Is there an increase in multistate foodborne disease outbreaks—United States, 1973–2010?

Food Safety Talk podcast nerds Chapman and Schaffner are forever going on about Betteridge’s Law.

For the uninitiated, Betteridge’s Law states that “any headline that ends in a question mark can be answered by the word no.”

interstate-mdBetteridge himself stated, “The reason why journalists use that style of headline is that they know the story is probably bullshit, and don’t actually have the sources and facts to back it up, but still want to run it.”

I use question marks in headlines to avoid lawsuits.

A new paper posits that changes in food production and distribution have increased opportunities for foods contaminated early in the supply chain to be distributed widely, increasing the possibility of multistate outbreaks.

In recent decades, surveillance systems for foodborne disease have been improved, allowing officials to more effectively identify related cases and to trace and identify an outbreak’s source.

Materials and Methods: We reviewed multistate foodborne disease outbreaks reported to the Centers for Disease Control and Prevention’s Foodborne Disease Outbreak Surveillance System during 1973–2010. We calculated the percentage of multistate foodborne disease outbreaks relative to all foodborne disease outbreaks and described characteristics of multistate outbreaks, including the etiologic agents and implicated foods.

Results: Multistate outbreaks accounted for 234 (0.8%) of 27,755 foodborne disease outbreaks, 24,003 (3%) of 700,600 outbreak-associated illnesses, 2839 (10%) of 29,756 outbreak-associated hospitalizations, and 99 (16%) of 628 outbreak-associated deaths. The median annual number of multistate outbreaks increased from 2.5 during 1973–1980 to 13.5 during 2001–2010; the number of multistate outbreak-associated illnesses, hospitalizations, and deaths also increased. Most multistate outbreaks were caused by Salmonella (47%) and Shiga toxin–producing Escherichia coli (26%). Foods most commonly implicated were beef (22%), fruits (13%), and leafy vegetables (13%).

Conclusions: The number of identified and reported multistate foodborne disease outbreaks has increased. Improvements in detection, investigation, and reporting of foodborne disease outbreaks help explain the increasing number of reported multistate outbreaks and the increasing percentage of outbreaks that were multistate. Knowing the etiologic agents and foods responsible for multistate outbreaks can help to identify sources of food contamination so that the safety of the food supply can be improved.

 Increase in multistate foodborne disease outbreaks—United States, 1973–2010

Foodborne Pathogens and Disease, August 18, 2015, doi:10.1089/fpd.2014.1908

Nguyen Von D., Bennett Sarah D., Mungai Elisabeth, Gieraltowski Laura, Hise Kelley, and Gould L. Hannah

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A former professor of food safety and the publisher of, Powell is passionate about food, has five daughters, and is an OK goaltender in pickup hockey. Download Doug’s CV here. Dr. Douglas Powell editor, retired professor, food safety 3/289 Annerley Rd Annerley, Queensland 4103 61478222221 I am based in Brisbane, Australia, 15 hours ahead of Eastern Standard Time