FoodNet and Enter-net: emerging surveillance programs for foodborne diseases.

The public health challenges of foodborne diseases are changing as a result of newly identified pathogens and vehicles of transmission , changes in food production and distribution, and an apparent decline in food safety awareness. Response to these new challenges requires new surveillance strategies to monitor the incidence of human illness and provide data for developing effective prevention strategies. FoodNet The Foodborne Diseases Active Surveillance Network (FoodNet), the principal foodborne disease component of the Centers for Disease Control and Prevention's (CDC) Emerging Infections Program (EIP), is a collaborative project with participating EIP sites, the U.S. Department of Agriculture (USDA), and the U.S. Food and Drug Administration (FDA). To determine more precisely the incidence of foodborne illness in the United States, FoodNet was established in five locations (selected counties in California, Connecticut, and Georgia, and the entire states of Minnesota and Oregon) in 1995 and was expanded to selected counties in Maryland and New York in 1997. The population of these seven FoodNet sites in 1997 was 20.3 million (7.7% of the U.S. population). The objectives of FoodNet are to 1) describe the epidemiology of new and emerging bacterial, parasitic, and viral foodborne diseases of national importance; 2) more precisely determine the frequency and severity of foodborne diseases in the United States; and 3) determine the proportion of foodborne disease caused by eating specific foods. By monitoring foodborne disease incidence over time, FoodNet will document the effectiveness of new food safety initiatives, such as the USDA Food and Safety Inspection Service's Pathogen Reduction and Hazard Analysis and Critical Control Points (HACCP) Rule, in decreasing the number of cases of foodborne disease in the United States each year. To address these objectives, FoodNet conducts active surveillance and related studies: a population survey, a physician survey, and a case-control study of Escherichia coli O157:H7 infections. and the entire states of Minnesota and Oregon. This survey provided an estimate of the prevalence of acute diarrhea and the frequency with which patients with acute diarrhea sought medical care. In 9,003 interviews, 11% of persons reported acute diarrhea in the 4 weeks before the interview, 12% of persons with acute diarrhea called a health-care provider as a result of this illness, and 8% sought medical care. These data indicate an estimated 1.4 acute diarrheal episodes per person each year in the United States, with 1% of the population seeking medical care because of acute diarrhea. responding …