Volume 17, Number 1—January 2011
Research
Foodborne Illness Acquired in the United States—Major Pathogens
, Robert M. Hoekstra, Frederick J. Angulo, Robert V. Tauxe, Marc-Alain Widdowson, Sharon L. Roy, Jeffery L. Jones, and Patricia M. Griffin
Table 3
Estimated annual number of domestically acquired foodborne hospitalizations and deaths caused by 31 pathogens, United States*
| Pathogen | Estimated annual number of hospitalizations |
Estimated annual number of deaths |
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|---|---|---|---|---|---|---|---|
| Hospitalization rate, %† | Total, mean (90% CrI) | Domestically acquired foodborne, mean (90% CrI) | Death rate, %† | Total, mean (90% CrI) | Domestically acquired foodborne, mean (90% CrI) | ||
| Bacteria | |||||||
| Bacillus cereus, foodborne‡ | 0.4 | 20 (0–86) | 20 (0–85) | 0 | 0 | 0 | |
| Brucella spp. | 55.0 | 132 (79–197) | 55 (33–84) | 0.9 | 2 (1–4) | 1 (0–2) | |
| Campylobacter spp. | 17.1 | 13,240 (6,770–23,827) | 8,463 (4,300–15,227) | 0.1 | 119 (0–523) | 76 (0–332) | |
| Clostridium botulinum, foodborne‡ | 82.6 | 42 (19–77) | 42 (19–77) | 17.3 | 9 (0–51) | 9 (0–51) | |
| Clostridium perfringens, foodborne‡ | 0.6 | 439 (45–2,015) | 438 (44–2,008) | <0.1 | 26 (0–163) | 26 (0–163) | |
| STEC O157 | 46.2 | 3,268 (844–7,052) | 2,138 (549–4,614) | 0.5 | 31 (0–173) | 20 (0–113) | |
| STEC non-O157 | 12.8 | 405 (0–1,451) | 271 (0–971) | 0.3 | 0§ | 0§ | |
| ETEC, foodborne‡ | 0.8 | 26 (0–119) | 12 (0–53) | 0 | 0 | 0 | |
| Diarrheagenic E. coli other than STEC and ETEC | 0.8 | 26 (0–120) | 8 (0–36) | 0 | 0 | 0 | |
| Listeria monocytogenes | 94.0 | 1,520 (544–3,152) | 1,455 (521–3,018) | 15.9 | 266 (0–765) | 255 (0–733) | |
| Mycobacterium bovis | 55.0 | 108 (79–140) | 31 (21–42) | 4.7 | 9 (8–11) | 3 (2–3) | |
| Salmonella spp., nontyphoidal | 27.2 | 23,128 (10,221–44,860) | 19,336 (8,545–37,490) | 0.5 | 452 (0–1,210) | 378 (0–1,011) | |
| S. enterica serotype Typhi | 75.7 | 623 (0–1,848) | 197 (0–583) | 0 | 0 | 0 | |
| Shigella spp. | 20.2 | 5,491 (1,100–13,741) | 1,456 (287–3,695) | 0.1 | 38 (0–254) | 10 (0–67) | |
| Staphylococcus aureus, foodborne‡ | 6.4 | 1,067 (173–3,006) | 1,064 (173–2,997) | <0.1 | 6 (0–48) | 6 (0–48) | |
| Streptococcus spp. group A, foodborne‡ | 0.2 | 1 (0–6) | 1 (0–6) | 0 | 0 | 0 | |
| Vibrio cholerae, toxigenic | 43.1 | 7 (0–16) | 2 (0–5) | 0 | 0 | 0 | |
| V. vulnificus | 91.3 | 202 (120–303) | 93 (53–145) | 34.8 | 77 (43–120) | 36 (19–57) | |
| V. parahaemolyticus | 22.5 | 129 (66–219) | 100 (50–169) | 0.9 | 5 (0–22) | 4 (0–17) | |
| Vibrio spp., other | 37.1 | 163 (101–240) | 83 (51–124) | 3.7 | 16 (6–36) | 8 (3–19) | |
| Yersinia enterocolitica | 34.4 | 637 (0–1,396) | 533 (0–1,173) | 2.0 | 34 (0–206) | 29 (0–173) | |
| Subtotal |
50,673 (30,578–75,466) |
35,796 (21,519–53,414) |
1,093 (358–2,247) |
861 (260–1,761) |
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| Parasites | |||||||
| Cryptosporidium spp. | 25.0 | 2,725 (777–6,558) | 210 (58–518) | 0.3 | 46 (0–241) | 4 (0–19) | |
| Cyclospora cayetanensis | 6.5 | 20 (0–190) | 11 (0–109) | 0.0 | 0 | 0 | |
| Giardia intestinalis | 8.8 | 3,581 (2,414–4,822) | 225 (141–325) | 0.1 | 34 (18–51) | 2 (1–3) | |
| Toxoplasma gondii | 2.6 | 8,889 (5,383–13,203) | 4,428 (2,634–6,674) | 0.2 | 656 (409–952) | 327 (200–482) | |
| Trichinella spp. | 24.3 | 6 (0–18) | 6 (0–17) | 0.2 | 0 | 0 | |
| Subtotal |
15,221 (10,617–20,867) |
4,881 (3,060–7,146) |
736 (456–1,094) |
333 (205–488) |
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| Viruses | |||||||
| Astrovirus | 0.4 | 17,430 (10,203–21,573) | 87 (32–147) | <0.1 | 5 (1–9) | 0 | |
| Hepatitis A virus | 31.5 | 2,255 (1,250–3,953) | 99 (42–193) | 2.4 | 171 (94–299) | 7 (3–15) | |
| Norovirus | 0.03 | 56,013 (32,197–86,569) | 14,663 (8,097–23,323) | <0.1 | 571 (331–881) | 149 (84–237) | |
| Rotavirus | 1.7 | 69,721 (55,958–84,348) | 348 (128–586) | <0.1 | 32 (23–40) | 0 | |
| Sapovirus | 0.4 | 17,430 (13,990–21,087) | 87 (32–147) | <0.1 | 5 (1–9) | 0 | |
| Subtotal |
162,850 (130,126–199,658) |
15,284 (8,719–23,962) |
783 (522–1,112) |
157 (91–245) |
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| Total | 228,744 (188,326–275,601) | 55,961 (39,534–75,741) | 2,612 (1,723–3,819) | 1,351 (712–2,268) | |||
*All estimates were based on US population in 2006. CrI, credible interval; STEC, Shiga toxin–producing Escherichia coli; ETEC, enterotoxigenic E. coli.
†For laboratory-confirmed illnesses. Unadjusted hospitalization and death rates are presented. These rates were doubled to adjust for underdiagnosis before being applied to the number of laboratory-confirmed cases to estimate the total number of hospitalizations and deaths. The hospitalization and death rates for astrovirus, norovirus, rotavirus, and sapovirus are the percent of total estimated illness and were not subject to further adjustment.
‡Estimates based on the number of foodborne illnesses ascertained in surveillance and therefore assumed to reflect only foodborne transmission.
§We report median values instead of means for the distributions of deaths caused by STEC non-O157 because of extremely skewed data.
1Current affiliation: Colorado School of Public Health, Aurora, Colorado, USA.