Increase in Multistate Foodborne Disease Outbreaks-United States, 1973-2010.
BACKGROUND
Changes in food production and distribution have increased opportunities for foods contaminated early in the supply chain to be distributed widely, increasing the possibility of multistate outbreaks. In recent decades, surveillance systems for foodborne disease have been improved, allowing officials to more effectively identify related cases and to trace and identify an outbreak's source.


METHODS
We reviewed multistate foodborne disease outbreaks reported to the Centers for Disease Control and Prevention's Foodborne Disease Outbreak Surveillance System during 1973-2010. We calculated the percentage of multistate foodborne disease outbreaks relative to all foodborne disease outbreaks and described characteristics of multistate outbreaks, including the etiologic agents and implicated foods.


RESULTS
Multistate outbreaks accounted for 234 (0.8%) of 27,755 foodborne disease outbreaks, 24,003 (3%) of 700,600 outbreak-associated illnesses, 2839 (10%) of 29,756 outbreak-associated hospitalizations, and 99 (16%) of 628 outbreak-associated deaths. The median annual number of multistate outbreaks increased from 2.5 during 1973-1980 to 13.5 during 2001-2010; the number of multistate outbreak-associated illnesses, hospitalizations, and deaths also increased. Most multistate outbreaks were caused by Salmonella (47%) and Shiga toxin-producing Escherichia coli (26%). Foods most commonly implicated were beef (22%), fruits (13%), and leafy vegetables (13%).


CONCLUSIONS
The number of identified and reported multistate foodborne disease outbreaks has increased. Improvements in detection, investigation, and reporting of foodborne disease outbreaks help explain the increasing number of reported multistate outbreaks and the increasing percentage of outbreaks that were multistate. Knowing the etiologic agents and foods responsible for multistate outbreaks can help to identify sources of food contamination so that the safety of the food supply can be improved.
Division of Foodborne, Waterborne, and Environmental Diseases, The Centers for Disease Control and Prevention , Atlanta, Georgia .
Von D
VD
Nguyen
Division of Foodborne, Waterborne, and Environmental Diseases, The Centers for Disease Control and Prevention , Atlanta, Georgia .
Sarah D
SD
Bennett
Division of Foodborne, Waterborne, and Environmental Diseases, The Centers for Disease Control and Prevention , Atlanta, Georgia .
Elisabeth
E
Mungai
Division of Foodborne, Waterborne, and Environmental Diseases, The Centers for Disease Control and Prevention , Atlanta, Georgia .
Laura
L
Gieraltowski
Division of Foodborne, Waterborne, and Environmental Diseases, The Centers for Disease Control and Prevention , Atlanta, Georgia .
Kelley
K
Hise
Division of Foodborne, Waterborne, and Environmental Diseases, The Centers for Disease Control and Prevention , Atlanta, Georgia .
L Hannah
LH
Gould
D002487:Centers for Disease Control and Prevention, U.S.; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology; D019649:Food Industry / Q000639:trends; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000382:microbiology; D005638:Fruit / Q000382:microbiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D062486:Public Health Surveillance; D000069466:Red Meat / Q000382:microbiology; D012478:Salmonella Food Poisoning / Q000453:epidemiology; D054323:Shiga-Toxigenic Escherichia coli; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014675:Vegetables / Q000382:microbiology