**This article was written by NALC Research Fellow Jeramy Ashton, a third-year law student at the University of Arkansas at Little Rock, William H. Bowen School of Law.

Recently, the Food and Drug Administration (FDA) and the Center for Disease Control and Prevention (CDC), announced a team effort to reduce the occurrence of foodborne illness risk factors in retail and foodservice establishments. FDA released a memorandum of understanding (MOU) outlining the agreement between the two federal agencies. The MOU directs to agencies to work together on aiding state, tribal, local, and territorial (STLT) governments in creating consistent programs that will promote a culture of food safety and reduce foodborne illness risk factors in retail and foodservice establishments.

A Primer on Foodborne Illness Outbreaks:

A foodborne related outbreak is established when two or more people get the same illness from the same contaminated food or drink. The government estimates there are about 48 million cases of foodborne related illness annually. Foodborne related illness results in an estimated 3,000 deaths per year. FDA is responsible for investigating outbreaks. FDA also maintains a list of outbreaks and investigations of foodborne illness to inform the public of active investigations. FDA also maintains a list of closed investigations to provide information on recalls and other investigations. In addition to FDA’s foodborne illness investigations, each week CDC coordinates approximately 17 to 36 foodborne related illness investigations, some of which span multiple states. At a local level, potential outbreaks are reported to the local or state health department. The local departments maintain records as well as report certain conditions to CDC.

Background:

Under the Food, Drug, and Cosmetic Act, FDA is directed to promote and protect public health by assuring the safety and security of drugs, foods, and cosmetics. Similarly, CDC works with partners throughout the nation to monitor and investigate health issues such as illnesses and outbreaks while conducting research to enhance preventive efforts in the field of health. FDA and CDC are not strangers to collaborative efforts. These agencies have worked together to create and update the Food Code which provides model uniform food safety and inspection standards. Over 90% of U.S. jurisdictions have adopted the U.S. Food Code and its scientifically proven food principles.

Individually, FDA investigates existing foodborne related outbreaks. Additionally, FDA works with CDC, and state and local public health and agriculture departments to stop the spread of outbreaks. CDC, on the other hand, collects information and creates surveillance systems to monitor, detect, and prevent outbreaks. CDC relies on state and local health agencies to track foodborne, waterborne, and animal contact diseases reported in the United States. CDC performs research and risk assessments to identify the link between reported illnesses and food in stores and homes. After identifying the source of illness, CDC will then respond by issuing outbreak notices. FDA uses CDC’s findings and its own investigations to issue appropriate training and protocol for future prevention of foodborne illness outbreaks. Therefore, FDA’s general focus is on preventing the spread of ongoing outbreaks, while CDC’s role is to monitor and collect data to identify whether there is a foodborne illness outbreak.

However, FDA and CDC can only become aware of and prevent the spread of a foodborne illness outbreak after enough people report having a foodborne illness. Symptoms from foodborne illnesses vary, but generally include diarrhea, vomiting, stomach pain, and dehydration. Suffers of foodborne illnesses commonly identify not knowing the cause, who to contact, and being too ill as reasons for not reporting foodborne illness.

Local medical providers and health departments assist FDA and CDC with the information necessary to identify and prevent further spread of foodborne illness outbreaks. Additionally, more than 3,000 state, local, and tribal agencies regulate the retail food and foodservice industries in the Unites States. As a result, FDA and CDC are aiming to collaborate on prevention efforts that are uniform and consistent to help better address foodborne illness outbreaks in the United States.

Goals and Objectives of Partnership:

The ultimate goal of the MOU is to reduce foodborne illness and “achieve a vision of a national integrated food safety system.” FDA and CDC have three primary goals related to reducing the occurrence of foodborne illness risk factors. These three goals are:

• Increase uniformity, consistency, and capacity of STLT retail food protection programs.
• Promote industry’s active managerial control of foodborne illness risk factors and promote a culture of food safety.
• Maintain a strong FDA National Retail Food Team and CDC National Center for Environmental Health workforce to assist STLT partners.

To achieve these goals, the MOU outlines four objectives. The first objective is to assist STLTs to improve their effectiveness in conducting inspections and investigations. Second, CDC and FDA aim to promote a food safety culture in retail and foodservice establishments with a particular focus on those facilities that serve highly susceptible populations such as correctional facilities, schools, and healthcare facilities. The third objective is to improve research that will help prevent foodborne illness outbreaks. Lastly, FDA and CDC will improve the knowledge skills, and abilities of their teams.

The partnership allows for increased knowledge and communication to prevent foodborne illness outbreaks. For example, CDC will collect information about the current ways food is prepared, stored, and transferred to other locations. The findings of CDC will help FDA to identify specific patterns and respond with high-quality training and relevant policies.

FDA and CDC already have ongoing projects which this MOU will guide. An example of a current project is using statistics to estimate what may or may not be the actual food source causes along the farm-to-table supply chain. The findings from projects like this help experts determine whether researchers were correct in their initial prediction of what they believed caused the foodborne illness. After compiling the results of how often initial predictions were the actual cause of the illness, data is then used with knowledge from other agencies to enhance proper education and training programs. The new findings will not only include accurate results but provide valuable training for everyone involved in the food service industry. Training will focus on educating farmers in the initial growing and fertilizing process, to small diners, and to large food chains.

Although the MOU does not represent final agency action, and therefore does not have the force of law, such a partnership will create opportunities for the collection of data and opportunities for improvement of foodborne illness risk factor reduction.

Conclusion:

The MOU has the potential to boost research efforts of CDC and regulatory action of FDA to modernize the retail food system. The use of individual strengths and calling on other experts in the field has the potential to aid the agencies in better identifying potential causes of foodborne illness. The MOU may help the agencies focus on reducing foodborne illness with real-world practical and statistical data from a wider area and create uniform training programs aimed at preventing future outbreaks. The MOU also has the potential to improve the training foodservice workers receive, which in turn can reduce foodservice establishments’ food safety liability.

To read the MOU, click here.

To read FDA’s constituent update announcing the MOU, click here.

For more information on food safety, read NALC’s food safety reading room here.