Questions and Answers, Surveillance for Foodborne Disease Outbreaks, 2008

Questions About Newest Report

1. What is the MMWR article “Surveillance for Foodborne Disease Outbreaks—United States, 2008” about?

• Foodborne illnesses are an important disease burden in the United States. This MMWR article, entitled “Surveillance for Foodborne Disease Outbreaks – United States, 2008,” is an annual summary of outbreak data collected through the Centers for Disease Control and Prevention’s (CDC) Foodborne Disease Outbreak Surveillance System
• This article presents data from reported foodborne disease outbreaks occurring in 2008; the information contributes to our understanding of the human health impact of foodborne outbreaks and the pathogens, foods, settings, and contributing factors involved in these outbreaks.

2. What is a foodborne disease outbreak?

• A foodborne disease outbreak is defined as the occurrence of two or more cases of a similar illness resulting from eating the same food. State, local, and territorial public health departments investigate foodborne outbreaks due to enteric bacteria, viruses, parasites, toxins and chemical agents and report their findings to CDC.
• For information on foodborne outbreak investigations, including multistate outbreaks and surveillance data from previous years visit the Outbreak Response website at OutbreakNet.

3. What are the main take-home points from the 2008 Surveillance for Foodborne Disease Outbreaks MMWR?

During 2008, a total of 1,034 foodborne disease outbreaks were reported, resulting in

• 23,152 illnesses
• 1,276 hospitalizations and
• 22 deaths

In outbreaks with a confirmed etiology, norovirus and Salmonellacontinued to be the pathogens responsible for the largest number of outbreaks and illnesses.

In outbreaks linked to foods in which all the ingredients belonged to a single food group, the following were responsible for the largest number of outbreaks:

• beef
• poultry and
• fish

The food groups responsible for the largest number of outbreak-associated illnesses were

• fruits and nuts
• vine vegetables and
• beef

Most foodborne illnesses are preventable, and timely investigation and reporting of foodborne outbreaks can provide information that may help to reduce foodborne illnesses.

To view the “Surveillance for Foodborne Disease Outbreaks – United States, 2008” MMWR in its entirety along with supplemental tables, visit Foodborne Disease Outbreak Surveillance.

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Questions About Outbreak Investigations and Preventing Foodborne Illness

1. What factors influence outbreak investigation and reporting by state, local and territorial public health agencies?

Outbreak detection, investigation, and reporting are influenced by many factors such as

• available resources (time, staff, and laboratory capacity)
• health department priorities and
• outbreak characteristics (size, severity)

CDC typically becomes involved in outbreak investigations only when an outbreak affects multiple states or when a state, local, or territorial public health agency asks for CDC assistance with a particularly large, severe, or unusual outbreak. To learn more about CDC’s role in multistate outbreaks, please visit CDC's Role in Multistate Foodborne Outbreaks.

2. How can this information be used to prevent foodborne illnesses?

Only a small proportion of foodborne illnesses occur as part of a recognized and reported outbreak. However, when individual illnesses occur outside of the setting of an outbreak, it is often difficult or impossible to know what food or other exposure caused them.

• Therefore, foodborne outbreak data provide some of the most detailed and complete information available about foodborne illnesses.
• Examining outbreak data can offer insights into the pathogens causing foodborne infections and into the factors that contribute to foodborne infections, such as specific food vehicles and food handling practices.
• This information can be used for foodborne illness prevention, education, and public policy.

3. Why is the food vehicle unknown for so many reported outbreaks?

CDC encourages states to report all foodborne outbreak investigations, even if the food vehicle is not determined. Even well-conducted investigations sometimes do not identify a food vehicle. There are many reasons for this – one is that sometimes most ill persons ate many of the same food items, so a single food can't be pinpointed.

Although determination of the contaminated food vehicle is ideal, much can still be learned from outbreaks that are known to be transmitted by food but for which the vehicle is not determined. For example, information about

• the pathogen
•  the setting (e.g., home, banquet, school)
•  the number ill
• whether someone was hospitalized or died, among other factors, is usually available.

These data can provide information regarding the burden of foodborne disease as well as the food preparation settings where preventive strategies can be targeted to the greatest effect.

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More Information

Where can I go for more information on foodborne outbreaks?

• For data on individual outbreaks including etiology, locations, and food vehicles, visit Foodborne Outbreak Online Database (FOOD) or the FOOD Frequently Asked Questions page.
• For information of CDC’s new Estimates of Foodborne Illness and Vital Signs report on Making Food Safer to Eat, visit CDC's site about Estimates of Foodborne Illness, and CDC Vital Signs.
• For information on CDC’s role in Foodborne outbreaks, including a fact sheet on Epidemiology for foodborne investigations, download the fact sheet, Foodborne Diseases Epidemiology at a Glance: Epi 101
• For information on foodborne disease prevention and current product recalls and alerts, visit CDC's Food Safety site and Foodsafety.gov.
• For information on the new Food Safety Modernization Act and CDC’s role, visit CDC and The Food Safety Modernization Act.

Please note: Some of these publications are available for download only as *.pdf files. These files require Adobe Acrobat Reader in order to be viewed. Please review the information on downloading and using Acrobat Reader software.

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