States with more public health funding track more foodborne illness outbreaks, according to a study published in Emerging Infectious Diseases. The study was conducted by scientists at the Colorado School of Public Health with assistance by the University of Minnesota, the CDC, the FDA, and the US Department of Agriculture Food Safety Inspection Service (FSIS).
Foodborne illness surveillance in states is critical to identifying multistate outbreaks. Unfortunately, not all outbreaks are detected and investigated. This study looked at 8,131 single-state outbreaks reported during the years 2009 to 2018. Multistate outbreaks were not included in this analysis.
Overall, high-reporting states reported four times more outbreaks than low reporting states. And low reporting states are less likely to implicate a food vehicle or setting in outbreaks. In fact, low reporters reported less than one third the number of outbreaks reported by high reporters; that doesn’t mean outbreaks are not occurring. High per capita funding was “strongly associated” with increased reporting. The conclusion was that investments in public health programming have a measurable effect on outbreak reporting.
Foodborne outbreaks are a public health challenge. There are 31 known pathogens that cause about 9,000,000 illnesses, 56,000 hospitalizations, and 1300 deaths every year in these single-state outbreaks. Overall, about 48,000,000 illnesses, 128,000 hospitalizations, and 3,000 deaths are caused by foodborne illness every year in the U.S. The outbreaks are investigated by local, state, and territorial health departments, the CDC, FDA, and USDA.
In the study, scientist looked at outbreaks caused by Salmonella, Shiga toxin-producing E. coli O157, norovirus, and toxins. They also assessed the effects of states’ variation in outbreak reporting.
The top 10 states reported four times more outbreaks per 10,000,000 population than the lowest 10 states. In addition, low reporters were more likely to report larger outbreaks caused by reportable conditions like Salmonella and E. coli.
High reporting states received about three times as much funding as low reporters. The ability of states to detect outbreaks depends on the type of surveillance system that is set up. Questionnaires, cluster and outbreak tracking systems, lab testing capacity, and case definitions all affect the ability of states to detect outbreaks.
Alice Water, MS, senior research instructor in the Department of Epidemiology on the University of Colorado Anschutz Medical Campus said in a statement, “Investments in public health programming produce large benefits, including increasing the number of foodborne outbreaks reported to national surveillance. This helps officials better identify foodborne disease patterns throughout the country which is important so that actions can be taken to help stop disease from spreading. Our results found per capita infectious disease funding was associated with increased reporting, indicating that investments in state public health programming measurably affect outbreak reporting.”
