FoodNet is a collaborative project of the CDC, ten EIP sites, the U.S. Department of Agriculture (USDA), and the Food and Drug Administration (FDA). The CEIP’s FoodNet project works in close partnership with local and state health departments to implement active surveillance and epidemiologic studies designed to help public health officials better understand the epidemiology of foodborne diseases in the United States. The 10 FoodNet sites nationwide serve as a network for responding to new and emerging foodborne diseases of national importance. Additionally, the main objectives of FoodNet are:

· Determine the burden of foodborne illness in the United States
· Monitor trends in the burden of specific foodborne illness over time
· Attribute the burden of foodborne illness to specific foods and settings
· Develop and assess interventions to reduce the burden of foodborne illness

For an overview of the FoodNet project click here.

Current FoodNet Projects (For completed and archived projects, click here)
· Active surveillance for selected foodborne pathogens
· Enhanced foodborne outbreak response and reporting
· Population survey
· Cohort study of clinical outcomes in multi-drug resistant non-Typhi Salmonella serotypes
· Cohort study of Escherichia coli O157:H7 infection: Antibiotic exposure and the risk of hemolytic
  uremic syndrome
· Case-control study of Salmonella Javiana, Salmonella Infantis, and Salmonella I 4,[5],12:i:-
  infection.

Active Surveillance
The core activity of the CEIP’s FoodNet project is laboratory-based active surveillance at over 30 clinical and reference laboratories that test stool samples in the catchment area, which consists of Alameda, Contra Costa, and San Francisco counties. FoodNet investigators identify and collect information on all laboratory-confirmed cases of selected foodborne illnesses at least once a month from laboratories in the catchment area. FoodNet active surveillance supplements the work of local health departments that rely on passive reporting by health care providers and laboratorians. Pathogens under surveillance include Salmonella, Shigella, Campylobacter, Escherichia coli O157, Shiga toxin-producing E. coli (STEC) non-O157, Listeria monocytogenes, Yersinia, Vibrio, Cryptosporidium, and Cyclospora infection among residents of the catchment area. In addition to laboratory surveillance, FoodNet conducts active surveillance of pediatric hemolytic uremic syndrome (HUS) through a network of nephrologists in the catchment area. Data are transmitted electronically to CDC and combined with data from other EIP FoodNet sites for analysis.
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Summary of 2007 FoodNet data in CDC’s Morbidity and Mortality Weekly Report (PDF)

Questions and Answers Related to the 2007 FoodNet MMWR

Enhanced Foodborne Outbreak Response and Reporting
FoodNet works with communicable disease and environmental health officials from Alameda County, the City of Berkeley, Contra Costa County, and San Francisco County to enhance the detection, investigation and reporting of foodborne outbreaks in their jurisdictions. Efforts in this area include assistance with outbreak investigation fieldwork, data analysis, and assistance with reporting of all outbreaks to CDC via the Foodborne Outbreak Reporting System (EFORS). The FoodNet Senior Epidemiologist also provides on-the-job-training to local health department staff during investigations to improve the capacity of local health departments to respond to outbreaks. In addition to working with public health officials, FoodNet invites participation from students from the University of California, Berkeley, School of Public Health in an effort to enhance their training and education.
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Population Survey
The FoodNet Population Survey is a telephone survey of the general population of the CEIP FoodNet catchment area that examines the incidence and impact of diarrheal disease along with environmental and food exposures. The survey also contains a set of questions to be administered specifically to residents of the CA FoodNet catchment area. These questions address knowledge, attitudes and practices with regard to undercooked ground beef consumption among children and handwashing after visiting petting zoos or fair areas where animals are housed. These data will facilitate improved prevention strategies. The CDC has contracted with Clearwater Research, Inc. to implement the survey, and enrollment began in May, 2006.
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For a report of a previous cycle of the Population Survey, see Atlas of Exposures, 2002

Cohort Study of Clinical Outcomes in Multi-Drug Resistant non-Typhi Salmonella Serotypes
On January 1, 2006, the CEIP launched a multi-site, prospective cohort study to investigate the impact of infection with non-Typhi Multi-Drug Resistant (MDR) Salmonella on clinical outcome. The study’s primary objective is to determine and compare the clinical outcomes observed among cases with non-Typhi MDR Salmonella infection to those of cases with pansusceptible non-Typhi Salmonella. In addition, the study looks for variations of clinical outcomes among subgroups with reference to age, sex, and immune status. The study is carried out by (i) identifying every 10th lab-confirmed non-Typhi Salmonella case from the surveillance area, (ii) interviewing them, and (iii) if hospitalized, extracting information about clinical course from their medical records. Salmonella study isolates were forwarded from the California Department of Public Health Microbial Diseases Laboratory (MDL) to the CDC’s National Antimicrobial Resistance Monitoring Surveillance (NARMS) laboratory for antimicrobial susceptibility testing and other microbial characterization tests.
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Cohort Study of Escherichia coli O157:H7 Infection: Antibiotic Exposure and the Risk of Hemolytic Uremic Syndrome
On March 2006, the CEIP FoodNet launched a three-year study to explore the important public health question on whether antibiotic treatment for E. coli O157 increases the risk for development of hemolytic uremic syndrome (HUS). Previous epidemiologic studies on this topic were unable to establish definitive conclusions due to limitations on study design and sample size. FoodNet is in a unique position to conduct a population-based cohort study with a large enough sample size of persons with laboratory-confirmed E. coli O157 to provide a more robust estimate of the association between antibiotic exposure and HUS. The study involves enrolling laboratory-confirmed E. coli O157 cases ascertained through routine active surveillance. Eligible study participants are interviewed by CEIP staff using a standardized questionnaire.
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Case-control study of Salmonella Javiana, Salmonella Infantis, and Salmonella I 4,[5],12:i:- infections
The CEIP is conducting a case-control study to identify risk factors for infection by selected Salmonella serotypes, including S. Javiana, S. Infantis and S. I 4,[5],12:i:-. S. Javiana and S. I 4,[5],12:i:- are emerging serotypes that had increased by 167% and 425%, respectively, in 2004 compared to baseline surveillance data from 1996–1998 in FoodNet. In addition, S. Infantis and S. I 4,[5],12:i:- have been shown to cause multi-drug resistant infection. Risk factors for infection with these serotypes have not been well described. The study will involve interview of cases and controls as well as the collection of isolates for PFGE analysis and antimicrobial susceptibility profiling.
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For more details on FoodNet projects, please visit the CDC FoodNet website:
http://www.cdc.gov/foodnet/index.htm

FoodNet Facts and Figures
http://www.cdc.gov/foodnet/factsandfigures.htm

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