(C-042) Active Surveillance of Foodborne Diseases in the United States

Background: Foodborne diseases represent a major source of illness and death in the United States, with diseases caused by Listeria and norovirus representing 2 of the top 5 causes of foodborne disease related deaths. While states and territories report cases of select foodborne diseases for monitoring at the national level, reported cases underestimate the true burden of disease, don’t include all foodborne diseases, and are subject to lags in data availability. 

Objectives: To assess the feasibility and capacity of Truveta to measure, in near real-time, the trends in foodborne disease cases, particularly infections with Shiga toxin-producing E. coli (STEC), Listeria, norovirus, and hepatitis A virus.  

Methods: Truveta is a growing collective of 30 US health systems which includes more than 120 million de-identified patients. This retrospective study identified four cohorts with one of the following foodborne diseases: STEC, listeriosis, norovirus, and hepatitis A. Patients were followed from 1/1/2016-12/31/2024. Resulting trends were compared to the Center for Disease Control and Prevention (CDC) National Notifiable Diseases Surveillance System (NNDSS). 

Results: A total of 48,597 patients were diagnosed with one of four foodborne diseases within the designated time period. The majority of patients were female (53%) and of white race (70%), with a mean age of 47 years (SD = 25.3). Of patients with location data available, 35% were located in the Southern US. Trends in STEC cases show increases in 2018 and a steady increase in cases from 2020 to 2024. Trends in listeriosis cases have some variability year over year but overall show an increase in cases from 2016 to 2024. Trends in norovirus cases show an increase in 2019 and a steady increase in cases from 2022 to 2024, in line with the recent increase in nationally reported norovirus outbreaks. Hepatitis A cases show a peak in 2019, consistent with a national outbreak. All of these trends are consistent with those seen in CDC’s available NNDSS data. 

Conclusions: The findings indicate that Truveta Data are comparable to the CDC NNDSS reports, as illustrated by four foodborne diseases. Truveta has the potential to support near real-time active safety surveillance studies.