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 ID: 912038
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Slide1
Epi-Ready
Foodborne Illness and its Impact
Module 2
Slide2Module 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 StatesDescribe the various agents that cause foodborne illnessApply terminology used by outbreak response teams
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Slide3Foodborne Illness in the United States
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Slide4Cost Associated with Foodborne Illness
Average annual economic burden
associated with the 15 major pathogens identified through outbreak response =
$15.5 billion
A
cute and chronic illness medical costsCosts associated with lost wagesCosts associated with premature deaths2-4Source: United States Department of
Agriculture
-
Economic Research
Service (2014)
Slide5Average Cost per Case
Pathogen
Total Cost
Total CasesIdentifiedAverage Cost per CaseVibrio vulnificus
$319,850,293
96
$3,331,773.89
Listeria monocytogenes
$2,834,444,202
1,591
$1,781,548.84
E. coli
O157
(STEC)
$271,418,69063,153$4,297.80Salmonella spp. (nontyphoidal)$3,666,600,0311,027,561$3,568.26Norovirus$2,255,827,3185,461,731$413.02
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).
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Source: United States Department of Agriculture - Economic Research Service (2014)
Slide6Burden on the Food Industry
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Seldom limited to one company
May impact entire community
Indirect costs also include:Litigation Regulatory complianceDirect cost can reach $10 million
Slide7Salmonella
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 millionTomatoes 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 $0.502-7
Slide8Restaurant-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 personsIncludes: meals lost per illness, lawsuits, legal fees, fines and higher insurance premiums2-8Source: Johns Hopkins Bloomberg School of Public Health
Slide9Bacterial Pathogens
Ability to multiply outside of host
Three pathways to illness:
Preformed toxin
Infection
Infection followed by enterotoxin production2-9E. coli
Slide10Viral 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 Virus2-10Norovirus
Slide11Parasites
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Free living or cause infection within a host
Protozoa
CyclosporaCryptosporidiumToxoplasma gondii Worms (Helminths)Taenia saginataTaenia soliumTrichinella spiralisCyclospora
cayetanensis
Slide12Toxins and Chemicals
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Marine algae
toxins
Fungal toxinsFish toxinsChemicals
Slide13Disease Outbreaks with Confirmed Etiology
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Source: Foodborne
Disease Outbreak Surveillance
System 2009-2015
Slide14Illness Characteristics
Intoxication
Infection
Enterotoxin
Food consumed with preformed toxin
Food consumed that is contaminated with microorganism
Food consumed that is contaminated with microorganism
Rapid onset of symptoms
Delayed onset of symptoms
Delayed onset of symptoms
Nausea and vomiting
Diarrhea and possibly fever
Diarrhea
No secondary spread of illness
Secondary spread of illness likely
May have some secondary exposures
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Slide15Common Food Source Attributions
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Source: Interagency
Food Safety Analytics Collaboration (IFSAC
)
Slide16Cluster or Outbreak Investigation
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Slide17Exception 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 Scombrotoxin2-17
Slide18Goals of the Outbreak Investigation
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Slide19Summary
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Slide20Coming Up Next
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