A recent report on foodborne illness surveillance in the United States has revealed that the country is falling short of its disease-reduction goals. However, this apparent setback may be partly attributed to the increased use of culture-independent diagnostic tests (CIDTs), which have enhanced the ability to detect infections that might have gone unreported in the past, according to the University of Minnesota’s CIDRAP.
The 2023 Foodborne Diseases Active Surveillance Network report, summarized in the Morbidity and Mortality Weekly Report, aims to compare the incidence of foodborne illnesses in 2023 with a baseline established from 2016 to 2018. This comparison is part of the Healthy People 2030 initiative, which sets reduction targets for infections caused by Campylobacter, Listeria, Salmonella, and Shiga toxin–producing Escherichia coli (STEC).
In 2023, the surveillance network identified 29,607 infections, 7,234 hospitalizations, and 177 deaths related to foodborne pathogens. The report indicates an increase in the incidence of domestically acquired campylobacteriosis, STEC infection, yersiniosis, vibriosis, and cyclosporiasis. Meanwhile, rates of listeriosis, salmonellosis, and shigellosis remained stable.
The widespread adoption of CIDTs over the past decade has significantly impacted these findings. While these tests enable quicker clinical diagnoses and treatment, they also complicate the interpretation of surveillance data and trends. The authors note that “CIDT adoption has varied over time, among clinical laboratories, and by pathogen, making it challenging to draw direct comparisons with historical data.”
This situation highlights a paradox in public health surveillance: improved diagnostic capabilities may lead to an apparent increase in disease incidence, even if the actual number of cases remains stable or decreases. This phenomenon stresses the critical need for careful interpretation of surveillance data and the importance of considering changes in diagnostic practices when assessing disease trends.
The report emphasizes the necessity for continued surveillance to monitor the impact of evolving diagnostic practices on disease trends. This ongoing monitoring will be crucial for accurately assessing progress towards the Healthy People 2030 goals and for developing effective strategies to reduce foodborne illnesses.
As diagnostic technologies continue to advance, public health officials and policymakers will need to adapt their approaches to disease surveillance and goal-setting. This may involve developing new metrics that account for changes in diagnostic practices or refining existing targets to reflect the increased sensitivity of modern testing methods.
Ultimately, while the report suggests that the United States is not meeting its current disease-reduction goals, it also points to the complexities of measuring progress in an era of rapidly evolving diagnostic capabilities. Moving forward, a nuanced understanding of these challenges will be essential for effectively tracking and combating foodborne illnesses.
Commenting on this story, one national food safety attorney said, “Scientific advancement in testing procedures is still a necessity to help identify and reduce the effects of foodborne illness.”
