Foodborne Diseases Active Surveillance (FoodNet)

On this page:

• Surveillance Activities
• Data
• Attribution
• Publications

Foodborne Diseases Active Surveillance Network (FoodNet) is a core component of U.S. Centers for Disease Control and Prevention (CDC) Emerging Infections Programs network (EIP), a collaboration between CDC, state health departments, and universities. (For foodborne disease outbreak reporting and investigation go tofoodborne outbreaks.)

FoodNet is an active laboratory and population-based surveillance system to monitor the incidence of foodborne diseases of local and national public health importance.

Objectives are to:

• Determine the burden of foodborne illness
• Monitor trends in the burden of specific foodborne illnesses over time
• Attribute the burden of foodborne illness to specific foods and settings
• Develop and assess interventions to reduce the burden of foodborne illness

FoodNet Ongoing Surveillance Activities

Surveillance is conducted for eight bacterial and one parasitic pathogen:

• Campylobacter
• Cyclospora
  
• Enterotoxigenic Escherichia coli (ETEC)
• Listeria
• Salmonella
• Shiga toxin producing Escherichia coli (STEC) O157 and non-O157
• Shigella
• Vibrio
• Yersinia

Activities include:

• Active laboratory-based surveillance for foodborne pathogens
  The core of FoodNet is population-based active surveillance of clinical laboratories in the participating sites. Clinical laboratories that test stool samples are contacted regularly to collect information on all of laboratory-confirmed cases of foodborne illness.
• Survey of the population
  The population survey is conducted to precisely estimate the burden of acute diarrheal illness and to describe the frequency of important exposures.
• Survey of clinical laboratory practices
  The periodic laboratory survey is conducted to determine which pathogens are included in routine bacterial stool cultures, which tests must be specifically requested by the physician, and which specific techniques are used to isolate the pathogens.
• Survey of physicians
  The periodic survey is conducted to understand knowledge, attitudes and practices of physicians.
• Disease attribution

FoodNet Data

• FoodNet Data and Annual Reports
• List of FoodNet Case-Control and Cohort Studies (pdf)
• FoodNet Special Studies, by pathogen
• CDC special update on foodborne illness: Vital Signs - Making Food Safer to Eat

Attribution

"Attribution" refers to attempts to assign illness caused by various enteric pathogens 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.

Below are links that 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.

CDC Data

• CDC National Outbreak Reporting System Dashboard
  
• CDC FoodNet Surveillance Data
  
• CDC outbreak surveillance summaries
• CDC National surveillance of bacterial foodborne illnesses
• National Antimicrobial Resistance Monitoring System (NARMS)
• FoodNet Population Survey: Atlas of Exposures
• CDC Salmonella Atlas

Other Data

• IFSAC 2019 source attribution estimates: Salmonella, E. coli  O157, Listeria monocytogenes, and Campylobacter (pdf) 
  
• IFSAC-2017 source attribution estimates: Salmonella, E. coli O157, Listeria monocytogenes, Campylobacter (pdf) 
• IFSAC-2013 source attributions: Salmonella, E. coli O157, Listeria, Campylobacter (pdf)
• FSIS datasets 
• USDA Food Availability Data
• USDA Foodborne Outbreak Investigation Annual Reports
  
• USDA Food Safety Inspection Service microbiologic data
• USDA Economic Research Service Annual Products
  
• What We Eat in America (National Health and Nutrition Examination Survey)
• FoodRisk.org (clearinghouse for quantitative risk assessment for information, Joint Institute for Food Safety and Applied Nutrition)
• World Tourism Organization statistics
  

Links

• Attributing salmonellosis cases to foodborne, animal contact and waterborne routes using the microbial subtyping approach and exposure weights
  
• Zoonotic Diseases (Diseases from animals)
• Emerging Pathogens Institute - University of Florida
• CDC FoodNet
  
• World Health Organization Foodborne Diseases webpage

Food Safety Regulations

• FDA Guidance and Regulation
• FDA Egg Safety Final Rule

Articles of Interest

• CDC Annual Summaries of Foodborne Outbreaks
• Attribution of Foodborne Illnesses, Hospitalizations, and Deaths to Food Commodities by using Outbreak Data, United States, 1998–2008 (CDC, Emerging Infectious Diseases, March 2013)
• Application of Foodborne Pathog Dis 2011 April 8(4) Bayesian Model for Salmonellosis Attribution (pdf)
• Marked Campylobacteriosis Decline After Interventions Aimed at Poultry, New Zealand
• The 10 Pathogen-Food Combinations with the Greatest Burden on Public Health, 2011
  
• 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)
• 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. Multistate surveillance for food-handling, preparation, and consumption behaviors associated with foodborne diseases: 1995 and 1996 BRFSS food-safety questions (pdf)

FoodNet Publications

Oregon EIP Foodborne Diseases Active Surveillance Network Publications

• Post Diarrheal Hemolytic Uremic Syndrome in Persons Aged 65 and Older in FoodNet Sites
  2000-2006.J Am Geriatr Soc. 2011 Feb;59(2):366-8. Abstract
• Laboratory Practices for the Identification of Shiga Toxin-Producing Escherichia Coli in the United States, FoodNet Sites, 2007
  Foodborne Pathog Dis. 2011 Apr;8(4):555-60. Epub 2010 Dec 27. Abstract
• Antimicrobial and Antimotility Agent Use in Persons with Shiga Toxin-Producing Escherichia Coli O157 Infection in FoodNet Sites
  Clin Infect Dis. 2011 May;52(9):1130-2. Abstract
• The Effect of Different Recall Periods on Estimates of Acute Gastroenteritis in the United States, FoodNet Population Survey 2006–2007
  Foodborne Pathog Dis. 2010 Oct;7(10):1225-8. Abstract
• Risk Factors for Sporadic Shigellosis, FoodNet 2005
  FoodbornePathog Dis.2010 Jul;7(7):741-7. Abstract
• Methods for Monitoring Trends in the Incidence of Foodborne Diseases: Foodborne Diseases Active Surveillance Network 1996-2008
  Foodborne Pathog Dis.2010 Nov;7(11):1421-6. E pub 2010 Jul 9. Abstract
• Application of Bayesian Techniques to Model the Burden of Human Salmonellosis Attributable to U.S. Food Commodities at the Point of Processing Adaptation of a Danish Model
  Foodborne Pathog Dis. 2011 Jan 16. [E pub ahead of print]. Abstract

See Also

• Oregon Administrative Rules (OAR) related to food safety
• Foodborne disease resources