I thought I was being overly concerned; she’d never been this sick, and I was overreacting.
PATHOGEN: E. coli HUS | SOURCE: Raw (unpasteurized), Fresh + Frozen Produce, Prepared Foods
“My tummy hurts. My tummy hurts. My tummy hurts.” My three-year-old daughter repeated this over and over again. Until that Tuesday evening, Anna had never complained about pain of any sort. In fact, when she fell down, she would leap up and say, “I’m OK,” and run off. Indeed, Anna was one, healthy, big kid for her age at 35 pounds. Though we eat out frequently, we have always tightly restricted her intake of sweets and pushed a lot of vegetables, fruits, legumes, and milk products like yogurt and cheese. She eats at fast food restaurants at most twice a year.
My husband and I had been on a rare Mommy-Daddy-only vacation when Anna fell sick. “I took her to the pediatrician’s yesterday,” Grandma said, though it was clear that she was worried. “He said it was probably flu, and she should be better by tomorrow.” By the time we returned from vacation, Anna had had chronic diarrhea with stomach cramps for four days, day and night. That night, I learned that the stomach cramps would even awaken her from sleep. Her diarrhea, at that point mostly fluid, was an odd, orangeish color. “By the way, I bought some of that Odwalla apple juice at the grocery store. She really loves it! We went through a whole jug of it and then I went back to the store to get more,” my mother added. I frowned. Apple juice is notoriously low in nutrition. We usually fed Anna strawberry/banana or sent her to nursery school with Odwalla carrot juice in her lunch box, but Grandmas have privileges that parents often don’t.
We scheduled a second appointment with the pediatrician the next day, and he was concerned it was food poisoning, either Shigella, Campylobacter, or Salmonella. It has recently become known that antibiotics given to kill off the first two can drive Salmonella into the gallbladder, so the doctor wanted to be sure of the infectious agent. Through the stethoscope, the rumbling in her tummy was loud and clear. He and I agreed that her stool might have blood in it, but neither of us was sure. We gave the lab a stool sample, which would take at least two days to culture. When Anna wasn’t running to the bathroom, she was lying in my arms, at times only whispering, “My tummy hurts. My tummy hurts.” Because she had to get up in the middle of the night to go to the bathroom, I slept in her room, awakening every two hours.
By Thursday, she had had diarrhea for six days straight and hadn’t eaten in four. She was going through panties so often that I put her into pull-ups at great offense to her ego. That afternoon, when there was still no sign of improvement, I took her to the doctor’s office for an IV. I thought I was being overly concerned; she’d never been this sick, and I was overreacting. My mother and I spoke frequently about where she might have contracted it. We reviewed what she had eaten. We noted that she had been to a petting zoo. I asked at her nursery school whether any other children had fallen similarly ill. There was no source. Because Anna was only drinking water, the doctor asked us to begin pushing fluids such as apple juice. I bought some more Odwalla apple juice and lots of Gatorade, but Anna would only drink a couple of sips at a time.
On Friday, after seeing her again, and after the results of her stool culture all came back negative, the doctor prepared me for the weekend. I should bring her in for a second IV if she didn’t drink a certain amount every hour. I should also bring her in if she developed a fever or if she didn’t pee more than twice in 24 hours. That night, Anna showed some brief improvement. As we ate dinner, she asked for some pasta of her own and ate a few pieces without anything on them.
Early Saturday morning, I thought we were making progress. Anna was drinking some fluids, and she hadn’t had diarrhea or peed since late on Friday. By the middle of the afternoon though, she had fallen behind in fluids and still had not peed. I spoke to the doctor on call. My husband thought I was worrying too much; she just needed to be pushed harder to drink fluids. We went to the emergency room to get an IV, and there, she vomited up all of the fluids she had consumed in the last five hours. The pediatrician on call took a sample of her blood before starting the IV, and fairly quickly thereafter, Anna had to go pee again.
“We’re admitting her,” the pediatrician on call announced. She went on to describe Anna’s blood counts were all slightly abnormal. Her creatinine, a measure of kidney function was not good. A month before, my aunt had died of complications resulting from chronic kidney disease. “We’re familiar with creatinine,” I said, explaining about my aunt. “That’s the one we worry about.” Admitting Anna also seemed like an overreaction, but she was clearly dehydrated. Better to be watched carefully rather than kicked out too soon. I nominated myself to stay at the hospital. That night, the electronic thermometers were not working, and they took Anna’s temperature rectally. By the time they came a third time, she yelled, “I don’t want them to put that stick in my bottom!” They took blood every four hours. I think the only way Anna managed to sleep was through exhaustion.
By 1:00a.m., I had barely slept. The bed I was given had loud squeaking springs. At one point, it almost collapsed on me, and I was trying to not wake Anna up. The nurse put through a call from the pediatrician. “We’ve identified Anna’s illness,” she said. “We think she has HUS.” I tried to follow what she was saying, but it all seemed like jargon. HUS was the leading cause of acute renal (kidney) failure in children. It crops up most often in the summer and fall. Children can get it from fast food places and swimming in lakes, neither of which Anna had visited. When they see clusters of cases, the doctors presume it is an outbreak of E. coli O157. Children can recover in 2 to 3 weeks. They were going to transfer her to Stanford Children’s Hospital, where the disease would be treated aggressively. She went on to talk about Anna’s increasing anemia. “Because you mentioned the creatinine and it’s increasing, I thought about this disease in particular. That’s why we checked under the microscope. When we found broken red blood cells, I suspected HUS, so I called the renal specialist at the Children’s Hospital, and he agrees.” The doctor closed with, “I’m very sorry that I have to tell you this. I told the nurse, ‘That poor mother…’ getting news like this in the middle of the night.”
I couldn’t understand the significance. Were Anna’s kidneys failing? I tried to call Scott, my husband, but our phones at home shut down at night. It was a long, lonely night. How would they treat this? What did it mean? Because I had received the early morning call about my aunt’s death, I knew the phones would turn back on at 6:00a.m. and called Scott promptly. After repeating as much as I could remember, I asked, “Please get on the Internet. Look for “Hemolytic uremic syndrome” and “E. coli O157. ” Scott came about an hour later.
As I poured over the materials, tears welled up in my eyes. At the Synsorb Biotech, Inc. site, it read: “Hemolytic Uremic Syndrome (HUS) is a disease that affects the kidneys and other organs. It poses a threat…as one of the leading causes of both acute and chronic kidney failure… The most common symptoms of E. coli O157:H7 Gastroenteritis or Hamburger Disease include: Diarrhea (often with blood in the stools), Vomiting, Abdominal Cramps…E. coli O157:H7 bacteria infect the intestine of cattle and less frequently the intestines of other animals. Typically carried in the feces, it can contaminate the meat during and after slaughtering. These bacteria are associated mainly with consumption of undercooked ground beef, unpasteurized milk and cheese, and contaminated water sources… If HUS develops, children spend an average of 2 weeks in hospital mainly to care for kidney problems of varying severity. Depending on the severity of the illness, a large majority will require some form of blood transfusion and approximately 50% will need temporary kidney dialysis. Modern medical care has allowed approximately 97% of the children to survive the illness; however, long-term follow-up is very important.”
