A recent report from the Centers for Disease Control and Prevention reveals that the incidence of eight domestically acquired infections commonly transmitted through food either increased or remained stable in 2023 compared to the 2016-2018 baseline. This news highlights the challenges in meeting federal disease reduction goals set by the Healthy People 2030 (HP2030) initiative.

The preliminary 2023 data from the Foodborne Diseases Active Surveillance Network (FoodNet) indicates that despite ongoing public health efforts, infections such as campylobacteriosis, Shiga toxin-producing Escherichia coli (STEC) infection, yersiniosis, vibriosis, and cyclosporiasis saw an increase. In contrast, incidences of listeriosis, salmonellosis and shigellosis remained stable.

Rising infections and diagnostic changes
A significant factor contributing to the reported rise in foodborne infections is the increased use of culture-independent diagnostic tests (CIDTs). These tests, which allow for quicker and more efficient diagnosis of infections, have become more prevalent in recent years. While CIDTs have improved the speed of clinical diagnosis and treatment, they also present challenges for public health surveillance.

CIDTs work by detecting the presence of a gene or antigen associated with a specific pathogen. CIDTs can be conducted more rapidly and yield results far sooner than traditional culture-based methods.

According to the CDC, the percentage of infections diagnosed by CIDTs continued to rise in 2023. This trend affects the observed incidence rates, as CIDTs can identify infections that might have gone undetected previously, leading to an apparent increase in reported cases. 

Implications for public health
According to the report, these findings emphasize the need for continued surveillance to monitor the impact of changing diagnostic practices on disease trends. Additionally, there is a call for targeted prevention efforts to reduce the incidence of foodborne diseases. Despite the apparent lack of progress towards HP2030 goals, the CDC emphasizes that the increase in reported cases may not necessarily indicate a true rise in infections but rather an artifact of improved detection methods.

In 2023, FoodNet expanded its catchment area for the first time since 2004, improving the representativeness of its data. This expansion is expected to enhance the network’s ability to monitor trends in disease incidence and generalize findings to the broader U.S. population.

Looking forward
The findings from the CDC report underscore the complexities in tracking and reducing foodborne illnesses in the United States. As diagnostic technologies evolve, so too must the strategies for monitoring and combating these infections.

The CDC’s ongoing surveillance and expanded FoodNet catchment area are critical steps toward understanding and addressing the dynamics of foodborne diseases in the U.S., ensuring that efforts are aligned with the evolving landscape of diagnostic practices and public health needs.

Read the full report here.