Yearly Archives: 2015

Foodborne and waterborne disease outbreaks — United States, 1971–2012

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The U.S. Centers for Disease Control and Prevention collects data on foodborne and waterborne disease outbreaks reported by all U.S. states and territories through the Foodborne Disease Outbreak Surveillance System (FDOSS) and the Waterborne Disease and Outbreak Surveillance System (WBDOSS), respectively. These two systems are the primary source of national data describing the number of illnesses, hospitalizations, and deaths; etiologic agents; water source or implicated foods; settings of exposure; and other factors associated with recognized foodborne and waterborne disease outbreaks in the United States.

infrared-cctv-dome-video-surveillance-cameras-120541This report summarizes data on foodborne disease outbreaks reported during 1973–2012 and waterborne disease outbreaks reported during 1971–2012. This report is a part of the first-ever Summary of Notifiable Noninfectious Conditions and Disease Outbreaks, which encompasses various surveillance years but is being published in 2015 (1). The Summary of Notifiable Noninfectious Conditions and Disease Outbreaks appears in the same volume of MMWR as the annual Summary of Notifiable Infectious Diseases (2).

Background

Foodborne Disease Outbreak Surveillance

Foodborne diseases cause an estimated 48 million illnesses each year in the United States, including 9.4 million caused by known pathogens (3,4). Only a minority of foodborne illnesses, hospitalizations, and deaths occur as part of recognized outbreaks (5). However, information gathered from foodborne disease outbreak surveillance provides valuable insights into the agents that cause foodborne illness, types of implicated foods and ingredients, and settings in which transmission occurs.

Foodborne disease outbreaks have been nationally notifiable since 2010; however, reports of foodborne disease outbreaks have been collected by CDC through FDOSS since 1973. Initially a paper-based system, FDOSS became web-based in 1998. In 2009, the system was transitioned to an enhanced reporting platform, the National Outbreak Reporting System (NORS), which also collects information on waterborne disease outbreaks and enteric disease outbreaks with modes of transmission other than food, including person-to-person contact, animal contact, and environmental contamination. Information about NORS is available at http://www.cdc.gov/nors.

Foodborne disease outbreak surveillance data highlight the etiologic agents, foods, and settings involved most often in outbreaks and can help to identify food commodities and preparation settings in which interventions might be most effective. Surveillance for foodborne disease outbreaks provides insight into the effectiveness of regulations and control measures, helps identify new and emerging pathogens, provides information regarding the food preparation and consumption settings where outbreaks occur, informs prevention and control measures in the food industry by identifying points of contamination, and can be used to describe trends in foodborne disease outbreaks over time.

Waterborne Disease Outbreak Surveillance

Despite advances in water management and sanitation, waterborne disease and outbreaks continue to occur in the United States. CDC collects data on waterborne disease outbreaks associated with drinking water, recreational water, and other water exposures through WBDOSS. Waterborne disease outbreaks have been nationally notifiable since 2010; however, reports of waterborne disease outbreaks have been collected by CDC since 1971. Initially utilizing a paper-based reporting process, the system transitioned to web-based reporting with the launch of NORS in 2009.

surveillanceCDC uses waterborne disease outbreak surveillance data to identify the types of etiologic agents, settings, recreational water venues, and drinking water systems associated with waterborne disease outbreaks; inform regulations and public awareness activities to promote healthy swimming and safe drinking water; and establish public health priorities to improve prevention efforts, guidelines, and regulations at the local, state, and federal levels.

Data Sources

Foodborne Disease Outbreak Surveillance

State, local, and territorial health departments use a standard form (CDC form 52.13, available at http://www.cdc.gov/nors/pdf/NORS_CDC_5213.pdf ) to report foodborne disease outbreaks to CDC. Data requested for each outbreak include reporting state; date of first illness onset; the number of illnesses, hospitalizations, and deaths; the etiology; the implicated food vehicle; the setting of food preparation and consumption; and contributing factors. Multistate outbreaks (i.e., those in which exposure to the implicated food occurred in more than one state) typically are reported to the system by CDC.

Only reports meeting the definition of a foodborne disease outbreak (i.e., the occurrence of two or more cases of a similar illness resulting from the ingestion of a common food) are included in this summary. Outbreaks that occurred on cruise ships and those involving food eaten outside the United States, even if the illness occurred in the United States, are not included in FDOSS.