The Lois Joy Galler Foundation was more dour, and I began to sob: Only 1 in 10 children develop HUS following an E. coli infection. “HUS is a dramatic, explosive illness that most commonly develops within 2 to 4 days after a bout of gastroenteritis that is accompanied by bloody diarrhea. Children are hospitalized with obvious irritability, fatigue, pallor and a noticeable decrease in urine production. Some severely affected children may have life-threatening gastrointestinal problems. Neurological dysfunction including lethargy, seizures, cerebral infarction, blindness and coma can be present at disease onset or develop during the course of the illness. Profound gastrointestinal or neurological disease are markers for more severe cases of HUS and may be harbingers of a poor prognosis.”
“Nearly 5-10% of children with HUS die during the acute phase of the disease as a consequence of complete renal failure or multiple organ complications. A small majority of children with HUS experience a complete recovery with full restoration of kidney function and almost no risk of the disease recurring. However, 10-30% of the children who survive have permanent kidney damage and many of these children will have progressive loss of kidney function over the next 5 to 10 years.”
I went into the bathroom in Anna’s room to take a shower. With the water falling all around me, I began to sob uncontrollably. What had happened to my little girl? Why was this happening to us? What lay ahead of us? How bad was it going to get? Would Anna ever come home with us? What if she were left blind or brain damaged?
As we waited for the ambulance to come, we watched a Sesame Street video about Big Bird’s trip to the hospital, which almost comically, word-for-word mimicked much of the situation as Anna was seeing it. We talked up the ambulance trip between the two hospitals to Anna. She wanted to walk to the ambulance rather than ride on a gurney, and so, with her IV bag attached, four ambulance people and a nurse, we went to the ambulance outside.
At Stanford, we went to a special wing. On the entrance doors to the wing, there were large signs indicating that this was the Immunologically Suppressant Ward; here, children were awaiting transplants. We walked past some rooms, and on the outside of two, I saw photos of the children as they had been before they got sick. We were put in a special room with air filtered as for transplant cases. There was an anteroom for observation; it was the biggest single hospital room I had ever seen.
Late in the day, Dr. Mak, the pediatric-nephrologist came to visit. He indicated that they had not found E. coli in Anna’s stool back at the original hospital, but in 50% of all cases, they never did find it; sometimes, HUS can be caused by other agents. E. coli, he believed, was a reportable disease in the State of California, but HUS was not, and he didn’t believe Anna could be part of an epidemic because Stanford had not seen any number of cases at a rate different than they usually did.
In HUS, the infectious agent spews toxins into the blood stream. Because it is not always known whether it is viral or bacterial, little is done to the original agent after the onset of HUS, but the symptoms must be monitored carefully to minimize damage. As I best understand this, they believe that toxins cause platelets to clump together and stick to the sides of the blood vessels. They also become “sharp,” perhaps like a net made up of knives, and they therefore cause the red blood cells to become broken. Most of the damage appears to occur in capillaries where the passageways are “small” and the RBCs probably cannot “get by” without brushing up against these. The kidneys, because they filter blood on such a detailed level, are a particularly sensitive organ to this type of damage but the damage happens to all organs.
As a result, the symptoms resulting are anemia (loss of red blood cells), loss of platelets, and micro-damage to blood cells. As the kidneys suffer damage and renal failure begins, the patient takes on fluid, eventually no longer peeing on their own. The fluid increases the chances of high blood pressure. Electrolytes become imbalanced, and if potassium goes too high, it can damage the heart. Examples of extreme symptoms are complete kidney failure, strokes causing brain damage, coma, and blindness. However, about 98% of Dr. Mak’s patients had gone home healthy.
The doctor described Anna’s case as being “moderate.” He indicated that Anna would get worse before she would get better, and they needed to watch her carefully. Indeed, she was up and acting like she was getting better already–all this transplant ward stuff was really looking like throwing a grenade when a water balloon would do. As for transfusions, which were likely given where her blood counts were going, we, her parents, were not advised to donate our blood. Because we were the best donors of kidneys should she ever need a kidney, they didn’t want her immune system to develop antibodies to our blood which would down-the-line interfere with her ability to accept a kidney from us.
Anna did very well on Sunday and Monday… she was active and laughing despite the fact that her blood indicators were showing decreasing red blood cells, decreasing platelets and increasing wastes building up in her blood. She was learning to draw with her left hand because the IV site on her right arm inhibited her use of her right hand. Good signs were that she was continuing to pee and had normal blood pressure. On Monday night, they endeavored to give her a transfusion, but she broke out in hives, so they had to back off. They could not determine the cause of the allergic reaction.
That day, Scott read on the Web that “road-side” apple juice had been the source of one E. coli outbreak. We wondered about the juice because it had featured so prominently in my mother’s description of Anna’s week at her house.
By Tuesday, Anna became increasingly irritable. Her normally rose-red lips lost color, and the rest of her color became quite ashen, as if dead. She became puffy, especially in her hands and feet where her arches disappeared, and they had to cut off the bracelets they had strapped on her within the last two days because they became too tight. She was on IVs until it was determined that she was “taking on” fluids, at which point she was placed on a fluid restricted diet. She would beg us for water, but we could give her only a sip every hour. Her lips became dried and bloody.
Tuesday afternoon, a friend stopped by and mentioned that she had heard they were recalling Odwalla apple juice in the State of Washington for having caused an E. coli outbreak there. Somewhere between 10 and 13 people had been affected. Scott called Odwalla, finally speaking with a founder about Anna’s situation. As I began to think about it, even though Stanford seemed to have thought the other lab had tested for E. coli, I didn’t remember anyone actually ordering such a test. As far as I remembered, we had only tested for Salmonella, Campylobacter, and Shigella. Now, Anna hadn’t had a stool in over four days. When questioned, the Stanford nursing staff reported back that there was actually neither a positive nor a negative on the stool culture for E. coli. I called Anna’s pediatrician and left a message.
Scott also initiated a call with the Santa Clara County Department of Health. They were very interested and said that HUS had just recently become a reportable disease in California, though they had no other examples found in Santa Clara County. Ironically, Stanford is just the other side of the border for San Mateo County. My mother had purchased the apple juice in San Mateo County, and shortly thereafter, cases were reported in San Mateo County.
They began a second transfusion on Tuesday afternoon. To reduce the likelihood of an allergic reaction, they gave her Benadryl and Tylenol and “washed down” the blood to be transfused. Anna’s eyes became glassy, and she stared into space when she wasn’t sleeping. As it went on, her color returned, but her numbers did not improve the way they expected. In fact, her platelet counts plummeted. Her BUN, a second measurement of wastes, rose above 100–in some patients, a sign of impending dialysis. They were constantly measuring the amount she peed, trying to determine whether her kidneys were keeping up with the fluid.
We were exhausted, living on at most four hours of sleep per night. Any time, day or night, that a transfusion or IV line didn’t flow correctly, an alarm that sounded like a doorbell would go off, repeating itself until we could get a nurse to change it. Likewise, if Anna bent her right index finger, her heart rate monitor would sound off. They moved us to another, smaller room in the ward, and I asked our friends not to visit because the grandparents, Scott, and I were now snapping at each other.
Word came back from Anna’s primary pediatrician–they had never tested for E. coli. He was upset. “It’s standard practice to look for E. coli as part of these tests, but the lab decided her stool wasn’t ‘bloody enough.’ ‘Not bloody enough’ — sounds real scientific, doesn’t it? We’ve got to change the standard practice.” Had E. coli been found early on, it was possible it could have been treated with antibiotics. Wednesday evening, the local news stations covered another child who had fallen ill and was at Oakland Children’s Hospital. She was already on dialysis. Scott and I agreed that our objective had to be to help other parents quickly identify this illness; we gave the media department a statement about Anna’s condition.
