Executive Summary
Preventing foodborne illness is a multi-tiered effort from the farm to the table, involving food producers and handlers, scientists, government officials, advocates and consumers. Vital to this effort are local and state public health officials, who track, investigate, and report foodborne illness outbreaks to the Centers for Disease Control and Prevention (CDC). Importantly, it is the compilation of outbreak data that helps to quantify the problem of foodborne illness in America—and helps with the design and implementation of strategies to minimize it. Despite the critical importance of outbreak detection and reporting to this effort, great variability exists among the states on outbreak surveillance and reporting.
FINDINGS
Using 10 years of outbreak data collected from CDC, the Center for Science in the Public Interest (CSPI) analyzed states’ reporting of outbreaks and created a profile of performance for each state. While differences in structure and resources make it difficult to compare states, the profiles offer a 10-year retrospective on each state, and reveal key issues for consideration by public health officials.
- The percentage of solved outbreaks—those with both an indentified food and identified pathogen—has declined over the 10-period, from a high of 44 percent in 2001 to 34 percent in
- In some years, nearly 70 percent of outbreaks are not solved, meaning that at least one essential data point (food or pathogen) is
- We have given states A to F letter grades based on the number of reported food-related outbreaks per million States with the most outbreaks received an A. While it may seem counter-intuitive to give the best grade to states with the most outbreaks, those states are the most likely to have robust detection and reporting systems, not the most actual outbreaks. (Note that most of the states receiving an F are southern states with climates most conducive to pathogen growth.)
- Seven states received an A: Florida, Hawaii, Maryland, Minnesota, Oregon, Washington, and Wyoming.
- Fourteen states received an F: Arizona, Arkansas, Indiana, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, Nevada, New Mexico, Oklahoma, South Carolina, Texas, and West
These findings suggest that many states lack adequate funding for public health services, leading to health departments that are overburdened and understaffed. The result is decreased outbreak investigation and detection and an incomplete picture of foodborne illness across the country. This paucity of information impedes efforts to prevent foodborne illnesses.
RECOMMENDATIONS
Many players can be involved in detecting and reporting outbreaks. CSPI recommends the following actions:
- Consumers should notify their local health department when they suspect they have been sickened by food and should seek medical treatment whenever needed.
- Physicians should report suspected cases of foodborne illness to local health departments and be more assertive about pursuing laboratory testing to detect and confirm these
- Physicians, labs, and health departments should work together to improve the mechanisms of reporting and the timeliness of investigations so that outbreaks can be solved and contained
- State legislators and governing officials should give local, county and state health departments adequate support for their investigatory and epidemiological staff.
- Federal officials should provide increased guidance and assistance to states to improve local investigation and Federal agencies should coordinate activities so that they are not adding to states’ burdens by shifting federal activities onto state and local public health departments.
Most importantly, state legislators should consider the public health and economic toll of foodborne illness when making budget decisions, and should ensure that health departments are properly funded to carry out their critical public health mandates. In addition to funding, states should recognize the critical importance of outbreak investigation and reporting, as well as the other important activities that can prevent outbreaks also conducted by these officials (for example, inspections of restaurants, nursing homes, hospitals and day care facilities).