Laboratory and clinical guidelines for confirming an etiology are specific to each bacterial, chemical/toxin, parasitic, and viral agent (http://www.cdc.gov/foodsafety/outbreaks/investigating-outbreaks/confirming_diagnosis.html). Suspected etiologies are those that do not meet the confirmation guidelines. The cause of an outbreak is categorized as “multiple etiologies” if more than one etiologic agent is reported.

Waterborne Disease Outbreak Surveillance

State, local, and territorial health departments use a standard form (CDC form 52.12, available at http://www.cdc.gov/nors/forms.html#waterborne) to report waterborne disease outbreaks to CDC. Data requested for each outbreak include reporting state; date of first illness onset; the number of illnesses, hospitalizations, and deaths; the etiology; the type of water exposure (e.g., recreational); the implicated venue or system, the setting of exposure; water quality indicators; and contributing factors.

Only reports meeting the definition of a waterborne disease outbreak (i.e., the occurrence of two or more cases of a similar illness resulting from exposure to a common water source) are included in this summary. WBDOSS includes reports of both gastrointestinal illness outbreaks and other illness outbreaks (e.g., legionellosis). Outbreaks that occurred on cruise ships and those in which the water exposure occurred outside the United States, even if the illness occurred in the United States, are not included in WBDOSS.

Interpreting Data

Outbreaks represent only a small fraction of the number of foodborne and waterborne illnesses reported each year. Outbreaks caused by certain pathogens or vehicles might be more likely to be recognized or investigated. However, some illnesses reported as sporadic likely are not recognized as being part of a reported outbreak or are part of undetected outbreaks. In addition, all outbreak-related illnesses might not be identified during an investigation, smaller outbreaks might not come to the attention of public health authorities, and some outbreaks might not be investigated or reported to CDC. Reporting practices for foodborne and waterborne disease outbreaks also vary among states, which might have differing definitions of which events are reportable and unique laws related to disease outbreak reporting. For these reasons, variations in reporting rates by state might reflect variations in levels of effort and funding for foodborne and waterborne disease outbreak investigation rather than actual differences in reporting rates by state. Finally, NORS maintains a dynamic database; this analysis included data on March 27, 2015 for foodborne disease outbreaks and April 27, 2015 for waterborne disease outbreaks. Results might differ from those published earlier or later.

Methods for Identifying Foodborne and Waterborne Disease Outbreaks

Guidance for states and jurisdictions for reporting foodborne and waterborne disease outbreaks is provided by CDC (http://www.cdc.gov/nors/forms.html). As for all notifiable conditions, reporting to CDC is voluntary, and state and local laws, regulations, and practices vary. For example, CDC advises states to report outbreaks with cases in the same household; however, state or local jurisdictions might determine that these outbreaks do not require investigation or might deem them nonreportable at the state level.

Publication Criteria

Foodborne disease outbreaks are defined as two or more cases of a similar illness resulting from ingestion of a common food. Waterborne disease outbreaks are defined as two or more cases of a similar illness linked epidemiologically by time and location to exposure to water or water-associated chemicals volatized into the air.

Highlights

Foodborne Disease Outbreaks

During 1973–2012, CDC received reports of 29,429 foodborne disease outbreaks with 729,020 outbreak-associated illnesses from 50 states, Puerto Rico, the District of Columbia, and freely associated states/territories. An average of 736 (range: 298–1404) outbreaks were reported each year (Figure 1). The average annual number of foodborne disease outbreaks reported to CDC during 1998–2012 was more than double the average annual number reported during 1973–1997, coinciding with the transition to an electronic reporting system.

In 2012, a total of 804 single-state exposure outbreaks were reported with 13,320 illnesses by 49 states and Puerto Rico (Table, Figure 2). An additional 25 multistate outbreaks (i.e., outbreaks in which exposure to the implicated food occurred in more than one state) with 1,496 associated illnesses were also reported.

More detailed annual summaries describing the implicated foods, etiologic agents, settings, and points of contamination associated with foodborne disease outbreaks are published periodically by CDC. A summary of foodborne disease outbreaks in 2013, the most recent year for which data are available, is available at http://www.cdc.gov/foodsafety/fdoss/data/annual-summaries/index.html.

Waterborne Disease Outbreaks

During 1971–2012, CDC received reports of 1,901 waterborne disease outbreaks with 639,949 outbreak-associated illnesses from 50 states and six freely associated states/territories. An average of 45 waterborne outbreaks were reported each year (Figure 1).

