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1.
J Food Prot ; 2022 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-35175331

RESUMO

A previously conducted national survey of restaurant inspection programs associated the practice of disclosing inspection results to consumers at the restaurant point-of-service (POS) with fewer foodborne outbreaks. We used data from the national Foodborne Disease Outbreak Surveillance System (FDOSS) to assess the reproducibility of the survey results. Programs that participated in the survey accounted for approximately 23% of the single state, foodborne illness outbreaks in restaurant settings reported to FDOSS during 2016 - 2018. Agencies that disclosed inspection results at the POS reported fewer outbreaks (mean = 0.29 outbreaks per 1,000 establishments) than those that disclosed results online (0.7) or not at all (1.0). Having any grading method for inspections was associated with fewer reported outbreaks than having no grading method. Agencies that used letter grades had the lowest numbers of outbreaks per 1,000 establishments. There was a positive association (correlation coefficient, r= 0.54) between the mean number of foodborne illness complaints per 1,000 establishments, per the survey, and the mean number of restaurant outbreaks reported to FDOSS (R2= 0.29). This association was stronger for bacterial toxin-mediated outbreaks (R2= 0.35) than for norovirus (R2= 0.10) or Salmonella (R2= 0.01) outbreaks. Our cross-sectional study findings are consistent with previous observations that linked the practice of posting graded inspection results at the POS with reduced occurrence of foodborne illnesses and outbreaks associated with restaurants. Support for foodborne illness surveillance programs and food regulatory activities at local health agencies is foundational for food safety systems coordinated at state and federal levels.

2.
Emerg Infect Dis ; 27(10): 2554-2559, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34545783

RESUMO

Novel outbreak-associated food vehicles (i.e., foods not implicated in past outbreaks) can emerge as a result of evolving pathogens and changing consumption trends. To identify these foods, we examined data from the Centers for Disease Control and Prevention Foodborne Disease Outbreak Surveillance System and found 14,216 reported outbreaks with information on implicated foods. We compared foods implicated in outbreaks during 2007-2016 with those implicated in outbreaks during 1973-2006. We identified 28 novel food vehicles, of which the most common types were fish, nuts, fruits, and vegetables; one third were imported. Compared with other outbreaks, those associated with novel food vehicles were more likely to involve illnesses in multiple states and food recalls and were larger in terms of cases, hospitalizations, and deaths. Two thirds of novel foods did not require cooking after purchase. Prevention efforts targeting novel foods cannot rely solely on consumer education but require industry preventive measures.


Assuntos
Doenças Transmitidas por Alimentos , Vigilância da População , Animais , Centers for Disease Control and Prevention, U.S. , Surtos de Doenças , Contaminação de Alimentos , Microbiologia de Alimentos , Doenças Transmitidas por Alimentos/epidemiologia , Humanos , Estados Unidos/epidemiologia
3.
Epidemiol Infect ; 149: e190, 2021 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-34275497

RESUMO

About 800 foodborne disease outbreaks are reported in the United States annually. Few are associated with food recalls. We compared 226 outbreaks associated with food recalls with those not associated with recalls during 2006-2016. Recall-associated outbreaks had, on average, more illnesses per outbreak and higher proportions of hospitalisations and deaths than non-recall-associated outbreaks. The top confirmed aetiology for recall-associated outbreaks was Salmonella. Pasteurised and unpasteurised dairy products, beef and molluscs were the most frequently implicated foods. The most common pathogen-food pairs for outbreaks with recalls were Escherichia coli-beef and norovirus-molluscs; the top pairs for non-recall-associated outbreaks were scombrotoxin-fish and ciguatoxin-fish. For outbreaks with recalls, 48% of the recalls occurred after the outbreak, 27% during the outbreak, 3% before the outbreak, and 22% were inconclusive or had unknown recall timing. Fifty per cent of recall-associated outbreaks were multistate, compared with 2% of non-recall-associated outbreaks. The differences between recall-associated outbreaks and non-recall-associated outbreaks help define the types of outbreaks and food vehicles that are likely to have a recall. Improved outbreak vehicle identification and traceability of rarely recalled foods could lead to more recalls of these products, resulting in fewer illnesses and deaths.


