CSPI Grades States on How They Handle Foodborne Illness

A report card grading the 50 states and the District of Columbia on how well they detect, investigate and report outbreaks of foodborne illness finds great variability -- suggesting that many states may only be reporting a small fraction of the number of outbreaks as states with better detection and reporting systems.

Using 10 years of data from the Centers for Disease Control and Prevention, as well as its own Outbreak Alert! database, Washington, D.C.-based watchdog group Center for Science in the Public Interest (CSPI) assigned a letter grade and created an outbreak profile for each state.

CSPI said it used Oregon and Minnesota as benchmarks, as those states are widely recognized for having strong investigating and reporting systems. They report nine and eight outbreaks per million people per year, respectively.

Oregon and Minnesota, as well as five states that reported equally high reporting rates for outbreaks, received A's: Florida, Hawaii, Maryland, Washington, and Wyoming.

In contrast, 14 states reported only one outbreak of foodborne illness per million people: Arizona, Arkansas, Indiana, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, Nevada, New Mexico, Oklahoma, South Carolina, Texas, and West Virginia.

"States that aggressively investigate outbreaks and report them to CDC can help nail down the foods that are responsible for making people sick," said CSPI food safety director Caroline Smith DeWaal. "But when states aren't detecting outbreaks, interviewing victims, identifying suspect food sources, or connecting with federal officials, outbreaks can grow larger and more frequent, putting more people at risk."

In its report, All Over the Map, CSPI acknowledges that it may seem counter-intuitive to give higher grades to states with more outbreaks. But, in fact, those states are the most likely to have robust detection and reporting systems, according to the group. The report card suggests that states that received D's or F's may lack adequate funding for public health services, leading to health departments that are understaffed and overburdened.

CSPI also identified that the percentage of solved outbreaks -- those with both an identified food and an identified pathogen -- has declined over the 10-year period, from 1998 through 2007. The peak reporting year was 2001 when 44 percent of outbreaks reported to CDC were solved; the lowest year, when only 34 percent were reported, was 2007.

Colorado, Illinois, Kansas, Maine, Michigan, Ohio, and Vermont received B's, with each state reporting six or seven outbreaks per million people.

Alabama, Alaska, California, Connecticut, Iowa, New Hampshire, North Dakota, and Wisconsin received C's, with each state reporting four or five outbreaks per million people.

Delaware, the District of Columbia, Georgia, Idaho, Massachusetts, Montana, New Jersey, New York, North Carolina, Pennsylvania, Rhode Island, South Dakota, Tennessee, Utah, and Virginia received D's. Those states and D.C. each only reported two or three outbreaks per million people.