping and other food-safety issues and threats. It appears in the publication, Foodborne Illness: Latest Threats and Emerging Issues. Emerging Trends in Foodborne Diseases.
- New dimension to tracing source of outbreaks: Notes from the editors: Consensus paper on MLVA development, validation, nomenclature and quality control – an important step forward for molecular typing-based surveillance and outbreak investigation.
- The first FoodCORE Model Practice: Initial Case-patient Interviewing describes the basic practices and characteristics of conducting comprehensive interviews for all enteric disease case-patients upon initial identification or first contact. See also Year One Summary Report [PDF - 11 pages] and Cumulative Year One SSL metrics table.
New Subspecies of Campylobacter fetus
- Recently, illness caused by subspecies of the less common Camplylobacter fetus has been reported for nine patients and might have come from exposure to traditional Asian foods or live reptiles. Persons at risk should avoid eating undercooked reptiles and should avoid live reptiles and their environments. Human Infections with New Subspecies of Campylobacter fetus.
- Preventing produce contamination within farm and processing environments is vital, as highlighted in this article examining the nationwide listeriosis outbreak in 2011 associated with cantaloupe.Multistate Outbreak of Listeriosis Associated with Cantaloupe.
- After examining an outbreak of Salmonella linked to not-ready-to-eat frozen pot pies, researchers found that most patients did not follow the product’s cooking instructions and did not know their oven’s wattage. Outbreak of Salmonella enterica serotype I 4,5,12:i:- infections: the challenges of hypothesis generation and microwave cooking.
- Researchers examined an outbreak of Salmonella enterica in North Carolina from unpasteurized tempeh and concluded that tempeh is a novel food vehicle for S. enterica infection.
Gastroenteritis outbreak associated with unpasteurized tempeh, North Carolina.
New web resources
- Dangerous Raw Oysters podcast
Hear about the dangers of eating unprocessed raw oysters and treatment methods for killing these potentially dangerous bacteria. Read more about this topic: Impact of 2003 State Regulation on Raw Oyster–associated Vibrio vulnificus Illnesses and Deaths, California, USA.
- Food Poisoning
Learn the risks and consequences of food poisoning in CDC’s current feature and in the fun, new web series, Recipes for Disaster – a fictional cooking show where the host, Maria, unintentionally makes common food safety mistakes when preparing her dishes.
CDC tracked 4 multistate outbreaks of foodborne illness during July-August:
* This outbreak falls under the jurisdiction of CDC's Division of Parasitic Diseases and Malaria
** This outbreak falls under the jurisdiction of CDC's Division of Viral Hepatitis
Select CDC Food Safety Publications
This is a report on botulism associated with home-fermented tofu in two Chinese immigrants in 2012.
Botulism Associated with Home-Fermented Tofu in Two Chinese Immigrants — New York City, March–April 2012.
Foodborne Disease Outbreaks
This report summarizes data associated with the 13,405 foodborne disease outbreaks reported to CDC from 1998-2008.
Surveillance for Foodborne Disease Outbreaks — United States, 1998–2008.
This article, part of an issue on food defense in the US, highlights CDC’s role in connecting human illness to food contamination and the importance of science and communications in targeting food safety.
Listeria – When Food Bites Back [PDF - 31 pages].
The CIFOR guidelines for owners, operators, and managers of restaurants and grocery stores were developed to help businesses prepare for the possibility of foodborne illness and outbreaks related to their operation.
CIFOR Foodborne Illness Response Guidelines for Owners, Operators And Managers Of Food Establishments.
This article includes data from the first two years of National Outbreak Reporting System surveillance, which highlight the predominant role of norovirus in acute gastroenteritis outbreaks.
Acute Gastroenteritis Surveillance through the National Outbreak Reporting System, United States.
This paper examines the diversity and predominance of food commodities implicated in outbreaks of salmonellosis during 1998–2008.
Outbreak-associated Salmonella enterica Serotypes and Food Commodities, United States, 1998–2008.
This report summarizes the multistate investigation of Salmonella Heidelberg infections linked to chicken.
Outbreak of Salmonella Heidelberg Infections Linked to a Single Poultry Producer – 13 States, 2012-2013.
An analysis of data strongly suggests that the 2003 regulation of the sale of raw oysters harvested from the Gulf of Mexico led to a significant reduction in reported raw oyster–associated V. vulnificus illnesses and deaths.
