William F. Balistreri, MD

Disclosures

February 08, 2016

In This Article

US Prevalence of Foodborne Pathogen-Related Illnesses

Recently published data from the Centers for Disease Control and Prevention (CDC) reported that each year, approximately 48 million people (1 in 6 Americans) get sick, 128,000 are hospitalized, and 3000 die from foodborne diseases.[1,8,9] While a significant proportion of illnesses due to eating contaminated food are identified during investigation of a confirmed foodborne disease outbreak, many sporadic, self-limited cases are not recognized or are underreported, and thus the true prevalence is underestimated.

The CDC Foodborne Disease Outbreak Surveillance System data characterized the epidemiology of multistate foodborne disease outbreaks that occurred in the United States during 2010–2014. [10] During this 5-year period, 120 multistate foodborne disease outbreaks due to an identified pathogen and recognized food or common setting were reported to the CDC. Every state was affected, as well as Washington, DC, and Puerto Rico, with the outbreaks leading to 7929 illnesses, 1460 hospitalizations, and 66 deaths. Salmonella (53% of outbreaks), Shiga toxin-producing E coli (28%), and Listeria monocytogenes (10%) were the leading pathogens. In order of occurrence, fruits, vegetable row crops, beef, sprouts, and seeded vegetables were the most commonly implicated foods. These multistate outbreaks accounted for only 3% of all reported foodborne outbreaks but were responsible for 11% of related illnesses, 34% of hospitalizations, and 56% of deaths. Salmonella accounted for the majority of illnesses (82%) and hospitalizations (65%) associated with these outbreaks, including the three largest.[10] Eighteen multistate outbreaks linked to imported foods accounted for 18% of illnesses, 21% of hospitalizations, and 9% of deaths.

According to a recent study sponsored by the Pew Charitable Trusts, acute foodborne illnesses cost the United States an estimated $152 billion annually in healthcare, workplace, and other economic losses.[11] More than a quarter of these costs, an estimated $39 billion, are thought to be attributable to foodborne illnesses associated with fresh, canned, and processed produce.

Centralization of food processing and national distribution practices may be partly responsible for an increase in the frequency and magnitude of foodborne outbreaks. Most outbreaks are confined to a limited locale; some are more widely dispersed, affecting persons in multiple states because products are distributed widely and rapidly.[8,9,10] In addition, detection methods have improved; thus, outbreaks are being recognized with increasing frequency.

The Global Burden of Food-Related Disease

The problem is not limited to the United States. Worldwide, children younger than 5 years account for nearly one third of all deaths from foodborne illnesses, making up 125,000 of 420,000 total deaths each year, according to the World Health Organization (WHO) Foodborne Disease Burden Epidemiology Reference Group's estimates.[12] Diarrheal diseases—most commonly caused by eating undercooked meat, eggs, fresh produce, or dairy products contaminated by an enteric pathogen—made up more than half of the burden, with 550 million cases and 230,000 deaths each year. The risk for foodborne disease was highest in low-income countries due to contributing factors such as poor hygiene, unsafe water, inadequate conditions for food storage, preparation, and production, as well as insufficient food safety legislation or implementation of such legislation. [12] These findings underscore the global threat posed by foodborne diseases and reinforce the need for targeted action by governments, the food industry, and individuals to ensure that our food is safe and thereby prevent foodborne diseases.

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