Comparison of zoonotic enteric disease outbreaks associated with ruminant and non-ruminant animal contact — United States, 2013–2021

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Introduction Contact with animals is a known risk factor for enteric illness outbreaks, but outbreak characteristics and pathogen distribution vary by animal type. Characterizing outbreaks associated with different animal groups can improve understanding of transmission patterns and inform prevention and response efforts. Methods We analyzed United States outbreak data reported to CDC’s National Outbreak Reporting System from 2013 to 2021 to compare outbreaks caused by Salmonella , Campylobacter , Cryptosporidium , or Shiga toxin-producing Escherichia coli (STEC) associated with ruminants (e.g., cattle, goats, sheep) or non-ruminants (e.g., poultry, reptiles, companion animals). We compared outbreak size, demographics, healthcare use, and health outcomes. Results Among 350 outbreaks (10,741 illnesses), 36% were associated with ruminants and 64% with non-ruminants. Ruminant-associated outbreaks were primarily caused by Cryptosporidium (70%) or STEC (17%), while non-ruminant outbreaks were caused by Salmonella (78%) or Campylobacter (20%). Ruminant-associated outbreaks were smaller (median: 4 vs. 14 cases) and had lower hospitalization rates (11% vs. 29%) and emergency room visit rates (14% vs. 21%). Adults aged 20–49 years accounted for a larger proportion of illnesses in ruminant-associated outbreaks, whereas non-ruminant outbreaks affected a broader age distribution, with a lower proportion of illnesses among persons aged 5–19 years. Discussion Zoonotic enteric outbreaks differ substantially by animal contact type in pathogen distribution, outbreak size, severity, and affected populations. Ruminant-associated outbreaks disproportionately affected adults aged 20–49 years and were more frequently associated with Cryptosporidium or STEC, whereas non-ruminant outbreaks more commonly involved Salmonella and showed a more evenly distributed age pattern. These findings support the need for animal-specific risk communication, targeted prevention strategies, and routine inclusion of animal exposure questions in public health investigations to improve outbreak detection and response.

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