RESUMEN
Reducing foodborne disease incidence is a public health priority. This report summarizes preliminary 2023 Foodborne Diseases Active Surveillance Network (FoodNet) data and highlights efforts to increase the representativeness of FoodNet. During 2023, incidences of domestically acquired campylobacteriosis, Shiga toxin-producing Escherichia coli infection, yersiniosis, vibriosis, and cyclosporiasis increased, whereas those of listeriosis, salmonellosis, and shigellosis remained stable compared with incidences during 2016-2018, the baseline used for tracking progress towards federal disease reduction goals. During 2023, the incidence and percentage of infections diagnosed by culture-independent diagnostic tests (CIDTs) reported to FoodNet continued to increase, and the percentage of cases that yielded an isolate decreased, affecting observed trends in incidence. Because CIDTs allow for diagnosis of infections that previously would have gone undetected, lack of progress toward disease reduction goals might reflect changing diagnostic practices rather than an actual increase in incidence. Continued surveillance is needed to monitor the impact of changing diagnostic practices on disease trends, and targeted prevention efforts are needed to meet disease reduction goals. During 2023, FoodNet expanded its catchment area for the first time since 2004. This expansion improved the representativeness of the FoodNet catchment area, the ability of FoodNet to monitor trends in disease incidence, and the generalizability of FoodNet data.
Asunto(s)
Enfermedades Transmitidas por los Alimentos , Vigilancia de la Población , Humanos , Incidencia , Enfermedades Transmitidas por los Alimentos/epidemiología , Enfermedades Transmitidas por los Alimentos/diagnóstico , Enfermedades Transmitidas por los Alimentos/parasitología , Estados Unidos/epidemiología , Pruebas Diagnósticas de Rutina , Microbiología de AlimentosRESUMEN
Each year, infections from major foodborne pathogens are responsible for an estimated 9.4 million illnesses, 56,000 hospitalizations, and 1,350 deaths in the United States (1). To evaluate progress toward prevention of enteric infections in the United States, the Foodborne Diseases Active Surveillance Network (FoodNet) conducts surveillance for laboratory-diagnosed infections caused by eight pathogens transmitted commonly through food at 10 U.S. sites. During 2020-2021, FoodNet detected decreases in many infections that were due to behavioral modifications, public health interventions, and changes in health care-seeking and testing practices during the COVID-19 pandemic. This report presents preliminary estimates of pathogen-specific annual incidences during 2022, compared with average annual incidences during 2016-2018, the reference period for the U.S. Department of Health and Human Services' Healthy People 2030 targets (2). Many pandemic interventions ended by 2022, resulting in a resumption of outbreaks, international travel, and other factors leading to enteric infections. During 2022, annual incidences of illnesses caused by the pathogens Campylobacter, Salmonella, Shigella, and Listeria were similar to average annual incidences during 2016-2018; however, incidences of Shiga toxin-producing Escherichia coli (STEC), Yersinia, Vibrio, and Cyclospora illnesses were higher. Increasing culture-independent diagnostic test (CIDT) usage likely contributed to increased detection by identifying infections that would have remained undetected before widespread CIDT usage. Reducing pathogen contamination during poultry slaughter and processing of leafy greens requires collaboration among food growers and processors, retail stores, restaurants, and regulators.
