U.S – In response to a significant foodborne illness outbreak associated with powdered infant formula contaminated by Cronobacter sakazakii in 2022, the Council of State and Territorial Epidemiologists (CSTE) has unanimously voted to declare C. sakazakii a nationally notifiable disease. 

This decision mandates that all health departments in the United States track and report cases of C. sakazakii to the U.S. Centers for Disease Control and Prevention (CDC). 

The recognition of C. sakazakii as a nationally notifiable disease aims to strengthen surveillance and prompt early detection of infections, ultimately safeguarding infant health.

The impetus for this action stemmed from a widespread outbreak of foodborne illness attributed to powdered infant formula products contaminated with C. sakazakii in 2022.

The subsequent recall of these products resulted in a national shortage, underscoring the urgent need for preventive measures and enhanced monitoring. As a result, C. sakazakii will be officially added to the list of nationally notifiable diseases in 2024.

Starting from the inclusion of C. sakazakii as a nationally notifiable disease, healthcare providers and laboratories will be obligated to report cases of C. sakazakii infection in infants less than one-year-old to their respective state health departments. 

This standardized reporting system will enable timely and accurate data collection, leading to a better understanding of the disease’s prevalence and distribution across the country.

The decision to designate C. sakazakii as a nationally notifiable disease received widespread support from various stakeholder groups. 

The U.S. Food and Drug Administration (FDA), in its November 2022 prevention strategy for C. sakazakii in powdered infant formula, advocated for the inclusion of C. sakazakii on the nationally notifiable diseases list. 

This collaborative effort highlights the commitment of regulatory bodies, healthcare professionals, and public health agencies to address and mitigate the risks posed by C. sakazakii.

Strengthening foodborne disease surveillance

C. sakazakii joins the ranks of other notable foodborne pathogens on the list of nationally notifiable diseases, including SalmonellaEscherichia coli, and Listeria monocytogenes

The inclusion of C. sakazakii in this list underscores the gravity of the pathogen’s impact and the urgency to enhance surveillance efforts. 

By expanding disease monitoring capabilities, health authorities can respond swiftly to outbreaks, initiate targeted interventions, and implement preventive measures to protect vulnerable populations, particularly infants.

The designation of C. sakazakii as a nationally notifiable disease reflects the ongoing commitment of the United States to prioritize food safety. 

Regulatory agencies, industry stakeholders, and healthcare professionals will continue to collaborate and innovate to prevent foodborne illnesses and protect public health. 

As part of a comprehensive approach, these efforts may include rigorous quality control measures, education campaigns, and advancements in food safety technologies.

C. sakazakii

C. sakazakii is an opportunistic pathogen that can cause severe infections, primarily affecting infants under the age of one, especially those who are premature or have weakened immune systems.

C. sakazakii infections are predominantly associated with powdered infant formula. The bacterium can contaminate the formula during production or through post-processing contamination, which can occur during improper handling, storage, or preparation of the formula. 

Infections can occur when infants consume contaminated formula or when caregivers use contaminated equipment, such as feeding bottles or utensils.

To prevent C. sakazakii infections, it is essential to practice proper hygiene and safe handling of powdered infant formula. This includes following the manufacturer’s instructions for formula preparation, using sterile equipment, ensuring clean water sources, and promptly discarding any unused formula. 

Manufacturers also play a crucial role in implementing stringent quality control measures to prevent contamination during production.

Given the severity of the infections, ongoing research aims to improve understanding of the bacterium’s characteristics, transmission routes, and pathogenesis. 

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