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. 1999 Sep-Oct;5(5):607–625. doi: 10.3201/eid0505.990502

Food-related illness and death in the United States.

P S Mead 1, L Slutsker 1, V Dietz 1, L F McCaig 1, J S Bresee 1, C Shapiro 1, P M Griffin 1, R V Tauxe 1
PMCID: PMC2627714  PMID: 10511517

Abstract

To better quantify the impact of foodborne diseases on health in the United States, we compiled and analyzed information from multiple surveillance systems and other sources. We estimate that foodborne diseases cause approximately 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths in the United States each year. Known pathogens account for an estimated 14 million illnesses, 60, 000 hospitalizations, and 1,800 deaths. Three pathogens, Salmonella, Listeria, and Toxoplasma, are responsible for 1,500 deaths each year, more than 75% of those caused by known pathogens, while unknown agents account for the remaining 62 million illnesses, 265,000 hospitalizations, and 3,200 deaths. Overall, foodborne diseases appear to cause more illnesses but fewer deaths than previously estimated.

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Selected References

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  1. Addiss D. G., Davis J. P., Roberts J. M., Mast E. E. Epidemiology of giardiasis in Wisconsin: increasing incidence of reported cases and unexplained seasonal trends. Am J Trop Med Hyg. 1992 Jul;47(1):13–19. doi: 10.4269/ajtmh.1992.47.13. [DOI] [PubMed] [Google Scholar]
  2. Bean N. H., Martin S. M., Bradford H., Jr PHLIS: an electronic system for reporting public health data from remote sites. Am J Public Health. 1992 Sep;82(9):1273–1276. doi: 10.2105/ajph.82.9.1273. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bell B. P., Shapiro C. N., Alter M. J., Moyer L. A., Judson F. N., Mottram K., Fleenor M., Ryder P. L., Margolis H. S. The diverse patterns of hepatitis A epidemiology in the United States-implications for vaccination strategies. J Infect Dis. 1998 Dec;178(6):1579–1584. doi: 10.1086/314518. [DOI] [PubMed] [Google Scholar]
  4. Black R. E., Craun G. F., Blake P. A. Epidemiology of common-source outbreaks of shigellosis in the United States, 1961-1975. Am J Epidemiol. 1978 Jul;108(1):47–52. [PubMed] [Google Scholar]
  5. Bokete T. N., O'Callahan C. M., Clausen C. R., Tang N. M., Tran N., Moseley S. L., Fritsche T. R., Tarr P. I. Shiga-like toxin-producing Escherichia coli in Seattle children: a prospective study. Gastroenterology. 1993 Dec;105(6):1724–1731. doi: 10.1016/0016-5085(93)91069-t. [DOI] [PubMed] [Google Scholar]
  6. Chalker R. B., Blaser M. J. A review of human salmonellosis: III. Magnitude of Salmonella infection in the United States. Rev Infect Dis. 1988 Jan-Feb;10(1):111–124. doi: 10.1093/clinids/10.1.111. [DOI] [PubMed] [Google Scholar]
  7. Chomel B. B., DeBess E. E., Mangiamele D. M., Reilly K. F., Farver T. B., Sun R. K., Barrett L. R. Changing trends in the epidemiology of human brucellosis in California from 1973 to 1992: a shift toward foodborne transmission. J Infect Dis. 1994 Nov;170(5):1216–1223. doi: 10.1093/infdis/170.5.1216. [DOI] [PubMed] [Google Scholar]
  8. Cohen M. L., Tauxe R. V. Drug-resistant Salmonella in the United States: an epidemiologic perspective. Science. 1986 Nov 21;234(4779):964–969. doi: 10.1126/science.3535069. [DOI] [PubMed] [Google Scholar]
  9. Dennis D. T., Smith R. P., Welch J. J., Chute C. G., Anderson B., Herndon J. L., von Reyn C. F. Endemic giardiasis in New Hampshire: a case-control study of environmental risks. J Infect Dis. 1993 Jun;167(6):1391–1395. doi: 10.1093/infdis/167.6.1391. [DOI] [PubMed] [Google Scholar]
