Foodborne Disease Attribution

"Attribution" refers to attempts to assign illness caused by various enteric patogens to specific food commodities.  Such "attribution" may be done at several levels, including animal reservoirs (e.g., cattle), food-processing plants (e.g., slaughterhouses or packaging plants), retail foods (e.g., ground beef), or even specific foods eaten (e.g., tacos).

In an outbreak of foodborne disease, the specific food source may be learned with certainty.  In the case of "sporadic" cases of foodborne illness, however, food sources cannot be attributed with certainty, but must be inferred.  Such inferences may be based on various data sources, including types of pathogens found in various food animals, the foods implicated as causes of outbreaks, or even by asking experts what their best guesses are.

This page is intended to highlight some of the efforts being made by FoodNet to attribute enteric illnesses to food sources and to offer links to efforts being made by other experts in foodborne illness.

• FoodNet case control studies (pdf)
• Food Attribution Work Group Projects

Data Sources:

• CDC Data
  • CDC Foodborne Outbreak Online Database (FOOD)
  • CDC outbreak surveillance summaries
  • National Antimicrobial Resistance Monitoring System (NARMS)
  • Salmonellosis, annual summaries

• Other Data
  • US food consumption data
  • CPSI searchable database of foodborne outbreaks
  • USDA Food Safety Inspection Service microbiologic data
  • USDA Economic Research Service Data Sets
  • Microbiological Testing Program for Escherichia coli O157:H7

Links:

• Food Safety Research Consortium
• Emerging Pathogens Institute at the University of Florida
• CDC FoodNet
• World Health Organization
• International Collaboration on Enteric Disease Burden of Illness

• FDA shell egg rule, 2009

• National Academy of Sciences. Letter Report on the Review of the Food Safety and Inspection Service Proposed Risk-Based Approach to and Application of Public-Health Attribution, 2009
• Attributions Bibliography (pdf)
• CDC. Surveillance for foodborne disease outbreaks -- United States, 2006
• Batz MB, Doyle MP, Morris G, Jr., et al. Attributing illness to food. Emerg Infect Dis 2005;11:993-9
• Adak GK, Meakins SM, Yip H, Lopman BA, O'Brien SJ. Disease risks from foods, England and Wales, 1996-2000. Emerg Infect Dis 2005;11:365-72
• CDC. Surveillance for foodborne disease outbreaks -- United States, 1998-2002. (pdf)
• CDC. Surveillance for foodborne disease outbreaks -- United States, 1988-1992 (pdf)
• CDC. Surveillance for foodborne disease outbreaks -- United States, 1993-1997 (pdf)
• CDC. Foodborne disease outbreaks, 5-year summary, 1983-1987 
• CDC. Foodborne disease outbreaks, annual summary, 1982
• CDC. Multistate surveillance for food-handling, preparation, and comsumption behaviors associated wtih foodborne diseases: 1995 and 1996 BRFSS food-safety questions (pdf)