New Web Resources
Produce safety poster. The new Steps to Safe and Healthy Fruits and Vegetables is available for free download. Test your produce safety knowledge with the new CDC.gov feature, which includes a quiz on safe produce handling.
Surveillance for Foodborne Disease Outbreaks Q&A. A new webpage contains questions and answers and new graphics for the recently released publication “Surveillance for Foodborne Disease Outbreaks – United States, 1998-2008.”
- Questions and Answers
- MMWR report
- Graphics: Impact of Contaminated Foods [PDF - 1 page], Foods Linked to Illnesses [PDF - 1 page], Foods Linked to Outbreaks [PDF - 1 page], Salmonella Outbreaks in Eggs [PDF - 1 page], Outbreaks with a Reported Setting in 1998 through 2008 [PDF - 1 page]
Interagency Food Safety Analytics Collaboration (IFSAC) webinar
In 2011, FDA, CDC, and USDA-FSIS formed the Interagency Food Safety Analytics Collaboration (IFSAC). This tri-agency analytic collaboration is currently focused on projects related to foodborne illness source attribution. IFSAC sponsored a webinar on June 18, 2013, to describe this tri-agency collaboration and its activities, and provide an update on the IFSAC project to improve the food classification system for attribution analysis.
Patient interviewing model. The first FoodCORE Model Practice: Initial Case-patient Interviewing describes the basic practices and characteristics of conducting comprehensive interviews for all enteric disease case-patients upon initial identification or first contact.Home canning and botulism. The CDC.gov feature on Home Canning and Botulism tells home canners how to can their fresh produce safely to avoid the risk of botulism, a potentially deadly illness.
New report shows which foods & germs linked to outbreaks
Tracking foodborne disease outbreaks provides valuable insight into the germs and foods that sicken an estimated 48 million Americans each year. CDC’s newly released MMWR Surveillance Summary, “Surveillance for Foodborne Disease Outbreaks – United States, 1998-2008,” offers a comprehensive look at what pathogens, foods, and select settings caused outbreaks during 11 years of a stable surveillance system. This paper also looks at how outbreak reporting and the foods associated with outbreaks changed over time.
Here are some facts:
Outbreak surveillance: Outbreak investigations provide direct links between foodborne illnesses and the foods causing them. Surveillance summaries of the outbreak investigations reported to CDC by state and local health departments provide important snapshots of the human health impact of foodborne outbreaks. Data from foodborne disease outbreak surveillance are our best data source for attributing illnesses to foods.
Tracking foods and germs over time: This report uses data associated with the 13,405 foodborne disease outbreaks reported to CDC from 1998-2008 collected through the Foodborne Disease Outbreak Surveillance System and describes 11 years of data about:
- The causes of outbreaks and where they occur
- The pathogens and foods that caused the most outbreaks, illnesses, hospitalizations, and deaths
- Trends in the pathogens and foods associated with outbreaks over time
Key changes: Several changes were observed, including a decrease from 1998 to 2008 in the number of outbreaks of Salmonella infections attributable to eggs and an increase in the number of outbreaks caused by dairy products and leafy green vegetables.
Targeting Prevention: The findings in this report underline the importance of targeted prevention measures for the specific foods that are associated with the most outbreaks and illnesses (i.e., beef, poultry, fish, and produce). Prevention measures include regulatory and industry-led systematic improvements in food safety as well as simple precautions that people can take in their own kitchens.
For more information visit
QUESTIONS AND ANSWERS: 1998-2008 MMWR Questions and Answers
- Impact of Contaminated Foods [PDF - 1 page]
- Foods Linked to Illnesses [PDF - 1 page]
- Foods Linked to Outbreaks [PDF - 1 page]
- Salmonella Outbreaks in Eggs [PDF - 1 page]
- Outbreaks with a Reported Setting in 1998 through 2008 [PDF - 1 page]
Select CDC Food Safety Publications
This report documents the first foodborne outbreak of STEC O145 infections in the United States.
Multistate Outbreak of Escherichia coli O145 Infections Associated with Romaine Lettuce Consumption, 2010 [PDF - 6 pages].
This article reports that almost all listeriosis occurs in persons in higher-risk groups. Prevention targeting higher-risk groups and control of Listeria monocytogenes contamination in foods implicated by outbreak investigations will have the greatest impact on reducing the burden of listeriosis.
Vital Signs: Listeria Illnesses, Deaths, and Outbreaks — United States, 2009–2011
This article reports an intraocular listeriosis case related to a multistate outbreak associated with contaminated cantaloupe.
