Foodborne diseases - Emerging pathogen and trends

Foodborne diseases have a major public health impact (Table 1).(14,117) Although precise figures are lacking, the yearly incidence of foodborne illness in the United States is estimated at between 6 and 80 million illnesses resulting in approximately 500 to 9000 deaths.(41) The annual economic burden is estimated at 5 billion U.S, dollars.(6) Although most foodborne illnesses are mild, the consequences can be severe. In addition to acute gastrointestinal symptoms, such as diarrhea and vomiting, many foodborne pathogens can cause invasive disease. For example, infection with Listeria monocytogenes can cause meningitis or sepsis in neonates and immunosuppressed patients: and miscarriage in pregnant women.(91) Salmonellosis may also result in sepsis.(67) Infection with some foodborne pathogens can be followed by chronic sequelae or disability. Toxoplasmosis is an important cause of congenital malformation.(59) Escherichia coli O157:H7 is a leading cause of hemolytic uremic syndrome, the most common cause of acute kidney failure in children.(49) Nontyphoidal Salmonella or Yersinia enterocolitica infection can cause reactive arthritis,(18,103) and campylobacteriosis can cause Guillain-Barre syndrome, one of the most common causes of flaccid paralysis in the United States since the control of poliomyelitis.(75) The epidemiology of foodborne diseases is rapidly changing as foodborne pathogens emerge. A variety of factors have contributed to the emergence of foodborne disease. The Institute of Medicine report on emerging infectious diseases identified six broad categories of change in the social environment that influence the emergence of infectious diseases.(57) These include changes in human demographics and behavior, technology and industry, international travel and commerce, microbial adaptation, economic development and land use, and the public health infrastructure. This article presents examples of emerging or reemerging foodborne pathogens, followed by examples of factors associated with the emergence of foodborne diseases. Approaches that may help to prevent and control emerging foodborne hazards are also discussed.