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Salmonella and Toxoplasma gondii are the costliest U.S. foodborne pathogens

Thursday, March 29, 2018

Estimates of the economic cost of foodborne illness play an important role in guiding food safety policy. They are used by the Federal Government in cost-benefit analysis of regulatory actions. Private and public decision makers use these cost estimates to compare the impact of illnesses that vary in number and severity. ERS researchers estimate that 15 major foodborne pathogens cost the U.S. economy $15.5 billion per year in medical care, lost time from work, and losses due to premature death. A foodborne pathogen’s economic burden is determined by both the number and severity of illnesses it causes. Salmonella and Toxoplasma gondii rank highest in cost because they cause the highest number of deaths each year. Norovirus ranks high because it sickens more people each year than the other pathogens, even though the symptoms of norovirus illness are generally mild and rarely require hospitalization. Listeria monocytogenes causes fewer illnesses than many other major foodborne pathogens, but it has serious outcomes for newborns whose mothers were sickened while pregnant. The statistics for this chart are from the ERS data product, Cost Estimates of Foodborne Illnesses.

Six foodborne pathogens rank high on per case costs and/or total economic burden

Monday, June 13, 2016

Both the total economic burden of a disease and the severity of individual cases are important indicators of how serious the disease is. ERS estimates the aggregate economic burden of 15 major foodborne illnesses at over $15 billion per year. But these 15 illnesses—and the pathogens that cause them—have very different total and per case impacts. For example, Salmonella’s total annual economic burden ($3.7 billion) is over 10 times Vibrio vulnificus’s ($320 million). But the per case burden of Vibrio vulnificus ($3.3 million) is almost 1,000 times that of a Salmonella case ($3,568). High per case burdens are the result of severe health outcomes, such as birth defects, renal failure, and death. Total annual economic burden reflects per case costs and how many people are sickened by the pathogens each year. Toxoplasma gondii ranks second behind Salmonella in terms of total economic burden and has a per case cost of $38,114. Listeria ranks high on both a per case basis ($1.8 million) and a total annual burden basis ($2.8 billion). Like Salmonella, Norovirus and Campylobacter also stand out as having high total impacts, though relatively lower per case costs. The statistics for this table are from ERS’s Cost Estimates of Foodborne Illnesses data product, March 2016.

Kidney damage responsible for 65 percent of illness costs from STEC O157

Thursday, December 3, 2015

While most E. coli bacteria are relatively harmless, a small group of E. coli produce a Shiga toxin that can severely damage a person’s kidneys. The most well-known Shiga toxin-producing E. coli (STEC), STEC O157, causes less than 1 percent of U.S. foodborne illnesses with an identifiable pathogen cause and only 2 percent of the cost of these pathogens. Yet, because it is a major cause of outbreaks and because it can cause kidney damage, STEC O157 is often in the news. ERS estimates that the 63,000 illnesses caused by STEC O157 (formerly called E. coli O157) each year in the United States impose $271.4 million in economic burden. Most people (97 percent) sickened with STEC O157 recover without being hospitalized. In roughly 2,100 cases of STEC O157 illnesses, however, people are hospitalized; in 15 percent of these cases the kidneys are affected—sometimes resulting in death, ongoing dialysis, or a kidney transplant. Cases in which the kidneys are affected account for 64.5 percent of the economic burden from foodborne STEC O157. This chart is based on a chart in the ERS report, Economic Burden of Major Foodborne Illnesses Acquired in the United States, May 2015.

Fatality rates are an important determinant of foodborne illness costs

Thursday, October 29, 2015

Quantifying the impacts of foodborne illness can help public health officials and food industry personnel better target food safety resources. ERS has analyzed the economic burden of the 15 pathogens responsible for close to 95 percent of the 9.4 million annual episodes of foodborne illness for which a pathogen cause can be identified. ERS estimates reveal that 83 percent of the economic burden from these 15 foodborne pathogens is due to the number of deaths they cause per year. For example, of the 1 million annual cases of foodborne illness caused by the pathogen Salmonella, an average of 91 percent of people recovered without visiting a doctor, 7 percent visited a doctor and recovered, and 2 percent of cases were severe enough to require hospitalization. Most people hospitalized with a Salmonella infection recover. However, the 378 people who do not survive account for $3.3 billion, or 89 percent, of the economic burden from this pathogen. This chart appears in “Quantifying the Impacts of Foodborne Illnesses” in the September 2015 issue of ERS’s Amber Waves magazine.