Vision Loss following Intraocular Listeriosis Associated with Contaminated Cantaloupe.
Outbreaks from spices
This review identified fourteen reported illness outbreaks attributed to consumption of pathogen-contaminated spice during the period 1973–2010.
Foodborne illness outbreaks from microbial contaminants in spices, 1973-2010.
CDC tracked 7 multistate outbreaks of foodborne illness during June-July:
Multistate Outbreak of Listeriosis Linked to Crave Brothers Farmstead Cheeses (ongoing)
Multistate outbreak of hepatitis A virus infections linked to pomegranate seeds from Turkey* (ongoing)
*Note: this outbreak falls under the jurisdiction of CDC’s Division of Viral Hepatitis.
New Web Resources
Pediatric infections. A new Medscape commentary for clinicians addresses foodborne and enteric infections in children.
Food safety in restaurants. CDC contributes regularly to the blog run by FoodSafety.gov. Check out our latest entry on Restaurant Safety: What You Should Know.
June 2013: Vital Signs
When Food Bites Back: Protecting people from deadly Listeria food poisoning
Each month the CDC Vital Signs Program releases a call-to-action about an important public health topic that uses the latest available surveillance data. June’s release was about food poisoning caused by Listeria and the people it targets.
Vital Signs Town Hall
When Food Bites Back: Act Locally, Control Nationally
Tuesday, June 11, 2013
Here are some facts
Most at risk: Listeria targets older adults, pregnant women and their babies, and those with weakened immune systems. These hard-hit groups account for at least 90 percent of reported Listeria infections.
Deadly consequences: Listeria is the third leading cause of death from food poisoning. Most people who have Listeria infections require hospital care and about 1 in 5 of them die.
Risky foods: Listeria can hide unnoticed in food-processing equipment subsequently leading to food contamination. Listeria outbreaks are mainly caused by soft Mexican-style cheeses like queso fresco and other soft cheeses that were either made from unpasteurized milk or that got contaminated during cheese-making. Some outbreaks have also been caused by foods that people may not think of as risky for Listeria, like celery, sprouts, and cantaloupe.
Progress stalled: Data indicate that no progress in reducing the rate of Listeria infection has occurred in over a decade. New food safety regulations proposed this year may help.
For more information visit
Vital Signs website
Digital press kit
Telebriefing Transcript | Transcript Audio | Press Release
CDC Listeria website (en Español)
CDC Feature (en Español)
Podcast (en Español)
Public Service Announcement
Hot off the presses! #Listeria — a rare & deadly germ is the number 3 cause of #death from germs in foods. #VitalSigns
Soft cheese, hot dogs, and raw milk, oh my! Learn how to prevent food poisoning from Listeria and other #foodborne germs. #VitalSigns
New Website: PulseNet tracks foodborne outbreaks
Did you know that PulseNet is the first step in identifying foodborne outbreaks?
Since 1996, PulseNet has connected foodborne illness cases together, using DNA "fingerprinting" of the bacteria making people sick, in order to detect and define outbreaks.
CDC’s new PulseNet website features lots of great information about this important resource.
- Frequently Asked Questions
- A slideshow illustrating How PulseNet Works
- Graphics on PulseNet’s role in outbreak detection
- An infographic detailing the pulsed-field gel electrophoresis (PFGE) process
- Laboratory protocols for bacteria PulseNet tracks
- Information about culture independent diagnostic testing
- And much more!
Visit the new PulseNet website.
Want to contribute to the conversation about PulseNet? Consider tweeting about it! Remember to use the #PulseNet hashtag.
#PulseNet uses DNA fingerprints to track foodborne outbreaks. Learn more.
#PulseNet has detected 1000s of foodborne outbreaks since it began, thanks to its member labs.
#PulseNet is meeting the challenge of changing diagnostic technology. Find out how.
Select CDC food safety publications
This paper suggest that methods to incorporate data from multiple surveillance systems and over several years are needed to improve estimation of the number of illnesses attributable to exposure sources.
Attributing sporadic and outbreak-associated infections to sources: blending epidemiological data.
This report reviews the progress made in the past 10 years in understanding and controlling Campylobacteriosis and suggests how contributing organizations can take action to reduce Campylobacter in the food chain and the burden of foodborne Campylobacteriosis.
