Preliminary Incidence and Trends of Infection With Pathogens Transmitted Commonly Through Food

Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2006-2014

Stacy M. Crim, MPH; Patricia M. Griffin, MD; Robert Tauxe, MD; Ellyn P. Marder, MPH; Debra Gilliss, MD; Alicia B. Cronquist, MPH; Matthew Cartter, MD; Melissa Tobin-D'Angelo, MD; David Blythe, MD; Kirk Smith, DVM; Sarah Lathrop, PhD; Shelley Zansky, PhD; Paul R. Cieslak, MD; John Dunn, DVM; Kristin G. Holt, DVM; Beverly Wolpert, PhD; Olga L. Henao, PhD


Morbidity and Mortality Weekly Report. 2015;64(18):495-499. 

In This Article


Foodborne illnesses represent a substantial, yet largely preventable, health burden in the United States. In 10 U.S. geographic areas, the Foodborne Diseases Active Surveillance Network* (FoodNet) monitors the incidence of laboratory-confirmed infections caused by nine pathogens transmitted commonly through food. This report summarizes preliminary 2014 data and describes changes in incidence compared with 2006–2008 and 2011–2013. In 2014, FoodNet reported 19,542 infections, 4,445 hospitalizations, and 71 deaths. The incidence of Shiga toxin–producing Escherichia coli (STEC) O157 and Salmonella enterica serotype Typhimurium infections declined in 2014 compared with 2006–2008, and the incidence of infection with Campylobacter, Vibrio, and Salmonella serotypes Infantis and Javiana was higher. Compared with 2011–2013, the incidence of STEC O157 and Salmonella Typhimurium infections was lower, and the incidence of STEC non-O157 and Salmonella serotype Infantis infections was higher in 2014. Despite ongoing food safety efforts, the incidence of many infections remains high, indicating that further prevention measures are needed to make food safer and achieve national health objectives.

FoodNet conducts active, population-based surveillance for laboratory-confirmed infections caused by Campylobacter, Cryptosporidium, Cyclospora, Listeria, Salmonella, Shiga toxin–producing Escherichia coli (STEC) O157 and non-O157, Shigella, Vibrio, and Yersinia in 10 geographic areas covering approximately 15% of the U.S. population (an estimated 48 million persons in 2013). FoodNet is a collaboration among CDC, 10 state health departments, the U.S. Department of Agriculture's Food Safety and Inspection Service (USDA-FSIS), and the Food and Drug Administration (FDA). Hospitalizations occurring within 7 days of specimen collection are recorded, as is the patient's vital status at hospital discharge or 7 days after specimen collection if the patient was not hospitalized. Hospitalizations and deaths that occur within 7 days of specimen collection are attributed to the infection. Surveillance for physician-diagnosed postdiarrheal hemolytic uremic syndrome, a complication of STEC infection characterized by renal failure, thrombocytopenia, and microangiopathic hemolytic anemia, is conducted through a network of nephrologists and infection preventionists and by hospital discharge data review. This report includes hemolytic uremic syndrome data for persons aged <18 years for 2013, the most recent year for which data are available.

Incidence was calculated by dividing the number of laboratory-confirmed infections in 2014 by U.S. Census estimates of the surveillance area population for 2013. Incidence of culture-confirmed bacterial infections and laboratory-confirmed parasitic infections (e.g., identified by enzyme immunoassay) are reported. A negative binomial model with 95% confidence intervals (CIs) was used to estimate changes in incidence from 2006–2008 to 2014 and from 2011–2013 to 2014. Change in the combined overall incidence of infection with six key foodborne pathogens§ was estimated. For STEC non-O157, because of changing diagnostic practices and testing methods, only change in incidence since 2011–2013 was assessed; for Cyclospora, change was not assessed because data were sparse. For hemolytic uremic syndrome, 2013 incidence was compared with that in 2006–2008. The number of reports of positive culture-independent diagnostic tests without corresponding culture confirmation is reported for Campylobacter, Salmonella, Shigella, STEC, and Vibrio. Incidence calculations do not include culture-independent diagnostic test reports.

*Additional information available at
Final incidence rates will be reported when population estimates for 2014 are available.
§The overall incidence of infection combines data for Campylobacter, Listeria, Salmonella, STEC O157, Vibrio, and Yersinia, six key bacterial pathogens for which >50% of illnesses are estimated to be transmitted by food.