Thursday, though Anna was looking better and some of her blood signs were improving, her platelet and red blood cell counts were still low. Because her kidney output was fine, she was taken off of the restricted fluids diet. Her normal blood pressure made everyone optimistic, but they wanted to give her a third transfusion. We mistakenly believed they could give us blood from the same source as the original transfusion, and we caused a stir when we insisted on speaking to the doctor about getting blood from the same source. It wasn’t possible, and we were confused. And tired.
Because Anna had still not had a stool, the doctors offered to do a rectal swab to see if they could find the E. coli. For them, the E. coli search must have seemed like a boondoggle. They were not seeing more cases at Stanford which would suggest an epidemic, and knowing that it was E. coli would not at that point have changed the treatment. But we wanted to know the source. Just when we thought we might have to do the swab, Anna passed her first stool in six days. It was rushed to the lab to be cultured.
On Friday, we received the great news for which we had prayed. Anna’s creatinine had gone down, and her platelets had shot back up. Her red blood cell counts were creeping back up as well. They were thinking she might go home the next day! An official from the Santa Clara County came to ask us the questions we had already asked ourselves. Had she been swimming in any bodies of water? Had she been to any fast food restaurants? Had she eaten any ground meat or unpasteurized cheeses? They took our empty and half-full Odwalla juice bottles. One from Grandma’s house had the stamp: October 24, 2FN on it. The other jug or jugs were already gone to recycling. We also were visited by one of the founders of the Odwalla company, who had left an emotional message on our answering machine the day before. Remarkably, she arrived just as things were finally looking up; she was as upset and apologetic as one can be without admitting fault. We believed that the “friend” who came with her was probably a lawyer.
Anna returned home from the Stanford Children’s Hospital on Saturday, November 2, around 1:00p.m. on Saturday. Her condition was not yet normal–she was anemic with a low platelet count–but the doctors have never seen a case of HUS relapse after the appropriate indicators turn the corner, so they felt confident in discharging her.
The doctors encouraged us to keep her home the first week in order to avoid any “accidents” which might result in bruising or cuts that required more platelets. Because this disease is relatively new, her long term prognosis is unknown. Her first blood check showed that her platelets had risen into a normal range. Three weeks after discharge she was still excreting blood cells in her urine and was still anemic. They will check her again in mid-December and continue to check up on her every year until adulthood. Possible long-term complications include kidney failure over time, permanent neurologic injury, and/or high blood pressure. E. coli O157:H7 was only recognized as the source of illness in 1982 and as a cause of HUS in 1985. Therefore, there is relatively little long-term data.
Anna’s stool culture results finally came back positive for O157:H7 more than a month after they were first taken to the lab. The State of Washington has found E. coli contamination in Odwalla apple juice with a lot number 2FO and the same expiration date as the bottle in Grandma’s refrigerator. However, they could not find E. coli in Grandma’s last jug of apple juice. When questioned about why the State of California’s response was relatively slow compared to the State of Washington, Dr. Jim Stratton, State Health Officer, indicated that there are three key features of Washington:
1. Washington has had multiple outbreaks and is therefore prepared to move quickly. 2. There is a single pediatric hospital in the Seattle/King County area; therefore, all cases are brought into a single point of communication, so an epidemic becomes obvious. 3. All diarrheal stools, bloody or not, are tested for E. coli. California chooses to test only bloody stools, thus choosing to miss cases. This lack of data, coupled with a lack of centralized reporting to a single source means that the U.S. does not have a firm grip on the increasing spread of this organism, nor can they tell you the likelihood of your child coming into contact with it.
What Needs To Change
The present notification and investigation systems available in most of the United States and the State of California are inadequate for detecting and preventing the spread of food poisonings, which can be deadly to children and adversely affect pregnant women. The nature of the United States in the 1990’s is that fresh produce and goods and ground-meat products, which can be contaminated with E. coli, can be distributed over many states and cause widely distributed epidemics that are no longer simple, isolated incidents such as local, roadside apple cider. The Centers for Disease Control and Prevention has a responsibility to make HUS a reportable disease in order to assist in the rapid gathering of information and preventing further spread of disease.
Throughout California, each county must begin immediately notifying neighboring counties of cases of suspected E. coli poisoning and HUS rather than waiting for the State Department of Health to begin its bureaucratic process. The nature of food poisoning is that by the time the symptoms are cultured and obvious, the initial food and thus evidence has been thrown out; yet, food still harboring infectious agents sits waiting on shelves for unsuspecting consumers. In the time that it takes bureaucracies to move forward, more children can be afflicted. I believe that the Seattle-King County Department of Public Health in the state of Washington has done more in this investigative area than other counties because they have been hit three times now with outbreaks of E. coli: once with the Jack-in-the-Box case in 1993, once with a salami case in 1994, and now with Odwalla. Other county health departments should follow King County’s example in the speed with which it acted to determine the cause of the infection and prevent its spread.
Blood labs MUST routinely scan for E. coli poisoning whenever any food poisoning such as Salmonella, Shigella, or Campylobacteris suspected, regardless of whether the stool appears bloody. If the course of treatment for the initial patient is not changed, at the very least, other cases may be prevented. Tests must be developed that rapidly determine infection from E. coli O157:H7 and Salmonella. The present stool culture mechanism is ridiculously long and hopelessly inadequate for quickly determining and acting upon a deadly disease.
Lastly, parents must be constantly vigilant for this type of disease. The symptoms of E. coli poisoning may be similar to the flu, but they are not identical in all cases. In our daughter’s case, the diarrhea did not appear particularly bloody. There was no fever, and there was no vomiting. However, there were constant, painful stomach cramps that awakened her every two hours throughout the night. Though she was toilet trained, she could rarely get to the bathroom in time.
As for Odwalla, I believe that the management team has an opportunity to lead the natural-food industry in researching new tests that quickly and accurately determine the contamination levels of fresh juices. Should the natural-food industry find itself unable to regulate contamination out of its products, I believe that all apple juice should carry a blatant warning: “WARNING: unpasteurized apple juice has been identified as a potential source of E. coli O157:H7 infections which can make you sick and are deadly to small children.” Likewise, the stores that carry organic produce should be required to post signs that say: “WARNING: this store sells produce of undetermined contamination levels. Food sold here may be contaminated with E. coli O157:H7, which is known to be deadly to small children.” We don’t feed alcoholic beverages to small children; why would we give them juices that might kill them?