Assuntos
Contaminação de Alimentos , Doenças Transmitidas por Alimentos/epidemiologia , Surtos de Doenças , Contaminação de Alimentos/legislação & jurisprudência , Microbiologia de Alimentos , Doenças Transmitidas por Alimentos/microbiologia , Humanos , Legislação sobre Alimentos , Estados Unidos
4.
J Food Prot ; 83(9): 1607-1618, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32421792

RESUMO

ABSTRACT: Norovirus is the leading cause of foodborne illness outbreaks in the United States, and restaurants are the most common setting of foodborne norovirus outbreaks. Therefore, prevention and control of restaurant-related foodborne norovirus outbreaks is critical to lowering the burden of foodborne illness in the United States. Data for 124 norovirus outbreaks and outbreak restaurants were obtained from Centers for Disease Control and Prevention surveillance systems and analyzed to identify relationships between restaurant characteristics and outbreak size and duration. Findings showed that restaurant characteristics, policies, and practices were linked with both outbreak size and outbreak duration. Compared with their counterparts, restaurants that had smaller outbreaks had the following characteristics: managers received food safety certification, managers and workers received food safety training, food workers wore gloves, and restaurants had cleaning policies. In addition, restaurants that provided food safety training to managers, served food items requiring less complex food preparation, and had fewer managers had shorter outbreaks compared with their counterparts. These findings suggest that restaurant characteristics play a role in norovirus outbreak prevention and intervention; therefore, implementing food safety training, policies, and practices likely reduces norovirus transmission, leading to smaller or shorter outbreaks.


Assuntos
Doenças Transmitidas por Alimentos , Norovirus , Surtos de Doenças , Contaminação de Alimentos , Manipulação de Alimentos , Doenças Transmitidas por Alimentos/epidemiologia , Humanos , Políticas , Restaurantes , Estados Unidos/epidemiologia
5.
Foodborne Pathog Dis ; 17(1): 15-22, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31503506

RESUMO

Produce is recognized as a source of Salmonella-related foodborne outbreaks in the United States. Identifying produce as a source of foodborne outbreaks is challenging given short product shelf lives and durations of many produce-associated outbreaks. Investigators consider produce a plausible source when illnesses occur over a short time period and disproportionately affect middle-aged or female individuals. We reviewed characteristics of past Salmonella produce outbreaks and their consistency with principles used by epidemiologists when generating hypotheses about an outbreak source. We queried the Foodborne Disease Outbreak Surveillance System for multistate, produce-associated Salmonella outbreaks reported to the Centers for Disease Control and Prevention from 2009 to 2015. All produce-associated outbreaks were classified as fruit outbreaks or vegetable outbreaks using an established classification scheme. We then compared fruit and vegetable outbreaks by characteristics of size, gender, age, age groups, geographic spread, duration, and velocity measures using Wilcoxon rank-sum tests. Epidemic curves were created to display visual representations of outbreak duration and velocity. We identified 14 fruit outbreaks and 24 vegetable outbreaks. The median number of illnesses for all produce-associated outbreaks was 30 and a high median percentage of illnesses were in females (61.9%). Median age was 34 years, with a median of 53.2% of illnesses affecting the 18-59 age group. For all outbreaks, median duration was 77 d and median time to the 50th percentile of illnesses was 32.5 d. Fruit and vegetable outbreaks differed only in the age groups affected. We used outbreak data to verify common indicators of produce-associated Salmonella outbreaks. Outbreaks affected females and middle-aged individuals more commonly, while fruit and vegetable outbreaks impacted different age groups. Although median outbreak duration was less than 12 weeks for both fruit and vegetable outbreaks, there was considerable variation, decreasing its utility as an indicator of produce as a source of the outbreak.


