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Foodborne Illness
Clinical Features More than 250 foodborne diseases have been described. Symptoms vary widely depending on etiologic agent. Diarrhea and vomiting are the most common. Etiologic Agent Many different bacteria (e.g., Campylobacter, Salmonella, E. coli O157:H7), viruses (e.g., caliciviruses), and parasites (e.g., Giardia, Cyclospora), and natural and manmade chemicals (e.g., mushroom toxins and heavy metals). Incidence Estimated to cause 76 million illnesses, 325,000 hospitalizations, and 5,200 deaths in the United States each year. Known pathogens account for an estimated 14 million illnesses, 60,000 hospitalizations, and 1,800 deaths annually. Sequelae Septicemia, abortion, localized infections, arthritis, hemolytic uremic syndrome, Guillain-Barré syndrome, death. Costs Unknown. Medical costs and lost wages due to foodborne salmonellosis, only 1 of many foodborne infections, have been estimated to be more than $1 billion/year. Transmission Ingestion of contaminated food, with or without subsequent spread from person to person by the fecal-oral route. Risk Groups All persons. Infants, elderly, and the immunocompromised at greatest risk of serious illness and death. Surveillance Laboratory-based surveillance for some foodborne pathogens (e.g., Salmonella, E. coli O157:H7, Campylobacter) – nationwide. Active, population-based surveillance (FoodNet) – detailed information for selected sites in the United States.
Foodborne Disease Outbreak Surveillance System provides information on >1000 outbreaks each year.
Trends New pathogens continue to emerge (e.g., multidrug-resistant Salmonella). However, the incidence of most pathogens under active surveillance in FoodNet decreased during 1996-2002.
Proportion of outbreaks caused by fruits and vegetables consumed without cooking has increased over recent decades.
Challenges Identify new foodborne pathogens. Define points of effective intervention. Implement and evaluate control strategies. Opportunities Identification of control points provides opportunity to directly intervene in the transmission of specific foodborne pathogens. December 2003