In 2012, a total of 73 outbreaks causing at least 1,261 illnesses occurred in 27 states and one territory. No multistate outbreaks were reported (Table,Figure 3).

CDC publishes separate and more detailed summaries of waterborne disease outbreaks associated with recreational water and waterborne disease outbreaks associated with drinking water. These summaries are available at http://www.cdc.gov/healthywater/surveillance/surveillance-reports.html.

References

  1. Summary of notifiable noninfectious conditions and disease outbreaks—United States. MMWR Morb Mortal Wkly Rep 2013;62(54).
  2. Summary of notifiable infectious diseases—United States. MMWR Morb Mortal Wkly Rep 2013;62(53).
  3. Scallan E, Hoekstra RM, Angulo FJ, et al. Foodborne illness acquired in the United States—major pathogens. Emerg Infect Dis 2011;17:7–15.
  4. Scallan E, Griffin PM, Angulo FJ, Tauxe RV, Hoekstra RM. Foodborne illness acquired in the United States—unspecified agents. Emerg Infect Dis 2011;17:16–22.
  5. Preliminary FoodNet data on the incidence of infection with pathogens transmitted commonly through food—10 states, 2009. MMWR Morb Mortal Wkly Rep 2010;59:418–22.

Women rock, Gwyneth doesn’t: Paltrow pushes debunked breast cancer myth

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Some women spend their time playing other people in front of cameras and offering lifestyle advice. Some women work in public health. Some play ice hockey, some are French professors.

girls.hockey.brisbaneFrom the annals of bad health advice, actress Gwyneth Paltrow is under fire for a post on her website GOOP by Dr. Habib Sadeghi with the inflammatory title “Could There Possibly Be a Link Between Underwire Bras and Breast Cancer??” The research discussed in the article has been widely discredited, including by the American Cancer Society.

A 2014 study in which 1,044 women ages 55 to 74 were interviewed about their bra wearing, Fred Hutchinson Cancer Research Center (also known as Fred Hutch) found absolutely no link between bras and breast cancer. Specifically, Lu Chen, a researcher in the Public Health Sciences Division at Fred Hutch, said in an article on the center’s website (one that’s cited in a footnote of the GOOP article), “Our study found no evidence that wearing a bra increases a woman’s risk for breast cancer. The risk was similar no matter how many hours per day women wore a bra, whether they wore a bra with underwire, or at what age they began wearing a bra.”

disease.detectiveDiane Mapes, who was diagnosed with breast cancer in 2011 and underwent chemotherapy, radiation and a double mastectomy (what she calls “the full monty”), is a public health writer for FredHutch.org and also blogs about her breast cancer experience at DoubleWhammied.com. She told Salon, “If you get your advice from Gwyneth Paltrow, you’re probably not serving yourself particularly well. If people want public health advice, there’s a lot of other sites where they can go to get it.”

Girls rock. Women rock. People rock. Gwyneth doesn’t.

Can Yelp help in tracking outbreaks of food poisoning?

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Doug Powell, a former professor of food safety at Kansas State University who now lives in Australia and writes for barfblog.com, regards Yelp and social media as potentially useful tools for public-health investigators.

yelp-395“But it doesn’t replace boots on the street, the epidemiological work that people have to do,” he said. “All these things have to be taken with a grain of salt, because Yelp is a business.”

That’s what I told Barbara Feder Ostrov, writing for The Atlantic and PBS, who says that when an outbreak of Shigella sickened 98 diners at a San Jose restaurant last weekend, Yelp reviewers were on the case, right alongside public health officials.

“PLEASE DO NOT EAT HERE!!!!” Pauline A. wrote in her Oct. 18 review of the Mariscos San Juan #3 restaurant. “My sister in and brother-in-law along with his parents ate here Friday night and all four of them ended up in the hospital with food poisoning!!!”

That same day, the Santa Clara County Public Health Department shut down the restaurant. Two days later, officials announced that more than 80 people who had eaten there had become acutely ill, with many requiring hospitalization. Twelve diners went to intensive care units.

Since then, the outbreak has grown to more than 90 cases in Santa Clara and Santa Cruz counties.

Some health researchers and public health professionals believe consumer review sites like Yelp might just help them identify and investigate food poisoning outbreaks similar to this one. It’s not unlike using Google searches to track potential flu and Dengue outbreaks.