Assuntos
Surtos de Doenças , Microbiologia de Alimentos , Frutas , Intoxicação Alimentar por Salmonella/epidemiologia , Verduras , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Surtos de Doenças/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância da População , Estados Unidos/epidemiologia , Adulto Jovem
6.
Foodborne Pathog Dis ; 15(11): 726-733, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30192164

RESUMO

Chicken liver has been implicated in several reported U.S. illness outbreaks, probably caused by inadequate cooking and pathogen contamination. To identify commonalities among these outbreaks that could represent targets for prevention, we describe chicken liver-associated U.S. outbreaks during 2000-2016 reported to the Food Safety and Inspection Service, to the Centers for Disease Control and Prevention, and in published literature. We identified 28 outbreaks (23 [82.1%] were campylobacteriosis only, 3 [10.7%] were salmonellosis only, and 2 [7.1%] were caused by both pathogens), with 18 (64.3%) occurring during 2014-2016. Common outbreak features included blended chicken liver dishes (e.g., pâté; 24 [85.7%]), inadequate cooking (26 [92.8%]), and preparation in foodservice settings (e.g., sit-down restaurants; 25 [89.3%]). The increasing frequency of reported outbreaks highlights chicken liver as an important food safety problem. Public health partners should collaborate on prevention measures, including education on proper foodservice preparation of blended chicken liver dishes.


Assuntos
Infecções por Campylobacter/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Doenças Transmitidas por Alimentos/epidemiologia , Fígado/microbiologia , Carne/microbiologia , Intoxicação Alimentar por Salmonella/epidemiologia , Animais , Galinhas/microbiologia , Culinária , Contaminação de Alimentos , Doenças Transmitidas por Alimentos/etiologia , Humanos , Restaurantes , Estados Unidos/epidemiologia
7.
MMWR Surveill Summ ; 67(10): 1-11, 2018 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-30048426

RESUMO

PROBLEM/CONDITION: Known foodborne disease agents are estimated to cause approximately 9.4 million illnesses each year in the United States. Although only a small subset of illnesses are associated with recognized outbreaks, data from outbreak investigations provide insight into the foods and pathogens that cause illnesses and the settings and conditions in which they occur. REPORTING PERIOD: 2009-2015 DESCRIPTION OF SYSTEM: The Foodborne Disease Outbreak Surveillance System (FDOSS) collects data on foodborne disease outbreaks, which are defined as the occurrence of two or more cases of a similar illness resulting from the ingestion of a common food. Since the early 1960s, foodborne outbreaks have been reported voluntarily to CDC by state, local, and territorial health departments using a standard form. Beginning in 2009, FDOSS reporting was made through the National Outbreak Reporting System, a web-based platform launched that year. RESULTS: During 2009-2015, FDOSS received reports of 5,760 outbreaks that resulted in 100,939 illnesses, 5,699 hospitalizations, and 145 deaths. All 50 states, the District of Columbia, Puerto Rico, and CDC reported outbreaks. Among 2,953 outbreaks with a single confirmed etiology, norovirus was the most common cause of outbreaks (1,130 outbreaks [38%]) and outbreak-associated illnesses (27,623 illnesses [41%]), followed by Salmonella with 896 outbreaks (30%) and 23,662 illnesses (35%). Outbreaks caused by Listeria, Salmonella, and Shiga toxin-producing Escherichia coli (STEC) were responsible for 82% of all hospitalizations and 82% of deaths reported. Among 1,281 outbreaks in which the food reported could be classified into a single food category, fish were the most commonly implicated category (222 outbreaks [17%]), followed by dairy (136 [11%]) and chicken (123 [10%]). The food categories responsible for the most outbreak-associated illnesses were chicken (3,114 illnesses [12%]), pork (2,670 [10%]), and seeded vegetables (2,572 [10%]). Multistate outbreaks comprised only 3% of all outbreaks reported but accounted for 11% of illnesses, 34% of hospitalizations, and 54% of deaths. INTERPRETATION: Foodborne disease outbreaks provide information about the pathogens and foods responsible for illness. Norovirus remains the leading cause of foodborne disease outbreaks, highlighting the continued need for food safety improvements targeting worker health and hygiene in food service settings. Outbreaks caused by Listeria, Salmonella, and STEC are important targets for public health intervention efforts, and improving the safety of chicken, pork, and seeded vegetables should be a priority. PUBLIC HEALTH ACTION: The causes of foodborne illness should continue to be tracked and analyzed to inform disease prevention policies and initiatives. Strengthening the capacity of state and local health departments to investigate and report outbreaks will assist with these efforts through identification of the foods, etiologies, and settings linked to these outbreaks.


