A recent study conducted by the Colorado School of Public health suggests that investment in public health programs can help prevent the spread of foodborne illness through increased outbreak reporting. The study, published in the U.S. Centers for Disease Control’s (CDC’s) Emerging Infectious Diseases journal, evaluated the structural and outbreak factors associated with reporting foodborne illness outbreaks. The findings revealed substantial variation across states in the amount and types of outbreaks reported, with funding for infectious disease programs being a large factor in the difference between “high” and “low” reporting states.
Using outbreak surveillance data from CDC’s Foodborne Disease Outbreak Surveillance System for 2009–2018, researchers categorized the 50 states and Washington D.C. as having “high,” “middle,” and “low” levels of outbreak reporting based on the number of reported outbreaks per 10 million people. The researchers excluded multistate outbreaks from their analysis, and focused on outbreaks linked to Salmonella, Shiga toxin-producing Escherichia coli O157:H7, norovirus, and bacterial toxins.
The study found that the top ten highest-reporting states reported four times more outbreaks than the ten lowest-reporting states. Additionally, the widest gap in outbreak reporting was for norovirus outbreaks. Low-reporting states were also more likely to report large outbreaks caused by reportable conditions, and were less likely to identify a setting or food vehicle in an outbreak.
The most notable characteristic associated with levels of outbreak reporting was funding for epidemiology and laboratory capacity for the prevention and control of emerging infectious diseases. High-reporting states received approximately three times more funding for public health programs than low-reporting states. According to the researchers, each jurisdiction’s established surveillance systems affect outbreak reporting rates, which are driven by the resources available to jurisdictions. Many jurisdictions lack the personnel to investigate outbreaks of less severe illness.
The researchers concluded that investments in state public health programs significantly affect outbreak reporting. The next step will be to analyze if states that expanded their funding over the ten-year period successfully increased their ability to report outbreaks.