Role of Attribution in Global Food Surveillance

National Center for Food Safety and Technology, Illinois Institute of Technology

Summary

The safety of the food supply has emerged as an important and complex global public health, social, and political issue. Although accurate statistics on the scope of foodborne illness are lacking, the World Health Organization (WHO) estimates that millions of individuals die each year from diarrheal diseases, many from contaminated food and water. Moreover, the economic cost of foodborne illness in the U.S. alone could be as much as $152 billion (U.S.) per year.

Surveillance is vital to providing accurate information on the impact of foodborne illness. Accurate and timely surveillance is needed to limit the scope of outbreaks, identify recognized and emerging sources of foodborne pathogens, and provide critical data for robust risk assessments. In addition, accurate surveillance statistics form the basis for developing and implementing mitigation strategies and directing appropriate national and international food safety policies. However, the current surveillance system in those countries that have them possesses only limited capability and capacity to provide the type and amount of data that stakeholders would need to implement a public health-targeted food safety policy.

Currently available surveillance statistics are valuable in terms of identifying and quantifying causality and developing public health goals for implicated microorganisms but lack the specificity required to make meaningful decisions needed to improve food safety. To do so, surveillance must be able to identify the food in which the organism was present and the geographical region from which the food or food ingredient originated. The term attribution is typically used by public health experts to describe the ability of a surveillance system to link cases of foodborne illness to a specific food or ingredient.

An ideal surveillance system would have to be national or international in scope, but would also require participation at the local and state/provincial level. Although attribution requires considerably more human resources than does conventional surveillance, advances in trace-back technologies, molecular typing and epidemiology, mathematical modeling of epidemic patterns, and advance computing and database management could be employed in the future to minimize the need for personnel while speeding up data collection and analysis.