Epidemiology of foodborne disease outbreaks from 2011 to 2016 in Shandong Province, China

Foodborne disease is a major public health concern in both developed and developing countries. China has established a nationwide Foodborne Disease Outbreak Surveillance System (FDOSS) for collection and periodic reporting of data on the occurrence and causes of foodborne disease outbreaks in China. Each provincial Centers for Disease Control and Prevention (CDC) conducts the system working. We reviewed foodborne disease outbreaks that occurred during 2011 to 2016 in Shandong Province from the FDOSS. The Wilcoxon test was used to compare the median number of ill persons in outbreaks. All data analysis was performed using Epi Info 7. During 2011 to 2016, Shandong CDC received reports of 1043 foodborne disease outbreaks, resulting in 8078 illnesses, 2442 hospitalizations, and 17 deaths. There were a median of 69 outbreaks annually [interquartile range (IQR) 10–342], resulting in 335 to 3824 illnesses each year. The median outbreak size was 3 persons (IQR 2–7). Hotels (including cruise ships, hotpot restaurants, barbecue shops) were the most common setting. Among the 744 (71.3%) outbreaks with an implicated food or contaminated ingredient reported, 704 (94.6%) could be assigned to one of 17 predefined commodity categories. Of the 280 outbreaks with a known etiology, 117 (41.8%) were caused by poisonous plants and animals and their toxins, 39 (13.9) were caused by nitrite, and 27 (9.6%) were caused by vibrio parahaemolyticus. Of the 491 (47.1%) outbreaks with at least a contributing factor to cause outbreak, 168 (34.2%) were caused by improper processing, and 100 (20.4) were caused by inedible and misuse. Timely investigation, disposal and reporting of foodborne disease outbreaks provides information that might help FDOSS to make full use of efficiency and FDOSS should be continued and strengthened even more in Shandong Province, such as an increase in diagnostic laboratory capacities.