use of the CDC outbreak data for purposes of food-attribution modeling may provide further incentives to state and local jurisdictions to report outbreaks accurately and quickly for use by CDC.
If FSIS continues to include attribution as a component in its PHRBIS, FSIS staff should work collaboratively with FoodNet and PulseNet staff to use sporadic-case and outbreak data in conjunction with subtype data more effectively to facilitate estimation of population-based attribution of sporadic cases to specific agents.
Recognizing that food-attribution data are of interest to many agencies, FSIS should work collaboratively with CDC, FDA, and other federal and state agencies to develop a common set of definitions for microbial foodborne-disease attribution; a coordinated approach to improve the quality and consistency of data used among agencies in determining food-attribution estimates; a process that allows for regular updating of attribution estimates; and a standardized coding scheme for food vehicles, including multi-component foods.
FSIS should continue to collaborate with CDC and other appropriate organizations in the serotyping and molecular subtyping of all Salmonella isolates, with emphasis on those obtained from specific food products. To the extent feasible, subtype data should also be collected for isolates from environmental samples and other sources of human exposure to Salmonella (for example, reptiles and pets). Recognizing that Salmonella serotyping and molecular subtyping will not only be critical for improved subtype-based attribution efforts, but will also enhance the agency’s ability to monitor pathogen trends (for example, emergence of new subtypes), FSIS should try to include serotyping and/or molecular subtyping in all of its future baseline studies. As part of these efforts, FSIS should establish and support collaborative arrangements with FDA to assure that Salmonella isolates obtained by USDA or FDA are characterized using the same molecular subtyping approaches and that results are available in a comprehensive database with harmonized nomenclature of human, animal, food, and environmental Salmonella isolates. In the future, it may be appropriate to expand such studies to other pathogens.
FSIS should continue to support the collection of serotype and molecular subtype data for Salmonella and perhaps other relevant pathogens, and the development of mathematical models that use these serotype and subtype data for understanding food (and source) attribution of human Salmonella infections. These efforts need to include research on developing new models, evaluating and validating existing models, and developing better quality data to populate the models.