Ruminant-dense environments increase risk of Shiga toxin-producing independently of ruminant contact.

Cattle and other domestic ruminants are the primary reservoirs of O157 and non-O157 Shiga toxin-producing (STEC). Living in areas with high ruminant density has been associated with excess risk of infection, which could be due to both direct ruminant contact and residual environmental risk, but the role of each is unclear. We investigated whether there is any meaningful risk to individuals living in ruminant-dense areas if they do not have direct contact with ruminants.

Syndromic Gastrointestinal Panel Diagnostic Tests Have Changed our Understanding of the Epidemiology of -Foodborne Diseases Active Surveillance Network, 2010-2021.

Background: In the US, yersinosis was understood to predominantly occur in winter and among Black or African American infants and Asian children. Increased use of culture-independent diagnostic tests (CIDTs) has led to marked increases in yersinosis diagnoses.

Methods: We describe differences in the epidemiology of yersiniosis diagnosed by CIDT versus culture in 10 US sites, and identify determinants of health associated with diagnostic method.

Cronobacter sakazakii Infections in Two Infants Linked to Powdered Infant Formula and Breast Pump Equipment - United States, 2021 and 2022.

Cronobacter sakazakii, a species of gram-negative bacteria belonging to the Enterobacteriaceae family, is known to cause severe and often fatal meningitis and sepsis in young infants. C. sakazakii is ubiquitous in the environment, and most reported infant cases have been attributed to contaminated powdered infant formula (powdered formula) or breast milk that was expressed using contaminated breast pump equipment (1-3).

Outbreak of Norovirus Gastroenteritis Associated With Ice Cream Contaminated by Frozen Raspberries From China-Minnesota, United States, 2016.

Background: Norovirus is the etiology for about 60% of foodborne outbreaks identified in Minnesota. Contamination of food during preparation by food handlers is by far the most common cause of these outbreaks. Norovirus outbreaks due to commercially distributed foods are rarely reported in the United States, and only 2 have been previously identified in Minnesota, both due to oysters.

Moving Away from Population-Based Case-Control Studies during Outbreak Investigations.

Population-based case-control studies are a time- and labor-intensive component of foodborne outbreak investigations. One alternative is a binomial trial that asks the question "if the likelihood of each case's having eaten a given food is no different from that of the average person in the population, how often would we find, by chance alone, that of (or more) cases would have eaten this food?" Calculating a binomial trial requires background exposure data. We conducted case-control studies and binomial trials in two foodborne outbreaks and compared results.

Multistate Outbreak of Salmonella Anatum Infections Linked to Imported Hot Peppers - United States, May-July 2016.

Foodborne salmonellosis causes an estimated 1 million illnesses and 400 deaths annually in the United States (1). Salmonella Anatum is one of the top 20 Salmonella serotypes in the United States. During 2013-2015 there were approximately 300-350 annual illnesses reported to PulseNet, the national molecular subtyping network for foodborne disease surveillance.

Characteristics of Clusters of Salmonella and Escherichia coli O157 Detected by Pulsed-Field Gel Electrophoresis that Predict Identification of Outbreaks.

Introduction: Molecular subtyping of pathogens is critical for foodborne disease outbreak detection and investigation. Many clusters initially identified by pulsed-field gel electrophoresis (PFGE) are not confirmed as point-source outbreaks. We evaluated characteristics of clusters that can help prioritize investigations to maximize effective use of limited resources.

Incidence of Cronobacter spp. infections, United States, 2003-2009.

During 2003-2009, we identified 544 cases of Cronobacter spp. infection from 6 US states. The highest percentage of invasive infections occurred among children <5 years of age; urine isolates predominated among adults.

Travel-associated enteric infections diagnosed after return to the United States, Foodborne Diseases Active Surveillance Network (FoodNet), 2004-2009.

Background: Approximately 40% of US travelers to less developed countries experience diarrheal illness. Using data from the Foodborne Diseases Active Surveillance Network (FoodNet), we describe travel-associated enteric infections during 2004-2009, characterizing the patients, pathogens, and destinations involved.

Methods: FoodNet conducts active surveillance at 10 US sites for laboratory-confirmed infections with 9 pathogens transmitted commonly through food.

Non-O157 Shiga toxin-producing Escherichia coli associated with venison.

We investigated an outbreak of non-O157 Shiga toxin-producing Escherichia coli at a high school in Minnesota, USA, in November 2010. Consuming undercooked venison and not washing hands after handling raw venison were associated with illness. E.

Use of traceback methods to confirm the source of a multistate Escherichia coli O157:H7 outbreak due to in-shell hazelnuts.

Traceback methods by state regulatory agencies were used to complement traditional epidemiological cluster investigation methods and confirmed hazelnuts (also referred to as filberts) as the vehicle in a multistate outbreak of Escherichia coli O157:H7 infections. Bulk in-shell hazelnut and mixed-nut purchase locations were identified during the initial epidemiological interviews. Based on purchase dates and case onset dates, regulators in Minnesota, Michigan, and Wisconsin traced product back through the supply chain.

Salmonella enterica pulsed-field gel electrophoresis clusters, Minnesota, USA, 2001-2007.

We determined characteristics of Salmonella enterica pulsed-field gel electrophoresis clusters that predict their being solved (i.e., that result in identification of a confirmed outbreak).