Editor's Note: This story originally appeared on Trace One.
Summer is peak season for many foodborne illnesses in the United States. Warmer temperatures, outdoor gatherings, and frequent handling of raw meat and fresh produce can create ideal conditions for bacteria and parasites to spread.
From backyard cookouts to picnics and festivals, food safety risks rise significantly in the warmer months.
This analysis draws on data from the National Notifiable Diseases Surveillance System (NNDSS), a nationwide program coordinated by the Centers for Disease Control and Prevention (CDC) to monitor the incidence of reportable diseases across all 50 states.
The NNDSS collects laboratory-confirmed case counts from state and local health departments for a wide range of infectious diseases, including those caused by foodborne pathogens such as salmonella, E. coli, and listeria.
These pathogens can cause a range of symptoms, including diarrhea, vomiting, abdominal cramps, and fever. While most cases are mild and resolve on their own, some infections can lead to serious complications such as kidney failure, bloodstream infections, or meningitis, particularly in young children, older adults, and people with weakened immune systems.
Using both recent national estimates and four years of finalized state-level data, researchers at Trace One — a product lifecycle management (PLM) and regulatory compliance software company for the food and beverage sector — examine trends in reported foodborne illness nationwide.
Following is a breakdown of the states where foodborne illness rates are highest. For details on data sources and methods, refer to the methodology at the end.
10. Kansas
- Reported foodborne illness rate per 100,000: 58.3
- Average annual reported cases: 1,702
- Most overrepresented pathogen: E. coli (STEC)
9. New Mexico
- Reported foodborne illness rate per 100,000: 58.8
- Average annual reported cases: 1,238
- Most overrepresented pathogen: Shigella
8. Montana
- Reported foodborne illness rate per 100,000: 59.7
- Average annual reported cases: 649
- Most overrepresented pathogen: E. coli (STEC)
7. Wisconsin
- Reported foodborne illness rate per 100,000: 60.5
- Average annual reported cases: 3,536
- Most overrepresented pathogen: Cryptosporidium
6. Florida
- Reported foodborne illness rate per 100,000: 61.9
- Average annual reported cases: 13,483
- Most overrepresented pathogen: Salmonella
5. Vermont
- Reported foodborne illness rate per 100,000: 62.0
- Average annual reported cases: 390
- Most overrepresented pathogen: Cryptosporidium
4. Wyoming
- Reported foodborne illness rate per 100,000: 66.4
- Average annual reported cases: 386
- Most overrepresented pathogen: E. coli (STEC)
3. Minnesota
- Reported foodborne illness rate per 100,000: 66.6
- Average annual reported cases: 3,775
- Most overrepresented pathogen: E. coli (STEC)
2. Nebraska
- Reported foodborne illness rate per 100,000: 74.4
- Average annual reported cases: 1,446
- Most overrepresented pathogen: E. coli (STEC)
1. South Dakota
- Reported foodborne illness rate per 100,000: 92.2
- Average annual reported cases: 825
- Most overrepresented pathogen: Cryptosporidium
Methodology
This analysis examines the states with the highest reported rates of foodborne illnesses in the United States, based on data from the NNDSS maintained by the CDC.
National-level statistics are from the CDC’s 2024 preliminary weekly estimates, while state-level statistics represent the most recent four years of finalized records (2019–2022), accessible through the CDC’s WONDER database.
The analysis focuses on eight foodborne pathogens for which surveillance data are most consistently available. These pathogens include campylobacter, salmonella, shigella, shiga toxin-producing Escherichia coli (STEC), cryptosporidium, cyclospora, vibrio, and listeria.
Notably, norovirus — a leading cause of foodborne illness — is excluded from this analysis because it is not a reportable disease and cases are often mild and undiagnosed.
Incidence rates were calculated as the number of reported cases per 100,000 population.
For each state, the most disproportionately represented pathogen was determined by calculating the percentage by which the state-specific rate for each exceeded the national rate. The pathogen with the highest percentage difference was flagged as the most overrepresented in that state. Only states that reported data for all eight tracked pathogens were included in the final results.
It is important to acknowledge the limitations of the NNDSS dataset. Reporting practices vary by state due to differences in public health infrastructure, diagnostic testing capacity, and case follow-up procedures. As a result, geographic differences in incidence rates may reflect not only actual differences in disease burden, but also variations in detection and reporting.
Moreover, many mild cases of foodborne illness go unreported, leading to an underestimation of true incidence. Despite this, NNDSS provides the most comprehensive and standardized data available for tracking reportable foodborne diseases in the U.S.
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