CDC to Collect Data on Cronobacter Infections, Addressing Infant Formula Crisis

CDC to Collect Data on Cronobacter Infections Following Infant Formula Crisis

The Centers for Disease Control and Prevention (CDC) will begin collecting data on infections caused by cronobacter, the pathogen responsible for last year’s infant formula crisis. The Council of State and Territorial Epidemiologists (CSTE) made the recommendation at a conference on Thursday, which the CDC has agreed to adopt starting next year. The decision was reached after close collaboration between CSTE members, CDC experts, and representatives from the Food and Drug Administration (FDA) and the Association of Public Health Laboratories.

The move comes more than a year after several babies fell ill and two died after consuming formula contaminated with Cronobacter sakazakii. As a result, a US plant that produced powdered formula temporarily shut down, and millions of units of formula were recalled, leading to a months-long shortage across the country.

Cronobacter will now be added to the list of “nationally notifiable” pathogens, which includes salmonella and around 120 other illnesses. This list is jointly managed by the CDC and CSTE. When a cronobacter infection is identified in an infant under one year old by doctors or laboratories, it will be reported to the state, which will then notify the CDC. Making the disease nationally notifiable will result in more reported infections, aiding in disease trend monitoring and the identification of preventive measures.

The infant formula crisis prompted significant changes in federal agencies responsible for ensuring food safety. The FDA recently announced the elevation of its food safety program by appointing a single leader to oversee the entire program. Previously, the Office of Regulatory Affairs, which handles investigations, inspections, and imports for all FDA-regulated products, was not overseen by the top food safety official.

FDA Commissioner Robert M. Califf stated that the agency’s thinking has significantly broadened, acknowledging the rapidly evolving landscape of consumer preferences, products, and manufacturing processes. The resignation of Frank Yiannas, the FDA’s deputy commissioner for food policy and response, earlier this year also highlighted the need for changes in the agency’s handling of the baby formula crisis.

Advocacy groups such as Stop Foodborne Illness, Consumer Reports, and the Environmental Working Group have been advocating for these changes in the FDA’s food safety program, as well as for cronobacter to be recognized as a nationally notifiable disease.

Mitzi Baum, CEO of Stop Foodborne Illness, believes that the decision will have a meaningful impact on infant mortality. While cronobacter is considered rare, Baum emphasizes the lack of data and research associated with the pathogen. Cronobacter infections are rare, and the majority of exposed children will not become ill. However, the CDC’s documented cases are likely an undercount due to inconsistent reporting by healthcare providers. Currently, only Minnesota and Michigan report infections to public health departments.

The first infant cronobacter infection of the 2021 cluster was discovered by Minnesota officials and reported to the FDA. This led to the exchange of information between the CDC, clinicians, and state and local health departments, resulting in the identification of additional cases in Texas and Ohio. Food safety advocacy groups argue that if cronobacter had been more widely reportable, the outbreak may have had a different outcome.

Janet Hamilton, executive director of CSTE, believes that these efforts will assist public health agencies in quantifying and identifying the cause of cronobacter infections. Coupled with education initiatives, Hamilton hopes that these measures will protect the health of the most vulnerable individuals and ultimately prevent these infections from occurring.

How will the new data collection on cronobacter infections contribute to better disease trend monitoring and the identification of preventive measures?

The CDC will start collecting data on cronobacter infections, the pathogen responsible for last year’s infant formula crisis. The decision came after a recommendation from the Council of State and Territorial Epidemiologists (CSTE) and collaboration with CDC experts, representatives from the FDA, and the Association of Public Health Laboratories. Cronobacter will now be added to the list of “nationally notifiable” pathogens, allowing for better disease trend monitoring and the identification of preventive measures. The infant formula crisis led to changes in federal agencies responsible for food safety, including the FDA appointing a single leader to oversee the entire food safety program.