Recipes for foodborne outbreaks: a scheme for categorizing and grouping implicated foods.
BACKGROUND
To better understand the sources of foodborne illness, we propose a scheme for categorizing foods implicated in investigations of outbreaks of foodborne diseases. Because nearly 2000 foods have been reported as causing outbreaks in the United States, foods must be grouped for meaningful analyses.


METHODS
We defined a hierarchy of 17 mutually exclusive food commodities. We defined the following three commodity groups from which nearly all food is derived: aquatic animals, land animals, and plants. We defined three commodities in aquatic animals, six in land animals, and eight in plants. We considered each food as a set of ingredients composed of one or more commodities. We defined a simple food as one made of ingredients that are all in one commodity and a complex food as one containing ingredients in more than one commodity. We determined likely ingredients using a panel of epidemiologists and a web-based search process.


RESULTS
We assigned 1709 (95%) of the 1794 foods implicated in outbreaks of foodborne diseases reported to Centers for Disease Control and Prevention from 1973 to 2006. Of those, 987 (57%) were simple foods and 722 (43%) were complex foods.


CONCLUSIONS
This categorization may serve as an input for modeling the attribution of human illness to specific food commodities and could be used by policy makers, health officials, regulatory agencies, and consumer groups to evaluate the contribution of various food commodities to illness.
Painter
John A
JA
Enteric Diseases Epidemiology Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vectorborne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. jpainter@cdc.gov
Ayers
Tracy
T
Woodruff
Rachel
R
Blanton
Elizabeth
E
Perez
Nytzia
N
Hoekstra
Robert M
RM
Griffin
Patricia M
PM
Braden
Christopher
C
D000818:Animals; D003296:Cooking / Q000706:statistics & numerical data; D003611:Dairy Products / Q000145:classification / Q000706:statistics & numerical data; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D004812:Epidemiologic Methods; D005502:Food / Q000145:classification* / Q000706:statistics & numerical data; D005516:Food Microbiology; D005517:Foodborne Diseases / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008460:Meat / Q000145:classification / Q000706:statistics & numerical data; D010945:Plants, Edible / Q000145:classification; D017747:Seafood / Q000145:classification / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology