Foodborne and Enteric Diseases

The Foodborne and Enteric Disease Program detects, investigates, and controls outbreaks of foodborne and enteric illness in Tennessee.

About the Foodborne & Enteric Diseases Program

Foodborne and enteric diseases are illnesses caused by consuming contaminated food or beverages. Many different disease-causing microorganisms—including bacteria, viruses, parasites, toxins, and chemicals—can contaminate food and water.

Most foodborne diseases are infections caused by bacteria, viruses, or parasites. Other illnesses are caused by harmful toxins or chemicals that contaminate food. In addition to food, some foodborne and enteric pathogens can be spread through drinking or recreational water, contact with animals or their environments, or person-to-person contact.

The Tennessee Department of Health conducts surveillance and responds to reports of foodborne and enteric diseases to identify cases, investigate outbreaks, and help prevent additional illnesses. This work is carried out in collaboration with local health departments, environmental health specialists, public health laboratories, healthcare providers, and federal partners, including the Centers for Disease Control and Prevention.

Outbreak Investigations in Tennessee

The Tennessee Department of Health investigates suspected and confirmed foodborne and enteric disease outbreaks by reviewing reports from healthcare providers, laboratories, and the public. These investigations help identify sources of illness, detect patterns or trends, and support actions to reduce the risk of additional cases.

Outbreak investigations are conducted in coordination with local health departments, environmental health programs, and laboratory partners.

Foodborne Complaints and Illness Reporting

Restaurant Complaints That Do Not Involve Illness

If you have a concern about a Tennessee restaurant that does not involve illness (such as sanitation or cleanliness issues):

These concerns are reviewed by Environmental Health staff.

Report a Foodborne Illness

If you believe something you ate at a Tennessee restaurant made you sick, you can report a suspected foodborne illness in one of the following ways:

Reports are sent to your local health department for review and possible investigation.

About the Tennessee Foodborne Illness Survey

The Tennessee Foodborne Illness Survey is an online reporting system that allows individuals to report illness while details are still fresh. The information provided helps local health departments assess potential food safety concerns and determine whether an investigation is needed.

Important: Investigations may be limited if contact information or the restaurant name and address are not provided.

Information Needed for an Investigation

Providing detailed information helps public health staff conduct a thorough review. You may be asked to provide:

  • Name and address of the restaurant
  • Dates when meals were eaten
  • Your name and contact information
  • Names and contact information of others in your dining party
  • Description of symptoms and when they began

Laboratory Testing

When a foodborne illness outbreak is suspected, the germ causing illness is often unknown. Laboratory testing helps identify the cause and supports outbreak investigations.

If you are experiencing symptoms:

  • Consider seeing a healthcare provider so specimens (such as stool samples) can be collected, or
  • Your local health department may contact you to request specimens

Learn more about germs that cause foodborne illness:
Food Safety | CDC

A Note About “Last Meal Bias”

People often associate illness with the most recent food or meal they consumed. While some germs can cause illness quickly, many foodborne illnesses take up to 72 hours (3 days) or longer to develop.

When completing a report, it is helpful to think about all foods eaten over the past several days, not just the most recent meal.

What Happens After You Submit a Report

After a foodborne illness report is submitted:

  1. The report is sent to the local health department
  2. Health department staff may contact the individual for additional information
  3. An Environmental Health Specialist reviews the information and determines next steps
  4. If warranted, the food establishment may be assessed, and reports reviewed for possible outbreak patterns

The goal is to identify and respond to potential food safety concerns and help prevent additional illnesses.

Related TDH Programs

How Foodborne Illness Spreads

Foodborne illness spreads through contaminated food or water, contact with infected people or animals, and contact with contaminated surfaces. Many foodborne illnesses are preventable by practicing good hygiene and safe food handling.

Hand Hygiene

Washing your hands with soap and warm water is one of the most effective ways to prevent the spread of germs. Germs can live on common surfaces such as door handles, faucets, countertops, phones, and remote controls.

Wash your hands often, especially:

  • Before touching or eating food
  • Between handling raw foods and ready-to-eat foods
  • After using the bathroom
  • After handling animals or animal waste

How to wash your hands properly:

  1. Wet hands with clean water
  2. Apply soap
  3. Scrub all hand surfaces
  4. Scrub for at least 20 seconds
  5. Rinse with clean water
  6. Dry hands

Learn more about handwashing:
CDC: Clean Hands - About Handwashing as a Healthy Habit in the Kitchen

Steps for Food Safety

Follow these four steps to reduce the risk of foodborne illness.

Clean

  • Wash hands for 20 seconds with soap and water
  • Clean utensils, cutting boards, and countertops with hot, soapy water
  • Rinse fruits and vegetables under running water

Separate

  • Keep raw meat, poultry, seafood, and eggs separate from ready-to-eat foods
  • Use separate cutting boards and utensils
  • Clean and sanitize surfaces between food preparation tasks

Cook

Food is safely cooked when it reaches a temperature high enough to kill germs. Always use a food thermometer.

Safe internal cooking temperatures:

  • Whole cuts of beef, pork, lamb, and veal: 145°F
  • Fish with fins: 145°F or until flesh is opaque
  • Ground meats: 160°F
  • Poultry (including ground): 165°F
  • Leftovers and casseroles: 165°F

Chill

  • Refrigerate perishable foods within 2 hours (or 1 hour if above 90°F)
  • Keep refrigerators at 40°F or below
  • Date-mark leftovers and discard unfrozen leftovers after 7 days
  • Thaw food safely in the refrigerator, cold water, or microwave

Learn when to throw out food:
Cold Food Storage Chart | FoodSafety.gov

Additional Prevention Tips

  • Do not prepare food for others if you have vomiting or diarrhea
  • Use safe drinking water and avoid swallowing recreational water
  • Practice food safety during holidays, cookouts, and outdoor events

People at Higher Risk

Some people are more likely to get very sick from foodborne illness, including:

  • Young children
  • Older adults
  • Pregnant people
  • People with weakened immune systems

These individuals should take extra care with food handling and avoid high-risk foods.