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Utah Department of Health/Report a Foodborne Illness
Cannon Health Building
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Salt Lake City, UT 84116
888-222-2542
Utah Association of Local Health Departments
Salt Lake County Health Department
Food Protection
Vermont Department of Health
Public Health Laboratory
108 Cherry Street, PO Box 70
Burlington, VT 05402
800-439-8550
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Food Safety and Consumer Protection
116 State Street
Montpelier, VT 05620
802-828-2430
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Food Safety
109 Governor Street
Richmond, VA 23219
804-864-7454
The Washington State Department of Health is no longer offering in-person customer service until further notice. For information about other services still available, call office at 360-236-4501 or 800-525-0127 during regular business hours. (April 2021)
You and Your Family > Food Safety
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608-266-1865
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Cheyenne, WY 82002
Call 1-866-571-0944 (toll free) or (307) 777-7656
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DC Department of Health Food Safety https://dchealth.dc.gov/service/division-food
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National Resources
US Food and Drug Administration (FDA)
FDA Center for Food Safety
888-SAFEFOOD (1-888-723-3366)
www.fda.gov
US Department of Agriculture (USDA)
USDA Meat & Poultry Hotline: 1-888-674-6854
USDA- Food Safety and Inspection Services (FSIS)
www.fsis.usda.gov
US Department of Health and Human Services (HHS)
www.foodsafety.gov
Centers for Disease Control and Prevention (CDC)
800-232-4636
www.cdc.gov/foodsafety/
Antibiotic Resistance Action Center
The Center for Food Safety
202-547-9359
International Food Information Council Foundation
202-296-6540
Council of State and Territorial Epidemiologists
www.cste.org
770-458-3811
_________________________________________
Office on Women’s Health
womenshealth.gov/index.html
US National Library of Medicine
www.nlm.nih.gov/
Medline Plus
www.nlm.nih.gov/medlineplus/
National Institutes of Health
www.nih.gov/
Agency for Healthcare Research and Quality
Food and Water Safety for Travelers
https://www.iamat.org/food-and-water-safety
Puerto Rico Done
https://www.fns.usda.gov/contact/puerto-rico-department-health
Guam Dept of Health
Guam Department of Agriculture
US Virgin Islands
Connecticut Department of Public Health
Food Protection Program
410 Capitol Avenue
Hartford, CT 06134
860-509-7297
Hartford Health Department
131 Coventry Street
Hartford, CT 06112
860-757-4726 or 860-757-4729
New Haven Health Department
54 Meadow Street
New Haven, CT 06519
203-946-6999
Texas Department of State Health Services
Food Establishments Group
PO Box 149347
Austin, TX 78714
512- 834-6753
www.dshs.state.tx.us/foodestablishments/
Texas Department of Agriculture
Food and Nutrition
1700 N Congress, 11th Floor
Austin, TX 78701
512-463-7476
www.squaremeals.org/
http://www.squaremeals.org/FandNResources/FarmtoSchool/ToolsforSchools/FoodSafety.aspx
Texas Health Departments (by District)
www.dshs.state.tx.us/regions/lhds.shtm
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Infectious Disease Control Unit
1100 West 49th Street, Suite T801
Austin, TX 78714
512-776-7676
www.dshs.state.tx.us/idcu/health/foodborne_illness/
Austin Food Establishment Inspections
https://data.austintexas.gov/dataset/Restaurant-Inspection-Scores/ecmv-9xxi
Dallas Food Establishment Inspections
http://www2.dallascityhall.com/FoodInspection/SearchScores.cfm
Fort Worth Food Establishment Inspections
www.fortworthgov.org/applications/Health/
Houston Food Establishment Inspections
http://houston.tx.gegov.com/media/search.cfm
San Antonio Food Establishment Inspections
www.sanantonio.gov/health/Food-Establishment-Inspection.html
Tennessee Department of Health
425 5th Avenue North
Cordell Hull Building, 3rd Floor
Nashville, TN 37243
615-741-3111
http://tn.gov/health
Division of Foodborne Illness
615-741-7247
Foodborne Illness Complaint Hotline
800-293-8228 (toll free)
Tennessee Restaurant Inspections
http://tn.gov/health/topic/eh-inspections
Health Departments in Tennessee by County
http://tn.gov/health/topic/localdepartments
Shelby County Health Department
814 Jefferson Avenue
Memphis, TN 38105
901-222-9243
www.shelbycountytn.gov/index.aspx?nid=1094
Metro Public Health Department of Nashville & Davidson County
311 23rd Avenue North
Nashville, TN 37203
615-340-5616
www.nashville.gov/Health-Department/Environmental-Health/Food-Protection-Services.aspx
South Dakota Department of Health
Office of Health Protection
600 E Capitol Avenue
Pierre, SD 57501
605-773-4945
doh.sd.gov/food/
South Dakota Department of Agriculture
523 E Capitol Avenue
Pierre, SD 57501
605-773-5425
sdda.sd.gov/farming-ranching-agribusiness/
South Dakota Food Establishment Inspections
sddoh.glsuite.us/glsuiteweb/Clients/SDDOH/Public/HealthInspectionSearch.aspx
South Carolina Department of Health and Environmental Control
Food Protection
2600 Bull Street
Columbia, SC 29201
803-898-3432
http://www.scdhec.gov/FoodSafety/
South Carolina Department of Agriculture
Food Safety and Compliance
State Capitol /Wade Hampton Building, 5th Floor
Columbia, SC 29211
803-734-2210
http://agriculture.sc.gov/divisions/consumer-protection/foodfeed-safety-compliance/
South Carolina Food Establishment Inspections
www.scdhec.gov/environment/envhealth/food/htm/inspection-rating/
Rhode Island Department of Health
Food Protection
3 Capitol Hill
Providence, RI 02908
401-222-5960
401-272-5952 (emergency after hours)
http://www.health.ri.gov/programs/foodprotection/
Rhode Island Department of Environment
Agriculture Division
235 Promenade Street
Providence, RI 02908
401-222-2781
http://www.dem.ri.gov/programs/bnatres/agricult/index.php
Rhode Island Food Establishment Inspections
http://www.health.ri.gov/food/
Pennsylvania Department of Agriculture
Bureau of Food Safety & Laboratory Services
2301 North Cameron Street
Harrisburg, PA 17110
866-366-3723
www.agriculture.state.pa.us
Pennsylvania Department of Health
625 Forster Street, 8th Floor West
Harrisburg, PA 17120
877-PA-HEALTH
www.portal.health.state.pa.us
Pennsylvania Food Establishment Inspections
https://www.pafoodsafety.state.pa.us/web/inspection/publicinspectionsearch.aspx
Oregon Health Authority
Healthy Environments/Foodborne Illness
800 NE Oregon Street, Suite 640
Portland, OR 97232
971-673-0451
