When cyclosporiasis or Salmonella ramp up, having real-time numbers of infections can strengthen public health response
Every day, we make countless decisions about what to eat, often without giving them much thought. We might grab a quick bite at a local fast-food restaurant before rushing to work and then piece together a quick bagged salad for lunch in between meetings. These small, ordinary daily decisions rely on a large, complex food safety surveillance system that we don’t even notice until something goes wrong.
The United States has a remarkably robust infrastructure to keep our food supply safe; even so, an estimated 48 million people get sick from foodborne illnesses every year (1, 2).
When someone gets sick from something they ate and goes to the doctor, a single laboratory test can set an entire public health surveillance system in motion. If the results show a reportable foodborne illness, scientists can sequence the organism and compare its genetic fingerprint with cases across the country, searching for matches.
Suddenly, what at first looked like random, isolated illnesses can reveal something larger: an outbreak.
Tracking down the likely culprit
As an epidemiologist specializing in foodborne illness, I’ve seen what happens next. I have spent the last decade thinking like a detective about outbreaks: how we spot them, how we connect seemingly unrelated illnesses, and ultimately how we figure out what made people sick.
The process involves retracing what and where people ate and finding the common thread. Was it the same restaurant? The same ingredient? A product purchased from the same store? Once investigators identify a likely source, food safety and regulatory agencies trace the contamination and rapidly get affected products off the shelves. At the end, most of us see only the recall notice, not the network of people working behind the scenes to connect the dots.
One thing becomes clear when you work inside this system: our ability to detect and understand an outbreak depends on the signals we are able to see. And timely access to electronic health record (EHR) data can offer an important window into what is happening as patients seek care.
Making sense of what’s happening while it’s happening
This summer, during the alarm over a widespread cyclosporiasis outbreak linked to iceberg lettuce spread across multiple states (4), our research team was able to use Truveta Data to place what was happening in real time against eight years of EHR history. The results were striking, showing that the 2026 rate of cyclosporiasis diagnoses was more than 11 times the average for the same month in prior years (5).
That study demonstrates what I find so promising about Truveta Data. We can compare what we are seeing today against years of historic precedent while also following the clinical journey surrounding an illness—from symptoms and laboratory testing and results to emergency department visits, hospitalizations, and what happens after diagnosis.
And because Truveta Data are updated daily, we can examine that broader clinical picture while an outbreak is still unfolding. Together, these insights into healthcare utilization, outcomes, and the patient experience can complement traditional public health surveillance and help inform public health interventions.
And there will be no shortage of opportunities to put these tools to work. This summer did not just see the Cyclospora linked to iceberg lettuce (4). Over the last few months, public health officials have investigated E. coli linked to frozen blueberries (6), Listeria linked to soft cheese (7), and Salmonella linked to jalapeños (8) and eggs (9). In the past few weeks alone, a recall of nearly 19.2 million eggs due to Salmonella was elevated to Class I status—the FDA’s highest health risk level (9).
The next outbreak will involve a different pathogen, a different food, and a different group of people. But the challenge will remain the same: seeing as much of the picture as possible, as clearly as possible, while it is still unfolding. With years of clinical history and de-identified electronic health records updated every day, Truveta Data gives us one more tool to meet the moment.
References Cited
Scallan, E., Griffin, P. M., Angulo, F. J., Tauxe, R. V., & Hoekstra, R. M. (2011). Foodborne illness acquired in the United States—unspecified agents. Emerging Infectious Diseases, 17(1), 16.
Council to Improve Foodborne Outbreak Response. (2020). Guidelines for foodborne disease outbreak response (3rd ed.).
Centers for Disease Control and Prevention. (2025, March 10). Foodborne Diseases Active Surveillance Network (FoodNet). https://www.cdc.gov/foodnet/index.html
U.S. Food and Drug Administration. (2026, August 13). Investigation of multistate outbreak of Cyclospora illnesses: Iceberg lettuce (July 2026).
Truveta Research. (2026, July 30). Cyclosporiasis diagnoses reach historic levels in 2026 summer outbreak. Truveta. https://www.truveta.com/blog/research/cyclosporiasis-2026-summer-outbreak/
U.S. Food and Drug Administration. (2026, July 30). Outbreak investigation of E. coli O145:H28: Frozen blueberries (July 2026). https://www.fda.gov/food/outbreaks-foodborne-illness/outbreak-investigation-e-coli-o145h28-frozen-blueberries-july-2026
U.S. Food and Drug Administration. (2026, June 29). Outbreak investigation of Listeria monocytogenes: Soft cheese (June 2026). https://www.fda.gov/food/outbreaks-foodborne-illness/outbreak-investigation-listeria-monocytogenes-soft-cheese-june-2026
U.S. Food and Drug Administration. (2026, August 5). Outbreak investigation of Salmonella: Jalapeño (August 2026). https://www.fda.gov/food/outbreaks-foodborne-illness/outbreak-investigation-salmonella-jalapeno-august-2026
U.S. Food and Drug Administration. (2026, July 24). Outbreak investigation of Salmonella: Eggs (July 2026). https://www.fda.gov/food/outbreaks-foodborne-illness/outbreak-investigation-salmonella-eggs-july-2026
