International investigation of outbreaks of foodborne disease

In 1992, the United States Institute of Medicine published a report entitled Emerging Infections: Microbial Threats to Health in the United States.1 The report, developed by an expert committee chaired by Drs Joshua Lederberg and Robert Shope, emphasised the fact that the world is truly a global village with respect to microbes. One factor is the change in the food industry. Foods, like many pathogens, are more likely than ever to cross national borders, and a single meal can combine products from many countries. In the United States and many other countries, importing of food from other parts of the world has increased greatly.2 One unintended consequence is that when food becomes contaminated the resulting outbreak can span continents. Indeed, Salmonella agona first spread around the world as a consequence of the use of contaminated Peruvian fish meal in chicken feed.3 More recent foodborne outbreaks of international scope include a multistate outbreak of Cyclospora cayetanenis infection in the United States and Canada related to raspberries imported from Guatemala,4 salmonellosis in the United States and several Scandinavian countries traced to alfalfa sprouts grown from imported seeds,5 6 shigellosis …