State health departments’ capacity to respond to foodborne illness outbreaks varies widely and can lead to delays in public health response, according to a recent survey conducted by Safe Tables Our Priority (S.T.O.P.), a non-profit  public health organization.

Thirty-nine of 51 state and DIstrict of Columbia health departments responded to the survey, which was commissioned by the Produce Safety Project (PSP), an initiative of The Pew Charitable Trusts at Georgetown University. The survey asked health departments about the types of questions and questionnaires used with victims of foodborne illness and how departments utilized the data from victims to get to the bottom of outbreaks.

cantaloupe-featured.jpgThe study found that, despite an increase in multi-state foodborne illness outbreaks tied to fresh produce, only 25 of the 39 states responding to the survey asked victims about specific produce items, even if the item had been previously associated with an outbreak.

“It is important to learn for our experience, and so it is surprising that many states are failing to ask about fruits and vegetables on their questionnaires given to foodborne illness victims,” said Jim O’Hara, PSP director.

“The lack of food attribution data and especially attribution to produce is astounding considering the large burden of foodborne illness in the U.S.,” said Donna Rosenbaum, the Executive Director of S.T.O.P

“It all starts with finding out what the person ate.  The public health system cannot find what it’s not looking for or asking about,” added Rosenbaum. “We certainly cannot fix the food safety system when we don’t know exactly where and how the contaminated produce makes it into the marketplace and onto consumers’ plates.”

The report, titled State Surveillance of Foodborne Illness, points out that questionnaires and interviews regarding specific food items are a critical tool in identifying the source of a foodborne illness outbreak. 

According to the report, investigators identified spinach as a potential vehicle for infection during the 2006 nationwide outbreak after only six interviews, during which five of the respondents said they had consumed bagged spinach.

Of the 36 states that responded, 80 percent of states reported they always administered questionnaires for cases of E. coli, Listeria monocytogenes, Vibrio, other forms of Shiga toxin-producing E. coli and Clostridium botulinim (or botulism). 

The report also found “substantial proportions” of the surveyed states employed questionnaires for cases of typhoid fever, hemolytic uremic syndrome (HUS), other types of Salmonella and for Hepatitis A. 

Even when states did utilize questionnaires and interviews to investigate the cause of foodborne illness, 60 percent of states in the survey reported that they lacked the ability to electronically link their investigative data for analysis.

“A critical step in improving our food safety system is better coordination on the types of information collected and better integration of that data at the state and local level, ” O’Hara said.