Spikes in Internet searches reflect consumers responding to food safety warnings

Thursday, September 10, 2015

Evidence from Internet searches suggests that many consumers actively seek information about foodborne pathogens in response to warnings from Federal health and safety officials. For example, searches using the term “Salmonella” display four large spikes, coincident with FDA’s February 2007 warnings about peanut butter products, the June 2008 warning to avoid tomatoes and other raw vegetables, regulatory actions taken in January and February 2009 regarding peanut butter, and FDA’s August 2010 egg recall. A recent ERS case study concludes that consumers can distinguish between different foodborne risks. In 2011 and 2012, consumers were warned away from cantaloupes because of bacterial contamination that could cause foodborne illness. The first recall was due to Listeria monocytogenes—a pathogen responsible for an often fatal illness when afflicting the elderly—and the second from two Salmonella serotypes, less lethal but more common. Consumers sought greater information on the more dangerous risk caused by a lesser known pathogen (Listeria) compared with the 2012 Salmonella-related recall. Cantaloupe queries spiked in September 2011 along with Listeria searches—a term not often searched during 2004-2014, except for September 2011 and several months following. Salmonella searches in response to FDA’s 2012 warnings were less numerous. This chart appears in the ERS report, How Much Does It Matter How Sick You Get? Consumers’ Response to Foodborne Disease Outbreaks of Different Severities, released on August 27, 2015.

Top 5 foodborne pathogens cost the U.S. economy $14 billion each year

Thursday, July 9, 2015

In a typical year, 15 pathogens cause over 95 percent of the 9.4 million cases of foodborne illness in the United States for which a pathogen cause can be identified. ERS estimates that these 15 pathogens impose $15.5 billion per year in medical costs, wages lost from time away from work, and societal willingness to prevent premature deaths. Just five pathogens—Salmonella (all non-typhoidal species), Toxoplasma gondii, Listeria monocytogenes, Norovirus, and Campylobacter—account for 90 percent of this economic burden. A foodborne pathogen’s economic burden is determined by both the number and severity of illnesses it causes. Norovirus is the most common U.S. foodborne illness, but one from which 90 percent of infected people recover without seeking medical care. In contrast, Listeria monocytogenes sickens a relatively small number of Americans each year, but almost 20 percent of those infected die. The statistics for this chart are from the ERS report, Economic Burden of Major Foodborne Illnesses Acquired in the United States, May 2015.

<i>Listeria</i> ranks third among foodborne pathogens in terms of economic burden in the United States

Wednesday, May 13, 2015

Listeria monocytogenes causes few illnesses compared to many other major U.S. foodborne pathogens, but these few cases have a high economic burden. According to 2011 estimates from the U.S. Centers for Disease Control and Prevention, each year about 1,300 adults in the United States are sickened by foodborne Listeria. These cases can have serious consequences, especially for older adults, those with compromised immune systems, and pregnant women and their unborn children. Ninety percent of those who are sickened by Listeria require hospitalization and around 250 die. Pregnant women generally recover without further complications to themselves, but their infections can have serious impacts on their fetuses. Each year, about a third of the 280 cases of congenitally-acquired Listeria infections result in permanent disability or death. ERS estimates that foodborne Listeria infections cause an estimated $2.8 billion annually in medical costs, lost wages, and societal willingness to pay to prevent deaths. About a quarter of that burden is from newborn and prenatal infections. This chart and similar charts for 14 other pathogens can be found in the ERS report, Economic Burden of Major Foodborne Illnesses Acquired in the United States, released on May 12, 2015.

