Monitoring Trends in Foodborne Disease Using U.S. Poison Center Data: 2000–2011

Introduction: Surveillance of foodborne disease (FBD) is a critical part of the food safety system and provides important information that is used to detect outbreaks, monitor trends, quantify disease burden, identify food safety hazards and potential interventions, and set public health priorities. Consumer complaint data have become increasingly useful for FBD surveillance and detection of outbreaks. Despite potential benefits, few studies have evaluated the effectiveness of syndromic surveillance for FBD.

Purpose: A retrospective analysis of self-identified FBD exposures reported to U.S. Poison Centers between 2000 and 2011 was undertaken to explore the use of National Poison Data System (NPDS) as an early detection surveillance system for FBD. 

Methods: Descriptive statistics were used to characterize NPDS self-reported FBD exposures, including gender, age, caller location, product implicated, exposure reason, exposure site, exposure duration, clinical effects, duration of clinical effects, and medical outcome, and analyze trends in case prevalence over time. CDC’s Early Aberration Reporting System was used to identify anomalies in daily case prevalence. The number of anomalies in case prevalence identified within 14 days before or after outbreaks and recalls were tabulated.

Results: There were 433,788 unique, self-reported cases of suspected FBD from 2001-2011. Overall, there was a decreasing trend in case prevalence. Only about half of cases reported common gastrointestinal symptoms. Eight anomaly-events in case prevalence occurred within 14 days before or after national outbreaks or recalls; seven of these occurred after a specific outbreak or recall. 

Significance: These data suggest that NPDS is a potential source of complaint data that could be used to monitor FBD. Several limitations, including questionable reliability of self-reported FBD cases, affect the utility of NPDS data. However, improved data collection and coordination with public health agencies may improve the ability to use NPDS data to monitor FBD, identify potential outbreaks, and improve situational awareness.