Fundamental Food Microbiology, Third Edition - Fuad Fathir

326 FUNDAMENTAL FOOD MICROBIOLOGY
C. Incidence of Foodborne Disease Outbreak
The incidence of foodborne illnesses in most of the developed countries is lower
than in many developing countries. 1–3 The major reasons for the low incidence are
the implementation of necessary regulations in production and handling of foods,
good sanitary practices, and the availability of necessary facilities to reduce abuse.
In the U.S., from 1983 to 1987, an average of 479 foodborne disease outbreaks were
reported each year, involving 18,336 individuals (Table 23.1). However, on average,
only 38% of the outbreaks, involving ca. 10,908 individuals, were confirmed. 2 This
shows that even for the reported incidents, only some could be confirmed from the
direct evidence. It is suspected that even in the developed countries, only a small
fraction of the total incidents are reported. In many instances, an individual does
not consult a doctor, and even if a person does consult a doctor, the incident might
not be reported to the regulatory agencies. Based on the mechanisms involved in
the surveillance system, it is estimated that in the U.S., ca. 5 million individuals are
affected by food- and waterborne diseases every year. Others consider this a conservative
estimate. According to them, if, on an average, a person is affected once
in 10 years, 10% of the population can become sick annually by foodborne illnesses.
In the U.S., this is equivalent to ca. 28 million people annually. Other groups think
that the numbers could go as high as 80 million annually. (See Section IV in this
chapter.)
D. Cost of Foodborne Diseases
Foodborne illnesses can be fatal as well as cause suffering, discomfort, and debilitation
among the survivors. The economic losses from various factors, such as
medical treatment, lawsuits, lost wages and productivity, loss of business, recall and
destruction of products, and investigation of the outbreaks, can be very high. In the
U.S., the annual cost of foodborne diseases is estimated to be more than $20 billion.
Costs in 1996 were estimated to be $20 to $37 billion from foodborne illnesses from
seven pathogens (Campylobacter jejuni, Clostridium perfringens, Escherichia coli
O157:H7, Listeria monocytogenes, Salmonella, Staphlococcus aureus, and Toxoplasma
gondii). 4
Table 23.1 Foodborne Disease Outbreaks from 1983 to 1987 in the U.S.
Reported
outbreaks
Total
cases
Confirmed
outbreaks
Confirmed
cases
1983 1984 1985 1986 1987
Average/
Year
505 543 495 467 387 479
(100%)
14,898 16,420 31,079 12,781 16,500 18,336
(100%)
187 185 220 181 136 182
(38%)
7,904 8,193 22,987 5,804 9,652 10,908
(59.5%)