The Global View of Campylobacteriosis: Report of Expert Consultation [PDF - 69 pages]
CDC tracked 3 multistate outbreaks of foodborne illness during May:
· Shiga toxin-producing Escherichia coli O121 Infections Linked to Farm Rich Brand Frozen Food Products
· Salmonella Saintpaul Infections Linked to Imported Cucumbers
· Salmonella Montevideo and Mbandaka infections linked to tahini sesame paste
New Web Resources
Global food safety shines in CDC's Center for Global Health
The newest issue of CDC Around the World, the Center for Global Health's popular newsletter, focuses on the issue of global food safety. Check out the features, including
- A photo of the week
- A blog on When Food Bites Back: Think locally, act globally
- An infographic on Tracing Food Back to the Source
- A video on Food Safety in a Global Economy
- A story from the field: PulseNet International: Tracking foodborne disease outbreaks throughout the world
New CDC Epidemic Intelligence Service Officers support food safety!
Each year, the Division of Foodborne, Waterborne & Environmental Diseases recruits a new “class” of Epidemic Intelligence Service (EIS) Officers who play a critical role in investigating outbreaks, among other duties. This year, the branches that work in foodborne disease will welcome five new EIS officers.
Last year, our EIS Officers assisted on four food-related Epi-Aids, or requests for epidemiologic assistance, both domestic and international, and on many other multistate outbreak investigations. Read the digitial press kit for more information about EIS Officers.
Check out these stories featuring the important work of CDC EIS Officers:
Select CDC food safety publications
The authors conducted an analysis to attribute STEC O157 infections to sources, and conclude that 27% and 15% of infections were attributed to a source in 1996 and 1999, respectively.
Attributing sporadic and outbreak-associated infections to sources: blending epidemiological data
Foodborne Disease Outbreaks
This article reports that from 1998–2008, 1,229 foodborne outbreaks caused by B. cereus, C. perfringens, and S. aureus were reported in the US; 39% were reported with a confirmed etiology.
Foodborne Disease Outbreaks caused by Bacillus cereus, Clostridium perfringens, and Staphylococcus aureus, United States, 1998-2008
This article uses FoodNet data to conclude that Black infants had a greater risk of salmonellosis and invasive disease than other racial group between 1996 and 2008.
Epidemiology of Infant Salmonellosis in the United States, 1996–2008: A Foodborne Diseases Active Surveillance Network Study
Trends in Foodborne Illness
The annual report on Trends in Foodborne Illness in the US (1996-2012) shows that Salmonella and Campylobacter have the highest incidence per 100,000 in 2012.
Incidence and Trends of Infection with Pathogens Transmitted Commonly Through Food — Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 1996–2012
CDC tracked two multistate outbreaks of foodborne illness during April:
Shiga toxin-producing Escherichia coli O121 Infections Linked to Farm Rich Brand Frozen Food Products
Salmonella Saintpaul Infections Linked to Imported Cucumbers
New Web Resources
New website: Integrated Centers of Excellence
The new Integrated Food Safety Centers of Excellence website showcases 5 regional Center locations around the United States.
The Centers identify and evaluate best practices for foodborne disease surveillance and outbreak investigation then share this knowledge in response to the Food Safety Modernization Act.
2012 FoodNet data and resources
The Foodborne Diseases Active Surveillance Network (FoodNet) annual report card is now live! See the digital press kit and CDC.gov feature for more details. FoodNet is a collaborative surveillance system in 10 sites covering about 15% of the U.S. population.
--A new trends page highlights the 2012 FoodNet data and includes a PDF fact sheet of the information.
--The 2012 preliminary data (tables and figures) illustrates incidence trends, hospitalizations, and case fatality ratios.
--The Campylobacter page was updated to reflect 2012 data.
--A new Questions and Answers page provides information about the report, specific infections, and other details.
Other CDC resources
Stories from the Field
Global Networks Make Food Safer
Foodborne diseases are preventable yet common causes of illness, disability, and death worldwide. CDC's collaboration with WHO called Global Foodborne Infections Network (GFN) and CDC's PulseNet International are worldwide organizations that help countries to strengthen their ability to detect and control diseases.
Training + country perspectives = better collaborations to prevent foodborne disease
In 2000, after a World Health Organization (WHO) survey showed that many countries lacked basic laboratory and public health resources to detect foodborne diseases, WHO, CDC and partners developed the Global Foodborne Infections Network.
This network integrates food, public health, and veterinary expertise to provide training in how to detect infections caused by contaminated food. Today, 1,600 members from national laboratories and other institutes in 180 countries make up this network.
