Diarreas En Estados Unidos

Synopses

Food-Related Illness and Death
in the United States
Paul S. Mead, Laurence Slutsker, Vance Dietz, Linda F. McCaig,
Joseph S. Bresee, Craig Shapiro,
Patricia M. Griffin, and Robert V. Tauxe
Centers for Disease Control and Prevention, Atlanta, Georgia, USA

To better quantify the impact of foodborne diseases on health in the United States,
we compiled and analyzed informationfrom 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 1,500deaths 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.

More than 200 known diseases are transmitted through food (1). The causes of foodborne
illness include viruses,bacteria, parasites,
toxins, metals, and prions, and the symptoms of
foodborne illness range from mild gastroenteritis
to life-threatening neurologic, hepatic, and renal
syndromes. In the United States, foodborne
diseases have been estimated to cause 6 million
to 81 million illnesses and up to 9,000 deaths
each year (2-5). However, ongoing changes in the
food supply, the identification ofnew foodborne
diseases, and the availability of new surveillance
data have made these figures obsolete. New,
more accurate estimates are needed to guide
prevention efforts and assess the effectiveness of
food safety regulations.
Surveillance of foodborne illness is complicated by several factors. The first is underreporting.
Although foodborne illnesses can be severe or
even fatal, mildercases are often not detected
through routine surveillance. Second, many
pathogens transmitted through food are also
spread through water or from person to person,
thus obscuring the role of foodborne transmission. Finally, some proportion of foodborne
illness is caused by pathogens or agents that
Address for correspondence: Paul S. Mead, Division of
Bacterial and Mycotic Diseases, Centersfor Disease Control
and Prevention, Mail Stop A38, 1600 Clifton Road, Atlanta, GA
30333, USA; fax: 404-639-2205; e-mail: pfm0@cdc.gov.

Vol. 5, No. 5, September–October 1999

have not yet been identified and thus cannot be
diagnosed. The importance of this final factor
cannot be overstated. Many of the pathogens of
greatest concern today (e.g., Campylobacter jejuni,
Escherichia coliO157:H7, Listeria monocytogenes,
Cyclospora cayetanensis) were not recognized as
causes of foodborne illness just 20 years ago.
In this article, we report new estimates of
illnesses, hospitalizations, and deaths due to
foodborne diseases in the United States. To
ensure their validity, these estimates have been
derived by using data from multiple sources,
including the newly establishedFoodborne
Diseases Active Surveillance Network (FoodNet).
The figures presented include estimates for
specific known pathogens, as well as overall
estimates for all causes of foodborne illness,
known, unknown, infectious, and noninfectious.

Data Sources
Data sources for this analysis include the
Foodborne Diseases Active Surveillance Network (FoodNet) (6), the National Notifiable
DiseaseSurveillance System (7), the Public
Health Laboratory Information System (8), the
Gulf Coast States Vibrio Surveillance System (9),
the Foodborne Disease Outbreak Surveillance
System (10), the National Ambulatory Medical
Care Survey (11), the National Hospital
Ambulatory Medical Care Survey (12-14), the

6 07

Emerging Infectious Diseases

Synopses
National Hospital Discharge Survey...