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Epidemiology of restaurant-associated foodborne disease outbreaks, United States, 1998–2013

  • K. M. ANGELO (a1), A. L. NISLER (a2), A. J. HALL (a2), L. G. BROWN (a3) and L. H. GOULD (a1)...

Summary

Although contamination of food can occur at any point from farm to table, restaurant food workers are a common source of foodborne illness. We describe the characteristics of restaurant-associated foodborne disease outbreaks and explore the role of food workers by analysing outbreaks associated with restaurants from 1998 to 2013 reported to the Centers for Disease Control and Prevention's Foodborne Disease Outbreak Surveillance System. We identified 9788 restaurant-associated outbreaks. The median annual number of outbreaks was 620 (interquartile range 618–629). In 3072 outbreaks with a single confirmed aetiology reported, norovirus caused the largest number of outbreaks (1425, 46%). Of outbreaks with a single food reported and a confirmed aetiology, fish (254 outbreaks, 34%) was most commonly implicated, and these outbreaks were commonly caused by scombroid toxin (219 outbreaks, 86% of fish outbreaks). Most outbreaks (79%) occurred at sit-down establishments. The most commonly reported contributing factors were those related to food handling and preparation practices in the restaurant (2955 outbreaks, 61%). Food workers contributed to 2415 (25%) outbreaks. Knowledge of the foods, aetiologies, and contributing factors that result in foodborne disease restaurant outbreaks can help guide efforts to prevent foodborne illness.

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Copyright

Corresponding author

*Author for correspondence: K. M. Angelo, DO, MPH-TM, 1600 Clifton Road NE, Atlanta, GA 30333, USA. (Email: kangelo@cdc.gov)

References

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1. Scallan, E, et al. Foodborne illness acquired in the United States – major pathogens. Emerging Infectious Diseases 2011; 17: 715.
2. Centers for Disease Control and Prevention. Surveillance for foodborne disease outbreaks – United States, 1998–2008. Morbidity and Mortality Weekly Report 2013; 62: 134.
3. Hoffman, S, Maculloch, B, Batz, M. Economic burden of major foodborne illnesses acquired in the United States, EIB-140, United States Department of Agriculture, Economic Research Service (http://www.ers.usda.gov/media/1837791/eib140.pdf). Accessed 15 September 2015.
4. Centers for Disease Control and Prevention. Surveillance for foodborne disease outbreaks, United States, 2013 (http://www.cdc.gov/foodsafety/pdfs/foodborne-disease-outbreaks-annual-report-2013-508c.pdf). Accessed 8 December 2015.
5. Sumner, S, et al. factors associated with food workers working while experiencing vomiting or diarrhea. Journal of Food Protection 2011; 74: 215220.
6. National Restaurant Association. 2015 Restaurant industry pocket factbook (http://www.restaurant.org/Downloads/PDFs/News-Research/research/Factbook2015_LetterSize-FINAL.pdf). Accessed 15 September 2015.
7. U.S. Department of Health and Human Services. Food Code (http://www.fda.gov/downloads/Food/GuidanceRegulation/RetailFoodProtection/FoodCode/UCM374510.pdf). Accessed 15 September 2015.
8. Centers for Disease Control and Prevention. National Outbreak Reporting System (http://www.cdc.gov/nors/about.html). Accessed 10 September 2015.
9. Centers for Disease Control and Prevention. Interagency Food Safety Analystics Collaboration (IFSAC) (http://www.cdc.gov/foodsafety/ifsac/projects/food-categorization-scheme.html). Accessed 18 September 2015.
10. Centers for Disease Control and Prevention. Guide to confirming an etiology in a foodborne disease outbreak (http://www.cdc.gov/foodsafety/outbreaks/investigating-outbreaks/confirming_diagnosis.html). Accessed 21 June 2016.
11. Centers for Disease Control and Prevention. National outbreak reporting system guidance document (http://www.cdc.gov/outbreaknet/pdf/NORS_Guidance_5213_06232009(compliant).pdf). Accessed 27 September 2015.
12. Green, L, Selman, C. Factors impacting food workers’ and managers’ safe food preparation practices: a qualitative study. Food Protection Trends 2005; 25: 981990.
13. DeBess, EE, et al. Food handler assessment in Oregon. Foodborne Pathogenesis and Disease 2009; 6: 329335.
14. Green, L, et al. Factors related to food workers hand hygiene practices. Journal of Food Protection 2007; 70: 661666.
15. Green, L, et al. Food service workers self-reported food preparation practices: an EHS-Net study. International Journal of Hygiene and Environmental Health 2005; 208: 2735.
16. Strohbehn, C, et al. Hand washing frequencies and procedures used in retail food services. Journal of Food Protection 2008; 71: 97106.
17. Norton, DM, et al. Managerial practices regarding workers working while ill. Journal of Food Protection 2015; 78: 187195.
18. Centers for Disease Control and Prevention. Diagnostic methods for norovirus (http://www.cdc.gov/norovirus/lab-testing/diagnostic.html) Accessed 22 December 2015.
19. Hall, AJ, et al. Epidemiology of foodborne norovirus outbreaks, United States, 2001–2008. Emerging Infectious Diseases 2013; 18: 15661573.
20. Teunis, PF, et al. Norwalk virus: how infectious is it? Journal of Medical Virology 2008; 80: 14681476.
21. Hall, AJ, et al. Vital signs: foodborne norovirus outbreaks – United States, 2009–2012. Morbidity and Mortality Weekly Report 2014; 63: 491495.
22. Hedberg, CW, et al. Systematic environmental evaluations to identify food safety differences between outbreak and nonoutbreak restaurants. Journal of Food Protection 2006; 69: 697702.
23. Food and Drug Administation. Scombrotoxin poisoning and decomposition (http://www.fda.gov/food/foodborneillnesscontaminants/buystoreservesafefood/ucm335658.htm).
24. National Oceanic and Atmospheric Administration. Commercial fisheries statistics (http://www.st.nmfs.noaa.gov/commercial-fisheries/fus/fus14/index). Accessed 31 August 2016.
25. Bennett, SD, Walsh, K, Gould, LH. Foodborne Disease Outbreaks caused by Bacillus cereus, Clostridium perfringens, and Staphylococcus aureus, United States, 1998–2008. Clinical Infectious Diseases 2013; 57: 425433.
26. Imanishi, M, et al. Factors Contributing to Decline in Foodborne Disease Outbreak Reports, United States. Emerging Infectious Diseases 2014; 20: 15511553.

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