The US. Centers for Disease Control reported today that in 2008, 1,034 foodborne disease outbreaks were reported, which resulted in 23,152 cases of illness, 1,276 hospitalizations, and 22 deaths. Among the 479 outbreaks with a laboratory-confirmed single etiologic agent reported, norovirus was the most common, accounting for 49% of outbreaks and 46% of illnesses. Salmonella was the second most common, accounting for 23% of outbreaks and 31% of illnesses. Among the 218 outbreaks attributed to a food vehicle with ingredients from only one of 17 defined food commodities, the top commodities to which outbreaks were attributed were poultry (15%), beef (14%), and finfish (14%), whereas the top commodities to which outbreak-related illnesses were attributed were fruits and nuts (24%), vine-stalk vegetables (23%), and beef (13%).

Since 1992, CDC has defined a foodborne disease outbreak as the occurrence of two or more similar illnesses resulting from ingestion of a common food. State, local, and territorial health department officials use a standard, Internet-based form to voluntarily submit reports of foodborne outbreaks to CDC. An online toolkit of clinical and laboratory information is available to support investigation and reporting of outbreaks.

The number (1,034) of outbreaks was 10% lower than the annual average reported (1,151) for 2003--2007, and the number of outbreak-related illnesses was 5% lower (23,152 versus 24,400).

Of the total number of outbreak-related foodborne illnesses, 1,276 (6%) resulted in hospitalization. Salmonella was the most common cause of outbreak-related hospitalizations, causing 62% of hospitalizations reported, followed by Shiga toxin--producing Escherichia coli (STEC) (17%) and norovirus (7%). Outbreaks caused by Clostridium botulinum resulted in the highest proportion of persons hospitalized (90%), followed by Listeria outbreaks (76%). Among the 22 deaths associated with foodborne disease outbreaks in 2008, 20 were attributed to bacterial etiologies (13 Salmonella, three Listeria monocytogenes, three STEC [two O157, one O111], one Staphylococcus), one to norovirus, and one to a mycotoxin.

Among the 868 outbreaks with a known single setting where food was consumed, 52% resulted from food consumed in a restaurant or deli, 15% in a private home, and the remainder in other locations.

Ref: Surveillance for foodborne disease outbreaks --- United States, 2008. Morbidity and Mortality Weekly Report, September 9, 2011 / 60(35); 1197-1202.

I finished our U.S. taxes early this morning and filed before the April 15 deadline.

Amy wasn’t taking advantage of our full deductions, so I pompously declared I would do the taxes this year – my first time filing in the U.S. – and then of course waited until the last day to file.

They’re done, at least until we get audited, so it’s back to foodborne illness and the annual FoodNet data which is awesome because it provides an annual snapshot, and sucks because it shows nothing is changing.

All the talk in Washington, all the outbreaks, all the Pulitzer-prize winning media coverage, all the ridiculously boring coverage of so-called foodborne illness in the vanity presses by those who can afford them and … the incidence of foodborne illness isn’t changing. So maybe it’s time to do something different.

In 2009, a total of 17,468 laboratory-confirmed cases of infection were identified. In comparison with the first 3 years of surveillance (1996--1998), sustained declines in the reported incidence of infections caused by Campylobacter, Listeria, Salmonella, Shiga toxin-producing Escherichia coli (STEC) O157, Shigella, and Yersinia were observed. The incidence of Vibrio infection continued to increase. Compared with the preceding 3 years (2006--2008), significant decreases in the reported incidence of Shigella and STEC O157 infections were observed. For most infections, reported incidence was highest among children aged <4 years; the percentage of persons hospitalized and the case fatality rate (CFR) were highest among persons aged ≥50 years. In 2009, the Healthy People 2010 target of ≤1.0 case per 100,000 population for STEC O157 infection (objective 10-1b) was met (2). Further collaborative efforts with regulatory agencies and industry are needed to sustain and extend recent declines and to improve prevention of foodborne infections.

Maybe someone should take leadership and stop gassing on about collaboration.

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In May 2008, a couple of Canadian researchers at the University of Regina put out a report that ostensibly attempted to rank 17 industrialized countries based on their food safety performance.

And who doesn’t love a completely meaningless top-17 list, that placed Canada fifth, the U.S. seventh and the United Kingdom first. Make mine piping hot.

Dr. Richard Holley of the University of Manitoba takes a different approach in the current Canadian Medical Association Journal, asserting that Canada's food safety system is reactive, lags behind other countries, and investment is needed to ensure it can adequately protect Canadians.

I’ll go with Holley.

Foodborne illness surveillance is needed to ensure safety from gastrointestinal infections caused by bacteria such as toxigenic E.coli, Salmonella, Campylobacter and Listeria. As there is no national foodborne illness surveillance program in Canada, the estimated 11 million cases of foodborne illness every year are based on surveys of self-reported gastrointestinal illness. More accurate data are needed to execute meaningful intervention.

European Union countries, the US and Australia have surveillance systems that allow them to collect information on food vehicles and organisms that cause foodborne illness, something Canada cannot currently do. Canada's multi-government system with national, provincial and local governments that share responsibility for health, as well as monitor the safety and quality of food are key reasons that we have a fragmented system with poor focus. The US suffers from the same problem, yet does a better (though not perfect) job.

Steps to food safety in Canada:

1. Government must go beyond interagency memoranda of understanding to develop permanent systems that promote cooperation and sharing of information on surveillance of foodborne illness and investigations of outbreaks.

2. Investment is needed to develop a surveillance program on foodborne illness that will characterize risks related to food and food pathogens in Canada.

3. Data from surveillance must be used to develop inspection policy that is based on risk and is uniform across the coun- try. That policy’s main priority must be to validate that approved food safety systems are operated properly.
 

Following the lead of mash-up artist Girl Talk, the Centre for Molecular Epidemiology led by Professor Frank Møller Aarestrup at Technical University of Denmark (DTU), is planning on creating a infectious disease surveillance tool by combining elements of google maps/pulsenet.  The new tool, nicknamed Google Bacterium, could allow laboratories across the globe to see outbreaks of foodborne illness in almost real-time (as soon as PFGE maps or sequences are uploaded).

The centre will develop software and hardware solutions which can handle these large volumes of data, analyse DNA sequences and swiftly return clinically, biologically and epidemiologically relevant information on bacteria species, strains, antimicrobial resistance and treatment options as an open source solution.

The plan is to start with salmonella, staphylococci and coli bacteria – with the potential for expanding the collaboration to also include viruses, parasites and other bacteria. In the long term, the system will also be able to include the identification of ‘good’ bacteria for industrial uses.

The centre will also develop an Internet platform which will show all the data on a world map to visualise the global spread of bacteria. It will be a bit like a Google Bacterium which will be accessible to everyone on the Internet.

Sounds awesome, mash it up, I'd love to be able to get email alerts about clusters of illnesses in certain geographic areas.