Foodborne disease causes an estimated 4.1 million cases of illness in Australia each year and is responsible for causing many significant common source outbreaks. We analyzed 18 years of foodborne outbreak data collected in New South Wales (NSW), and classified the likely pathogen type responsible for outbreaks of unknown etiology, to track broad trends over time. A total of 869 outbreaks were reported in NSW from 2000 to 2017. The majority (53%) of outbreaks did not have a pathogen identified and underwent pathogen type categorization based on the epidemiology of the outbreak. The proportion of outbreaks due to toxin producing bacteria decreased over time, whereas the proportion of outbreaks due to other bacterial pathogens increased. The proportion of outbreaks due to viral gastroenteritis pathogens had no overall changing trend over time. Bacterial outbreaks had significantly more identified cases and had more hospitalizations than other pathogen type causes. Other features associated with high case numbers, hospitalizations, and deaths in foodborne outbreaks included being due to food contaminated in primary production, involving consumption of raw products, and having evidence of poor sanitation in the food preparation areas. Eggs were the most commonly determined pathogen food source, occurring in 12% of outbreaks; however, most outbreak investigations (77%) did not have a pathogen food source identified. This analysis demonstrates a changing landscape of foodborne outbreaks over time. Increases in outbreaks due to bacterial and viral pathogens coincide with increases in sporadic notifications of the same pathogens, whereas decreases in toxin caused outbreaks followed the introduction of mandatory food safety training in retail food businesses. Recognizing issues in food production and implementing improvements that reduce the number of pathogens in food will be key to reducing the incidence of foodborne outbreaks.

中文翻译：

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描述 2000 年至 2017 年新南威尔士州食源性疾病暴发的流行病学。

据估计，食源性疾病每年在澳大利亚引起 410 万例疾病，并导致许多重大的共同源爆发。我们分析了在新南威尔士州 (NSW) 收集的 18 年食源性疾病暴发数据，并对导致未知病因暴发的可能病原体类型进行了分类，以追踪随时间推移的广泛趋势。从 2000 年到 2017 年，新南威尔士州共报告了 869 起疫情。 大多数 (53%) 的疫情没有确定病原体，并根据疫情的流行病学进行了病原体类型分类。随着时间的推移，由产毒细菌引起的暴发比例下降，而由其他细菌病原体引起的暴发比例增加。由病毒性胃肠炎病原体引起的暴发比例总体上没有随时间变化的趋势。与其他病原体类型的原因相比，细菌爆发的确诊病例和住院人数明显更多。与食源性疾病暴发中高病例数、住院和死亡相关的其他特征包括由于初级生产中的食品受到污染，涉及食用生产品，以及食品制备区卫生条件差的证据。鸡蛋是最常确定的病原体食物来源，发生在 12% 的爆发中；然而，大多数暴发调查 (77%) 没有确定病原体食物来源。该分析表明，随着时间的推移，食源性疾病暴发的格局正在发生变化。由细菌和病毒病原体引起的暴发增加与相同病原体的零星通报增加同时发生，而在零售食品企业引入强制性食品安全培训后，毒素引起的爆发减少。认识到食品生产中的问题并实施减少食品中病原体数量的改进措施将是减少食源性疾病爆发的关键。