  10. Donelli G., Ruggeri F. M., Tinari A., Marziano M. L., Menichella D., Caione D., Concato C., Rocchi G., Vella S. A three-year diagnostic and epidemiological study on viral infantile diarrhoea in Rome. Epidemiol Infect. 1988 Apr;100(2):311–320. doi: 10.1017/s0950268800067443. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Garthright W. E., Archer D. L., Kvenberg J. E. Estimates of incidence and costs of intestinal infectious diseases in the United States. Public Health Rep. 1988 Mar-Apr;103(2):107–115. [PMC free article] [PubMed] [Google Scholar]
  12. Glass R. I., Noel J., Mitchell D., Herrmann J. E., Blacklow N. R., Pickering L. K., Dennehy P., Ruiz-Palacios G., de Guerrero M. L., Monroe S. S. The changing epidemiology of astrovirus-associated gastroenteritis: a review. Arch Virol Suppl. 1996;12:287–300. doi: 10.1007/978-3-7091-6553-9_31. [DOI] [PubMed] [Google Scholar]
  13. Guerina N. G., Hsu H. W., Meissner H. C., Maguire J. H., Lynfield R., Stechenberg B., Abroms I., Pasternack M. S., Hoff R., Eaton R. B. Neonatal serologic screening and early treatment for congenital Toxoplasma gondii infection. The New England Regional Toxoplasma Working Group. N Engl J Med. 1994 Jun 30;330(26):1858–1863. doi: 10.1056/NEJM199406303302604. [DOI] [PubMed] [Google Scholar]
  14. Hedberg C. W., Savarino S. J., Besser J. M., Paulus C. J., Thelen V. M., Myers L. J., Cameron D. N., Barrett T. J., Kaper J. B., Osterholm M. T. An outbreak of foodborne illness caused by Escherichia coli O39:NM, an agent not fitting into the existing scheme for classifying diarrheogenic E. coli. J Infect Dis. 1997 Dec;176(6):1625–1628. doi: 10.1086/517342. [DOI] [PubMed] [Google Scholar]
  15. Herwaldt B. L., Ackers M. L. An outbreak in 1996 of cyclosporiasis associated with imported raspberries. The Cyclospora Working Group. N Engl J Med. 1997 May 29;336(22):1548–1556. doi: 10.1056/NEJM199705293362202. [DOI] [PubMed] [Google Scholar]
  16. Hlady W. G., Klontz K. C. The epidemiology of Vibrio infections in Florida, 1981-1993. J Infect Dis. 1996 May;173(5):1176–1183. doi: 10.1093/infdis/173.5.1176. [DOI] [PubMed] [Google Scholar]
  17. Hoffman T. A., Ruiz C. J., Counts G. W., Sachs J. M., Nitzkin J. L. Waterborne typhoid fever in Dade County, Florida. Clinical and therapeutic evaluation of 105 bacteremic patients. Am J Med. 1975 Oct;59(4):481–487. doi: 10.1016/0002-9343(75)90255-7. [DOI] [PubMed] [Google Scholar]
  18. Holmberg S. D., Blake P. A. Staphylococcal food poisoning in the United States. New facts and old misconceptions. JAMA. 1984 Jan 27;251(4):487–489. [PubMed] [Google Scholar]
  19. Jin S., Kilgore P. E., Holman R. C., Clarke M. J., Gangarosa E. J., Glass R. I. Trends in hospitalizations for diarrhea in United States children from 1979 through 1992: estimates of the morbidity associated with rotavirus. Pediatr Infect Dis J. 1996 May;15(5):397–404. doi: 10.1097/00006454-199605000-00004. [DOI] [PubMed] [Google Scholar]
  20. Kilgore P. E., Holman R. C., Clarke M. J., Glass R. I. Trends of diarrheal disease--associated mortality in US children, 1968 through 1991. JAMA. 1995 Oct 11;274(14):1143–1148. [PubMed] [Google Scholar]
  21. Klotz S. A., Jorgensen J. H., Buckwold F. J., Craven P. C. Typhoid fever. An epidemic with remarkably few clinical signs and symptoms. Arch Intern Med. 1984 Mar;144(3):533–537. doi: 10.1001/archinte.144.3.533. [DOI] [PubMed] [Google Scholar]
