APPENDIX V—PREVENTION OF INFECTIOUS DISEASE FROM 1037 CONTAMINATED FOOD PRODUCTS Appendix V Prevention of Infectious Disease From Contaminated Food Products1 Foodborne diseases are associated with significant morbidity and mortality in people of all ages. In 2017, the Centers for Disease Control and Prevention (CDC) reported 841 foodborne outbreaks, resulting in roughly 15 000 illnesses, 800 hospitaliza- tions, 20 deaths, and 14 food product recalls ( foodborneoutbreaks_508.pdf). Young children, pregnant women, the elderly, and immunocompromised people are especially susceptible to illnesses and complica- tions caused by many of the organisms associated with foodborne illness. Norovirus is the most common cause of outbreaks of foodborne illness in the United States. The system for surveillance and reporting for norovirus outbreaks is known as CaliciNet ( The Foodborne Diseases Active Surveillance Network (FoodNet) of the CDC Emerging Infections Program conducts active, population-based surveillance at 10 sites in the United States, for all laboratory-diagnosed infections with select enteric pathogens transmitted commonly through food. The FoodNet program conducts surveillance for illnesses attributable to Campylobacter species, Cyclospora cayetanensis, Listeria monocytogenes, Salmonella species, Shiga toxin-producing Escherichia coli (STEC) O157 and non-O157 STEC, Shigella species, Vibrio species, and Yersinia enterocolitica. FoodNet also conducts surveillance for hemolytic-uremic syndrome (HUS), a compli- cation of STEC infection. In 2019, compared with the previous 3 years, the incidence of infections caused by pathogens transmitted commonly through food increased (for Campylobacter, Cyclospora, STEC, Vibrio, Yersinia) or remained unchanged (for Listeria, Salmonella, Shigella).2 Additional information about FoodNet can be found at www.cdc. gov/foodnet/index.html. Outbreak surveillance provides insights into the causes of foodborne illness, types of implicated foods, and settings where transmission occurs. The CDC collects data on foodborne disease outbreaks submitted from all states and territories (www.cdc. gov/foodsafety/fdoss/index.html). Public health, regulatory, and agricultural professionals can use this information when creating targeted control strategies and to support efforts to promote safe food preparation practices among food industry employees and the public. Data on foodborne disease outbreaks are available online through the National Outbreak Reporting System Dashboard ( norsdashboard). Four general rules should be followed for food safety: 1. Clean: Wash hands and surfaces thoroughly and often. 2. Separate: Do not cross-contaminate. 1 Centers for Disease Control and Prevention. Diagnosis and management of foodborne illnesses: a primer for physicians. MMWR Recomm Rep. 2004 53(RR-4):1–33 2 Tack DM, Ray L, Griffin PM, et al. Preliminary incidence and trends of infections with pathogens transmitted commonly through food—Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2016–2019. MMWR Morb Mortal Wkly Rep. 2020 69(17):509-514. DOI: mmwr.mm6917a1 Red_Book_2020_APPENDIX_1027-1060.indd 1037 19/02/21 10:05 AM
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