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Epi-Ready. Foodborne Illness and its Impact. Module 2. Module Objectives. By the end of this module, participants will be able to identify the agents of foodborne illness and the associated burden on the United States. Explain the burden of foodborne illness in the United States
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Epi-Ready Foodborne Illness and its Impact Module 2
Module Objectives • By the end of this module, participants will be able to identify the agents of foodborne illness and the associated burden on the United States. • Explain the burden of foodborne illness in the United States • Describe the various agents that cause foodborne illness • Apply terminology used by outbreak response teams
Cost Associated with Foodborne Illness • Average annual economic burden associated with the 15 major pathogens identified through outbreak response = $15.5 billion • Acute and chronic illness medical costs • Costs associated with lost wages • Costs associated with premature deaths Source: United States Department of Agriculture- Economic Research Service (2014)
Average Cost per Case • The high costs associated with Vibrio vulnificus and Listeria monocytogenes stem from costs attributed to premature deaths (97% of the cost for Vibrio vulnificus, and 75%of the cost for Listeria monocytogenes). • Source: United States Department of Agriculture - Economic Research Service (2014)
Burden on the Food Industry • Seldom limited to one company • May impact entire community • Indirect costs also include: • Litigation • Regulatory compliance • Direct cost can reach $10 million
Salmonella Saintpaul Outbreak - 2008 • Initially tomatoes were implicated in an outbreak of 1442 ill in 43 states, D.C., and Canada • FDA issued a warning not to eat tomatoes • Ongoing investigation revealed that Jalapeno and Serrano peppers were the cause of the outbreak. • Florida and Georgia tomato growers lost $100 to $125 million • Tomatoes that were selling for $18-19 per box before the FDA announcement were selling for just $4 afterwards. Some Florida growers reported selling boxes for $0.50
Restaurant-Associated Burden • $4000 for an outbreak involving 5 people in a fast food restaurant • No loss of revenue and no lawsuits, legal fees, or fines • $2.6 million for a Listeria outbreak in a fine dining restaurant involving 250 persons • Includes: meals lost per illness, lawsuits, legal fees, fines and higher insurance premiums Source: Johns Hopkins Bloomberg School of Public Health
Bacterial Pathogens • Ability to multiply outside of host • Three pathways to illness: • Preformed toxin • Infection • Infection followed by enterotoxin production E. coli
Viral Pathogens • Must replicate in a host cell • Cause of illness is infection • Virus commonly associated with foodborne illness in the U.S.: • Norovirus • Hepatitis A Virus Norovirus
Parasites • Free living or cause infection within a host • Protozoa • Cyclospora • Cryptosporidium • Toxoplasma gondii • Worms (Helminths) • Taenia saginata • Taenia solium • Trichinella spiralis Cyclospora cayetanensis
Toxins and Chemicals • Marine algae toxins • Fungal toxins • Fish toxins • Chemicals
Disease Outbreaks with Confirmed Etiology Source: Foodborne Disease Outbreak Surveillance System 2009-2015
Common Food Source Attributions Source: Interagency Food Safety Analytics Collaboration (IFSAC)
Exception to Outbreak and Cluster Rules Requires a Response! • Botulism. A case of botulism poses a significant health risk, prompt response is necessary to administer life-saving medical attention and remove product from distribution. • Others such as Vibrio parahaemolyticus infection and Scombrotoxin