Foodborne illness epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Epidemiology and Demographics
Global Impact
In modern times, rapid globalization of food production and trade has increased the potential likelihood of food contamination. Many outbreaks of foodborne diseases that were once contained within a small community may now take place on global dimensions. Food safety authorities all over the world have acknowledged that ensuring food safety must not only be tackled at the national level but also through closer linkages among food safety authorities at the international level. This is important for exchanging routine information on food safety issues and to have rapid access to information in case of food safety emergencies.
It is difficult to estimate the global incidence of foodborne disease, but it has been reported that in the year 2000 about 2.1 million people died from diarrheal diseases. Many of these cases have been attributed to contamination of food and drinking water. Additionally, diarrhea is a major cause of malnutrition in infants and young children.
Even in industrialized countries, up to 30% of the population of people have been reported to suffer from foodborne diseases every year. In the U.S, around 76 million cases of foodborne diseases, which resulted in 325,000 hospitalizations and 5,000 deaths, are estimated to occur each year. Developing countries in particular, are worst affected by foodborne illnesses due to the presence of a wide range of dieases, including those caused by parasites. Foodborne illnesses can and did inflict serious and extensive harm on society. In 1994, an outbreak of salmonellosis due to contaminated ice cream occurred in the USA, affecting an estimated 224,000 persons. In 1988, an outbreak of hepatitis A, resulting from the consumption of contaminated clams, affected some 300,000 individuals in China.
Food contamination creates an enormous social and economic strain on societies. In the U.S., diseases caused by the major pathogens alone are estimated to cost up to US $35 billion annually (1997) in medical costs and lost productivity. The re-emergence of cholera in Peru in 1991 resulted in the loss of US $500 million in fish and fishery product exports that year.
Statistics
Every year there are about 76 million foodborne illnesses in the United States (26,000 cases for 100,000 inhabitants), 2 million in the United Kingdom (3,400 cases for 100,000 inhabitants) and 750,000 in France (1,210 cases for 100,000 inhabitants).
United States
In the United States, there are approximately 76 million foodborne illnesses (26,000 cases for 100,000 inhabitants):[1]
- 325,000 were hospitalized (111 per 100,000 inhabitants)
- 5,000 people died (1.7 per 100,000 inhabitants)
- Major pathogens from food borne illness in the United States cost upwards of US $35 billion dollars in medical costs and lost productivity (1997)
France
In France, for 750,000 cases(1,210 per 100,000 inhabitants):
- 70,000 people consulted in the emergency department of an hospital (113 per 100,000 inhabitants);
- 113,000 people were hospitalized (24 per 100,000 inhabitants);
- 400 people died (0.9 per 100,000 inhabitants).
Australia
In Australia, there are an estimated 5.4 million cases of food-borne illness every year, causing:[2]
- 18,000 hospitalizations
- 120 deaths
- 2.1 million lost days of work
- 1.2 million doctor consultations
- 300,000 prescriptions for antibiotics
| Cause | Annual cases | Rate (per 100,000 inhabitants) | |
|---|---|---|---|
| 1 | Salmonella | ~8,000 cases | 13 |
| 2 | Campylobacter | ~3,000 cases | 4.8 |
| 3 | Parasites incl. Toxoplasma |
~500 cases ~400 cases |
0.8 0.65 |
| 4 | Listeria | ~300 cases | 0.5 |
| 5 | Hepatitis A | ~60 cases | 0.1 |
| Cause | Annual | Rate (per 100,000 inhabitants) | |
|---|---|---|---|
| 1 | Salmonella | ~300 cases | 0.5 |
| 2 | Listeria | ~80 cases | 0.13 |
| 3 | Parasites | ~37 cases | 0.06 (95% due to toxoplasma) |
| 4 | Campylobacter | ~15 cases | 0.02 |
| 5 | Hepatitis A | ~2 cases | 0.003 |
Outbreaks
The vast majority of reported cases of foodborne illness occur as individual or sporadic cases. The origin of most sporadic cases is undetermined. In the United States, where people eat outside the home frequently, most outbreaks (58%) originate from commercial food facilities (2004 FoodNet data). An outbreak is defined as occurring when two or more people experience similar illness after consuming food from a common source.
Often, a combination of events contributes to an outbreak, for example, food might be left at room temperature for many hours, allowing bacteria to multiply which is compounded by inadequate cooking which results in a failure to kill the dangerously elevated bacterial levels.
Outbreaks are usually identified when those affected know each other. However, more and more, outbreaks are identified by public health staff from unexpected increases in laboratory results for certain strains of bacteria. Outbreak detection and investigation in the United States is primarily handled by local health jurisdictions and is inconsistent from district to district. It is estimated that 1–2% of outbreaks are detected.
Political Issues
United Kingdom
In the UK serious outbreaks of foodborne illness since the 1970s prompted key changes in UK food safety law. These included the death of 19 patients in the Stanley Royd Hospital outbreak [5] and the bovine spongiform encephalopathy (BSE, mad cow disease) outbreak identified in the 1980s. The death of 17 people in the 1996 Wishaw outbreak of E. coli O157 was a precursor to the establishment of the Food Standards Agency which, according to Tony Blair in the 1998 white paper A Force for Change Cm 3830 "would be powerful, open and dedicated to the interests of consumers".
United States
In 2001, the Center for Science in the Public Interest (CSPI) petitioned the United States Department of Agriculture to require meat packers to remove spinal cords before processing cattle carcasses for human consumption, a measure designed to lessen the risk of infection by variant Creutzfeldt-Jakob disease. The petition was supported by the American Public Health Association, the Consumer Federation of America, the Government Accountability Project, the National Consumers League, and Safe Tables Our Priority. This was opposed by the National Cattlemen's Beef Association, the National Renderers Association, the National Meat Association, the Pork Producers Council, sheep raisers, milk producers, the Turkey Federation, and eight other organizations from the animal-derived food industry. This was part of a larger controversy regarding the United States' violation of World Health Organization proscriptions to lessen the risk of infection by variant Creutzfeldt-Jakob disease.
References
- ↑ "Food safety and foodborne illness". Unknown parameter
|pulisher=ignored (|publisher=suggested) (help) - ↑ "Food borne illness in Australia" (PDF). Unknown parameter
|pulisher=ignored (|publisher=suggested) (help) - ↑ "Report of the French sanitary agencies" (PDF) (in French). INVS/Afssa.
- ↑ "Summary of Report of the French sanitary agencies" (PDF) (in French). INVS/Afssa.
- ↑ "The Stanley Royd hospital scandal of 1984, by Brian Deer". Retrieved 2013-03-12.