About Foodborne Illness

13674_loresThe US food supply is among the safest in the world, but organisms that you can’t see, smell, or taste – bacteria, viruses, and tiny parasites – are everywhere in the environment. According to the Centers for Disease Control and Prevention (CDC) each year 48 million illnesses, 128,000 hospitalizations, and 3,000 deaths in this country can be traced to foodborne pathogens.

Foodborne illness costs Americans billions of dollars each year, and serves as a constant challenge for consumers, researchers, government and industry.

The Food and Drug Administration estimates that two to three percent of all foodborne illnesses lead to serious secondary long-term illnesses. For example, certain strains of E.coli can cause kidney failure in young children and infants; Salmonella can lead to reactive arthritis and serious infections; Listeria can cause meningitis and stillbirths; and Campylobacter may be the most common precipitating factor for a debilitating disease, Guillain-Barre syndrome.

For more information on foodborne illness, visit the CDC website.


Extent of Illness 

According to the best available estimates by public health and food safety experts, millions of illnesses and thousands of deaths each year in this country can be traced to contaminated food. The Centers for Disease Control and Prevention (CDC) estimates that foodborne microorganisms cause 48 million illnesses, 128,000 hospitalizations and 3,000 deaths.

Not only can you get sick from foodborne pathogens, the Food and Drug Administration estimates that two to three percent of all foodborne illnesses lead to serious secondary long-term illnesses. For example, hemolytic uremic syndrome, the main cause of kidney failure in children, is caused by infection with E. coli O157:H7 (CDC); reactive arthritis(RA) occurs in approximately eight percent of foodborne illness cases, and it is associated with many different foodborne pathogens including Campylobacter and Salmonella (Buzby & Roberts, 2009); irritable bowel syndrome(IBS) has been associated with various food-related gastrointestinal infections including Norovirus and various bacterial illnesses (Spiller & Garsed, 2009); fetal loss, meningitis, and sepsis have all been linked to Listeria(CDC); and individuals infected with Campylobacter are at a 77-fold greater risk of developing the Guillian-Barre syndrome than the general population (Tam et al., 2006).

About Foodborne IllnessThe foodborne pathogens known to cause the most number of illnesses as recognized by the CDC are Salmonella,Campylobacter, E .coli O157:H7 and Norovirus. Only a small proportion of infected people are tested and diagnosed, with as few as 2 percent of cases reported to CDC.

The Centers for Disease Control and Prevention (CDC) estimates that over 1 million people in the United States are infected each year with Salmonella. According to the CDC, Campylobacter is the most common bacterial cause of diarrhea in the United States, resulting in 845,024 cases per year. Since 1982, E. coli O157:H7 has emerged as an important cause of foodborne illness. The CDC estimates this pathogen causes approximately 2,138 hospitalizations in the United States each year. According to 2009 preliminary CDC data, rates of infection were at least 25% lower for Shigella, Yersinia, Campylobacter, and Listeria than they were a decade ago.

Costs to Society 

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Foodborne illness is much more than the “stomach flu”, and it is a serious health issue and economic burden for consumers. According to the Economic Research Service (ERS) of the USDA, each year $6.9 billion in costs are associated with five bacterial pathogens, Campylobacter, Salmonella, Listeria monocytogenes, E. coli O157:H7, andE. coli non-O157:H7 STEC (2000).These costs are associated with medical expenses, lost productivity, and even death.

The ERS estimates that the annual economic cost of salmonellosis—the illness caused by the Salmonella bacterium—is $2.65 billion (2009). This estimate is for all cases of salmonellosis, not just foodborne cases. The estimate includes medical costs due to illness, the cost (value) of time lost from work due to nonfatal illness, and the cost (value) of premature death.

The ERS estimates that the annual economic cost of illness caused by shiga toxin-producing E. coli (STEC O157) is $478 million (2009). This estimate is for all cases of STEC O157 disease, not just foodborne cases. The estimate includes medical costs due to illness, kidney dialysis and transplant costs, and the cost (value) of time lost from work due to nonfatal illness, and the cost (value) of premature death.

The ERS estimates that the annual economic cost of illness caused by Campylobacter, the most frequently isolated cause of foodborne diarrhea, is $1.2 billion. The estimate includes medical costs, lost productivity, and death due tocampylobacteriosis from food sources and costs associated Guillain-Barré syndrome (GBS), a form of paralysis.

Estimates for the cost of foodborne illness do not include other significant costs to both industry and government.

Challenges 

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In a perfect world, no one would get sick, least of all from eating food. Unfortunately, the nonprofit Council for Agricultural Science and Technology (CAST) has reported that zero risk of microbiological hazards is not possible and no method will eliminate all pathogens or toxins from the food chain (“Food Safety and Fresh Produce:An Update”, 2009).

Why? Despite progress improving the quality and safety of foods, the CAST report explains, any raw agricultural product can be contaminated. Bacteria may survive despite aggressive controls at the processing level, or the food may become contaminated somewhere along the way during transport, preparation, cooking, serving, and storage.

Further, the CAST report stresses what food safety and public health officials have all recognized: Everyone in the food system, from producers to preparers, must be vigilant in controlling microbiological hazards.  The following factors make controlling foodborne pathogens particularly challenging:

  • Emerging pathogens demand even greater food safety vigilance than what was required in previous generations because as pathogens are evolving and becoming more widespread, bacteria are becoming more resistant to treatments.
  • The food supply has become global, with many different countries supplying food products to the United States.
  • More food is prepared and consumed away from home. The U.S. Department of Agriculture (USDA) estimates that consumers spend 48 cents of every food dollar eating out. Also, an increasing amount of food prepared away from the home is then taken home for consumption, thus creating more opportunities for contamination.
  • Consumers may not always be consistent with handwashing and safe thawing habits.

Adding to the challenge, microorganisms continue to adapt and evolve, often increasing their degree of virulence. For example, E. coli O157:H7 was first identified in 1982, but the bacterium has already been indicated as a cause for severe vomiting, bloody diarrhea, and even hemolytic uremic syndrome, which leads to kidney failure (CDC).

Foodborne pathogens emerge for many reasons including: the globalization of our food supply; introduction of pathogens in different geographic areas as in the case of Vibrio cholerae introduced in the southern U.S. by ballast water; international travelers are often introduced to foodborne pathogens that are uncommon in the U.S.; and changes in microorganisms leading to antibiotic resistance and ability to thrive in different environmental conditions(WHO, 2002).

At the same time, bacteria already recognized as sources of foodborne illness have found new modes of transmission. While many illnesses from E. coli O157:H7 occur from eating undercooked ground beef, the bacterium has also been traced to other foods, including salami, raw milk, lettuce, and unpasteurized apple cider.

For these reasons, food safety and public health officials agree that along with aggressive efforts to identify, assess, and control microbiological hazards associated with each segment of the food production system, teaching everyone about safe food handling must be a national priority. Consumers, as the last stop in the farm-to-table continuum, have an important role to play in reducing their risk of foodborne illness.