Food Safety Resources

For more information on handwashing and food safety, visit the following resources:

Centers for Disease Control and Prevention (CDC)

United States Department of Agriculture (USDA)

Food and Drug Administration (FDA)

Foodborne and Enteric Diseases

Foodborne and enteric illnesses are caused by consuming contaminated food or beverages. Many different disease-causing microorganisms, including bacteria, viruses, parasites, toxins, and chemicals, can contaminate food and water.

Some foodborne pathogens can also be spread through:

  • Drinking or recreational water
  • Contact with contaminated environments
  • Person-to-person contact

Learn more about foodborne and enteric illnesses, symptoms, and pathogens: CDC Food Safety

What Is Foodborne Illness?

Foodborne illness is a sickness that occurs when people eat or drink harmful microorganisms such as bacteria, parasites, viruses, or chemical contaminants found in food or water.

Learn more about foodborne illness, symptoms, and germs: Food Safety Basics | CDC

What Are Enteric Diseases?

Enteric diseases are intestinal illnesses caused by microorganisms such as viruses, bacteria, and parasites. Exposure typically occurs through contaminated food or water, and some enteric diseases can spread from person to person.

Most enteric diseases are mild and last a short time. However, some cases can be severe and may result in hospitalization.

Reportable Foodborne Diseases in Tennessee

The following foodborne diseases are reportable in Tennessee. Healthcare providers (inpatient or outpatient), laboratories, and other persons who know of or suspect a case are required to report it to the health department.

Select a disease below to learn more about symptoms, transmission, and prevention:

Reporting and Public Health Guidance

Timely reporting of foodborne and enteric diseases is critical for identifying outbreaks, protecting public health, and preventing additional illnesses.

The following resources support disease reporting, investigation, and control:

Healthcare providers and laboratories should follow Tennessee reporting requirements and submit reports promptly to their local or state health department.

Foodborne Illness Complaints (Public Reporting)

If you believe you may have gotten a foodborne illness from an establishment in Tennessee, you can submit a foodborne illness complaint so it can be reviewed by your local health department.

Submitting a complaint helps identify potential outbreaks and protect others from becoming sick.

Agritourism and Animal Contact Safety

Agritourism is any agricultural activity that brings visitors to a farm. These activities provide opportunities for family-focused recreation, education, and connections to local producers and products.

Examples of agritourism businesses include:

  • Working farms with petting zoos
  • Farm tours and educational programs
  • Animal interaction activities (such as goat yoga)
  • Corn mazes
  • Wine tastings
  • Weddings, festivals, and special events

While agritourism offers many benefits, contact with animals and farm environments can increase the risk of illness. Proper planning, hygiene, and education can help reduce these risks.

Prevention Strategies

Agritourism operators can reduce the risk of disease by:

  • Providing accessible handwashing stations with soap, running water, and signage
  • Encouraging handwashing after animal contact and before eating
  • Preventing eating and drinking in animal areas
  • Educating staff, visitors, school groups, and chaperones on safe animal interaction
  • Maintaining clean and well-managed animal environments

Resources for Agritourism Owners and Operators

Accessibility Notice:
Some of the documents and resources listed below may not fully meet current ADA accessibility standards. These materials are provided for historical reference and informational purposes. If you need an accessible version of a document or assistance accessing this information, please contact the Tennessee Department of Health.

Guidance and Educational Materials

School and Group Visit Resources

These resources support safe school and group visits to agritourism facilities:

National Guidance

Agritourism operators are encouraged to review the most recent National Association of State Public Health Veterinarians (NASPHV) Animals in Public Settings Compendium, which provides nationally recognized guidance for managing animal contact settings.

EHS-Net (Environmental Health Specialists Network)

EHS-Net is a CDC-led program that supports food safety by studying restaurant and retail food practices to help prevent foodborne illness and outbreaks.

What Is EHS-Net?

Recognizing the important role environmental health programs play in retail food safety, the Centers for Disease Control and Prevention (CDC) created EHS-Net (pronounced “S-Net”) in 2000.

EHS-Net is a collaborative forum of environmental health specialists that researches restaurant and retail food safety policies and practices to better understand and prevent foodborne illness and outbreaks.

Learn more about EHS-Net: CDC Stacks | EHS-Net

Why EHS-Net Matters

EHS-Net research has helped strengthen provisions in the U.S. Food and Drug Administration (FDA) Food Code. These improvements support safer food handling practices and help reduce norovirus and other causes of foodborne illness in restaurants and retail food establishments.

EHS-Net Partner Activities

EHS-Net partners work together to:

  • Research restaurant food safety policies and practices to understand environmental causes of foodborne illness and outbreaks
  • Translate research findings into recommended food safety prevention practices, policies, and training using a systems-based approach
  • Strengthen collaboration among epidemiology, laboratory, and environmental health programs at the local, state, and federal levels

EHS-Net Resources

EHS-Net offers a variety of tools and resources to support environmental health specialists and food safety programs.

Available resources include:

Access additional EHS-Net resources: CDC: Resources for Environmental Health Professionals

This Page Last Updated: March 26, 2026 at 4:44 PM