The Foodborne Disease Outbreak Surveillance System (FDOSS), managed by the Centers for Disease Control and Prevention (CDC), serves as a critical mechanism for collecting and analyzing data on foodborne illness outbreaks across the United States. This system gathers detailed information on outbreak locations, the number of affected individuals, specific pathogens involved, and the foods implicated. By categorizing foods using the Interagency Food Safety Analytics Collaboration (IFSAC) scheme, FDOSS enables public health officials to identify patterns and emerging threats in the food supply chain. These data are instrumental in shaping policies and preventive measures aimed at reducing the burden of foodborne illnesses.
FDOSS has evolved significantly since its inception. Initially focused on milk borne outbreaks in the 1920s, it expanded to include all foodborne outbreaks and was later integrated into the National Outbreak Reporting System (NORS) in 2009. Today, it forms part of a broader surveillance network that includes waterborne and animal-contact diseases. Between 2009 and 2015, FDOSS received reports of 5,760 outbreaks resulting in over 100,000 illnesses, with norovirus and Salmonella identified as the most common pathogens. Multistate outbreaks, though only 3% of total outbreaks, accounted for a disproportionate number of severe outcomes, including 54% of deaths.
The system’s ability to pinpoint contamination sources is enhanced through collaboration with advanced laboratory networks like PulseNet and CaliciNet, which provide genetic sequencing data to link cases across jurisdictions. This integration allows for rapid identification of widespread outbreaks, such as those involving Listeria or E. coli, often stemming from contaminated produce, dairy, or poultry. For example, analysis of outbreaks between 2009 and 2015 revealed that chicken, pork, and seeded vegetables were responsible for the most illnesses.
One of FDOSS’s key functions is identifying unexpected contamination sources. For instance, recent outbreaks have been linked to diverse foods such as flour and onions, highlighting evolving risks in the food system. By analyzing contributing factors, categorized as contamination, proliferation, or survival of pathogens, FDOSS helps uncover root causes, such as improper temperature control or cross-contamination during food preparation. This information is vital for developing targeted interventions, such as improved worker health policies and consumer advisories.
Looking ahead, technological advancements like whole-genome sequencing and machine learning are poised to enhance the speed and accuracy of outbreak investigations. These tools, coupled with initiatives like the FDA’s Foodborne Outbreak Response Improvement Plan (FORIP), aim to streamline traceback processes and root cause analyses. Ultimately, FDOSS and its complementary systems provide a foundation for reducing foodborne illnesses through data-driven insights and collaborative public health action.