  22. Levine W. C., Bennett R. W., Choi Y., Henning K. J., Rager J. R., Hendricks K. A., Hopkins D. P., Gunn R. A., Griffin P. M. Staphylococcal food poisoning caused by imported canned mushrooms. J Infect Dis. 1996 May;173(5):1263–1267. doi: 10.1093/infdis/173.5.1263. [DOI] [PubMed] [Google Scholar]
  23. Levine W. C., Griffin P. M. Vibrio infections on the Gulf Coast: results of first year of regional surveillance. Gulf Coast Vibrio Working Group. J Infect Dis. 1993 Feb;167(2):479–483. doi: 10.1093/infdis/167.2.479. [DOI] [PubMed] [Google Scholar]
  24. Levine W. C., Smart J. F., Archer D. L., Bean N. H., Tauxe R. V. Foodborne disease outbreaks in nursing homes, 1975 through 1987. JAMA. 1991 Oct 16;266(15):2105–2109. [PubMed] [Google Scholar]
  25. Mahon B. E., Mintz E. D., Greene K. D., Wells J. G., Tauxe R. V. Reported cholera in the United States, 1992-1994: a reflection of global changes in cholera epidemiology. JAMA. 1996 Jul 24;276(4):307–312. [PubMed] [Google Scholar]
  26. Mermin J. H., Townes J. M., Gerber M., Dolan N., Mintz E. D., Tauxe R. V. Typhoid fever in the United States, 1985-1994: changing risks of international travel and increasing antimicrobial resistance. Arch Intern Med. 1998 Mar 23;158(6):633–638. doi: 10.1001/archinte.158.6.633. [DOI] [PubMed] [Google Scholar]
  27. Mishu B., Blaser M. J. Role of infection due to Campylobacter jejuni in the initiation of Guillain-Barré syndrome. Clin Infect Dis. 1993 Jul;17(1):104–108. doi: 10.1093/clinids/17.1.104. [DOI] [PubMed] [Google Scholar]
  28. Monto A. S., Koopman J. S. The Tecumseh Study. XI. Occurrence of acute enteric illness in the community. Am J Epidemiol. 1980 Sep;112(3):323–333. doi: 10.1093/oxfordjournals.aje.a112998. [DOI] [PubMed] [Google Scholar]
  29. Osterholm M. T., Forfang J. C., Ristinen T. L., Dean A. G., Washburn J. W., Godes J. R., Rude R. A., McCullough J. G. An outbreak of foodborne giardiasis. N Engl J Med. 1981 Jan 1;304(1):24–28. doi: 10.1056/NEJM198101013040106. [DOI] [PubMed] [Google Scholar]
  30. Ostroff S. Yersinia as an emerging infection: epidemiologic aspects of Yersiniosis. Contrib Microbiol Immunol. 1995;13:5–10. [PubMed] [Google Scholar]
  31. Pang X. L., Joensuu J., Vesikari T. Human calicivirus-associated sporadic gastroenteritis in Finnish children less than two years of age followed prospectively during a rotavirus vaccine trial. Pediatr Infect Dis J. 1999 May;18(5):420–426. doi: 10.1097/00006454-199905000-00005. [DOI] [PubMed] [Google Scholar]
  32. Parashar U. D., Holman R. C., Clarke M. J., Bresee J. S., Glass R. I. Hospitalizations associated with rotavirus diarrhea in the United States, 1993 through 1995: surveillance based on the new ICD-9-CM rotavirus-specific diagnostic code. J Infect Dis. 1998 Jan;177(1):13–17. doi: 10.1086/513808. [DOI] [PubMed] [Google Scholar]
  33. Petersen C. Cryptosporidiosis in patients infected with the human immunodeficiency virus. Clin Infect Dis. 1992 Dec;15(6):903–909. doi: 10.1093/clind/15.6.903. [DOI] [PubMed] [Google Scholar]
  34. Petersen C. Cryptosporidium and the food supply. Lancet. 1995 May 6;345(8958):1128–1129. doi: 10.1016/s0140-6736(95)90972-9. [DOI] [PubMed] [Google Scholar]
  35. Petersen L. R., Cartter M. L., Hadler J. L. A food-borne outbreak of Giardia lamblia. J Infect Dis. 1988 Apr;157(4):846–848. doi: 10.1093/infdis/157.4.846. [DOI] [PubMed] [Google Scholar]