public.health.oregon.gov/HealthyEnvironments/FoodSafety/Pages/index.aspx
erica.vaness@state.or.us
Oregon Department of Agriculture
Food Safety Program
635 Capitol Street NE
Salem, OR 97301
503-986-4720
www.oregon.gov/ODA/fsd/Pages/index.aspx
Oregon Health Departments (by County)
public.health.oregon.gov/ProviderPartnerResources/LocalHealthDepartmentResources/Pages/lhd.aspx
Multnomah County (Portland) Food Establishment Inspections
www3.multco.us/MCHealthInspect/ListSearch.aspx
Oklahoma Department of Health
Food Safety and Foodborne Diseases
1000 NE 10th Street, Room 605
Oklahoma City, OK 73117
405-271-4060
800-522-0203 (toll free)
www.ok.gov/health/Disease,_Prevention,_Preparedness/Acute_Disease_Service/Disease_Information/Food_Safety_and_Foodborne_Diseases/
Oklahoma Department of Agriculture Food and Forestry
2800 N Lincoln Boulevard
Oklahoma City, OK 73105
405-521-3864
www.oda.state.ok.us/food/
Oklahoma Food Establishment Inspections
www.phin.state.ok.us/Inspections/
Ohio Department of Health
Food Safety Program
246 N High Street
Columbus, OH 43215
614-466-1390
www.odh.ohio.gov/odhprograms/eh/foods/food2.aspx
Find Your Local Health Department (Ohio)
odhgateway.odh.ohio.gov/lhdinformationsystem/Directory/GetMyLHD
Ohio Department of Agriculture
Food Safety Division
8995 E Main Street
Reynoldsburg, OH 43068
614-728-6250
www.agri.ohio.gov/foodsafety
www.agri.ohio.gov/divs/meat/meat.aspx
Columbus Public Health
Food Protection Program
240 Parsons Avenue
Columbus, Ohio 43215
614-645-8191
publichealth.columbus.gov/food-protection.aspx
Columbus Food Establishment Inspections
www.decadeonline.com/main.phtml?agency=COL
Franklin County Food Establishment Inspections
www.myfcph.org/foodinspections.php
Cleveland Food Establishment Inspections
www.clevelandhealth.org/network/environment/review_inspection_report.php
Cincinnati Food Establishment Inspections
www.cincinnati-oh.gov/noncms/health/inspection/
Ohio Inspections by County
www.ohioinspections.org/category.php
North Dakota Department of Health
600 E Boulevard Avenue
Bismarck, ND 58505
701-328-2372
www.ndhealth.gov/disease/GI/default.aspx
North Dakota Division of Food and Lodging
www.ndhealth.gov/foodlodging
North Dakota Department of Agriculture
Meat Inspection
www.nd.gov/ndda/program/meat-inspection
North Carolina Department of Agriculture and Consumer Services
NC Food Safety
4000 Reedy Creek Road
Raleigh, NC 27607
919-733-7366
http://www.ncfoodsafety.com/
North Carolina Department of Health
Food Protection Program
5605 Six Forks Road
Raleigh, NC 27609
919-707-5854
ehs.ncpublichealth.com/faf/food/index.htm
Report a Foodborne Illness
NCDPH Epidemiology
225 N McDowell Street
Raleigh, North Carolina 27603
919-733-3419 (24 hr access)
epi.publichealth.nc.gov/cd/report.html#who
North Carolina Health Department Directors (by County)
http://www.ncalhd.org/directors
Restaurant Inspections
www.wral.com/5onyourside/restaurants/page/1001540/
New York Department of Agriculture & Markets
Food Safety & Inspection
10B Airline Drive
Albany, NY 12235
518-457-4492
www.agriculture.ny.gov/FS/FSHome.html
New York Department of Health
Empire State Plaza
Albany, NY 12237
800-458-1158 (toll free)
518-473-4436
www.health.ny.gov/environmental/indoors/food_safety/index.htm
New York Health Departments (by Region, District and County)
www.health.ny.gov/environmental/water/drinking/doh_pub_contacts_map.htm
New York City Restaurant Inspection
www.nyc.gov/html/doh/html/services/restaurant-inspection.shtml
New Mexico Environment Department
Food Program
PO Box 5469
Santa Fe, NM 87502
505-476-9102
www.nmenv.state.nm.us/fod/Food_Program
New Mexico Department of Health
1190 South Saint Francis Drive
Santa Fe, NM 87502
505-827-2613
www.health.state.nm.us
New Mexico Public Health Offices Map (by County)
http://nmhealth.org/location/public/
Albuquerque Food Inspection and Safety
www.cabq.gov/envhealth/inspections
New Jersey Department of Health
Food and Drug Safety Program
PO Box 360
Trenton, NJ 08625
609-826-4935
www.nj.gov/health/foodanddrugsafety/consumer.shtml
New Jersey Department of Agriculture
PO Box 330
Trenton, NJ 08625
609-588-7606
www.state.nj.us/agriculture/news/hottopics/topics070319.html
New Jersey Departments of Health (by County or Municipality)
www.nj.gov/health/lh/directory/lhdselectcounty.shtml
Rutgers University/NJ Agricultural Experiment Station
88 Lipman Drive
New Brunswick, NJ 08901
njaes.rutgers.edu/health/
New Hampshire Department of Health & Human Services
Public Health Services/Food Protection
129 Pleasant Street
Concord, NH 03301
603-271-4589
www.dhhs.nh.gov/dphs/fp
Foodborne Illness Surveillance
29 Hazen Drive
Concord, NH 03301
603-271-5300 (24 hr)
800-852-3345, x5300 (toll free 24 hr)
www.dhhs.nh.gov/dphs/cdcs/surveillance/food.htm
Nevada Division of Public and Behavioral Health
Environmental Health
4126 Technology Way
Carson City, NV 89706
775- 684-4200
775-684-5920 (emergency/after hours)
www.health.nv.gov
Nevada Department of Agriculture
Animal Disease & Food Safety
405 South 21st Street
Sparks, NV 89431
775-353-3718
http://www.nasda.org/Policy/6460/9885/foodsafety.aspx
Nevada Food Safety Task Force
2283 Cartwright Road
Reno, NV 89521
702-715-9266
hwww.nfstf.com/
Southern Nevada Health District Restaurant Inspections
southernnevadahealthdistrict.org/restaurants/index.php
Report a Foodborne Illness
702-759-1300
southernnevadahealthdistrict.org/foodborne/index.php
Health Topics/Food Safety
southernnevadahealthdistrict.org/health-topics/food-safety.php
Nebraska Department of Health & Human Services
Epidemiology/Foodborne Illness
301 Centennial Mall South
Lincoln, NE 68509
402-471-2937
dhhs.ne.gov/publichealth/EPI/Pages/Foodborne.aspx
Nebraska Department of Agriculture
Food Safety and Consumer Protection
301 Centennial Mall South
Lincoln, NE 68509
402-471-3422
ttp://www.nda.nebraska.gov/fscp/index.html
Nebraska Health Departments (by County and Rural District)
dhhs.ne.gov/publichealth/Pages/puh_oph_lhd.aspx#Websites
Omaha-Douglas County Health Department
Disease Control/Foodborne Illness
1111 South 41st Street at Pacific
Omaha, NE 68105
402-444-7214
402-444-7000 (after hours)
www.douglascountyhealth.com/disease-a-immunization/food-borne-illness
Restaurant Inspections
www.douglascountyhealth.com/food-a-drink/food-facility-ratings?rname=all&submit=Search
Lincoln-Lancaster County Health Department
3140 N Street
Lincoln, NE 68510
402-441-6280
www.lincoln.ne.gov/city/health/environ/consumer/food/foodsafety.htm
Food Establishment Inspections
logisrv01.lincoln.ne.gov/health/rdPage.aspx?rdReport=EPH.Default
