The Centers for Disease Control and Prevention (CDC) maintains statistics on foodborne outbreaks. From 1988 to 1992 (13), among outbreaks for which the etiology was determined, bacterial pathogens caused the largest percentage of outbreaks (79%) and the largest percentage of cases (90%); chemical agents caused 14% of outbreaks and 2% of cases; parasites, 2% of outbreaks and 1% of cases; and viruses, 4% of outbreaks and 6% of cases.
The Center for Science in the Public Interest compiled an inventory of 225 foodborne illness outbreaks (14) that occurred between 1990 and 1998. Ground beef caused 37 of 65 outbreaks; fruits and salads were the second most likely foods to be linked with an outbreak, with a total of 48 outbreaks. Seafood, both finfish and shellfish, was re sponsible for 32 outbreaks. Multi-ingredient foods, which included desserts, sauces, egg dishes, pasta dishes, and stuffing, were responsible for 63 outbreaks. In three-quarters of these outbreaks, the cause of illness was Salmonella enteridis. It is possible that emerging and re-emerging pathogens contributed to the large number of outbreaks of unknown etiology (14).
The Council for Agriculture and Science Technology (CAST) concludes that microbial pathogens in foods cause 6.5 to 44 million cases of human illnesses and up to 9000 deaths each year (15). It has been estimated that the costs of human illness for six bacterial pathogens—Salmonella, Campylobacter, E. coli 0157:H7, Listeria, Staphylococcus aureus, and Clostridium pefigus—are estimated to be $9.3 to $12.9 billion. Of these costs, $2.9 to $6.7 billion are attributed to foodborne bacteria (16). The estimated annual cost of Campylobacter-associ&ted Guillain-Barre syndrome was $0.2 to $8.0 billion, with an estimation of $0.8 to $5.6 billion from food sources (17). Estimates are subject to errors because most of the comprehensive population-based studies have not attempted to determine which proportion of the reported illnesses are from food consumption and which are from other sources; also, foodborne illnesses can cause clinical conditions, not characteristically gastrointestinal symptoms (5,18).
Foodborne Diseases Active Surveillance Network (FoodNet) is a collaborative project among CDC; the health departments of California, Connecticut, Georgia, New York, Maryland, Minnesota, and Oregon; FDA; and USD A. The following bacteria have been targeted: Salmonella, Shigella, Campylobacter, E. coli 0157:H7, Listeria, Yersinia, and Vibrio (19). FoodNet reports that Campylobacter was the most frequently isolated foodborne bacterium pathogen (49.4%), followed by Salmonella (27.4%), Shigella (15.7%), E. coli 0157:H7 (4.2%), Yersinia (1.1%), Listeria (1%), and Vibrio (0.6%) (20). FoodNet estimated that there were 8 million cases of these bacterial infections in 1997 in the United States (21).
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