Foodborne illnesses caused by Salmonella cost the U.S. an estimated $3.7 billion annually

Monday, January 5, 2015

Each year, roughly a million people in the United States become ill from a foodborne Salmonella infection according to 2011 estimates from the U.S. Centers for Disease Control and Prevention. For most healthy people, the infection causes short-lived symptoms that do not require medical attention. However, 7 percent of those infected are sick enough to visit a physician before recovering. Over 19,000 people a year are admitted to the hospital with a foodborne Salmonella infection, and roughly 380 of them die. Salmonella ranks first among 15 leading U.S. foodborne pathogens in terms of economic burden. Foodborne Salmonella infections impose an estimated $3.7 billion each year in the United States in medical costs, wages lost from time away from work, and societal willingness to pay to prevent deaths. Almost 90 percent of this burden—$3.3 billion—is due to premature deaths; 8 percent is due to hospitalization, and the remaining 3 percent are the costs associated with the non-hospitalized cases. The statistics for this chart and similar costs for 14 other foodborne pathogens can be found in ERS’s Cost Estimates of Foodborne Illnesses data product.

Norovirus ranks 4th among 15 foodborne pathogens in terms of economic burden in the U.S.

Tuesday, October 28, 2014

Over 95 percent of illnesses, hospitalizations, and deaths from the 9.4 million episodes of foodborne illnesses in the United States that can be tied to identifiable pathogens are caused by 15 foodborne pathogens. A new ERS data product provides cost estimates for these 15 pathogens in terms of medical costs, wages lost from time away from work, and value of death. Norvirus illnesss is the most common U.S. foodborne illness and accounts for 60 percent of foodborne illnesses that can be tied to a specific pathogen—5.5 million cases a year. Although in 90 percent of cases people recover without seeking medical care, Norovirus ranks 4th among foodborne pathogens in terms of economic burden—an estimated $2.3 billion in a typical year. Fifty-seven percent of these costs are due to deaths, 16 percent are due to hospitalizations, and the remainder are incurred by those who treat themselves at home or visit a doctor. The statistics for this chart, and similar costs for 14 other foodborne pathogens, can be found in the Cost Estimates of Foodborne Illnesses data product released on October 7, 2014.

Salmonella imposes the greatest cost among major U.S. foodborne pathogens

Thursday, November 21, 2013

Estimates of the economic cost of foodborne illness play an important role in guiding food safety policy. A recent ERS study put the cost of foodborne illness at $14.6 billion per year, which accounts for medical care, lost time from work, and losses due to premature death. The cost of a foodborne pathogen is determined by both the number and severity of illnesses it causes. Salmonella and Toxoplasma gondii rank highest in cost because they cause the highest number of deaths each year. Norovirus ranks high because it sickens more people each year than the other pathogens, even though the symptoms of norovirus illness are generally mild and rarely require hospitalization. E. coli O157:H7 accounts for a relatively small fraction (2 percent) of illness costs attributed to the 14 major pathogens, but it receives a great deal of attention from the news media and policymakers partly because it can have severe impacts on children. This chart appears in “Recent Estimates of the Cost of Foodborne Illness Are in General Agreement” in ERS’s November 2013 Amber Waves magazine.

Foodborne illness outbreak in fall 2006 linked to spinach caused consumers to seek substitutes

Wednesday, August 7, 2013

In January 2011, Congress passed the Food Safety Modernization Act, which included a set of mandatory food safety practices for U.S. produce growers. Produce imports would need to provide the same level of public health protection. The new regulations, designed to reduce the risk of foodborne illnesses, followed several major foodborne illness outbreaks traced to produce. In 2006, an outbreak traced to spinach contaminated with E. coli O157:H7 resulted in over 300 illnesses and 3 deaths. For about 2 weeks, most of the spinach in the United States was off the market following Government warnings not to eat bagged or fresh spinach. But even after the warnings were lifted, consumers were slow to return to their previous spinach purchases. ERS researchers analyzed retail scanner data and found that lost consumer expenditures at U.S. grocery stores totaled $60.6 million for all fresh leafy greens (spinach and lettuces) between the September 2006 outbreak and December 2007. Spinach sales fell by $202.5 million, while sales of lettuce grew by $141.9 million as some consumers switched from spinach to other leafy greens that were not implicated in the outbreak. The data for this chart appeared in "Consumers' Response to the 2006 Foodborne Illness Outbreak Linked to Spinach" in ERS’s Amber Waves, March 2010.

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