II. CDC Updates

Some of IFSAC’s accomplishments in 2017 include the release of the IFSAC 2017–2021 strategic plan and corresponding action plan, informing new partners about IFSAC’s work, responding to requests, and initiating and completing multiple projects. IFSAC held a webinar on December 17, 2017, to present one of its key accomplishments, the 2013 foodborne illness source attribution estimates for four priority pathogenspdf icon.

• IFSAC previously developed a new method for estimating foodborne illness source attribution for four priority pathogens based on outbreak data: Salmonella, Escherichia coli O157, Listeria monocytogenes, and Campylobacter.
• IFSAC published the 2012 estimates in a short report in 2015. More technical aspects of the study will be published via a manuscript.

CDC’s focus is on foodborne illness rather than food safety regulation; however, information collected from outbreak investigations helps drive prevention policy. CDC is building laboratory and epidemiology capacity across the country to improve outbreak detection and investigation, which will improve prevention and control efforts. By the end of 2017, nearly 100% of state public health laboratories will have a sequencer and personnel trained to operate it. This will lead the way for making WGS routine for public health surveillance of enteric bacteria. CDC is also working to improve epidemiology support through the FoodCORE and OBNE programs, which currently fund 33 states (approximately 88% of the U.S. population).

FoodNet launched the new cycle of the Population Survey in December 2017. This survey was previously conducted in 2006–2007 to estimate the burden of acute gastrointestinal illness in the United States and to assist with hypothesis generation during cluster and outbreak investigations. The new cycle will update the data used for these purposes and includes modernized methods. FoodNet is also conducting surveillance of CIDTs to quantify the trend away from culture. Cases with only CIDT results are becoming an increasingly larger portion of cases reported to public health. Data from FoodNet’s surveillance will inform interpretation of incidence rates and strategies for adapting to the changing diagnostic environment. With the expanding use of WGS, antimicrobial resistance information will be included as part of the data collected in FoodNet.

CDC conducts epidemiologic surveillance for select pathogens to detect outbreaks, identify emerging threats and trends, identify sources of illness, and monitor the impacts of public health interventions. Current low-tech surveillance operations are slow, potentially inaccurate, laborious, and expensive. Public health personnel need to be able to link epidemiologic and laboratory data in real-time because this impacts the time it takes to detect an outbreak and the number of outbreaks that are able to be solved and lead to regulatory action. At present, real-time data entry and case-linking is done only for Listeria because the current manual methods would overwhelm staff if expanded to other pathogens. To address this issue, CDC is upgrading its enteric case databases and is working to develop a system where states can send surveillance data to CDC electronically for real-time upload without the need for duplicate entry. This method is being piloted with four states through HL7 message mapping, but investments need to be made in state informatics capacity in order for this process to work nationwide.