Foodborne Disease Outbreaks in U.S. Correctional Facilities—A Review of Epidemiology and Law

Roughly 1.8 million individuals were detained or incarcerated in U.S. correctional facilities in 2022. Prior research has found that incarcerated persons are at increased risk for foodborne outbreaks. We aim to summarize recent national outbreak surveillance data and describe the nexus between disease burden and the law to inform prevention efforts. First, we describe epidemiological data for single-state correctional and all noncorrectional foodborne outbreaks during 1998-2022 that were reported to the Centers for Disease Control and Prevention's Foodborne Disease Outbreak Surveillance System. Second, we summarize state statutes and regulations for seven key food safety provisions in the 10 states with the largest incarcerated populations. Incarcerated and detained individuals experience nearly seven times as many outbreak-associated illnesses per 100,000 individuals than the public. Further, the median number of illnesses per outbreak in correctional settings is nearly six times greater than noncorrectional settings. All 10 states codified all or most of the seven food safety provisions for food service establishments, whereas express legal requirements instituting these provisions within correctional facilities were largely absent. Legal interventions, rigorous food safety practices, and collaborations with health departments are critical tools needed to reduce foodborne outbreaks in correctional facilities.