Information for Health Departments

State, local, and territorial public health departments have the primary responsibility for identifying and investigating enteric (intestinal) disease outbreaks and voluntarily reporting them to CDC through a web-based program called the National Outbreak Reporting System (NORS). State public health laboratories also play a critical role in tracking foodborne infections and outbreaks in the United States. Public health laboratories conduct DNA fingerprinting of germs commonly transmitted through food, including Salmonella, Shigella, Listeria, and Shiga toxin-producing E. coli.

CDC funds several programs to build capacity in state and local health departments to make food safer through the following actions:

  • Improving foodborne disease surveillance
  • Investigating foodborne disease outbreaks
  • Implementing practices to better detect, stop, and prevent foodborne disease outbreaks

These programs are funded by the Epidemiology and Laboratory Capacity for Infectious Diseases Cooperative Agreement (ELC). The ELC program funds projects and services intended to prevent and control the spread of infectious disease, to reduce illness and deaths.

OutbreakNet Enhanced

Logo for Outbreak Net Enhanced

OutbreakNet Enhanced is a CDC program started in August 2015 to provide epidemiologic support to state and local health departments to improve their capacity to detect, investigate, control, and respond to enteric disease outbreaks. Activities focus on improving detection and rapid interviewing of cases of Salmonella, Shiga toxin-producing E. coli (STEC), and Listeria, as well as any cases of enteric disease with pathogens that demonstrate antimicrobial resistance. There are 29 sites participating in OutbreakNet Enhanced, including 26 states and 3 cities. Sites document the burden, timeliness, and completeness of enteric disease surveillance and response through performance metrics that are reported annually. By collecting and reviewing performance metric data, sites are able to identify gaps in their enteric disease investigation processes and develop targeted strategies for improvement.


FoodCORE logo

FoodCORE started in 2009 to provide epidemiologic, laboratory, and environmental health support to local and state health departments in order to develop new and better methods to detect, investigate, respond to, and control multistate outbreaks of enteric diseases. There are 10 FoodCORE Centers, which cover 18% of the U.S. population, or 58 million people. Centers measure the burden, timeliness, and completeness of enteric disease activities through performance measures. When they find an activity or practice that works, a success story or model practice is written and published to the FoodCORE website so others can learn and implement successful practices in their health departments.

Integrated Food Safety Centers of Excellence

Food Safety Centers of Excellence logo

The Integrated Food Safety Centers of Excellence (CoEs) were established by CDC in 2012 under direction from the Food Safety Modernization Act (FSMA). The CoEs develop tools, deliver trainings, and provide consultations to public health professionals in other state and local health departments to build their region’s capacity for enteric illness surveillance and investigations. The CoEs are state health departments and affiliated university partners in Colorado, Florida, Minnesota, New York, Oregon, and Tennessee. The CoEs work together to identify and implement best practices in enteric disease surveillance and outbreak response and to serve as resource for other state, regional, and local public health professionals.