  36. Riepenhoff-Talty M., Saif L. J., Barrett H. J., Suzuki H., Ogra P. L. Potential spectrum of etiological agents of viral enteritis in hospitalized infants. J Clin Microbiol. 1983 Feb;17(2):352–356. doi: 10.1128/jcm.17.2.352-356.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Roberts C. L., Morin C., Addiss D. G., Wahlquist S. P., Mshar P. A., Hadler J. L. Factors influencing Cryptosporidium testing in Connecticut. J Clin Microbiol. 1996 Sep;34(9):2292–2293. doi: 10.1128/jcm.34.9.2292-2293.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Rowe P. C., Orrbine E., Lior H., Wells G. A., McLaine P. N. A prospective study of exposure to verotoxin-producing Escherichia coli among Canadian children with haemolytic uraemic syndrome. The CPKDRC co-investigators. Epidemiol Infect. 1993 Feb;110(1):1–7. doi: 10.1017/s0950268800050615. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Schuchat A., Lizano C., Broome C. V., Swaminathan B., Kim C., Winn K. Outbreak of neonatal listeriosis associated with mineral oil. Pediatr Infect Dis J. 1991 Mar;10(3):183–189. doi: 10.1097/00006454-199103000-00003. [DOI] [PubMed] [Google Scholar]
  40. Shapiro R. L., Altekruse S., Hutwagner L., Bishop R., Hammond R., Wilson S., Ray B., Thompson S., Tauxe R. V., Griffin P. M. The role of Gulf Coast oysters harvested in warmer months in Vibrio vulnificus infections in the United States, 1988-1996. Vibrio Working Group. J Infect Dis. 1998 Sep;178(3):752–759. doi: 10.1086/515367. [DOI] [PubMed] [Google Scholar]
  41. Skeels M. R., Sokolow R., Hubbard C. V., Andrus J. K., Baisch J. Cryptosporidium infection in Oregon public health clinic patients 1985-88: the value of statewide laboratory surveillance. Am J Public Health. 1990 Mar;80(3):305–308. doi: 10.2105/ajph.80.3.305. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Suzuki H., Konno T., Kutsuzawa T., Imai A., Tazawa F., Ishida N., Katsushima N., Sakamoto M. The occurrence of calicivirus in infants with acute gastroenteritis. J Med Virol. 1979;4(4):321–326. doi: 10.1002/jmv.1890040410. [DOI] [PubMed] [Google Scholar]
  43. Talan D. A., Moran G. J., Mower W. R., Newdow M., Ong S., Slutsker L., Jarvis W. R., Conn L. A., Pinner R. W. EMERGEncy ID NET: an emergency department-based emerging infections sentinel network. The EMERGEncy ID NET Study Group. Ann Emerg Med. 1998 Dec;32(6):703–711. doi: 10.1016/s0196-0644(98)70071-x. [DOI] [PubMed] [Google Scholar]
  44. Tappero J. W., Schuchat A., Deaver K. A., Mascola L., Wenger J. D. Reduction in the incidence of human listeriosis in the United States. Effectiveness of prevention efforts? The Listeriosis Study Group. JAMA. 1995 Apr 12;273(14):1118–1122. doi: 10.1001/jama.1995.03520380054035. [DOI] [PubMed] [Google Scholar]
  45. Taylor J. P., Perdue J. N. The changing epidemiology of human brucellosis in Texas, 1977-1986. Am J Epidemiol. 1989 Jul;130(1):160–165. doi: 10.1093/oxfordjournals.aje.a115308. [DOI] [PubMed] [Google Scholar]
  46. Tucker A. W., Haddix A. C., Bresee J. S., Holman R. C., Parashar U. D., Glass R. I. Cost-effectiveness analysis of a rotavirus immunization program for the United States. JAMA. 1998 May 6;279(17):1371–1376. doi: 10.1001/jama.279.17.1371. [DOI] [PubMed] [Google Scholar]
  47. Vial P. A., Kotloff K. L., Tall B. D., Morris J. G., Jr, Levine M. M. Detection by immune electron microscopy of 27-nm viral particles associated with community-acquired diarrhea in children. J Infect Dis. 1990 Mar;161(3):571–573. doi: 10.1093/infdis/161.3.571. [DOI] [PMC free article] [PubMed] [Google Scholar]
  48. Wolfaardt M., Taylor M. B., Booysen H. F., Engelbrecht L., Grabow W. O., Jiang X. Incidence of human calicivirus and rotavirus infection in patients with gastroenteritis in South Africa. J Med Virol. 1997 Apr;51(4):290–296. doi: 10.1002/(sici)1096-9071(199704)51:4<290::aid-jmv6>3.0.co;2-0. [DOI] [PubMed] [Google Scholar]

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