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, 19 (3), 407-15

Attribution of Foodborne Illnesses, Hospitalizations, and Deaths to Food Commodities by Using Outbreak Data, United States, 1998-2008

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Attribution of Foodborne Illnesses, Hospitalizations, and Deaths to Food Commodities by Using Outbreak Data, United States, 1998-2008

John A Painter et al. Emerg Infect Dis.

Abstract

Each year, >9 million foodborne illnesses are estimated to be caused by major pathogens acquired in the United States. Preventing these illnesses is challenging because resources are limited and linking individual illnesses to a particular food is rarely possible except during an outbreak. We developed a method of attributing illnesses to food commodities that uses data from outbreaks associated with both simple and complex foods. Using data from outbreak-associated illnesses for 1998-2008, we estimated annual US foodborne illnesses, hospitalizations, and deaths attributable to each of 17 food commodities. We attributed 46% of illnesses to produce and found that more deaths were attributed to poultry than to any other commodity. To the extent that these estimates reflect the commodities causing all foodborne illness, they indicate that efforts are particularly needed to prevent contamination of produce and poultry. Methods to incorporate data from other sources are needed to improve attribution estimates for some commodities and agents.

Keywords: E. coli; Salmonella; Shiga toxin–producing Escherichia coli; United States; animals; bacteria; commodities; commodity groups; contamination; epidemiology; food; foodborne illnesses; foodborne infections; outbreak data; plans; salmonella.

Figures

Figure 1
Figure 1
Hierarchy of food commodities. Italics indicate commodity groups.
Figure 2
Figure 2
Minimum, most probable, and maximum estimates of the annual number of foodborne illnesses, hospitalizations, and deaths from all etiologies attributed to food commodities, United States, 1998–2008. A) Foodborne illnesses; 102,275 (1.1%) illnesses were not attributed to a commodity and are not shown. B) Foodborne illness–associated hospitalizations; 4,639 (8.1%) hospitalizations were not attributed to a commodity and are not shown. C) Foodborne illness–associated deaths; 366 (25.2%) deaths were not attributed to a commodity and are not shown. Minimum and maximum values represent extreme boundaries for the most probable estimate; they are not the SE of the most probable estimate. For commodities with outbreaks associated with only simple food vehicles, the minimum, maximum, and most probable estimate are the same. For commodities with outbreaks associated with both simple and complex foods, the minimum and maximum estimates reflect the different weighting given to outbreaks associated with complex foods relative to simple. When the most probable estimate for a commodity is close to the minimum estimate, most illnesses from outbreaks associated with complex foods were attributed to another commodity in the food implicated in the outbreak; when the most probable estimate for a commodity is close to the maximum estimate, most illnesses from outbreaks associated with complex foods were attributed to that commodity.

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