Asunto(s)
COVID-19 , Enfermedades Transmitidas por los Alimentos , Humanos , Animales , Incidencia , Pandemias , Espera Vigilante , COVID-19/epidemiología , Enfermedades Transmitidas por los Alimentos/epidemiologíaRESUMEN
To evaluate progress toward prevention of enteric infections in the United States, the Foodborne Diseases Active Surveillance Network (FoodNet) conducts active population-based surveillance for laboratory-diagnosed infections caused by Campylobacter, Cyclospora, Listeria, Salmonella, Shiga toxin-producing Escherichia coli (STEC), Shigella, Vibrio, and Yersinia at 10 U.S. sites. This report summarizes preliminary 2021 data and describes changes in annual incidence compared with the average annual incidence for 2016-2018, the reference period for the U.S. Department of Health and Human Services' (HHS) Healthy People 2030 goals for some pathogens (1). During 2021, the incidence of infections caused by Salmonella decreased, incidence of infections caused by Cyclospora, Yersinia, and Vibrio increased, and incidence of infections caused by other pathogens did not change. As in 2020, behavioral modifications and public health interventions implemented to control the COVID-19 pandemic might have decreased transmission of enteric infections (2). Other factors (e.g., increased use of telemedicine and continued increase in use of culture-independent diagnostic tests [CIDTs]) might have altered their detection or reporting (2). Much work remains to achieve HHS Healthy People 2030 goals, particularly for Salmonella infections, which are frequently attributed to poultry products and produce, and Campylobacter infections, which are frequently attributed to chicken products (3).
Asunto(s)
COVID-19 , Enfermedades Transmitidas por los Alimentos , Vibrio , Enfermedades Transmitidas por los Alimentos/epidemiología , Humanos , Incidencia , Pandemias , Vigilancia de la Población , Salmonella , Estados Unidos/epidemiología , Espera VigilanteRESUMEN
BACKGROUND: Produce-associated outbreaks of Shiga toxin-producing Escherichia coli (STEC) were first identified in 1991. In April 2018, New Jersey and Pennsylvania officials reported a cluster of STEC O157 infections associated with multiple locations of a restaurant chain. The Centers for Disease Control and Prevention (CDC) queried PulseNet, the national laboratory network for foodborne disease surveillance, for additional cases and began a national investigation. METHODS: A case was defined as an infection between 13 March and 22 August 2018 with 1 of the 22 identified outbreak-associated E. coli O157:H7 or E. coli O61 pulsed-field gel electrophoresis pattern combinations, or with a strain STEC O157 that was closely related to the main outbreak strain by whole-genome sequencing. We conducted epidemiologic and traceback investigations to identify illness subclusters and common sources. A US Food and Drug Administration-led environmental assessment, which tested water, soil, manure, compost, and scat samples, was conducted to evaluate potential sources of STEC contamination. RESULTS: We identified 240 case-patients from 37 states; 104 were hospitalized, 28 developed hemolytic uremic syndrome, and 5 died. Of 179 people who were interviewed, 152 (85%) reported consuming romaine lettuce in the week before illness onset. Twenty subclusters were identified. Product traceback from subcluster restaurants identified numerous romaine lettuce distributors and growers; all lettuce originated from the Yuma growing region. Water samples collected from an irrigation canal in the region yielded the outbreak strain of STEC O157. CONCLUSIONS: We report on the largest multistate leafy greens-linked STEC O157 outbreak in several decades. The investigation highlights the complexities associated with investigating outbreaks involving widespread environmental contamination.
Asunto(s)
Infecciones por Escherichia coli , Escherichia coli O157 , Enfermedades Transmitidas por los Alimentos , Escherichia coli Shiga-Toxigénica , Brotes de Enfermedades , Infecciones por Escherichia coli/epidemiología , Escherichia coli O157/genética , Microbiología de Alimentos , Enfermedades Transmitidas por los Alimentos/epidemiología , Humanos , Lactuca , Pennsylvania , Escherichia coli Shiga-Toxigénica/genética , Estados Unidos/epidemiologíaRESUMEN
Human health is inextricably linked to the health of animals and the viability of ecosystems; this is a concept commonly known as One Health. Over the last 2 decades, the Institute of Medicine (IOM) and the National Research Council (NRC) have published consensus reports and workshop summaries addressing a variety of threats to animal, human, and ecosystem health. We reviewed a selection of these publications and identified recommendations from NRC and IOM/NRC consensus reports and from opinions expressed in workshop summaries that are relevant to implementation of the One Health paradigm shift. We grouped these recommendations and opinions into thematic categories to determine if sufficient attention has been given to various aspects of One Health. We conclude that although One Health themes have been included throughout numerous IOM and NRC publications, identified gaps remain that may warrant targeted studies related to the One Health approach.
