Foodborne Illness Outbreaks

The FSMA overhauled the federal government’s authority to address foodborne illness outbreaks. The Centers for Disease Control and Prevention (CDC) reports that 48 million cases of foodborne illness occur each year in the United States from people consuming contaminated food, resulting in thousands of hospitalizations and approximately 3,000 deaths.^[1] Food may be contaminated during the production, processing, distribution, or preparation stages.^[2] See Figure 5.1 for the foods associated with foodborne outbreak-associated illnesses from 2008 to 2012. The federal government defines “foodborne illness outbreak” as the occurrence of two or more cases of a similar illness resulting from the ingestion of a certain food.^[3]

figure 5.1 Total foodborne outbreak-associated illnesses, 2008-2012 = 81,757.

Source: CDC National Outbreak Reporting System, 2008-2012.^a

^aCDC. CDC and Food Safety. http://www.cdc.gov/foodborneburden/PDFs/CDC-and-Food-Safety.pdf

The most common method for government to respond to a foodborne disease outbreak is through identification and investigation by state, local, and territorial public health departments.^[4] Generally an outbreak is first identified at the local level and the state health department offers assistance if it spreads across the state. If an outbreak overwhelms a state’s capabilities and resources, the state may ask the CDC for assistance. In the case of multistate outbreaks, the CDC will collaborate with the FDA, the USDA’s Food Safety and Inspection Service (FSIS), or the EPA, but the CDC generally leads the investigation. As required by the FSMA, the CDC also named the state health departments in Colorado, Florida, Minnesota, Oregon, and Tennessee as Integrated Food Safety Centers of Excellence to identify and implement best practices to assist the CDC in responding to foodborne disease outbreaks.^[5]

The FSMA requires the FDA to inspect domestic food facilities on a regular basis, permits FDA to access the facilities’ food safety plans and records, and requires the FDA to establish a program for food laboratory testing.^[6] The FSMA also required the FDA to enhance the foodborne illness surveillance systems by improving the collection, analysis, reporting, and usefulness of data on food- borne illness by coordinating across agencies and with state and local systems by sharing information, developing improved epidemiological tools, and expanding the capacities of these systems.^[3] During an active investigation of a foodborne illness outbreak, or when the FDA determines that the following is necessary to prevent a foodborne illness outbreak, the FSMA permits the FDA to request that a farm identify potential immediate recipients, other than consumers, of any food that is or was adulterated or that presents a threat of serious adverse health consequences or death to humans or animals.^[8]

The USDA’s FSIS operates under the authority of the Federal Meat Inspection Act, the Poultry Products Inspection Act, and the Egg Products Inspection Act to inspect all poultry, livestock, and egg products, analyze these products for adulterants, and set food safety standards for processing facilities. FSIS also conducts epidemiological studies and risk assessments to provide science-based information for risk management and communication.^{[9] [10] [11]}

Once a food is identified as contaminated, the FDA or FSIS will alert the public about the contamination and issue recalls of the contaminated food.^39,40 Voluntary or mandatory recall may occur due to the discovery of a contaminant or organism in food, which can cause illness, or the discovery of a major allergen in a food product that is misbranded due to failure to disclose the ingredient on the label. The FSMA gave the FDA enhanced capabilities to issue a mandatory recall when a company fails to voluntarily recall unsafe food. The FSMA also permits the FDA to suspend the registration of a food facility that the agency determines poses a reasonable probability of serious adverse health consequences.^[6] Under its new authority, the FDA issued its first food seizure order in September 2011 after inspections found rodent and insect infestation at a food storage and processing facility in Washington state.^[13]

• [1] Centers for Disease Control and Prevention. Foodborne Outbreak Tracking and Reporting.Fast Facts and FAQs. April 24, 2014. http://www.cdc.gov/foodsafety/fdoss/faq/index.html
• [2] FoodSafety.gov. How Government Responds to Food Illness Outbreaks. http://www.food-safety.gov/poisoning/responds/
• [3] 21 USC 2224.
• [4] Centers for Disease Control and Prevention. Foodborne Outbreaks. Guide to Confirminga Diagnosis in Foodborne Disease. November 13, 2013. http://www.cdc.gov/foodsafety/outbreaks/investigating-outbreaks/confirming_diagnosis.html
• [5] Centers for Disease Control and Prevention. CDC and the Food Safety Modernization Act.September 16, 2013 http://www.cdc.gov/foodsafety/fsma.html#section399
• [6] Food and Drug Administration Background on Food Safety Modernization Act. FSMAFACTS. July 12, 2011.
• [7] 21 USC 2224.
• [8] 21 USC 2223.
• [9] United States Department of Agriculture Food Safety and Inspection Service. Factbook.Chapter 9. http://www.usda.gov/factbook/chapter9.htm
• [10] Food and Drug Administration. http://www.fda.gov/Food/ResourcesForYou/Consumers/ucm180323 .htm#federal
• [11] United States Department of Agriculture. http://www.usda.gov/factbook/chapter9.htm
• [12] Food and Drug Administration Background on Food Safety Modernization Act. FSMAFACTS. July 12, 2011.
• [13] Food and Drug Administration. Press Announcement. FDA: U.S. Marshals Seize FoodsStored at Washington State Facility. October 11, 2011. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm275204.htm