China's success story & consumers' role in global food safety
Please visit the CDC Feature web page on Global Food Safety to learn about China's food safety success story that started in the laboratory and connects to the field, and about the role that consumers play in global food safety.
Select CDC food safety publications
Culture Independent Diagnostics
- This article notes the unfavorable cascade of events to be set in motion if clinical laboratories stop culturing specimens and switch entirely to culture independent diagnostic tests that do not allow for serotyping and molecular subtyping.
- Atkinson R, Maguire H, Gerner-Smidt P. A Challenge and an Opportunity to Improve Patient Management and Public Health Surveillance for Foodborne Infections through Culture-Independent Diagnostics [PDF - 12 pages]. J Clin Microbiol. 2013.
- This article provides perspectives from recent efforts to address concerns about microbial contamination of food plants and resulting foodborne illness.
- Fletcher J, Leach JE, Eversole K, Tauxe R. Human pathogens on plants: designing a multidisciplinary strategy for research. Phytopathology. 2013 Apr;103(4):306-15.
- A new article reviews all reports of outbreaks during 1973–2008 in which salsa or guacamole was reported as a vehicle and finds that these increased in the United States from 1984 to 2008, especially in later years, and especially in restaurants.
- Kendall M, Mody R, Mahon B, Doyle M, Herman K, Tauxe R. Emergence of Salsa and Guacamole as Frequent Vehicles of Foodborne Disease Outbreaks in the United States, 1973–2008. Foodborne Pathogens and Disease [epub ahead of print].
- This article describes an increase in resistance to ceftriaxone and nonsusceptibility to ciprofloxacin and an overall decline in multidrug resistance among nontyphoidal Salmonella in the United States from 1996 through 2009.
- Medalla F, Hoekstra RM, Whichard JM, Barzilay EJ, Chiller TM, Joyce K, et al. Increase in Resistance to Ceftriaxone and Nonsusceptibility to Ciprofloxacin and Decrease in Multidrug Resistance Among Salmonella Strains, United States, 1996-2009. Foodborne pathogens and disease. 2013 Mar 6.
- A recently published MMWR article describing the investigation of an outbreak of shigellosis associated with a private bridge club documents the first known transmission of Shigella sonnei with decreased susceptibility to azithromycin in the U.S.
- Reporter R, Pulido M, Bowen A, Karlsson MS. Notes from the field: outbreak of infections caused by Shigella sonnei with decreased susceptibility to azithromycin—Los Angeles, California, 2012. MMWR. 2013;62(9):171.
New Web Resources
The Division contributes regular Medscape commentaries on food safety, which deliver CDC's authoritative guidance directly to physicians, nurses, pharmacists, and other healthcare professionals.
Botulism: Countering Common Clinical Misperceptions: Dr. Agam Rao discusses how to recognize and treat botulism and addresses common clinical misperceptions about the illness.
–Watch more Medscape commentaries about food safety at the Food Safety — Medscape Commentaries web page.
- CDC.gov features are available for syndication on your website!
Our Work, Our Stories 2011–2012
Read about CDC's work in reducing foodborne illness. This month the National Center for Emerging and Zoonotic Infectious Diseases, which houses CDC's Food Safety Office, released Our Work, Our Stories 2011–2012, the first public report about who we are and what we do. The report features more than 50 spotlight stories and captioned visuals that offer an engaging look at our work during the past two years to prevent infections, protect people, and save lives.
Stories about food safety
- Benjamin Silk, CDC disease detective (Listeria) (page 18)
- PulseNet at work—detecting hazardous hazelnuts (E. coli) (page 26)
- Bioinformatics—Accelerating detection and analysis in the laboratory (page 28)
- Defeating diarrheal disease—a leading killer of adults and children in India (page 39)
- FoodCORE and NYC “Team Salmonella” (page 49)
- Tainted Turkey-Tracking antimicrobial resistance in food (a NARMS contribution) (page 66)
- Foodborne Disease and Food Safety (contributed to the investigations and content for the Tainted Turkey and Listeria and Cantaloupes stories) (page 71)
- FoodNet and reducing E. coli contamination (page 70)
- Targeting salmonella (page 72)
Not just food: Zoonoses
- A Sample of Zoonotic Disease Outbreaks Caused by Contact with Animals (page 56)
- Cute but Contaminated - Small Turtles (page 60)
Medscape highlights CDC’s major multistate foodborne and zoonotic outbreaks for 2012
- Clinician outreach. Medscape slideshows highlighting the Major Foodborne Illness Outbreaks of 2012 and Major Outbreaks of Enteric Zoonoses in 2012 are available on the Division of Foodborne, Waterborne & Environmental Diseases website.
