VI. CDC Updates

Surveillance Modernizations Efforts

During the 2018 BSC FSMA SWG discussions, there was significant interest in learning more details about CDC’s Division of Foodborne, Waterborne, and Environmental Diseases’ next steps to modernize and better integrate CDC’s surveillance systems. At the May 2019 BSC FSMA SWG meeting, CDC DFWED shared plans to

• Complete the Data and IT Modernization Strategic Plan work started in 2018
• Assess all systems in DFWED
  • Inventory by surveillance data life cycle
  • External evaluation against guiding principles and system requirements
• Develop a roadmap for system modernization including priorities, actions, assignments, and timelines

Information from FoodNet Surveillance

Nearly 36,000 surveys were completed for the Population Survey. The final data set is expected in August, and the analysis should be complete by December 2019.

May 2018 CIDT Meeting Follow-up Actions

The May 2018 BSC FSMA SWG meeting focused on identifying CIDT issues and knowledge gaps and generating potential solutions in public health practice, surveillance, and technology. Follow-up discussions at the May 2019 BSC FSMA SWG meeting revolved around the already commonplace but still increasing use of CIDTs in the clinical world and the need for CDC and regulatory agencies to determine how to best adapt to the technology. Federal and state agencies involved in foodborne illness surveillance are in a transitional and transformational stage of using WGS as a standard in PulseNet, where an isolate is necessary, yet future technology, such as the use of metagenomics, may not require an isolate. Future discussion on this topic is anticipated given the challenges faced now and in the future.

DFWED Mission Coordination Update and the Future

As a result of a strategic assessment, DFWED anticipates

• Division-level coordination of surveillance system development including connections with agency-wide efforts
• Coordinated expansion and exploration of WGS methods and other technological platforms across DFWED
• Better integration of ELC-supported activities and connections with DFWED activities
• Improved coordination of communications and strategic partnerships across DFWED
• Developing priorities for prevention in support of each branch’s efforts

Globalization of the Food Supply: Implications for the United States

The number of outbreaks linked to imported foods in the United States has steadily increased. In addition, molecular testing has identified many new food vehicles as the source of multistate foodborne outbreaks in the United States; of note, 42% of these outbreaks have been associated with imported food products.

Challenges of food globalization for the United States:

• Consumer demand 24/7, 365 days
• Increasing global food supply
  • More than 20% of food is imported
  • Food is imported from more than 150 countries
  • Food is imported through more than 300 ports
  • Approximately 200,000 foreign firms are registered by the FDA

The International Food Safety Authorities Network (INFOSAN) is the voluntary network of national authorities involved in food safety from around the world (600+ participants from 188 member states managed jointly by the Food and Agriculture Organization and World Health Organization). INFOSAN aims to

• Promote the rapid exchange of information during food safety–related events
• Share information on important food safety–related issues of global interest
• Promote partnerships and collaboration between countries, and between networks
• Help countries strengthen their capacity to manage food safety emergencies

Review of 2018 U.S. foodborne disease outbreak notifications posted in WHO INFOSAN:

• All CDC multistate outbreak website postings were shared with INFOSAN.
• Those outbreaks with potential international link were posted as INFOSAN events.
• INFOSAN followed up with potential donor and receiving countries.

Challenges encountered in foodborne disease outbreaks from internationally distributed products:

• Determining whether illnesses are occurring in other countries when a U.S. outbreak is identified
• Traceability to growers/producers
• Overcoming reluctance of countries to share outbreak information including WGS results
• Ability to identify the root causes of contamination at growers/producers