Montana Department of Public Health and Human Services
Food & Consumer Safety
1400 Broadway
Helena, MT 59604
406-444-4542
www.dphhs.mt.gov/publichealth/fcs/index.shtml
Montana Health Departments (by County or Tribal Agency)
www.dphhs.mt.gov/publichealth/phep/countytribalhealthdepts.shtml
Montana Food Star Award Program
http://web.hhs.mt.gov/publichealth/fcs/foodstar.shtml
Montana DPHHS Food and Consumer Safety
http://dphhs.mt.gov/publichealth/FCSS
Missouri Department of Health and Senior Services
PO Box 570
Jefferson City, MO 65102
866-628-9891 (toll free)
www.health.mo.gov/safety/foodsafety
Missouri Department of Agriculture
Food Safety
1616 Missouri Boulevard
Jefferson City, MO 65102
573-751-4211
mda.mo.gov/connect/foodsafety.php
Kansas City Department of Healt
Food Protection Program
2400 Troost Ave, Suite 3000
Kansas City, MO 64108
816-513-6315
http://kcmo.gov/health/environmental-health-services/environmental-public-health-program/
Kansas City Food Establishment Inspections
www.inspectionsonline.us/foodsafety/mousakansascity/search.htm
St. Louis County Department of Health
Safe Food Center
www.stlouisco.com/HealthandWellness/FoodandRestaurants
St. Louis Restaurant Inspections
www.stlouisco.com/HealthandWellness/FoodandRestaurants/RestaurantInspections
Mississippi Department of Health
Food Safety, Restaurant Inspections
570 East Woodrow Wilson Drive
Jackson, MS 39216
866-458-4948
msdh.ms.gov/msdhsite/_static/43,0,377.html
Reporting a Foodborne Illness
800-556-0003
601-576-7400 (after hours/holidays)
Mississippi Public Health Laboratory
570 East Woodrow Wilson
Jackson, MS 39216
601- 576-7582
601-576-7725 (Office of Epidemiology)
msdh.ms.gov/msdhsite/_static/14,0,73.html
Mississippi Department of Agriculture & Commerce
Consumer Protection
PO Box 1609
Jackson, MS 39215
601-359-1148
https://www.mdac.ms.gov/bureaus-departments/regulatory-services/consumer-protection/
Minnesota Department of Public Health
Food Safety
PO Box 64975
St Paul, MN 55164
651-201-5000
888-345-0823 (toll free from greater MN)
www.health.state.mn.us/foodsafety
Reporting a Suspected Foodborne Illness
877-366-3455
www.health.state.mn.us/divs/idepc/dtopics/foodborne/reporting.html
Minnesota Department of Agriculture
Food Safety
625 Robert Street North
St Paul, Minnesota 55155
651-201-6000
800-967-2474
www.mda.state.mn.us/food/safety
Infectious Disease Epidemiology, Prevention and Control (IDECP)
625 N Robert Street
PO Box 64975
St Paul, MN 55164
77-676-5414 (toll free from greater MN)
877-FOOD-ILL (877-366-3) Foodborne Illness Hotline
Minneapolis Department of Health
Food Safety Program
Public Service Center
250 S 4th Street, Room 510
Minneapolis, MN 55415
612-673-2301
http://www.ci.minneapolis.mn.us/health/inspections/foodsafety
Michigan Department of Agriculture & Rural Development
Food Safety
PO Box 30017
Lansing, MI 48909
800-292-3939
www.michigan.gov/mdard/0,4610,7-125-50772—,00.html
www.michigan.gov/mdard/0,4610,7-125-1572_2875_31948-8257–,00.html
Michigan Department of Community Health
Bureau of Disease Control, Prevention, Epidemiology
Capitol View Building
201 Townsend Street
Lansing, MI 48913
517-373-3740
517-335-9030 (emergency after hours)
www.michigan.gov/mdch/0,4612,7-132-2945_5104—,00.html
Michigan Food Inspections
secure1.state.mi.us/misafe/Default.aspx
Kent County (Grand Rapids) Health Department
700 Fuller Avenue NE
Grand Rapids, MI 49503
616- 632-6900
www.accesskent.com/Health/FoodServices/default.htm
Massachusetts Department of Public Health
Food Protection Program
305 South Street
Jamaica Plain, MA 02130
617-983-6700
617-522-3700 (emergency/after hours)
www.mass.gov/dph/fpp
Massachusetts Health Departments (by County)
www.healthguideusa.org/massachusetts_local_health_departments.htm
Massachusetts Partnership for Food Safety Education
www.mafoodsafetyeducation.info
City of Boston Department of Health
Inspectional Services Department/Health Division
1010 Massachusetts Avenue, 4th floor
Boston, MA 02118
617-635-5300
www.cityofboston.gov/isd/health
Worcester Department of Public Health\
25 Meade Street
Worcester, MA 01610
508-799-8531
www.worcesterma.gov/ocm/public-health
Maryland Department of Health
Office of Food Protection; Center for Retail Food, Plan and Process Reviews
6 Saint Paul Street, Suite 1301
Baltimore, MD 21202
410-767-8400
phpa.dhmh.maryland.gov/OEHFP/OFPCHS/SitePages/Home.aspx
Foodborne Illness/Emerging Infections Program
phpa.dhmh.maryland.gov/OIDEOR/EIP/SitePages/Home.aspx
Baltimore City Health Department\
1001 E Fayette Street
Baltimore, MD 21202
410-396-4398
baltimorehealth.org/foodcontrol.html
http://health.baltimorecity.gov/environmental-health/food-facilities
Montgomery County (Germantown, Silver Spring) Department of Health
Disease Control and Epidemiology
Dennis Avenue Health Center
2000 Dennis Avenue
Silver Spring, MD 20902
240-777-1755
www.montgomerycountymd.gov/HHS-Program/Program.aspx?id=PHS/PHSDControl-p270.html
Howard County (Columbia) Department of Health
Food Protection Program
7178 Columbia Gateway Drive
Columbia, MD 21046
410-313-1772
866-313-6300 (toll free 24/7 access)
www.howardcountymd.gov/DisplayPrimary.aspx?id=4294969400
Food Establishment Inspection Program
howard.envhealth.info/
Maine Department of Health and Human Services
Division of Environmental Health
221 State Street
Augusta, ME 04333
207-287-8016
www.maine.gov/dhhs/mecdc/environmental-health/el/postings.htm
Maine Center for Disease Control and Prevention
286 Water Street, State House Station 11
Augusta, ME 04333
800-606-0215
www.maine.gov/dhhs/boh/food_safety_in_maine.html
Report a Foodborne Illness
800-821-5821 (24 hr access)
Maine Department of Agriculture, Food and Rural Resources
www.maine.gov/agriculture/qar/index.html
University of Maine Food Safety Program
5741 Libby Hall
Orono, ME 04469
207-581-3188
extension.umaine.edu/food-health/food-safety/
Portland Health & Human Services
389 Congress Street
Portland, ME 04101
207-874-8633
http://www.portlandmaine.gov/610/Food-Safety
Portland Restaurant Inspections
www.pressherald.com/special/portland_maine_restaurant_inspection_report.html
Louisiana Department of Health & Hospitals
Food and Drug Unit
PO Box 629
Baton Rouge, LA 70821-0629
225-342-9500
dhh.louisiana.gov/index.cfm/page/300
Louisiana Community Health Units (by Parish)
www.dhh.louisiana.gov/index.cfm/page/394
Reporting Foodborne/Waterborne Disease
1450 Poydras Street, Suite 2146
New Orleans, LA 70112
504-568-8316
www.dhh.louisiana.gov/index.cfm/page/535
Louisiana Restaurant Inspections
inspections.eatsafe.la.gov/default.aspx
Louisiana Department of Agriculture and Forestry