Assuntos
Surtos de Doenças/estatística & dados numéricos , Doenças Transmitidas por Alimentos/epidemiologia , Vigilância da População , Humanos , Estados Unidos/epidemiologia
8.
Foodborne Pathog Dis ; 14(12): 701-710, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28926300

RESUMO

BACKGROUND: Foodborne disease data collected during outbreak investigations are used to estimate the percentage of foodborne illnesses attributable to specific food categories. Current food categories do not reflect whether or how the food has been processed and exclude many multiple-ingredient foods. MATERIALS AND METHODS: Representatives from three federal agencies worked collaboratively in the Interagency Food Safety Analytics Collaboration (IFSAC) to develop a hierarchical scheme for categorizing foods implicated in outbreaks, which accounts for the type of processing and provides more specific food categories for regulatory purposes. IFSAC also developed standard assumptions for assigning foods to specific food categories, including some multiple-ingredient foods. The number and percentage of outbreaks assignable to each level of the hierarchy were summarized. RESULTS: The IFSAC scheme is a five-level hierarchy for categorizing implicated foods with increasingly specific subcategories at each level, resulting in a total of 234 food categories. Subcategories allow distinguishing features of implicated foods to be reported, such as pasteurized versus unpasteurized fluid milk, shell eggs versus liquid egg products, ready-to-eat versus raw meats, and five different varieties of fruit categories. Twenty-four aggregate food categories contained a sufficient number of outbreaks for source attribution analyses. Among 9791 outbreaks reported from 1998 to 2014 with an identified food vehicle, 4607 (47%) were assignable to food categories using this scheme. Among these, 4218 (92%) were assigned to one of the 24 aggregate food categories, and 840 (18%) were assigned to the most specific category possible. CONCLUSIONS: Updates to the food categorization scheme and new methods for assigning implicated foods to specific food categories can help increase the number of outbreaks attributed to a single food category. The increased specificity of food categories in this scheme may help improve source attribution analyses, eventually leading to improved foodborne illness source attribution estimates and enhanced food safety and regulatory efforts.


Assuntos
Surtos de Doenças , Contaminação de Alimentos , Alimentos/classificação , Doenças Transmitidas por Alimentos/epidemiologia , Laticínios/microbiologia , Ovos/microbiologia , Manipulação de Alimentos , Microbiologia de Alimentos , Inocuidade dos Alimentos , Frutas/microbiologia , Humanos , Carne/microbiologia , Pasteurização
9.
MMWR Morb Mortal Wkly Rep ; 64(54): 1-6, 2017 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-28796765

RESUMO

The Summary of Notifiable Noninfectious Conditions and Disease Outbreaks: Surveillance Data Published Between April 1, 2016 and January 31, 2017 - United States, herein referred to as the Summary (Noninfectious), contains official statistics for nationally notifiable noninfectious conditions and disease outbreaks. This Summary (Noninfectious) is being published in the same volume of MMWR as the annual Summary of Notifiable Infectious Diseases and Conditions (1). Data on notifiable noninfectious conditions and disease outbreaks from prior years have been published previously (2,3).


Assuntos
Doença Crônica/epidemiologia , Notificação de Doenças/estatística & dados numéricos , Surtos de Doenças/estatística & dados numéricos , Vigilância da População , Humanos , Estados Unidos/epidemiologia
10.
MMWR Morb Mortal Wkly Rep ; 63(55): 79-84, 2016 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-27736832

RESUMO

CDC collects data on foodborne and waterborne disease outbreaks reported by all U.S. states and territories through the Foodborne Disease Outbreak Surveillance System (FDOSS) (http://www.cdc.gov/foodsafety/fdoss/surveillance/index.html) and the Waterborne Disease and Outbreak Surveillance System (WBDOSS) http://www.cdc.gov/healthywater/surveillance), respectively. These two systems are the primary source of national data describing the number of reported outbreaks; outbreak-associated illnesses, hospitalizations, and deaths; etiologic agents; water source or implicated foods; settings of exposure; and other factors associated with recognized foodborne and waterborne disease outbreaks in the United States.


Assuntos
Surtos de Doenças/estatística & dados numéricos , Doenças Transmitidas por Alimentos/epidemiologia , Vigilância da População , Doenças Transmitidas pela Água/epidemiologia , Humanos , Estados Unidos/epidemiologia
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