Understanding the Foodborne Illness Landscape
Maintaining food safety is a critical responsibility shared by government agencies, industry professionals, and the general public. Foodborne illnesses can have serious consequences, ranging from mild discomfort to life-threatening conditions. In the United States, the Centers for Disease Control and Prevention (CDC) estimates that each year, 48 million people get sick, 128,000 are hospitalized, and 3,000 die from foodborne diseases.
To combat this public health challenge, a multidisciplinary approach is essential. The Food Safety Modernization Act (FSMA) has empowered the U.S. Food and Drug Administration (FDA) to enhance prevention-focused food safety practices, while the CDC plays a pivotal role in strengthening foodborne illness surveillance and outbreak response.
Rapid detection and effective response to foodborne disease outbreaks are crucial to stop outbreaks, prevent them from happening, and ultimately decrease the burden of foodborne illness. The CDC supports FSMA’s objectives through four key activities:
- Enhancing foodborne illness surveillance systems: Improving the collection, analysis, and reporting of foodborne illness data.
- Advancing foodborne disease outbreak detection and investigation: Rapidly identifying the source of outbreaks to stop them and prevent future occurrences.
- Strengthening food safety prevention practices: Providing guidance and support to food producers, processors, and retailers.
- Fostering collaboration between federal, state, and local agencies: Coordinating a unified response to foodborne illness outbreaks.
The FSIS Foodborne Illness Investigation Process
The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) plays a critical role in investigating foodborne illnesses potentially associated with FSIS-regulated meat, poultry, or egg products. FSIS Directive 8080.3 outlines the agency’s comprehensive approach to these investigations, which involves a multidisciplinary team and a structured, dynamic process.
Surveillance and Information Monitoring
FSIS becomes aware of potential associations between human illness and FSIS-regulated products through various channels, including:
- Notification from public health officials: Local, state, or national public health agencies may identify a potential link between human illness and an FSIS-regulated product and notify the agency.
- FSIS’ own monitoring activities: The FSIS Office of Public Health Science (OPHS) conducts surveillance through the CDC PulseNet system, media reports, and analysis of FSIS laboratory sampling data.
When FSIS receives information about a potential association, the Applied Epidemiology Staff (AES) within OPHS assesses the strength of the evidence to determine if a plausible basis exists to initiate a foodborne illness investigation.
Initiating a Foodborne Illness Investigation
If AES investigators determine that the reported human illness may be associated with an FSIS-regulated product, they initiate a formal foodborne illness investigation. This process involves:
- Creating an investigation record: The AES lead investigator creates an investigation record in the FSIS Inspection Management System (FIMS) to document and track the investigation.
- Issuing an alert: The AES Director or designee may issue an email alert to provide early notification of the investigation and the potential need for additional agency resources or action.
- Notifying OIEA: If the situation involves suspected intentional product tampering or criminal violations, FSIS personnel must immediately notify the Office of Investigation, Enforcement and Audit (OIEA).
Product Sampling and Laboratory Analysis
A critical aspect of the investigation is determining whether to submit product samples for laboratory analysis. AES investigators consult with the OPHS Science Staff (SciS) and the FSIS Field Service Laboratories (FSLs) to consider factors such as:
- The availability of suspect product samples
- The potential for positive findings to support the investigation
- The validity and utility of non-intact package product samples
If product sampling and testing are deemed necessary, SciS coordinates the development of an investigative sampling plan and oversees the collection, preparation, and shipping of samples to the appropriate laboratory.
Environmental Assessment and Traceback/Traceforward
Concurrently with product sampling, FSIS personnel from the Office of Field Operations (OFO) and OIEA conduct environmental assessments and product traceback/traceforward activities to gather additional evidence and identify the potential source of the contamination.
Data Analysis and Assessment
Throughout the investigation, the AES lead investigator, in consultation with other FSIS teams, analyzes the accumulated data, including epidemiologic, laboratory, traceback, and environmental assessment findings. They assess the strength of the evidence to determine whether there is a credible link between the FSIS-regulated product and the human illness.
Agency Actions and Outcomes
Based on the findings of the foodborne illness investigation, FSIS may take various actions to protect public health, including:
- Recommending a product recall: If there is credible evidence that an FSIS-regulated product contains a pathogen or is otherwise harmful to human health, FSIS may recommend a product recall to prevent further exposure.
- Issuing a public health alert: If the implicated product is no longer available for sale, FSIS may recommend a public health alert to inform consumers of the potential risk.
- Implementing other agency actions: Depending on the evidence, FSIS may take additional actions, such as intensifying product sampling, conducting an environmental investigation at the implicated facility, or initiating enforcement actions.
Throughout the investigation and subsequent actions, FSIS maintains ongoing communication with public health partners, industry, and the public to ensure a coordinated and transparent response.
Continuous Improvement and Collaboration
FSIS is committed to continuously evaluating and improving its foodborne illness investigation processes. After each investigation, the AES team convenes an after-action review, involving representatives from various FSIS program areas and, when appropriate, external public health partners.
These reviews assess the events leading to the investigation, as well as the agency’s response, to identify opportunities for policy and procedural enhancements. The findings are then shared with FSIS leadership and the broader food safety community to drive continuous improvement.
Additionally, FSIS engages in regular, ongoing collaboration with the CDC and the FDA through the CDC-FDA-USDA Tri-Agency meeting. This forum facilitates the sharing of information, the identification of emerging issues, and the coordination of joint initiatives to strengthen the nation’s food safety system.
By fostering a multidisciplinary approach, leveraging advanced surveillance and investigation techniques, and continuously evaluating and improving its processes, FSIS is at the forefront of safeguarding the public against the threat of foodborne illnesses. As the Kitchen Warrior community, we can all play a role in this collaborative effort by staying informed, practicing safe food handling and preparation, and reporting any suspected foodborne illness incidents to the appropriate authorities.
To learn more about FSIS’ role in food safety and how you can contribute to the cause, visit the Kitchen Warrior website.