Food Quality
PO Box 1951
Baton Rouge, LA 70821
225-925-3772
http://www.ldaf.state.la.us/food-safety/
New Orleans Health Department
1300 Perdido Street, Suite 8E18
New Orleans, LA 70112
311
www.nola.gov/health-department/
Kentucky Department Public Health
Cabinet for Health and Family Services
275 E Main Street, 1E-B
Frankfort, KY 40621
502-564-7181
www.chfs.ky.gov/dph/info/phps/food.htm
Kentucky Department of Agriculture
Consumer & Environmental Protection
107 Corporate Drive
Frankfort, KY 40601
502-573-0282
www.kyagr.com/consumer/division-of-food-distribution.html
Louisville Health and Wellness
400 East Gray Street
Louisville, KY 40202
502-574-6520
http://louisvilleky.gov/government/health-wellness/food-safety
Restaurant Inspections
http://portal.louisvilleky.gov/applications/RestaurantInspectionScores
Lexington-Fayette County Health Department
Environmental Health
804A Newtown Circle
Lexington, KY 40511
859-231-9791
www.lexingtonhealthdepartment.org/ProgramsServices/FoodProtection/tabid/200/Default.aspx
Barren River District (Bowling Green) Health Department
1109 State Street
Bowling Green, KY 42102
270-781-8039
270-202-5785 (24 hr access)
www.barrenriverhealth.org/mx/hm.asp?id=RestaurantScores
Kansas Department of Agriculture
Food Safety
109 SW Ninth Avenue
Topeka, KS 66612
785-296-3556
https://agriculture.ks.gov/divisions-programs/food-safety-lodging
Kansas Restaurant Inspections
https://agriculture.ks.gov/divisions-programs/food-safety-lodging/inspection-results
Kansas Department of Health and Environment
Curtis State Office Building
1000 SW Jackson
Topeka, Kansas 66612
785-296-1500
www.kdheks.gov/epi/foodborne.htm
Sedgwick County (Wichita) Health Department
1900 E Ninth Street
Wichita, KS 67214
316-660-7300
www.sedgwickcounty.org/healthdept/
Report a Foodborne Illness
316-660-5555 (24 hr access)
Johnson County (Overland Park) Health Department
http://www.jocogov.org/health
Wyandotte County (Kansas City) Health Department
619 Ann Avenue
Kansas City, KS 66101
913-321-4803
www.wycokck.org/dept.aspx?id=488
Iowa Department of Public Health
Bureau of Environmental Health
321 E 12th Street
Des Moines, IA 50319
515-281-7689
www.idph.state.ia.us/eh/food_safety.asp
Iowa Food System Council
www.iowafoodsystemscouncil.org
Center for Acute Disease Epidemiology (CADE)
www.idph.state.ia.us/Cade/Foodborne.aspx
Iowa State University Food Safety Project
www.extension.iastate.edu/foodsafety/
Iowa Department of Inspections & Appeals
Food and Consumer Safety Bureau
www.state.ia.us/government/dia/page3.html
Polk County (Des Moines) Health Department
1907 Carpenter Avenue
Des Moines, IA 50314
515-286-3798
ms.polkcountyiowa.gov/health/
Linn County (Cedar Rapids) Health Department
935 2nd Street SW
Cedar Rapids, IA 52404
319-892-5000
http://ia-linncounty.civicplus.com/603/Food-Safety
Scott County (Davenport) Health Department
Food Protection Program
600 W Fourth Street
Davenport, Iowa 52801
563-326-8618
www.scottcountyiowa.com/health/food.php
Indiana Department of Health
Food Protection
100 North Senate Avenue, N855
Indianapolis, IN 46204
317-234-8569
www.in.gov/isdh/20640.htm
Indiana Food Protection (by County)
www.in.gov/isdh/23962.htm
Report a Complaint to the Health Department
www.in.gov/isdh/20887.htm
Indiana Food Defense Program
317-233-8476
www.in.gov/isdh/20994.htm
Marion County (Indianapolis area) Department of Food Safety
3838 N Rural Street
Indianapolis, IN 46205
317-221-2222
www.mchd.com/fdp.htm
Fort Wayne-Allen County Department of Health
200 E Berry Street, Suite 360
Fort Wayne, IN 46802
260-449-7561
http://www.allencountyhealth.com/get-informed/environmental-health-hazards/consumer-alerts/
Evansville & Vanderburgh County Department of Health
Food Safety Program
420 Mulberry Street
Evansville, Indiana 47713-1231
812- 435-2400
www.evansville.in.gov/Index.aspx?page=623
Illinois Department of Public Health
535 West Jefferson Street
Springfield, IL 62761
217-782-4977
www.idph.state.il.us
Report Foodborne Illness (Health Departments by County)
www.idph.state.il.us/local/alpha.htm
Illinois Department of Agriculture
Food Inspection
PO Box 19281, State Fairgrounds
Springfield, IL 62794-9281
217- 782-2172
www.agr.state.il.us/programs/consumer/foodinsp.html
Restaurant Inspections (Chicago)
webapps.cityofchicago.org/healthinspection.jsp
Report Foodborne Illness
Chicago: 312-747-3663 | @foodbornechi (Twitter)
Suburban Cook County: @foodsafecookco (Twitter)
Cook County Department of Public Health
Food Safety Resources
15900 S Cicero Avenue – Building E
Oak Forest, IL 60452
708-633-4000
http://cookcountypublichealth.org/services/food-safety
Kane County Health Department
Environmental Health
1240 N Highland Avenue
Aurora, IL 60506
Or
1750 Grandstand Place
Elgin, IL 60123
630-444-3040
kanehealth.com/food_safety.htm
Idaho Department of Health and Welfare
Food Protection Program
PO Box 83720
Boise, ID 83720
208-334-6996
www.healthandwelfare.idaho.gov/Health/FoodProtection/tabid/96/Default.aspx
Questions/To Request Informational CD
208-334-5938
Idaho Health Districts (Reporting Illness, Restaurant Inspections, and More)
www.healthandwelfare.idaho.gov/Health/HealthDistricts/tabid/97/Default.aspx
Idaho Department of Agriculture
Food Safety Program
2270 Old Penitentiary Road
Boise, Idaho 83712
208-332-8500
www.agri.idaho.gov/Categories/InspectionsExams/FoodSafety/indexfoodSafetyHome.php
Boise Area Food Establishment Inspection Records
secure.cdhd.idaho.gov/cdhpublic/LicenseBrowser.aspx
Hawaii Department of Health
591 Ala Moana Boulevard
Honolulu, HI 96813
808-586-8012
health.hawaii.gov/food-drug/for-consumers/
http://hdoa.hawaii.gov/blog/ag-resources/food-safety-on-farm/
Reporting Foodborne Illness (District Health Offices)
Oahu 808-586-4586
Maui 808-984-8213
Kauai 808-241-3563
Hilo 808-933-0912
Kona 808-322-4877
808-566-5049 (after hours)
800-360-2575 (toll free)
Hawaii Food Education
www.ctahr.hawaii.edu/NEW/index.html
Hawaii Department of Agriculture
hdoa.hawaii.gov/agricultural-resources/
Georgia Department of Health
Office of Environmental Health
2 Peachtree Street NW, 13 Floor
Atlanta, GA 30303
404-657-6534
dph.georgia.gov/environmental-health
Environmental Health Inspections
dph.georgia.gov/environmental-health-inspections
Digital Health Department
http://www.garrisonenterprises.com/
Fulton County Health & Wellness (Atlanta)
141 Pryor Street
Atlanta, GA 30303
404-612-4000
fultoncountyga.gov/dhw-home
Restaurant Inspections
fultoncountyga.gov/dhw-restaurant-inspections
Richmond County Health Department (Augusta)
950 Laney-Walker Boulevard
