Attributing Illness to Food

Michael B. Batz; Michael P. Doyle; J. Glenn Morris, Jr.; John Painter; Ruby Singh; Robert V. Tauxe; Michael R. Taylor; Danilo M.A. Lo Fo Wong

Disclosures

Emerging Infectious Diseases. 2005;11(7) 

In This Article

Abstract and Introduction

Identification and prioritization of effective food safety interventions require an understanding of the relationship between food and pathogen from farm to consumption. Critical to this cause is food attribution, the capacity to attribute cases of foodborne disease to the food vehicle or other source responsible for illness. A wide variety of food attribution approaches and data are used around the world, including the analysis of outbreak data, case-control studies, microbial subtyping and source tracking methods, and expert judgment, among others. The Food Safety Research Consortium sponsored the Food Attribution Data Workshop in October 2003 to discuss the virtues and limitations of these approaches and to identify future options for collecting food attribution data in the United States. We summarize workshop discussions and identify challenges that affect progress in this critical component of a risk-based approach to improving food safety.

Foodborne microbiologic hazards may be responsible for as many as 76 million cases of illness in the United States each year[1] and are thus an important food safety challenge. To lower the incidence of foodborne disease, many experts and stakeholders urge the development of a science- and risk-based food safety system, in which decision makers prioritize hazards and interventions using the best available data on the distribution and reduction of risks.[2,3] Such a system requires an understanding of the many risk factors between the point of production and the point of consumption and the ability to systematically target intervention efforts along this "farm-to-fork" continuum.

Although the Foodborne Diseases Active Surveillance Network (FoodNet), administered by the Centers for Disease Control and Prevention (CDC), is producing increasingly robust data on the incidence of illness due to specific enteric pathogens, no method exists to categorize these illnesses by mode of transmission, whether drinking water, environmental exposure, or consumption of a specific food. Interventions are almost always food (or process) specific. To design and prioritize effective food safety interventions, we must be able to perform food attribution—that is, identify which foods are vehicles for specific cases of illness. Such data are of particular importance for US government agencies that regulate food and food animals, including the Food Safety Inspection Service (FSIS) of the US Department of Agriculture (USDA), and the Center for Food Safety and Applied Nutrition (CFSAN) and the Center for Veterinary Medicine (CVM) of the Food and Drug Administration (FDA).

Foodborne illnesses can be attributed to foods by using a variety of data sources and analytic approaches; each has its virtues and limitations. In Atlanta on October 31, 2003, the Food Safety Research Consortium (FSRC) sponsored the Food Attribution Data Workshop to explore these approaches in detail. Attendees included representatives from CDC, FSIS, CFSAN, CVM, the Environmental Protection Agency (EPA), consumer advocacy organizations, and member institutions of FSRC, including the University of Maryland at Baltimore, University of Georgia, Iowa State University, University of California at Davis, and Resources for the Future. This article summarizes material discussed at the workshop and identifies challenges that affect progress in this critical component of a risk-based approach to improving food safety.

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