Public health workers in New York, aided by Columbia University researchers, scanned thousands of Yelp reviews in 2012 and 2013 to find previously undetected food-borne illness, unearthing nearly 900 cases that were worthy of further investigation by epidemiologists. Ultimately, the researchers found three previously unreported restaurant-related outbreaks linked to 16 illnesses that would have merited a public health investigation if officials had known of them at the time. Follow-up inspections of the restaurants found food-handling violations.

In another study, researchers from Boston Children’s Hospital analyzed more than 5,800 Yelp reviews of food services businesses near 29 colleges in 15 states, concluding that reviews describing food poisoning tracked closely with food-borne illness data maintained by the U.S. Centers for Disease Control and Prevention. The timeliness and often-graphic details of the reviews could prove useful for public health agencies investigating food poisoning outbreaks, the researchers concluded.

Researchers also have examined Twitter and Facebook as possible food-borne illness surveillance tools, and Chicago’s public health agency automatically sends information about its Foodborne Chicago reporting site to local Twitter users who complain of food poisoning.

But Yelp’s usefulness for epidemiologists is going to depend a lot on how it handles food poisoning complaints down the road.

The company has been accused of approaching restaurants to remove negative reviews in exchange for advertising dollars, although a class action lawsuit on those grounds was dismissed.

On Tuesday, the company placed an “Active Cleanup Alert” notice on Mariscos San  Juan #3’s review page noting that because the business “recently made waves in the news,” Yelp would “remove both positive and negative posts that appear to be motivated more by the news coverage itself than the reviewer’s personal consumer experience with the business.”

While some reviews were easily visible, others were segregated into Yelp’s “not currently recommended” category, which requires readers to click to see them and do not figure in the establishment’s overall rating.

Fancy food ain’t safe food: Waldorf Astoria edition

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DNA Info reports that a banquet kitchen at New York City’s Waldorf Astoria hotel was shut down by the Health Department on Monday when inspectors discovered it was overridden with flies.

waldorfOne of eight banquet kitchens at the tony 301 Park Ave. hotel was forced to close for violations including presence of filth flies, storing food at unsafe temperatures and failure to protect food from potential contamination, according to online records.

The hotel was reinspected and allowed to reopen on Wednesday, according to the DOH.

Waldorf Astoria New York has four restaurants and bars that remained open while that particular kitchen was closed, according to a spokesman for the hotel.

The hotel has 40 banquet rooms for parties with up to 1,500 guests.

A spokesman for the hotel defended cleanliness at the Waldorf Astoria, and said staff worked quickly to address the issues raised in the recent inspection.

“Along with the safety of our guests, the cleanliness of our hotel is of the utmost importance and is a focal point of our operations,” said a spokesman for Waldorf Astoria New York.

Maybe charge whoever booked the caterer: Criminal action called for in Brantford outbreak that sickened 94

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The chief doctor in Brantford, Ontario, Canada, is recommending charges be laid against an unlicensed caterer connected with an outbreak of foodborne illness that sickened about 100 staff at Brant Family and Children’s Services last month.

chicken-wrap-300x193Dr. Malcolm Lock, Brant County medical officer of health, told board of health members on Wednesday that he believes enough information has been gathered during the investigation into the outbreak to warrant the laying of charges under the Health Protection and Promotion Act. The suggested charges relate to serving food unfit for human consumption and operating as an unlicensed caterer.

The scope of the outbreak necessitated the health unit “do everything we can under the law,” Lock said.

He said that consultations are underway with the local Crown’s office but no final decision had been made regarding the charges. If and when charges are laid, the caterer’s name would be released, he said.

Lock issued an order that the caterer not cater any functions or handle any food for public consumption.

Word about possible charges comes nearly six weeks after a Sept. 10 luncheon, organized by Brant Family and Children’s Services and held at the South Dumfries Community Centre in St. George, that resulted in nearly 100 people becoming ill with quick-onset gastrointestinal symptoms including cramping and often severe diarrhea. Those attending the luncheon were served a catered lunch of egg salad wraps, chicken wraps and potato salad.

By Oct. 5, the health unit had reported that almost all those who became ill had recovered.

The transportation of the food was “totally inadequate,” Lock told board members on Wednesday.

In addition, it was earlier confirmed that the caterer was not registered with the health unit nor inspected by food inspectors.

Stool samples from those sickened were sent to health laboratories for identification and two organisms were later confirmed as culprits.

One was identified as Plesiomonas shigelloides, an organism often associated with raw shellfish and unsanitary conditions, and usually associated with tropical or sub-tropical regions.

