The Centers for Disease Control and Prevention estimates that 1 in 6 people in the U.S. get food poisoning each year—leading to 128,000 hospital stays and 3,000 deaths. CDC has seen an increase in foodborne illness outbreaks that span multiple states in recent years.
CDC has developed tools to identify possible multistate outbreaks, investigate their cause, and communicate about them to the public. But it needs to balance the need to communicate quickly against the need to provide accurate and specific information.
Government Accountability Office recommendations include that CDC publicize its decision-making process for communicating about multistate outbreaks.
In identifying and responding to multistate foodborne illness outbreaks, CDC faces challenges related to clinical methods and communication, and it has taken some steps to respond to these challenges. One challenge stems from the increasing clinical use of culture-independent diagnostic tests (CIDTs). CIDTs diagnose foodborne illnesses faster and cheaper than traditional methods, but because they do not create DNA fingerprints that can specify a pathogen, they may reduce CDC’s ability to identify an outbreak. A CDC working group recommended in May 2018 that CDC develop a plan to respond to the increasing use of CIDTs. By developing a plan, CDC will have greater assurance of continued access to necessary information. CDC also faces a challenge in balancing the competing needs for timeliness and accuracy in its outbreak communications while maintaining public trust. CDC has an internal framework to guide its communications decisions during outbreaks, and it recognizes that stakeholders would like more transparency about these decisions. By making its framework publicly available, CDC could better foster public trust in its information and guidance during outbreaks.
CDC has taken steps to evaluate its performance in identifying and responding to multistate outbreaks. Specifically, CDC has developed general strategic goals and taken initial steps to develop performance measures. However, CDC has not yet established other elements of a performance assessment system—an important component of effective program management.
In particular, CDC has not set specific performance goals, used performance measures to track progress, or conducted a program evaluation of its multistate foodborne illness outbreak investigation efforts. By implementing all elements of a performance assessment system, CDC could better assess its progress toward meeting its goals, identify potentially underperforming areas, and use that information to improve its performance.
GAO is recommending that CDC (1) develop a plan to respond to the increasing use of CIDTs, (2) make publicly available its decision-making framework for communicating about multistate foodborne illness outbreaks, and (3) implement all the elements of a performance assessment system. CDC concurred with all three recommendations.