Foodborne illness acquired in the United States--major pathogens

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.

Figure

Example schematic diagram of the estimation and uncertainty model used to estimate episodes of illness, hospitalizations, and deaths in the United States. Count, data (empirical distribution); Year, factor to standardize non-2006 counts to 2006 (constant); Sub, expansive factor to scale area surveillance to the entire US population (constant); Ob, expansive factor to scale outbreak counts up to outbreak plus sporadic counts (beta distribution); CS, expansive factor to scale care seekers to all ill, with severe and mild illness versions (PERT distribution); SS, expansive factor to scale submitted samples to all visits, with severe and mild illness versions (PERT distribution); PS, estimated proportion of illnesses that are severe (PERT distribution); LT, expansive factor to scale tests performed up to samples submitted (PERT distribution); LS, expansive factor to scale positive test results up to true positive specimens (PERT distribution); H, contractive factor to scale illnesses down to hospitalized illnesses (PERT distribution); D, contractive factor to scale illnesses down to deaths (PERT distribution); F, contractive factor to scale illnesses down to foodborne illnesses (PERT distribution).