Tests later confirmed the presence of a second organism, enterotoxigenic Escherichia coli, also known at ETEC, in samples sent to health laboratories for identification. ETEC is most commonly associated with traveller’s diarrhea, Lock said.

Board members heard Wednesday that the caterer had returned from a trip to Haiti shortly before the luncheon.

Katie’s Norovirus Nightmare

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The NoroCORE Collaborative is running a series of posts for Halloween on norovirus nightmares. The first post comes from one of my graduate students, Katie Overbey.

During Spring Break of 2014 I was spent the week with my boyfriend in New Orleans and we stayed with my aunt. As one does in New Orleans, we ate lots of tasty food and tried lots of drinks. On the Saturday of our trip, after eating at my aunt’s favorite Mexican restaurant (side note: who eats Mexican food when they visit New Orleans?) she decided to take us on what has since been deemed the ‘drinking tour of the French Quarter.’ KatieOverbeyAfter about three hours I started to feel queasy right in the middle of the iconic Pat O’Briens Bar. We thought maybe I was hungry from our day of activities so we headed to get dinner. The place was packed and while waiting for our food, it hit me. I weaved through the crowd to get to the bathroom, just to discover that one stall was broken, the other was occupied and there was a line. I apologized to the people in line for what was about to happen and then proceeded to throw up in the sink, because as anyone who’s had norovirus knows – when it decides to hit, there’s not much you can do.

After cleaning up as best I could (though after my master’s research I now know that bathroom was doomed because of all my aerosolized vomit) we headed back to my aunt’s as fast as possible. I proceeded to get sick all night long, which ironically put a damper on the rest of my relaxing vacation.

At first, my aunt and boyfriend thought I had enjoyed the drinking tour too much, but I knew that what I had was way worse. I suspect that it had something to do with the Mexican food because after my aunt ate some of my leftovers, she got sick too.

Katie Overbey is an MS student in Food Science at NC State studying how to better communicate with schools having norovirus outbreaks and environmental detection of norovirus

Guidance on study design for drugs to reduce STEC in cattle

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The U.S. Food and Drug Administration has published guidance on study design and criteria that the Center for Veterinary Medicine (CVM) thinks are the most appropriate for the evaluation of the effectiveness of new animal drugs that are intended to reduce pathogenic Shiga toxin-producing Escherichia coli (STEC) in cattle.

cow-faceSection II discusses general considerations regarding the development of protocols, study conduct, animal welfare, substantial evidence of effectiveness, experimental parameters, nutritional content of experimental diets, and the assessment of drug concentrations in experimental diets. Section III discusses the studies and analyses CVM recommends for sponsors to substantiate the effectiveness of pathogenic STEC reduction drugs.

The guidance is not a comprehensive source of information on conducting clinical effectiveness studies. Alternative study designs for providing substantial evidence of effectiveness may be acceptable. Sponsors should contact CVM to discuss their development plan prior to initiating any studies. Sponsors and clinical investigators should consult the Code of Federal Regulations (21 CFR Parts 511 and 514) for information on the proper shipment, use, and disposition of investigational new animal drugs, as well as submission of the results of clinical investigations. This guidance does not address the evaluation of human food safety with respect to microbial food safety and/or concerns related to antimicrobial resistance. CVM encourages sponsors to discuss any related concerns in their project plan with CVM as early as possible in the development process.

FDA’s guidance documents, including this guidance, do not establish legally enforceable responsibilities. Instead, guidances describe the Agency’s current thinking on a topic and should be viewed only as recommendations, unless specific regulatory or statutory requirements are cited. The use of the word should in Agency’s guidances means that something is suggested or recommended, but not required.

98 sick: Shigella cases linked to San Jose restaurant

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Officials said 11 people are hospitalized in intensive care after contracting Shigella at a San Jose restaurant, prompting the Santa Clara County Public Health Department to issue a warning.

french.dont.eat.poopThe patients ate at the Mariscos San Juan restaurant in downtown San Jose on either Friday or Saturday, according to authorities. The restaurant is now closed.

Officials also said the number of suspected cases of Shigella has now risen to 98.

Food is often contaminated with Shigella if it is prepared by someone whose hands are covered in fecal matter.

Time to revise the don’t eat poop mantra (or at least cook the poop).

 

15 sick: Wisconsin football team stricken with Cryptosporidium

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Milton School District says they now have three confirmed cases of Cryptosporidium at the Milton High School.

north.dallas.fortyMilton football coach Bill O’Leary told 27 News Tuesday he has “lots” of sick kids on his team. Health officials are trying to get samples from those who are ill to either confirm or deny they have Cryptosporidium.

