Improving Foodborne Disease Detection Through Better Surveillance and Rapid Response

The WHO’s 2025 stage-one manual shows how countries can better detect and control foodborne diseases by strengthening existing disease surveillance, event reporting, rapid risk assessment, and outbreak response systems rather than creating new ones. It emphasizes early warning, multisectoral coordination, and practical, low-cost actions to reduce illness from contaminated food and protect public health.

Produced by the World Health Organization in 2025 with contributions from research and public health institutions such as the Institut Pasteur (France), the Technical University of Denmark, Africa Centres for Disease Control and Prevention, the Public Health Agency of Canada, the International Atomic Energy Agency, and national food safety agencies in countries including Singapore, Mexico, Oman, and the Netherlands, the report responds to a persistent global problem: foodborne diseases remain widespread but poorly detected. Updating earlier guidance from 2017, the document targets countries that already have basic disease surveillance systems but struggle to identify when illnesses are linked to contaminated food. Its central message is straightforward: most countries do not need new systems, but better use of the systems they already have.

Building Stronger Surveillance from What Exists

The manual focuses on countries at “stage one” of system strengthening, meaning they already collect health data but need to make it more useful for detecting foodborne risks. It emphasizes indicator-based surveillance, especially notifiable disease systems that track conditions such as diarrhoea, bloody diarrhoea, and neurological symptoms. Diarrhoea is highlighted as the minimum condition every country should monitor, because sudden increases often signal food or water contamination. The manual explains how countries can store surveillance data in simple, stable databases, apply consistent case definitions, and regularly analyse trends over time and across regions. Rather than relying on complex models, it encourages practical tools such as alert thresholds, which flag unusual increases in illness and prompt further investigation.

Catching Early Warnings Through Events

Recognizing that routine data alone cannot capture all risks, the manual places strong emphasis on event-based surveillance. Foodborne threats often first appear as rumours, media reports, or observations by clinicians and inspectors, not as confirmed outbreaks. The document advises countries to designate a national focal point with the authority to receive and assess reports of unusual events, supported by a dedicated phone number or email. It recommends simple event report forms and databases that record where the event occurred, who was affected, and whether food may be involved. Importantly, the manual encourages widening the group of reporters beyond health workers to include food and sanitary inspectors, helping bridge the gap between public health and food safety systems.

From Detection to Action: Assessing and Responding

Once a potential foodborne event is detected, rapid risk assessment becomes the key decision-making tool. The manual stresses that suspected events should be assessed within 24 hours to determine whether they pose a real public health risk. Risk assessment teams are guided to ask three core questions: what is the likely hazard, how likely is further spread, and what would be the consequences if the event escalates. The updated guidance places new emphasis on social and equity considerations, urging authorities to consider how outbreaks and control measures may affect vulnerable populations. When a response is required, outbreak response teams are expected to collect basic epidemiological evidence, interview affected people, analyse patterns by time and place, and gather laboratory samples where possible. Even when laboratory capacity is limited, the manual shows how referral systems and partial evidence can still support effective action.

Working Together and Measuring Progress

A recurring theme throughout the manual is multisectoral collaboration. Foodborne diseases sit at the intersection of public health, food safety, agriculture, laboratories, and trade, and effective response depends on clear communication among these sectors. The document calls for named focal points, agreed channels for rapid information exchange, and joint participation in risk assessments and outbreak investigations. Corrective actions such as food recalls, inspections, and public warnings are described as shared responsibilities, while long-term prevention relies on regulation, training of food handlers, consumer education, and research. Finally, the manual emphasizes monitoring and evaluation, encouraging countries to track how well their systems function, identify delays or gaps, and integrate foodborne disease priorities into broader national surveillance plans.

Taken together, the manual presents foodborne disease surveillance not as a specialized add-on, but as a core public health function. Its message is practical and hopeful: with timely data, clear roles, and coordinated action, even resource-constrained countries can significantly reduce the health and economic burden of foodborne diseases