Incidence and Cost of Foodborne Diarrheal Disease in the United States

Abstract

An estimated 68.7 to 275 million cases of diarrheal disease episodes from all causes occur annually in the United States, representing an average of 0.29 to 1.1 cases per person per year. The total number of cases of foodborne origin and subsequent person-to-person transfer was estimated to be at least 24 million and perhaps as many as 81 million or more cases per year. Updating previously published patient cost estimates, including lost wages as well as direct medical costs, the average estimate-based value for food-associated illness is in the billions of dollars per year. Scientifically established chronic sequellae to diarrheal disease further increase the total economic burden but cannot be estimated from available data. Other associated clinical problems that are likely to be related to acute diarrheal episodes would further increase costs.

Contemporary issues: diseases with a food vector

“…A recent estimate suggests that, on the average, every U.S. citizen has at least one episode of enteric (diarrheal) disease annually (6). Foodborne disease conservatively constitutes one-third of the total, or more than 80 million cases annually (6). This does not indicate that our food supply is inherently unsafe, but rather that people make food unsafe by handling it improperly or by transmitting their diseases via food.…”

“…A recent estimate suggests that, on the average, every U.S. citizen has at least one episode of enteric (diarrheal) disease annually (6). Foodborne disease conservatively constitutes one-third of the total, or more than 80 million cases annually (6).…”

Trends in indigenous foodborne disease and deaths, England and Wales: 1992 to 2000

“…Previous attempts to estimate the burden of foodborne disease were limited by using data from unrepresentative sources, 2 failing to account for the diversity of pathogens causing foodborne disease, [3][4][5][6] or through reliance on expert opinion. 7 The Centers for Disease Control and Prevention (CDC) developed an approach overcoming these limitations, producing pathogen specific morbidity, hospital admission, and mortality estimates for foodborne infections in the USA.…”

Foods and microbiological risks

“…In Europe, morbidity from foodborne illness is second only to respiratory diseases and recent estimates of illness would indicate that in many European countries there are at least 50 000 cases of acute gastro-enteritis per million population per year with a figure of 300000 recently suggested for the Netherlands (Guiguet e t al., 1992;Notermans & van der Giessen, 1993). Estimates for the USA are even higher and one recent estimate suggests that up to 350000 persons per million population per year suffer acute ga4tro-enteritis and the majority of this is probably associated with contaminated food (Archer & Kvenberg, 1985). Whilst death rates from foodborne illness are considerably lower in developed than in developing countries, it is increasingly recognized that between 1 and 5 ' 6 of episodes of acute gastro-enteritis lead to serious, and often chronic, sequelae including rheumatoid conditions (such as ankylosing spondylitis and Reiter's syndrome), nutritional and malabsorption problems, ha e m o 1 y t i c-u raemi c s y n d r o me (caused by ve r o t oxin-p r oducing strains of Escherichia coli, and particularly serotype 0 1 57 : H7), and other illnesses such as atherosclerosis, and Guillain-Barre syndrome following infection by Campylobacter spp.…”