According to WKOW-TV, two community meals among the football players have led to the outbreak.

The health department and school are taking precautionary measures and the high school will be closed for 24 hours for disinfection.

The Kremlin of local government: Philly restaurant inspections stay secret for 30 days

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Of the U.S.’s 10 largest cities, Philadelphia is the only one that does not allow the public to see restaurant inspection reports for 30 days, time in which diners could unknowingly patronize restaurants with serious hygiene problems.

No captionWith the exception of Phoenix, which takes 72 hours to process its reports, the remaining major cities – including New York, Chicago, and Los Angeles – publish restaurant inspections immediately, according to a survey by Philly.com.

Pittsburgh posts its reports immediately. So do the counties of Bucks, Montgomery, and Chester, the last of which posts its findings on the Pennsylvania Department of Agriculture database. That database includes most of the state, including many Delaware County municipalities, and it posts them without delay.

In New Jersey, Camden County posts results online within three to five business days; Burlington County does so at least as fast. Gloucester County’s website is updated monthly, with limited details.

The Philadelphia policy puzzles experts who wonder why the city would keep restaurant inspections private for so long.

“Give the restaurant a month to fix [the problems]?” asked Jim Chan, recently retired manager of Toronto’s DineSafe program.

“Is that fair to the public? Is that good health policy? No.”

“This seems like a strange protocol,” said Michael P. Doyle, director of the Center for Food Safety at the University of Georgia. “It certainly doesn’t help the customer.”

Andres Marin, professor of culinary arts at Community College of Philadelphia, said a weeklong delay might be acceptable to fix minor problems.

“But the question should be: What is the reason that we’re making these public?” Marin said. “We want to let the public know about the restaurant’s cleanliness and the way they’re handling the food. Withholding a report for 30 days makes no sense.”

sleeper1Philadelphia Public Health Department spokesman Jeff Moran said reports are kept under wraps so owners of food establishments can challenge a sanitarian’s findings.

How did the policy begin?

“My understanding is that this has been a long-standing policy, that it arose from [the] fact that [the] proprietor has [a] 30-day period to appeal an inspection,” city Health Commissioner James Buehler wrote via email Monday.

On Feb. 10, a city health employee inspected Joy Tsin Lau, a dim sum eatery with a banquet hall on Arch Street, and found improperly stored food, no soap in the employees’ restroom, and mouse droppings.

Her findings were kept secret. Seventeen days later, on Feb. 27, about 100 lawyers and law students were stricken with food poisoning after attending a banquet at the restaurant. Many were treated in city emergency rooms for what turned out to be norovirus, the leading cause of disease outbreaks from contaminated food in the United States, according to the Centers for Disease Control and Prevention. City inspectors do not test specifically for norovirus and other pathogens.

“No one would have gone there knowing about mouse droppings and the other sanitation violations,” said lawyer Richard Kim, who represents one of the sickened lawyers in a lawsuit against Joy Tsin Lau. “Nobody would have done that.”

Catherine Adams Hutt, a consultant for the National Restaurant Association, said the city’s 30-day policy was not responsible for sickening the lawyers.

“It doesn’t matter when an inspection report is posted,” Hutt said. “It’s the responsibility of the restaurant owner to correct the violations. There’s no excuse for a restaurant for food poisoning 17 days after an inspection.”

In a subsequent editorial, the disclosure this week by Philly.com that the city’s Health Department keeps its food-inspection reports secret for 30 days is the latest example of why the department is the Kremlin of local government.

Information is released on a need-to-know basis, if you can negotiate the maze set up to keep the public in the dark.

When it comes to food inspections, for instance, the department boasts of its transparency and posts online the full inspection reports on every institution it inspects, including the city’s 5,000 eat-in restaurants.

Now, Philly.com reveals that those reports are kept offline for 30 days, which happens to be just enough time for a restaurant to pass a reinspection.

Even if you do find the inspection reports (phila.gov/health/foodprotection) the department tells us too little by telling us too much. The raw reports are posted online, noting whether an establishment is in or out of compliance in 56 categories.

A regular member of the eating public would have trouble making sense of the reports, which are a jumble of bureaucratese.

One thing evident is that some restaurants are inspected again and again yet never can get their act together to pass an inspection.

Simpler public disclosure and enforcement with teeth would go a long way toward giving the public confidence – and that would benefit the entire food industry.