Augusta, Georgia 30901
706-721-5900
www.ecphd.com/common/content.asp?PAGE=661
Columbus Department of Public Health
Office of Environmental Health
2100 Comer Avenue
Columbus, GA 31904
888-810-4316 toll free
www.columbushealth.com/chd/columbusHealth/index.cfm/community/environmental-health/
Emergency/After Hours
1-800-PUB-HLTH (782-4584)
Florida Department of Health
Food and Waterborne Disease Program
4052 Bald Cypress Way, Bin #A08
Tallahassee, FL 32399
850-245-4401
doh.state.fl.us/environment/medicine/foodsurveillance/FoodandWaterborneDiseaseProgramFinalIndexPage.html
On Facebook
www.facebook.com/FLDepartmentofHealth
Reporting a Problem with Food in Florida
doh.state.fl.us/environment/medicine/foodsurveillance/HowtoReportaProblemwithFoodinFlorida.htm
Florida Department of Agriculture and Consumer Services
Division of Food Safety
3125 Conner Boulevard, Suite D
Tallahassee, Florida 32399
850-245-5595
University of Florida Food Safety and Quality
fycs.ifas.ufl.edu/foodsafety/
Florida Restaurant Inspections (All Counties)
www.ledgerdata.com/restaurant-inspections/alachua/
Hillsborough County Department of Health (Tampa)
1105 E Kennedy Boulevard
Tampa, FL 33602
813-307-8000
www.hillscountyhealth.org/
Dade County Department of Health (Miami)
Miami-Dade Service Sites
http://miamidade.floridahealth.gov/programs-and-services/clinical-and-nutrition-services/service-sites.htm
Contact 24/7
305-324-2400
www.dadehealth.org
Duval County Department of Health (Jacksonville)
900 University Boulevard, N
Jacksonville, FL 32211
904-253-1000
www.dchd.net/our-programs/epidemiology
Delaware Department of Health
Office of Food Protection
417 Federal Street
Dover, DE 19901
302-744-4546
www.dhss.delaware.gov/dhss/dph/hsp/ofp.html
Food Establishment Inspection Reports
dhss.delaware.gov/dhss/dph/hsp/Default.aspx
Colorado Department of Public Health
Division of Environmental Health
4300 Cherry Creek Drive South B-2
Denver, Colorado 80246=
303-692-3645
www.cdphe.state.co.us/cp/
Colorado Department of Agriculture
Fruit and Vegetable Section
PO Box 407
Monte Vista, CO 81144
719-852-4749
Reporting Foodborne Illness by County
www.colorado.gov/cs/Satellite/CDPHE-Main/CBON/1251588365684
Colorado Inspection & Consumer Services
www.colorado.gov/cs/Satellite/ag_ICS/CBON/1251599400393
Food Safety (Statewide)
www.colorado.gov/cs/Satellite/ag_Main/CBON/1251634013356
Tri-County (Denver area) Health Department
6162 South Willow Drive, Suite 100
Greenwood Village, CO 80111
303-220-9200
http://www.tchd.org/246/Restaurants-Grocery
http://www.tchd.org/171/Infectious-Diseases
Denver Restaurant Health Inspection Reports
www.denvergov.org/eh/tabid/435231
Denver Foodborne Illness Investigations
www.denvergov.org/?TabId=391974
El Paso County (Colorado Springs) Food Safety
www.elpasocountyhealth.org/service/food-safety
California Department of Public Health
Food and Drug Branch
1500 Capitol Avenue, MS 7602
Sacramento, CA 95899
916- 650-6500
www.cdph.ca.gov/programs (Follow link to Food, Drug, and Radiation Safety)
California Department of Food and Agriculture
Inspection Services Division
1220 N Street
Sacramento, CA 95814
916-900-5020
inspection_services@cdfa.ca.gov
Consumer Complaints (Statewide)
800-495-3232
Restaurant Inspections by County
www.ca.gov/OnlineServices/OS_Consumers_inspections.html
Los Angeles Area Food Illness Report
https://www.visualcmr.net/webvcmr/pages/public/pub_FBI_Report.aspx
Los Angeles Area Restaurant/Market Ratings
publichealth.lacounty.gov/rating/
San Diego Food Complaints
http://www.sandiegocounty.gov/content/sdc/deh/fhd/food/foodcomplaints.html
San Diego Foodborne Epidemiology
http://www.sandiegocounty.gov/content/sdc/deh/fhd/food/foodborneepidemiology.html
Santa Clara County Food Facility Inspections
sccinspections.org/onlineinsp/
San Francisco Restaurant Safety Scores
www.sfdph.org/dph/EH/Food/score/default.asp
San Francisco Food Safety
www.sfdph.org/dph/EH/Food/default.asp
Arkansas Department of Health
Office of Environmental Health
4815 West Markham Street, Slot 46
Little Rock, AR 72205
501-661-2171
www.healthy.arkansas.gov
Food Protection
www.healthy.arkansas.gov/programsServices/environmentalHealth/foodProtection/Pages/default.aspx
Foodborne Illness
www.healthy.arkansas.gov/programsServices/epidemiology/Environmental/Pages/FoodborneDisease.aspx
Report a Foodborne Illness
www.healthy.arkansas.gov/programsServices/epidemiology/Environmental/Documents/ADHEntericCaseReportForm(web)forthePublic.pdf
Contact Local Health Unit to Report Foodborne Illness
www.healthy.arkansas.gov/programsServices/localPublicHealthOffices/Pages/default.aspx
Arizona Department of Health Services
www.azdhs.gov/preparedness/epidemiology-disease-control/food-safety-environmental-services/index.php
Office of Food Safety and Environmental Health
150 N 18th Avenue, #140
Phoenix, AZ 85007
602-364-3118
Maricopa County Department of Public Health
4041 N Central Avenue
Phoenix, AZ 85012
602-506-6900
www.maricopa.gov/publichealth/
Maricopa County Food Safety Inspections
www.azcentral.com/HealthInspectionMaps
Pima County Health Department
webcms.pima.gov/government/health_department
Pima County Consumer Health & Food Safety Administration
webcms.pima.gov/health/food-safety/
Pima County Restaurant Ratings
www.pima.gov/restaurantratings/
State of Alaska Food Safety and Sanitation Program
555 Cordova Street, 5th Floor
Anchorage, AK 99501
907- 269-7501 / 877-233-3663 (87 Safe Food – toll free)
www.dec.alaska.gov/eh/fss/index.htm
Food Safety & Sanitation by Location
www.dec.state.ak.us/eh/fss/Food/sanstaff.htm
Food Safety Inspections (Statewide)
www.dec.alaska.gov/eh/fss/Food/food_inspections.htm
Making a Complaint (Food and Sanitation)
http://dec.alaska.gov/eh/fss/Food/Complaints.html
Food Safety for Consumers
dec.alaska.gov/eh/fss/consumers/consumers.html
Foodborne & Waterborne Disease Information
www.epi.hss.state.ak.us/id/dod/foodwater/default.htm
Anchorage Area Food Safety Inspections
hhs.muni.org/fss/
Alabama Department of Public Health
201 Monroe Street, Suite 1250
Montgomery, AL 36104
334-206-5300 / 800-ALA-1818
www.adph.org
Division of Food, Milk, and Lodging
www.adph.org/foodsafety/
Food Establishment Scores
www.adph.org/foodscores
County Health Departments in Alabama
www.adph.org/administration/Default.asp?id=505
Jefferson County Department of Health
1400 Sixth Avenue South
Birmingham, AL 35233
205-933-9110
www.jcdh.org
Mobile County Health Department
251 North Bayou Street
Mobile, AL 36603
251-690-8158
www.mobilecountyhealth.org
Mobile County Department of Food & Lodging
251-690-8116