Foodborne Illness: An Acute and Long-Term Health Challenge

The Center for Foodborne Illness Research & Prevention (CFI) has released a report that documents what is currently known about the long-term health outcomes associated with several foodborne illnesses. The report also discusses how under-reporting, inadequate follow-up and a lack of research make it difficult to assess the impact that foodborne illness is having on Americans.

CFI's report, “The Long-Term Health Outcomes of Selected Foodborne Pathogens,” calls for a new approach to foodborne illness research and surveillance and provides expert reviews about some of the long-term health outcomes for five foodborne pathogens. The outcomes range from hypertension and diabetes to kidney failure and mental retardation.

"Foodborne illness is a serious public health issue in the 21st century," says Dr. Tanya Roberts, chair of CFI's board of directors and an author of the report. "But the vast majority of these illnesses are never reported to public health agencies, leaving us with many unanswered questions about the impact that foodborne illness is having on different populations, particularly young children and the elderly."

The five foodborne pathogens reviewed in this report include:

1.Campylobacter infection afflicts millions of Americans and hospitalizes over ten thousand annually. It is associated with Guillain-Barré syndrome (GBS), the most common cause of neuromuscular paralysis in the United States. GBS can result in permanent disabilities and many patients require long-term care.

2.E. coli O157:H7 can cause serious foodborne illness, particularly in children. E. coli O157:H7 can lead to hemolytic uremic syndrome (HUS), the leading cause of acute kidney failure in children in the United States. HUS can lead to death or long-term health complications such as end-stage kidney disease, neurological complications and other disabling conditions.

3.Listeria monocytogenes, the leading cause of foodborne illness deaths in the United States, infects thousands of Americans every year and has been associated with infections of the brain and spinal cord, resulting in serious long-term neurological dysfunctions and impaired ability to see, hear, speak or swallow. Most reported cases occur in children under the age of 4, but most of the deaths are in the elderly population. In pregnant women, listeriosis can cause miscarriage, premature birth or still birth.

4.Salmonella, as well as other foodborne pathogens, can trigger reactive arthritis (ReA) in certain individuals, leaving them with temporary or permanent arthritis. ReA causes painful and swollen joints and can greatly affect an individual's ability to work and quality of life. Besides ReA, Salmonella is also associated with many other complications and is the second leading cause of foodborne illness deaths in the United States. Nearly half of all reported Salmonella cases occur in children.

5.Toxoplasma gondii is the third leading cause of foodborne illness deaths in the United States. Infection can result in visual impairment or mild to severe mental retardation, with 80% of infected fetuses/infants manifesting impairment by age 17.

"Clearly, the United States needs to adopt a new approach to protect its citizens from the acute and long-term effects of foodborne illness," states Barbara Kowalcyk, CFI's director of food safety and an author of the report. "Improving foodborne illness surveillance, along with systematic follow-up and improved data sharing between and among local, state and federal agencies, are important first steps to increase our knowledge about the frequency and severity of the long-term health outcomes of foodborne illness, which will, in turn, help identify food safety priorities so that limited resources can be applied appropriately to ensure the greatest public health benefit."

Other co-authors of the report include Patricia Buck, CFI's executive director; Martin J. Blaser, MD; J.K. Frenkel, MD; Bennett Lorber, MD; James Smith, PhD; and Phillip I. Tarr, MD.