- “Solve the Outbreak” app launched. CDC has launched an innovative new iPad app, “Solve the Outbreak.” This free, interactive app lets users play the role of Disease Detectives. Users puzzle their way through various clues, charts, and data, trying to figure out what disease they’re dealing with and how the outbreak started. Available from the iTunes store.
Attribution of Foodborne Illnesses, Hospitalizations, and Deaths to Food Commodities, United States, 1998–2008
Emerging Infectious Diseases Volume 19, Number 3—March 2013: “Attribution of Foodborne Illnesses, Hospitalizations, and Deaths to Food Commodities by using Outbreak Data, United States, 1998-2008.”
New websites. Attribution of Foodborne Illness, Attribution of Foodborne Illness, 1998-2008
New podcast. Knowing which foods make us sick will help guide food safety regulations. Dr. John Painter, an epidemiologist with the Centers for Disease Control and Prevention, discusses his study about which foods can make us sick.
- Listen Now or Download MP3 Length: 13:47
- Download Transcript [PDF - 5 pages]
- View full-text article: Attribution of Foodborne Illnesses, Hospitalizations, and Deaths to Food Commodities by using Outbreak Data, United States, 1998–2008
Key CDC publications for food safety in February 2013
- A recent MMWR Notes from the Field reports the fifth outbreak of botulism in a prison associated with pruno, an illicit alcoholic beverage self-brewed by prisoners.
- Yasmin S, Adams L, Rao A, Mody R, Luquez C, Dykes J, et al. Notes from the Field: Botulism From Drinking Prison-Made Illicit Alcohol – Arizona, 2012. MMWR. 62(05); 88-88.
- A recently published study shows that, from 1998 to 2010, among the 144 outbreaks caused by Clostridium perfringensand attributed to a single food commodity, beef was the most common commodity (66 outbreaks, 46%), followed by poultry (43 outbreaks, 30%), and pork (23 outbreaks, 16%).
- Grass JE, Gould LH, Mahon BE. Epidemiology of Foodborne Disease Outbreaks Caused by Clostridium perfringens, United States, 1998-2010. Foodborne pathogens and disease. 2013 Feb 4.
- A recently published study describes a multistate outbreak of STEC O157:H7 infections associated with consumption of romaine lettuce. Traceback analysis determined that a single common lot of romaine lettuce was linked to the outbreak strain but the investigation did not identify the source of contamination.
- Slayton RB, Turabelidze G, Bennett SD, Schwensohn CA, Yaffee AQ, Khan F, et al. Outbreak of Shiga Toxin-Producing Escherichia coli (STEC) O157:H7 Associated with Romaine Lettuce Consumption, 2011. PloS one. 2013;8(2):e55300
- In 2005, 2008, and 2011, an investigation found donated platelets contaminated with Listeria monocytogenes. This underscores the value of screening for bacterial contaminants.
- Menon M, Graves L, McCombs K, Hise K, Silk B, Kuehnert M, Lynch M. Listeria monocytogenes in donated platelets: a potential transfusion-transmitted pathogen intercepted through screening. Transfusion. 2013 Jan 30. doi: 10.1111/trf.12097. [Epub ahead of print]
- A recent MMWR Notes from the Field reports on the multistate outbreak of Salmonella Bredeney infections linked to Sunland peanut butter. A total of 41 cases of Salmonella Bredeney infections were identified in 20 states.
- MacDonald JK, Julian E, Alvina C, Dion J, Boden W, Viazis S, et al. Notes from the Field: Salmonella Bredeney Infections Linked to a Brand of Peanut Butter – United States, 2012. MMWR. 62(06); 107-107.
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, visit the Estimates of Foodborne Illness in the United States sites with a special page devoted to the study.
- 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:
- 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.
- 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 years old are more likely to be diagnosed. However, overall rates of illness remain higher in children after adjusting for under-diagnosis in both groups, story to come in Food Quality magazine.
- 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 [PDF - 27 pages]. Clin. Infect. Dis. 2013 Feb;56(3):376-82.
- 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.
- 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. [PDF - 4 pages] 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.
- 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.
- 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.
- 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.