An Economic Assessment of Food Safety Regulations


Table 1--Cases of illness and death for seven major microbial pathogens



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An economic assesment of food safety regulations meet and poultry
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Table 1--Cases of illness and death for seven major microbial pathogens

Estimated

Estimated

Estimated

Foodborne

Foodborne

Pathogen and

annual


annual

share


annual

annual


disease/complication

cases


deaths

foodborne

cases

deaths


------------Number-----------

Percent


-------------Number-----------

Bacteria

Campylobacter jejuni or coli

Campylobacteriosis

2,000,000-10,000,000

200-730

55-70


1,100,000-7,000,000

110-511


Clostridium perfringens

C. perfringens intoxications

10,000

100


100

10,000


100

Escherichia coli O157:H7

E. coli O157:H7 disease

10,000-20,000

100-250

80

8,000-16,000



80-200

Hemolytic uremic syndrome

1

400-820


120-291

80

320-656



96-233

Subtotal


N/A

220-541


N/A

N/A


176-433

Listeria monocytogenes

2

Listeriosis



1,092-1,860

270-510


85-95

928-1,767

230-485

Complications

26-43

0

85-95



22-41

0

Subtotal



N/A

270-510


N/A

N/A


230-485

Salmonella (non-typhoid)

Salmonellosis

800,000-4,000,000 1,000-2,000

87-96

696,000-3,840,000



870-1,920

Staphylococcus aureus

S. aureus intoxications

8,900,000

2,670

17

1,513,000



454

Parasite

Toxoplasma gondii

3

Toxoplasmosis



435

79

50



217

40

Complications



3,083

0

50



1,541

0

Subtotal



3,162

79

N/A



1,581

40

 Total



4

11,700,000-22,900,000 4,500-6,600

N/A

3,300,000-12,300,000



1,900-3,900

Notes: N/A = Not applicable.

1

 Kidney failure.



2

 Includes only hospitalized patients because of data limitations.

3

 Includes only toxoplasmosis cases related to fetuses and newborn children who may become blind or mentally retarded.  Some



cases do not have noticeable acute illness at birth but develop complications by age 17.  Does not include all other cases of

toxoplasmosis.  Another high-risk group for this parasite is the immunocompromised, such as patients with AIDS.

4

 Totals are rounded down to reflect the uncertainty of the estimates.



Source: Buzby and Roberts, 1996.


4

Economic Research Service/USDA

An Economic Assessment of Food Safety Regulations

lobacter jejuni/coli, Staphylococcus aureus, Escherichia

coli (E. coli) O157:H7, Clostridium perfringens, Listeria

monocytogenes, and Toxoplasma gondii.   The table also

presents the estimated percent attributable to foodborne

sources and the resulting cases of foodborne illness

cases and associated deaths.

Human illness caused by 

Salmonella is frequently

associated with poultry, beef, and egg consumption (Lin,

Roberts, and Madison, 1993).  Symptoms generally

occur 6-72 hours after eating contaminated food

(Benenson, 1990), and can last from days to weeks

(although most last only a day or two).  Acute symptoms

include abdominal pain, nausea, stomachache, vomiting,

cold chills, fever, exhaustion, and, in rare cases,  bloody

stools.  Endocarditis (infection of the heart), meningitis

(infection of the brain), and pneumonia may follow the

acute stage.  The pathogen can also cause chronic

complications such as rheumatoid syndromes, colitis,

and thyroiditis.  Death may result from the illness.  A new

strain, 


Salmonella enteritidis, can be passed to eggs

before the shell forms if the hen is infected.   Raw shell

eggs and their products can be contaminated with

Salmonella enteritidis.  Home-made foods containing raw

eggs, such as ice cream, egg nog, mayonnaise, cake

frosting, lightly cooked egg dishes, and Caesar salad,

are potentially risky.  A recent outbreak of 

Salmonella

enteritidis-related illness in the Midwest was traced to ice

cream transported in containers that had previously

carried unpasteurized liquid eggs.

Human illness caused by 

Campylobacter has been

linked to chicken or poultry consumption.  Symptoms

usually begin 1-10 days after exposure to contaminated

food (Benenson, 1990) and can last for days.  These

symptoms include malaise, diarrhea, vomiting, severe

abdominal pain, (occasionally) bloody diarrhea, and

fever.  Other complications may follow, such as meningi-

tis, arthritis, cholecystitis, urinary tract infection, appendi-

citis, septicemia, Reiter syndrome, and Guillain-Barré

syndrome (GBS) -- a major cause of nontrauma-related

paralysis in the United States.  A small proportion of

patients die.

Illness caused by 

E. coli O157:H7 is less widespread, but

has received considerable publicity following a 1993

outbreak in California, Idaho, Nevada, and Washington

attributed to undercooked hamburgers in a fast-food

restaurant chain, a 1996 outbreak in Japan of unknown

origin, and a 1996 outbreak related to unpasteurized

apple juice in the Midwest. The pathogen has also been

found in raw milk, unpasteurized apple cider, processed

sausage, and home-prepared hamburgers.  The latter

present a particular risk; the bacteria can live on the

surface of meat products and are normally destroyed by

cooking.  However, when meat is ground to make

hamburger or sausage the organism can be distributed

throughout the product, and the raw meat ground into

hamburger can come from many different meat car-

casses.  (This can increase the probability of contamina-

tion.)  If the sausage or hamburger is undercooked or

eaten rare, the bacteria in the center of the meat might

not be killed.  It generally takes 3-7 days before symp-

toms occur after eating contaminated food.  Acute

symptoms, lasting 6-8 days, are diarrhea (often bloody),

abdominal pain, vomiting, and little or no fever.  Chronic

consequences include hemolytic uremic syndrome

(HUS), which is characterized by kidney failure and

strikes mostly children under the age of 5.  Some propor-

tion of patients will die.

Not all segments of the population are equally at risk

from microbial foodborne disease.  Much of the in-

creased risk is from impaired immune systems; organ-

isms, which a healthy immune system can fight, may

pose a greater risk to some population subgroups than

others (table 2). Elderly individuals may undergo a

decrease in immune function as they age.  The immune

system of neonates (newborn children) and young

children is not fully developed.  Pregnancy puts the fetus

at special risk of foodborne illness caused by pathogens

such as 


Listeria monocytogenes and Toxoplasma gondii;

miscarriage, stillbirth, or fetal abnormality may occur.

Since, by definition, the immune systems of people with

AIDS or infected by the HIV virus are damaged or

destroyed, these patients are also at greater risk of

foodborne disease.

Foodborne illness trends over time are not consistent

across pathogens.  Some illnesses may be decreasing

over time, while others may be increasing.  The U.S.

population is increasing at a little over 1 percent each

year, and part of this growth is attributed to a greater

number of children and elderly people, two categories

most affected by foodborne illnesses (although the

proportion of children as a share of the total population is

expected to decline).  However, it seems clear that, as


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