Asunto(s)
Directrices para la Planificación en Salud , Programas Nacionales de Salud/legislación & jurisprudencia , Administración en Salud Pública , Salud Pública/legislación & jurisprudencia , Animales , Humanos , National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division , National Academy of Sciences, U.S. , Programas Nacionales de Salud/normas , Salud Pública/educación , Salud Pública/normas , Estados UnidosRESUMEN
ABSTRACT: Leafy greens contaminated with Shiga toxin-producing Escherichia coli have continued to cause foodborne illness outbreaks in recent years and present a threat to public health. An important component of foodborne illness outbreak investigations is determining the source of the outbreak vehicle through traceback investigations. The U.S. Food and Drug Administration is home to traceback investigation experts who use a standardized process to initiate, execute, and interpret the results of traceback investigations in collaboration with the Centers for Disease Control and Prevention and state and local partners. Traceback investigations of three outbreaks of Shiga toxin-producing E. coli infections linked to romaine lettuce in 2018 and 2019 were examined to demonstrate challenges, limitations, and opportunities for improvement. The three outbreaks resulted in a total of 474 illnesses, 215 hospitalizations, and 5 deaths. These illnesses were linked to the consumption of romaine lettuce from three distinct growing regions in Arizona and California. Some of the challenges encountered included the time it took to initiate a traceback, limited product-identifying information throughout the supply chain, lack of interoperability in record-keeping systems, and comingling of product from multiple suppliers. These challenges led to time delays in the identification of the farm source of the leafy greens and the inability to identify the root cause of contamination. Implementation of technology-enabled traceability systems, testing of these systems, and future regulations to incentivize adoption of traceability systems are some of the initiatives that will help address these challenges by improving traceback investigations and ultimately preventing foodborne illnesses and future outbreaks from occurring.
Asunto(s)
Infecciones por Escherichia coli , Escherichia coli O157 , Arizona , Brotes de Enfermedades , Infecciones por Escherichia coli/epidemiología , Microbiología de Alimentos , LactucaRESUMEN
Military and Coast Guard recruits are particularly susceptible to respiratory infections. Although seasonal influenza vaccinations are mandatory for recruits, the vaccine expires annually in June. On 29 July 2016, the U.S. Coast Guard Training Center Cape May, NJ, identified an increase in febrile respiratory illness (FRI) among recruits. During 24 July-21 August, a total of 115 recruits reported symptoms. A total of 74 recruits tested positive for respiratory infections: influenza A (H3) (n=34), rhinovirus (n=28), influenza/rhinovirus co-infection (n=11), and adenovirus/rhinovirus co-infection (n=1), while 41 recruits had no laboratory-confirmed specimen but were considered suspected cases. Only one recruit reported receiving the seasonal influenza vaccine within the previous 12 months. Influenza predominated during 24 July-6 August, whereas rhinovirus predominated during 7 August-20 August. Most (92.2%) cases were identified in four of 10 recruit companies; incidence rates were highest among recruits in weeks 2-4 of an 8-week training cycle. Key factors for outbreak control included rapid detection through routine FRI surveillance, quick decision-making and streamlined response by using a single chain of command, and employing both nonpharmaceutical and pharmaceutical interventions.
