FoodNet, Disease Surveillance, and the Future of Public Health
- Channy Chan
- 8 minutes ago
- 4 min read
In 1995 the Centers for Disease Control and Prevention (CDC) established the Foodborne Diseases Active Surveillance Network (FoodNet), a partnership between several government agencies and healthcare sites in 10 different states to report these illnesses to the local health departments as they occur. Specifically, eight specific bacterial pathogens which cause significant burden of disease were selected for required reporting to state health departments. For the last 30 years, FoodNet has been important in tracking and discovering trends in foodborne illness, such as the 2015 E. coli outbreak in the United States which uncovered several cases of the illness tied to locations of the fast food chain, Chipotle, in Oregon and Washington state.
As of July of 2025 only two pathogens, Salmonella and Shiga toxin producing E. coli (STEC), are now required to be reported to local health departments while the other six are optional. Other CDC programs exist which track and investigate larger foodborne illness outbreaks as they occur, but there are worries that the cuts to FoodNet may send a message that disease surveillance is not worth the time or resources.
What exactly is disease surveillance?
In a nutshell, disease surveillance is the collection of disease data which is used to uncover trends, identify vulnerable populations, and inform public health measures to prevent new disease. There are three major forms of surveillance: passive, active, and sentinel. Passive surveillance relies solely on healthcare systems to voluntarily report data of incidence, or new cases of a disease, to health departments. Active surveillance is a form of proactive tracking where health departments will actively seek out data on incidences of disease from healthcare sites. Sentinel surveillance is a form of active surveillance which is a collaborative network between health authorities and healthcare systems to provide current information on specific diseases. All types of surveillance are valuable public health tools, but the data gathered from active and sentinel programs are usually more complete and timely compared to passive surveillance.
How does FoodNet work?
FoodNet is a sentinel surveillance program, with data and new cases of foodborne illness proactively sought out from a network of healthcare sites as they occur. The process starts with the person getting sick and seeking care, which includes submitting a stool sample at the hospital or clinic, which is tested for various pathogens. If the sample tests positive for a reportable foodborne pathogen, then it is reported to the local health department which confirms results; the health department's own laboratory may also perform additional testing. Afterwards, the person will be contacted by the health department to go through a standardized questionnaire which asks about specifics of their illness (i.e. when did they start feeling sick, severity and duration of symptoms) and any foods they may have eaten in a specific time period, typically a week or so, before they started experiencing their symptoms. Participation is voluntary, but the information gathered from the questionnaire can be very valuable.
Does it really matter if we track these diseases or not?
Realistically, there is a high level of difficulty to eliminate all diseases, although this remains a lofty goal in the world of public health. Perhaps the most important objective of public health is disease prevention through education. In order to educate a larger population, programs like FoodNet are essential in gathering and distilling all of the useful information regarding diseases that the general public can use to make safer choices and to reduce the number of new cases of illness.
Take the human immunodeficiency virus (HIV) for example. Since 1981, the CDC has tracked cases of HIV through the National HIV Surveillance System (NHSS). The prevalence, or total amount of people who have a disease, of HIV has remained high due to advances in medicine which has increased the lifespan of these patients, but the incidence of HIV has decreased dramatically since 2010 due to the efforts of data collection and education of public health institutions.
Disease surveillance is also beneficial to global health. The World Health Organization (WHO) estimates that somewhere around 200 different illnesses are caused by foods tainted with bacteria, viruses, parasites, and other environmental contaminants. In most people, these illnesses will cause a few days of gastrointestinal symptoms like nausea, vomiting, and diarrhea; mostly, an inconvenient experience. However, for vulnerable populations like children, the elderly, or those who are immunocompromised, foodborne illnesses can become serious enough to affect other body systems such as the brain and kidneys, and can even result in death. Regular surveillance can improve the quality of education, which in turn can give people the knowledge to prevent illness all on their own.
Conclusion
While FoodNet was not the first surveillance program, the robustness of its requirements and collaboration between state and federal agencies has cemented FoodNet as a pioneer in foodborne illness reporting and disease surveillance in general. The recent cuts to the program signals a turning point in the focus of public health. Public health programs like FoodNet can be costly, but the possible poor health outcomes that can arise from foodborne illnesses can have significant impacts on the community.
References:
The Centers for Disease Control and Prevention
Foodborne Diseases Active Surveillance Network, Timeline, https://www.cdc.gov/foodnet/about/timeline.html
2015 E. coli Outbreak Linked to Chipotle Mexican Grill Restaurants https://archive.cdc.gov/www_cdc_gov/ecoli/2015/o26-11-15/index.html
Foodborne Diseases Active Surveillance Network, About FoodNet https://www.cdc.gov/foodnet/about/index.html
HIV.gov - U.S. Statistics, https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics
World Health Organization - Foodborne diseases, https://www.who.int/health-topics/foodborne-diseases#tab=tab_1
Assessed and Endorsed by the MedReport Medical Review Board