The incidence of foodborne infections in the United States increased during 2018 compared with between 2015 and 2017, according to the Morbidity and Mortality Weekly Report. The report also noted that the incidence of Cyclospora infections increased markedly, partly as a result of large produce-associated outbreaks, and that infections caused by Campylobacter and Salmonella, especially serotype Enteritidis, remain high.

The report summarized preliminary 2018 data and changes since 2015 and included data from the Foodborne Diseases Active Surveillance Network (FoodNet) of Center for Disease Control and Prevention’s Emerging Infections Program. FoodNet monitors cases of laboratory diagnosed infection caused by 8 pathogens commonly transmitted in food.

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During 2018, FoodNet identified 25,606 cases of infection, including 5893 cases that resulted in hospitalization and 120 deaths. Incidence per 100,000 population was highest for Campylobacter at 19.5, and then Salmonella at 18.3, followed by 5.9 cases per 100,000 for Shiga toxin-producing Escherichia coli, 4.9 for Shigella, 1.1 of Vibrio, 0.9 of Yersinia, 0.7 of Cyclospora, and 0.3 of Listeria. Compared with data from 2015 to 2017, the incidence significantly increased for Cyclospora, Vibrio, Yersinia, Shiga toxin-producing E coli, Campylobacter, and Salmonella, rising 399%, 109%, 58%, 26%, 12%, 9%, respectively.

The report’s authors noted several limitations to the data, including the fact that incidence trends are becoming more complex to interpret as a result of changing diagnostic methods. For example, increases in incidence may be in part, or entirely, attributable to changes in clinician ordering practices, increased use of DNA based syndrome panels, and changes in laboratory practices in response to the availability of these panels. Also, the report authors noted that some culture independent diagnostic tests may be false positives, and year-to-year variations, attributable to large outbreaks, might not be indicative of sustained trends.

Recommendations made in the report to reduce foodborne illness included enhanced targeting of Campylobacter contamination of chicken; strengthening prevention measures during egg production; vaccinating poultry against Salmonella enteritidis; decreasing Salmonella contamination of produce, poultry, and meat; and continued implementation of the Food Safety Modernization Act, specifically the US Food and Drug Administration’s Produce Safety Rule.

Reference

Tack DM, Marder EP, Griffin PM, et al. Preliminary incidence and trends of infections with pathogens transmitted commonly through food – Foodborne diseases active surveillance network, 10 U.S. sites, 2015-2018. MMWR Morb Mortal Wkly Rep. 2019;68:369-373.