Foodborne Disease Outbreaks in United States Schools
Foodborne Disease Outbreaks in United States Schools
Background: The objective of this study was to describe the epidemiology of foodborne disease outbreaks in schools and to identify where preventive measures could be targeted.
Methods: Reports by state and local health departments of foodborne disease outbreaks occurring in primary and secondary schools, colleges and universities from January 1, 1973, through December 31, 1997, were reviewed. Data from ill persons identified through foodborne outbreak investigations and subsequently reported to the Centers for Disease Control and Prevention in the Foodborne Outbreak Surveillance System were examined. The number and size of foodborne disease outbreaks, as well as the etiologic agents, food vehicles of transmission, site of food preparation and contributing factors associated with outbreaks were also examined.
Results: From 1973 through 1997, states and local health departments reported 604 outbreaks of foodborne disease in schools. The median number of school outbreaks annually was 25 (range, 9 to 44). In 60% of the outbreaks an etiology was not determined, and in 45% a specific food vehicle of transmission was not determined. Salmonella was the most commonly identified pathogen, accounting for 36% of outbreak reports with a known etiology. Specific food vehicles of transmission were epidemiologically identified in 333 (55%) of the 604 outbreaks. The most commonly implicated vehicles were foods containing poultry (18.6%), salads (6.0%), Mexican-style food (6.0%), beef (5.7%) and dairy products excluding ice cream (5.0%). The most commonly reported food preparation practices that contributed to these school-related outbreaks were improper food storage and holding temperatures and food contaminated by a food handler.
Conclusions: Strengthening food safety measures in schools would better protect students and school staff from outbreaks of foodborne illness. Infection control policies, such as training and certification of food handlers in the proper storage and cooking of foods, meticulous hand washing and paid sick leave for food handlers with gastroenteritis, could make meals safer for American students.
Each weekday millions of American students eat meals prepared and served at school. In fiscal year 2000 >27.4 million children each day got their lunch through the National School Lunch Program. Although numerous foodborne disease outbreaks in schools have been reported, the extent of these outbreaks has not been systematically described. To better define the epidemiology of these outbreaks and thus identify areas where prevention might be improved, we reviewed data on outbreaks of foodborne disease in schools reported to the CDC from 1973 through 1997. A summary of foodborne disease outbreaks was published for years 1993 through 1997. The present report summarizes data for foodborne disease outbreaks in schools reported to CDC from 1973 through 1997 and describes trends in pathogens and food vehicles that emerged during the 25-year period.
Background: The objective of this study was to describe the epidemiology of foodborne disease outbreaks in schools and to identify where preventive measures could be targeted.
Methods: Reports by state and local health departments of foodborne disease outbreaks occurring in primary and secondary schools, colleges and universities from January 1, 1973, through December 31, 1997, were reviewed. Data from ill persons identified through foodborne outbreak investigations and subsequently reported to the Centers for Disease Control and Prevention in the Foodborne Outbreak Surveillance System were examined. The number and size of foodborne disease outbreaks, as well as the etiologic agents, food vehicles of transmission, site of food preparation and contributing factors associated with outbreaks were also examined.
Results: From 1973 through 1997, states and local health departments reported 604 outbreaks of foodborne disease in schools. The median number of school outbreaks annually was 25 (range, 9 to 44). In 60% of the outbreaks an etiology was not determined, and in 45% a specific food vehicle of transmission was not determined. Salmonella was the most commonly identified pathogen, accounting for 36% of outbreak reports with a known etiology. Specific food vehicles of transmission were epidemiologically identified in 333 (55%) of the 604 outbreaks. The most commonly implicated vehicles were foods containing poultry (18.6%), salads (6.0%), Mexican-style food (6.0%), beef (5.7%) and dairy products excluding ice cream (5.0%). The most commonly reported food preparation practices that contributed to these school-related outbreaks were improper food storage and holding temperatures and food contaminated by a food handler.
Conclusions: Strengthening food safety measures in schools would better protect students and school staff from outbreaks of foodborne illness. Infection control policies, such as training and certification of food handlers in the proper storage and cooking of foods, meticulous hand washing and paid sick leave for food handlers with gastroenteritis, could make meals safer for American students.
Each weekday millions of American students eat meals prepared and served at school. In fiscal year 2000 >27.4 million children each day got their lunch through the National School Lunch Program. Although numerous foodborne disease outbreaks in schools have been reported, the extent of these outbreaks has not been systematically described. To better define the epidemiology of these outbreaks and thus identify areas where prevention might be improved, we reviewed data on outbreaks of foodborne disease in schools reported to the CDC from 1973 through 1997. A summary of foodborne disease outbreaks was published for years 1993 through 1997. The present report summarizes data for foodborne disease outbreaks in schools reported to CDC from 1973 through 1997 and describes trends in pathogens and food vehicles that emerged during the 25-year period.
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