Emerging needs and opportunities in foodborne disease detection and prevention: From tools to people.

A variety of technological advances have tremendously improved the ability of surveillance systems to detect and prevent foodborne disease cases and outbreaks. Molecular subtyping methods and surveillance systems, including PFGE and, more recently, whole genome sequencing (WGS) have been particularly important advances, but the responsible food vehicle and causative agent are still only conclusively determined in a small fraction of outbreaks. Microbial foodborne disease cases continue to take a considerable public health toll, primarily in developing countries. According to recent WHO estimates, at least 600 million cases of foodborne illness and 420,000 associated deaths occur each year; the true numbers are likely significantly higher. This review summarizes the current and anticipated global impact of improved technologies for foodborne disease surveillance and proposes key areas that will require particular attention, including the need for training activities, public-private partnerships supporting food safety, and appropriate food safety policy frameworks. The manuscript places particular focus on the development of WGS tools for surveillance of Listeria monocytogenes because this technology represents one of the most disruptive food safety technologies introduced over the last 10 years, which has revolutionized routine surveillance of L. monocytogenes in several countries. As such, it provides valuable insights into how technological advances can improve foodborne illness surveillance and illustrates the training, policy and infrastructure needs created by introduction of disruptive novel technologies. Moreover, WGS can help identify new sources of foodborne outbreaks and inform risk assessments, thereby providing valuable insights for risk-based policies aimed at preventing future foodborne illness.