Surveillance for foodborne disease outbreaks – United States, 2012 : annual report
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Surveillance for foodborne disease outbreaks – United States, 2012 : annual report

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    Foodborne diseases cause an estimated 48 million illnesses each year in the United States, including 9.4 million caused by known pathogens. Though only a small proportion of these illnesses occur in the setting of an outbreak, data collected during outbreak investigations can provide valuable insight into the pathogens and foods that cause illness. Public health officials, regulatory agencies, and the food industry can use this information to create targeted control strategies along the farm-to-table continuum to address specific pathogens and foods.

    A foodborne disease outbreak is defined as the occurrence of two or more cases of a similar illness resulting from ingestion of a common food. Foodborne disease outbreaks are a nationally notifiable condition (http://c. CSTENotifiableConditionListA.pdf). CDC conducts foodborne disease outbreak surveillance in the United States through the Foodborne Disease Outbreak Surveillance System. Public health agencies in all 50 states, the District of Columbia, U.S. territories, and Freely Associated States voluntarily submit reports of outbreaks investigated by their agencies using a web-based reporting platform, the National Outbreak Reporting System (NORS) ( NORS also collects reports of enteric disease outbreaks caused by other modes of transmission, including person-to- person contact, animal contact, water, environmental contamination, and unknown mode of transmission.

    Investigating and reporting agencies use a standard outbreak reporting form (http://www. to report foodborne disease outbreaks. Data requested for each outbreak include the reporting state; date of first illness onset; number of illnesses, hospitalizations and deaths; etiology; implicated food and ingredients; locations of food preparation; and factors contributing to food contamination (see appendix). Outbreaks that are excluded from the Foodborne Disease Outbreak Surveillance System include those that occurred on cruise ships with both US and international ports and those in which the food was eaten outside the United States, even if the illness occurred in the United States.

    This report includes foodborne disease outbreaks that were reported to the Foodborne Disease Outbreak Surveillance System by October 17, 2013, in which the first illness occurred during 2012. Etiologic agents were reported as confirmed if they met pre-defined confirmation criteria; otherwise, they were reported as suspected. For outbreaks caused by a single confirmed or suspected etiology, etiologies were grouped as bacterial, chemical and toxin, parasitic, or viral. Multistate outbreaks were defined as outbreaks in which exposure to the implicated food occurred in more than one state or territory. Population-based outbreak reporting rates were calculated for each state using United States Census estimates of the 2011 state populations (; multistate outbreaks were included in population-based outbreak reporting rates by assigning one outbreak to each state that reported cases in the outbreak. Implicated foods were classified into one of 24 single food categories if a single contaminated ingredient was identified or if all ingredients belonged to that category. Outbreaks attributed to foods that could not be assigned to one of these single food categories, or for which the report contained insufficient information for category assignment, were not attributed to any category.

    During 2012, 831 foodborne disease outbreaks were reported, resulting in 14,972 illnesses, 794 hospitalizations, and 23 deaths. Outbreaks were reported by public health officials from all 50 states, the District of Colombia, and Puerto Rico. The median rate was 3.4 foodborne disease outbreaks per 1 million population; rates ranged from 1.0 outbreak per 1 million population in Mississippi to 11.4 outbreaks per 1 million population in Rhode Island.

    Suggested citation: Centers for Disease Control and Prevention (CDC). Surveillance for Foodborne Disease Outbreaks, United States, 2012, Annual Report. Atlanta, Georgia: US Department of Health and Human Services, CDC, 2014.

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