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Outlook” for June looked at federal foodborne illness statistics and concluded that reporting and data disclosure is “out of date and woefully incomplete.”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.