Multistate foodborne disease outbreaks are on the rise in the US, sickening thousands each year and sparking a call for better collaboration between the food industry and federal and state governments.

In the first five years of this decade, 120 multistate outbreaks were reported, an average of two dozen a year—a significant increase from 11 a year reported from 1995 to 2009, according to the CDC.

Why are more outbreaks being reported? Part of it is due to better detection methods and thorough investigations. In addition, wider food distribution has increased the likelihood contaminated foods will cross state borders.

The biggest culprits in multistate outbreaks—Salmonella, E. coli and Listeria—are more dangerous than the leading causes of single-state outbreaks. These three bacteria, which cause 91 percent of multistate outbreaks, can contaminate widely distributed foods, such as vegetables, beef, chicken and fresh fruits.

“Americans should not have to worry about getting sick from the food they eat,” says Tom Frieden, CDC director. “Top-notch epidemiology and new gene sequencing tools are helping us quickly track down the source of foodborne outbreaks. Together with our national partners, we are working with the food industry to prevent them from happening in the first place.”

CDC’s recent Vital Signs report analyzed data from CDC’s Foodborne Disease Outbreak Surveillance System during 2010 to 2014. Scientists compared the number of illnesses, hospitalizations and deaths from outbreaks in two or more states with those from outbreaks that occurred in a single state. They found the 120 multistate outbreaks during the five-year study period were responsible for 11 percent of all foodborne outbreak illnesses, 34 percent of the hospitalizations and 56 percent of the deaths. An average of 24 multistate outbreaks occurred each year, involving two to 37 states.

Other highlights from the report on multistate foodborne outbreaks during 2010 to 2014 include:

-Salmonella accounted for the most illnesses and hospitalizations and was the cause of the three largest outbreaks, which were traced to eggs, chicken and raw ground tuna.

-Listeria caused the most deaths, largely due to an outbreak caused by contaminated cantaloupe in 2011 that killed 33 people.

-Imported foods accounted for 18 of the 120 reported outbreaks. Food imported from Mexico was the leading source in these outbreaks, followed by food imported from Turkey.

The Vital Signs report recommends that local, state and national health agencies work closely with the food industry to speed multistate outbreak investigations. By doing this, CDC says these investigations can reveal fixable problems that resulted food contamination and the lessons learned that can help strengthen food safety.

In addition, the report highlights the need for the food industry to play a larger role in improving food safety by following best practices for growing, processing and shipping foods. CDC says the food industry can help stop outbreaks and lessen their impact by keeping detailed records to allow faster tracing of foods from source to destination, by using store loyalty cards to help identify which foods made people sick and by notifying customers of food recalls.

Under the 2011 FDA Food Safety Modernization Act, the Food and Drug Administration (FDA) is developing new regulations that will require importers to verify their suppliers meet US food safety standards and will hold both domestic and foreign companies accountable for preventing foodborne illness before it occurs. Final regulations for preventive controls were announced in September. Additional regulations covering produce, imported foods, intentional adulteration and sanitary transportation are expected in the coming months.

“The continued partnership of FDA, CDC, USDA and our partners at the state and local levels is essential to responding to foodborne outbreaks. Consumers should be able to have confidence that steps are being taken from farm to table to minimize the risk of illness from the food they feed their families,” says Michael Taylor, FDA deputy commissioner for foods and veterinary medicine. “By continuing to work with our government partners and industry, we can build a food safety system and culture focused on prevention.”

Over the past six years, USDA has taken an increasingly science-based approach to preventing foodborne illness, relying heavily on available data, trends and technological advances. “The USDA Food Safety and Inspection Service’s top priority is preventing multistate foodborne illness outbreaks from occurring. As we look toward the future, USDA will continue to work with FDA, CDC, industry and the states to advance our science-based approach to food safety,” says Phillip Derfler, USDA deputy administrator for the Food Safety and Inspection Service. “By focusing on collaboration and modernization, we are confident there will be a decline in multistate outbreaks.”