Asunto(s)
Coinfección/epidemiología , Gripe Humana/epidemiología , Personal Militar/estadística & datos numéricos , Infecciones del Sistema Respiratorio/epidemiología , Infecciones por Adenovirus Humanos/diagnóstico , Infecciones por Adenovirus Humanos/epidemiología , Infecciones por Adenovirus Humanos/terapia , Adenovirus Humanos/aislamiento & purificación , Adulto , Antivirales/uso terapéutico , Coinfección/diagnóstico , Estudios Transversales , Brotes de Enfermedades , Femenino , Humanos , Subtipo H3N2 del Virus de la Influenza A/aislamiento & purificación , Vacunas contra la Influenza , Gripe Humana/diagnóstico , Gripe Humana/terapia , Masculino , New Jersey/epidemiología , Oseltamivir/uso terapéutico , Infecciones por Picornaviridae/diagnóstico , Infecciones por Picornaviridae/epidemiología , Infecciones por Picornaviridae/terapia , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/terapia , Infecciones del Sistema Respiratorio/virología , Rhinovirus/aislamiento & purificación , Adulto JovenRESUMEN
Gastrointestinal (GI) infections in the U.S. Armed Forces have consistently been among the most frequent disease and non-battle injury diagnoses. A retrospective analysis of surveillance data categorized as GI infections among active component service members during 2012-2014 was performed. During the study period, 99% of inpatient and outpatient GI encounters were reported as nonspecific GI infection (13,331 cases per 100,000 people), leaving only a small percentage of cases attributed to specific causes. The five most common organisms associated with GI infections were Campylobacter (10.30 per 100,000 people), nontyphoidal Salmonella (7.43), Giardia (3.15), Shigella (2.11), and norovirus (1.25). The civilian population incidence rates of foodborne diseases during the same time period are significantly greater than incidence rates within the U.S. active component for all select bacterial and parasitic pathogens, except Campylobacter. Nonspecific gastroenteritis incidence increased during winter months, which is similar to the seasonal pattern for viruses such as norovirus. The preponderance of nonspecific infections highlights the need for increased testing and a more in-depth review of the impact of GI infections on operational effectiveness within the U.S.
Asunto(s)
Enfermedades Gastrointestinales/epidemiología , Infecciones/epidemiología , Personal Militar/estadística & datos numéricos , Infecciones por Campylobacter/epidemiología , Infecciones por Enterobacteriaceae/epidemiología , Femenino , Gastroenteritis/epidemiología , Enfermedades Gastrointestinales/microbiología , Enfermedades Gastrointestinales/parasitología , Enfermedades Gastrointestinales/virología , Programas Gente Sana/estadística & datos numéricos , Humanos , Incidencia , Infecciones/microbiología , Infecciones/parasitología , Infecciones/virología , Masculino , Vigilancia de la Población , Estudios Retrospectivos , Infecciones por Salmonella/epidemiología , Estados Unidos/epidemiologíaAsunto(s)
Infecciones por Caliciviridae/epidemiología , Gastroenteritis/epidemiología , Norovirus/aislamiento & purificación , Infecciones por Caliciviridae/diagnóstico , Infecciones por Caliciviridae/transmisión , Brotes de Enfermedades , Gastroenteritis/diagnóstico , Alemania/epidemiología , Humanos , Personal Militar/estadística & datos numéricos , Norovirus/clasificación , Norovirus/patogenicidad , Estados Unidos/epidemiologíaAsunto(s)
Beneficios del Seguro/estadística & datos numéricos , Familia Militar/estadística & datos numéricos , Enfermedades Profesionales/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Infección por el Virus Zika/epidemiología , Adolescente , Adulto , Niño , Preescolar , Femenino , Programas de Gobierno , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/virología , Vigilancia de la Población , Embarazo , Complicaciones Infecciosas del Embarazo/virología , Estados Unidos/epidemiología , United States Department of Defense , Adulto JovenRESUMEN
The public health burden of arthritis and related conditions is incompletely described by commonly used public health surveillance systems. We examined the potential of administrative data as a supplement. The administrative data sources we used underestimated the prevalence of arthritis and overestimated service utilization for persons with arthritis when data from only one year were used. The use of five year's data doubled the prevalence estimate and reduced the service utilization estimate by half. The demographics of the population covered by administrative data also influence the prevalence estimate. Administrative data may usefully supplement routine public health surveillance systems but must be used with caution.