Foodborne illness outbreaks in the U.S. are not getting worse, but the government response to food-related outbreaks is deteriorating, according to a paper published by the American Enterprise Institute this week.

Conservative think-tank AEI’s “Regulation Outlook” for June looked at federal foodborne illness statistics and concluded that reporting and data disclosure is “out of date and woefully incomplete.” The paper noted that there has been a significant increase in the percentage of outbreaks that public officials never attribute to a particular food.

“Responding effectively to [foodborne illness] outbreaks depends on knowing what food item caused the outbreak; this information underpins both enforcement action and targeted public health measures like recalls and ‘do not eat’ warnings,” writes Randall Lutter, an adjunct scholar at AEI, in the paper, which was released Tuesday.

To combat what it claims is a breakdown in successful food attribution, which Lutter notes cannot be pinpointed to a single cause, the paper recommends that the Centers for Disease Control and Prevention “fully and promptly” disclose all food-safety data to improve analysis and accountability. “The CDC should also explicitly adopt quantitative performance goals for responding to [foodborne illness] outbreaks,” says Lutter.

The paper notes that outbreaks not only hurt public health, but also the food industry by “depressing consumption and disrupting markets even after an outbreak is declared over.”

According to AEI’s analysis, between the three years ending in 2000 and the three years ending in 2008, the percentage of all large outbreaks–those involving more than 100 illnesses–that food safety agencies were unable to implicate a specific food item increased by 25 percentage points. Lutter explores a number of theories as to why agencies have struggled with foodborne illness attribution and reporting.

“In principle, agencies may identify responsible food items in fewer outbreaks if the costs of doing so are rising or the benefits are falling. Unfortunately, determining agency behavior is difficult or impossible with available data,” says Lutter, adding that his analysis shows deterioration is not  likely due to additional workload — the total number of outbreaks has remained relatively constant — though a drop in resources could be playing a role.

Tom Frieden, director of CDC, told reporters this week that state and local funding plays a critical part in foodborne illness surveillance: “We are concerned about the kind of reductions that we’re seeing in state and local public health departments, which may undermine our ability to both detect and respond to outbreaks as well as contribute to further prevention.”

Lutter also explores the theory that it might be getting harder to identify food sources because outbreaks could be occurring more in private homes and away from institutions, which keep better records on exactly what is served, when, and to whom, and determines that it doesn’t account for the apparent drop in performance.

Other theories explored in the paper: the fact that pulse field gel electrophoresis (PFGE), also known as DNA fingerprinting, takes longer than conventional processes, that standards for naming a responsible food item have improved, or that there are increasing lags in exposure times and symptoms. None fully explain the deterioration in successful attribution.      
Overall, the paper points to the inadequate management hypothesis. “Foodborne illness outbreaks merit a stronger administrative response than has been seen to date,” says Lutter.  

  • hhamil

    Here’s the link to the report
    It contains quite a bit of very interesting information not mentioned above.

  • Harry Hamil

    Here’s the link to the report
    It contains quite a bit of very interesting information not mentioned above.

  • Ringo

    The AEI report calls for the strengthening of local, state and federal food surveillance and outbreak response capabilities? You betcha!

  • Jim Schmidt

    Ok I read the “report”. Although I would like to see improvements to our ability to investigate possible foodborne Illness the report is so far off, at least from a local HD perspective. The author of the “report” just has no clue of how FI investigation are done and appears to have the goal of beating up on the federal aspect of FI when in fact most investigations start at the local level.
    How many times does the Doctor do a stool sample to confirm FI if it just appears to be mild? Where is the authors outrage at this sector for not doing a stool sample every time a patient presents with FI symptoms so it can help us pin down the source that much quicker! I would imagine the amount of reported cases would greatly increase.

  • Gabrielle Meunier

    Team Diarrhea knows how to do it. We need a federally coordinated system based upon the Minnesota and Oregon model with less reliance on the state level which is depending on local funding and administration that comes and goes.

  • Jim Schmidt

    Gabrielle, as I work for a local health dept here in Oregon, your comment really doesn’t match what happens here in Oregon, nor does it resemble how it was handled in NJ when I worked there.
    When people feel they became ill from ingesting food they will either call the local health dept or if they don’t know, they will call the state and then it gets referred back to the county that has jurisdiction. If the person doesn’t know the reason for their illness and it’s bad enough they may go to the doctor. If the doctor takes any tests for infection and they come back for a reportable disease (this includes foodborne) healthcare is required to notify the local health dept. Some states, Oregon being one of them, participate in the electronic surveillance system which allows recognition of possible related events but separated by distance.
    The Federal Government very seldom gets i nvolved if at all. In Oregon if it’s a larger outbreak (I don’t know what criteria the State folks use)they’ll help out with epidiemiology, testing etc but the local health dept will probably doing the field work.
    Unless you are going to increase the state staff significantly to be able to respond to investigations and figure a way to cover all the counties in Oregon, I don’t see that model working. There is no educational difference between Federal,State, and Local HD employees. However the local HD employee will have a better knowledge of the area, sources, etc than someone just coming in for one investigation.
    Remember that some local HD may get a large number of foodborne illness complaints that end up as unfounded complaints. For my dept, depending on factors determines how far the investigation has to go but all get investigated to conclusion.