Foodborne Illness, USA—Major Pathogens | CDC EID

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Volume 17, Number 1–January 2011
Research
Foodborne Illness Acquired in the United States—Major Pathogens
Elaine Scallan,1 Robert M. Hoekstra, Frederick J. Angulo, Robert V. Tauxe, Marc-Alain Widdowson, Sharon L. Roy, Jeffery L. Jones, and Patricia M. Griffin
Author affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Suggested citation for this article

Abstract
Estimates of foodborne illness can be used to direct food safety policy and interventions. We used data from active and passive surveillance and other sources to estimate that each year 31 major pathogens acquired in the United States caused 9.4 million episodes of foodborne illness (90% credible interval [CrI] 6.6–12.7 million), 55,961 hospitalizations (90% CrI 39,534–75,741), and 1,351 deaths (90% CrI 712–2,268). Most (58%) illnesses were caused by norovirus, followed by nontyphoidal Salmonella spp. (11%), Clostridium perfringens (10%), and Campylobacter spp. (9%). Leading causes of hospitalization were nontyphoidal Salmonella spp. (35%), norovirus (26%), Campylobacter spp. (15%), and Toxoplasma gondii (8%). Leading causes of death were nontyphoidal Salmonella spp. (28%), T. gondii (24%), Listeria monocytogenes (19%), and norovirus (11%). These estimates cannot be compared with prior (1999) estimates to assess trends because different methods were used. Additional data and more refined methods can improve future estimates.
Estimates of the overall number of episodes of foodborne illness are helpful for allocating resources and prioritizing interventions. However, arriving at these estimates is challenging because food may become contaminated by many agents (e.g., a variety of bacteria, viruses, parasites, and chemicals), transmission can occur by nonfood mechanisms (e.g., contact with animals or consumption of contaminated water), the proportion of disease transmitted by food differs by pathogen and by host factors (e.g. age and immunity), and only a small proportion of illnesses are confirmed by laboratory testing and reported to public health agencies.

Laboratory-based surveillance provides crucial information for assessing foodborne disease trends. However, because only a small proportion of illnesses are diagnosed and reported, periodic assessments of total episodes of illness are also needed. (Hereafter, episodes of illness are referred to as illnesses.) Several countries have conducted prospective population-based or cross-sectional studies to supplement surveillance and estimate the overall number of foodborne illnesses (1). In 2007, the World Health Organization launched an initiative to estimate the global burden of foodborne diseases (2).

In 1999, the Centers for Disease Control and Prevention provided comprehensive estimates of foodborne illnesses, hospitalizations, and deaths in the United States caused by known and unknown agents (3). This effort identified many data gaps and methodologic limitations. Since then, new data and methods have become available. This article is 1 of 2 reporting new estimates of foodborne diseases acquired in the United States (hereafter referred to as domestically acquired). This article provides estimates of major known pathogens; the other provides estimates for agents of acute gastroenteritis not specified in this article (4).

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Foodborne Illness, USA—Major Pathogens | CDC EID


Suggested Citation for this Article
Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson M-A, Roy SL, et al. Foodborne illness acquired in the United States—major pathogens. Emerg Infect Dis [serial on the Internet]. 2011 Jan [date cited].

http://www.cdc.gov/EID/content/17/1/7.htm

DOI: 10.3201/eid1701.P11101



1Current affiliation: Colorado School of Public Health, Aurora, Colorado, USA.


Comments to the Authors
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Elaine Scallan, Department of Epidemiology, Colorado School of Public Health, Mailstop B119, Rm W3146, UCD-AMC Bldg 500, 13001 E 17th Pl, Aurora, CO 80045, USA; email: elaine.scallan@ucdenver.edu