Volume 28, Number 6—June 2022
Synopsis
Foodborne Illness Outbreaks Reported to National Surveillance, United States, 2009–2018
, Alexandra R. Tillman, Craig Hedberg, Beau B. Bruce, Michael Batz, Scott A. Seys, Daniel Dewey-Mattia, Michael C. Bazaco, and Elaine Scallan Walter
Table 2
Outbreak characteristics from high, middle, and low outbreak reporter states, all etiologies, Foodborne Disease Outbreak Surveillance System, United States, 2009–2018*
| Characteristic | Highest 10 reporters | Middle 31 reporters | Lowest 10 reporters | p value |
|---|---|---|---|---|
| Total no. outbreaks |
2,416 |
5,091 |
624 |
|
| Etiology identified | 1,897 (78.5) | 3,733 (73.3) | 356 (57.1) | <0.01 |
| Confirmed etiology‡ | <0.01 | |||
| Norovirus | 546 (35.7) | 913 (59.7) | 70 (4.6) | |
| Salmonella | 245 (22.3) | 731 (66.4) | 125 (11.4) | |
| Bacterial toxins† | 67 (26.0) | 167 (64.7) | 24 (9.3) | |
| STEC O157 | 44 (31.7) | 87 (62.6) | 8 (5.8) | |
| Other known§ | 257 (27.5) | 642 (68.7) | 36 (3.9) | |
| Confirmed or suspected | <0.01 |
|||
| Norovirus | 1,036 (37.0) | 1,661 (59.4) | 101 (3.6) | |
| Salmonella | 264 (22.2) | 782 (65.7) | 145 (12.2) | |
| Bacterial toxins† | 168 (27.2) | 416 (67.4) | 33 (5.3) | |
| STEC O157 | 48 (32.0) | 92 (61.3) | 10 (6.7) | |
| Other known§ |
381 (31.0) |
782 (63.6) |
67 (5.4) |
|
| Setting identified | 2,310 (95.6) | 4,678 (91.9) | 457 (73.2) | <0.01 |
| Settingঠ| <0.01 | |||
| Restaurant | 1,528 (66.2) | 2,893 (61.8) | 237 (51.9) | |
| Institution | 78 (3.4) | 186 (4.0) | 31 (6.8) | |
| Private residence | 217 (9.4) | 366 (7.8) | 45 (9.9) | |
| Other single setting | 119 (5.2) | 303 (6.5) | 32 (7.0) | |
| Multiple setting |
368 (15.9) |
930 (19.9) |
112 (24.5) |
|
| Food vehicle confirmed or suspected | 879 (36.4) | 1,917 (37.7) | 164 (26.3) | <0.01 |
| Food‡ | <0.01 | |||
| Multiple | 314 (35.7) | 704 (36.7) | 73 (44.5) | |
| Aquatic animals | 192 (21.8) | 335 (17.5) | 11 (6.7) | |
| Land animals | 214 (24.4) | 522 (27.2) | 51 (31.1) | |
| Plant | 138 (15.7) | 290 (15.1) | 24 (14.6) | |
| Other# | 21 (2.4) | 66 (3.4) | 5 (3.1) | |
| Food vehicle confirmed |
656 (74.6) |
1,440 (75.1) |
92 (56.1) |
<0.01 |
| Season | 0.02 | |||
| Winter | 649 (26.9) | 1,306 (25.7) | 128 (20.5) | |
| Spring | 639 (26.5) | 1,481 (29.1) | 195 (31.3) | |
| Summer | 613 (25.4) | 1,282 (25.2) | 166 (26.6) | |
| Autumn |
515 (21.3) |
1,022 (20.1) |
135 (21.6) |
|
| Sex of case-patients unknown |
196 (8.1) |
443 (8.7) |
79 (12.7) |
<0.01 |
| No. cases, median (IQR)** | 6 (11) | 8 (13) | 10 (20) | <0.01†† |
*Values are no. (%) except as indicated. The highest reporter states were the highest outbreak reporting quintile, middle reporters the middle 3 quintiles, and low reporters the lowest quintile, based on number of outbreaks reported per 10 million population. p values are from χ2 test results compared across the 3 reporting tiers. STEC, Shiga toxin–producing Escherichia coli. †Bacterial toxin outbreaks include Clostridium perfringens, Bacillus cereus, Staphylococcus aureus.‡Among outbreaks with characteristic identified. §Includes outbreaks associated with multiple pathogens. ¶Restaurant setting includes caterer, banquet hall; Institution includes daycares, hospitals, long-term care facilities/nursing homes/assisted living facilities, prison/jails, and school/college/universities; Other setting category includes camp, fair, festival, other temp or mobile services, farm/dairy, grocery store, hotel/motel, office/indoor workplace, other, religious facility, ship/boat. #Includes foods that were unclassifiable or invalid using food categories defined by the Interagency Food Safety Analytics Collaboration (8). **Laboratory-confirmed and probable primary cases. ††By Kruskal-Wallis test.