Infection with Salmonella, Shigella, botulism, Listeria, Escherichia coli O157:H7, other Shiga toxin-producing E. coli, hemolytic uremic syndrome (HUS) and Hepatitis A are reportable almost everywhere in the United States. Infection with other pathogens may also be reportable. Authority for disease reporting rests at the state level and states voluntarily report nationally notifiable conditions to CDC. The list of nationally notifiable diseases is updated annually by the Council for State and Territorial Epidemiologists (CSTE) with recommendations from CDC. Frequently, diagnoses remain unconfirmed until laboratory tests are completed. However, outbreaks of suspected foodborne illness and individual illnesses suspected to be foodborne should also be reported. By investigating foodborne disease outbreaks, public health officials learn about possible problems in food production, distribution and preparation that may lead to illness.

Public health laboratories contribute importantly to the surveillance of foodborne infections in the United States. Public health laboratories routinely serotype all Salmonella and Shigella, and routinely subtype all isolates of Listeria and Shiga toxin-producing E. coli (STEC) by pulsed-field gel electrophoresis (PFGE). Many also subtype representative samples of Salmonella and Shigella isolates with PFGE, among other foodborne pathogens. For more information on the national network of public health and food regulatory agency laboratories conducting molecular surveillance, visit the PulseNet website.

State public health laboratory directors and state and territorial epidemiologists should report information for Shigella, Salmonella and Shiga toxin-producing E. coli isolated from human sources to the Public Health Laboratory Information System (PHLIS). In addition to reports through PHLIS and the Nationally Notifiable Disease Surveillance System (NNDSS), the Enteric Diseases Epidemiology Branch (proposed) at CDC requests that extended forms be used to report some conditions, such as typhoid fever, listeriosis, cholera and other Vibrio illnesses. These forms are available through CDC’s National Case Surveillance for Foodborne and Diarrheal Diseases page [link to Case Surveillance page]. Some states have adopted new integrated National Electronic Disease Surveillance Systems (NEDSS) or compatible locally developed systems. In the future, these systems are intended to integrate NNDSS, PHLIS and some of the forms which collect additional information, but this has not yet occurred. NEDSS does not yet replace reporting through PHLIS.

Botulism:

Any suspect case of botulism is considered a public health emergency due to the severity of the illness and the possibility that a source food may cause others to become seriously ill. Suspect botulism cases should be reported immediately to your State Health Department. CDC staff are available 24 hours a day to provide consultation on diagnosis, treatment or investigation, as well as antitoxin release by calling 770.488.7100.

Most states require that local health departments report outbreaks of illnesses related to a food source to their state health department. If you are unsure, please contact your state health department.

If you work in a state health department, we request that you report any foodborne disease outbreak through the state administrator of the Electronic Foodborne Disease Outbreak Reporting System (eFORS).

FDA and USDA regulate the safety of the food supply. They inspect food products, promulgate and enforce food safety regulations, test suspect foods, and work with industry to improve safety practices. While FDA is responsible for non-meat products such as seafood, fruits, vegetables and shell eggs, USDA oversees meat, poultry and processed egg products. Both agencies work extensively with state food regulatory partners.

CDC monitors human health by disease surveillance and by assisting states in outbreak investigations. CDC is a non-regulatory, scientific agency. It aims to provide credible information in order to enhance health decisions made by the regulatory agencies, professionals in the health sector, the food industry, as well as individuals. CDC’s scientific investigations may define new problems, and areas in need of more research. CDC’s mission is “to promote health and quality of life by preventing and controlling disease, injury, and disability”. CDC works extensively with state, local and tribal health department partners. To learn more about CDC and its duties, click here.

In regards to food, CDC’s Division of Foodborne, Bacterial and Mycotic Diseases (proposed) conducts surveillance for foodborne diseases, assists local and state health departments in their response to foodborne disease outbreaks, collects, organizes and publishes information on foodborne illnesses and outbreaks reported in the United States, maintains the national reference laboratories for foodborne pathogens, and develops new strategies for diagnosing and fingerprinting them.