CDC Scale-Back of FoodNet Raises Concerns for Pharmacists on Identifying Foodborne Illnesses

Pharmacists across the US raise alarms over changes in how the CDC tracks foodborne illnesses, saying future outbreaks could go untracked and unreported to media and the public.

Foodborne illness remains a major public health concern in the US, sickening an estimated 48 million individuals, hospitalizing 128,000, and causing 3,000 deaths annually.¹ Pharmacists, often the first health care professionals consulted when patients present with nonspecific gastrointestinal (GI) complaints, play a key role in recognizing when symptoms may signal something more than a mild stomach upset. Recent modifications in the CDC Foodborne Diseases Active Surveillance Network (FoodNet) could complicate that task.

What is FoodNet?

The CDC established FoodNet after a deadly E. coli outbreak that was traced to undercooked hamburgers at Jack in the Box in 1995. Its purpose FoodNet is to actively monitor the occurrence of foodborne pathogens across 10 states in coordination with the CDC, FDA, and USDA.² In contrast to passive surveillance systems that rely on laboratory reporting, FoodNet had more than 700 labs working hand in hand to proactively identify cases of illness caused by pathogens such as salmonella, listeria, vibrio, shigella, campylobacter, and yersinia.³

Through this active model, FoodNet became 1 of the main pillars to rapidly pinpoint the sources of outbreaks. For instance, the surveillance of FoodNet uncovered associations between cantaloupe and listeria in 2007, which was a discovery that contributed later to determining the source of a lethal outbreak.⁴

As of summer 2025, FoodNet is limiting its scope to salmonella and shiga toxin-producing E. coli (STEC) only. These 2 groups of pathogens are the leading causes of hospitalizations and deaths resulting from foodborne illnesses. The non-monitored pathogens such as listeria, vibrio, shigella, campylobacter, yersinia, and cyclospora, which are a few of the etiologies of infectious diseases, continue to be of clinical significance. Data from Foodnet in 2022 revealed that campylobacter and listeria were the causes of more than 70 deaths.⁵

According to Elaine Scallan Walter, PhD, professor of epidemiology at the Colorado School of Public Health, “We’re really gutting one of the cornerstones of food safety”.⁶ Without active surveillance of these pathogens, subtle early trends may go unnoticed, delaying recognition of outbreaks.

Implications for Pharmacists

Pharmacists should remain vigilant when encountering patients with GI complaints such as persistent diarrhea, abdominal pain, fever, or signs of dehydration. While many patients self-treat with over-the-counter antidiarrheal products, pharmacists should be prepared to ask additional question:

• Dietary history: Has the patient consumed raw seafood, unpasteurized dairy, undercooked meat, or recently recalled produce? vibrio infections, for instance, are strongly linked to raw oyster consumption.³
• Travel exposure: Certain pathogens, such as cyclospora, are often linked to imported fresh produce or international travel.⁷
• Vulnerable populations: Pregnant women, immunocompromised patients, older adults, and young children are at higher risk for complications from pathogens like listeria and STEC.¹

By considering foodborne illness as a possible underlying cause, pharmacists can encourage patients with severe or worsening symptoms to seek immediate medical evaluation. Early recognition may shorten the time to diagnosis and prevent complications.

FoodNet reduction warnings by public health professionals emphasize that consumers and healthcare workers at the front line will have increased tasks. Confidence in the security of the food chain is decreasing according to surveys, with just half of the US population considering themselves “very confident” in its safety compared to ¾ in 2012.⁸ This mistrust may result in the adoption of overcareful food handling habits, but it hardly can compensate for the importance of the national surveillance systems.

Pharmacists are uniquely positioned to fill some of the resulting gaps by helping patients differentiate between self-limiting GI upset and illnesses that may signal something more dangerous. Education around proper food handling, symptom monitoring, and appropriate medical referral becomes even more critical in this environment.

Conclusion

It is not only a change in the FoodNet bureaucracy that the reduction of FoodNet means, but it also transforms the way new foodborne threats are identified and managed. It is essential for pharmacists to know that such changes in the FoodNet system mean that they have to be more vigilant when assessing the symptoms of their patients. Pharmacists can play a key role in disease prevention by careful symptom assessment, providing relevant food safety information, and recognizing the appropriate time for referral.

REFERENCES

1. CDC. Estimates: Burden of Foodborne Illness in the United States. Food Safety. Published April 21, 2025. https://www.cdc.gov/food-safety/php/data-research/foodborne-illness-burden/?CDC_AAref_Val=https://www.cdc.gov/foodborneburden/estimates-overview.html

2. Scallan E, Mahon BE. Foodborne Diseases Active Surveillance Network (FoodNet) in 2012: a foundation for food safety in the United States. Clin Infect Dis. 2012;54 Suppl 5(Suppl 5):S381-S384. doi:10.1093/cid/cis257

3. CDC. About FoodNet. Foodborne Diseases Active Surveillance Network. Published 2024. https://www.cdc.gov/foodnet/about/index.html

4. Painter JA, Hoekstra RM, Ayers T, et al. Attribution of foodborne illnesses, hospitalizations, and deaths to food commodities by using outbreak data, United States, 1998-2008. Emerg Infect Dis. 2013;19(3):407-415. doi:10.3201/eid1903.111866

5. CDC. Template Package 4. Centers for Disease Control and Prevention. Published October 14, 2018. https://wwwn.cdc.gov/foodnetfast

6. Legaspi CH. Cuts to the Food Safety System Threaten Americans’ Health. Nytimes.com. Published September 10, 2025. https://www.nytimes.com/2025/09/10/well/cdc-foodnet.html

7. Casillas SM, Hall RL, Herwaldt BL. Cyclosporiasis Surveillance — United States, 2011–2015. MMWR Surveillance Summaries. 2019;68(3):1-16. doi:10.15585/mmwr.ss6803a1

8. International Food Information Council. https://ific.org/