New study puts cost of US foodborne illness at $77 billion

Jan 3, 2012 (CIDRAP News) – Although the estimated annual toll of foodborne illnesses and deaths in the United States was revised sharply downward by federal officials in 2010, foodborne disease still costs the nation up to $77.7 billion a year, according to a new study in the Journal of Food Protection.

The study, by Robert L. Scharff of Ohio State University, is based on the Centers for Disease Control and Prevention's (CDC's) December 2010 estimate that the nation has 48 million cases of foodborne illness with 3,000 deaths annually. Those numbers replaced an often-cited 1999 CDC estimate of 76 million cases with 5,000 deaths each year.

In an earlier study, Scharff used the CDC's 1999 figures to estimate that foodborne illness cost the nation up to $152 billion a year. He revised his estimate to reflect the newer, lower numbers from the CDC. When it released the lower estimates, the CDC said the decreases were mainly due to better data and new estimation methods.

Scharff's new study presents two different sets of cost estimates based on two different models. His "basic" model includes medical costs, productivity losses, and deaths, whereas his "enhanced" cost-of-illness model assigns costs for pain, suffering, and functional disability as well as the other factors. But neither model includes costs to the food industry or to public health agencies, nor costs due to certain long-term sequelae, such as post-infectious irritable bowel syndrome, the author notes.

He estimated costs associated with 30 classes of pathogens, including 20 types of bacteria, 5 parasites, and 5 viruses.

In the basic model, the overall cost burden for foodborne diseases is estimated at $51.0 billion (90% credible interval [CI], $31.2 billion to $76.1 billion), well below the enhanced-model estimate of $77.7 billion (90% CI, $28.6 billion to $144.6 billion). The overall average cost per case of illness is $1,068 in the basic model and $1,626 in the enhanced model.

According to the enhanced model, the most expensive foodborne diseases are associated with Salmonella, at $11.39 billion per year; Campylobcter, $6.88 billion; norovirus, $3.68 billion; Toxoplasma gondii, $3.46 billion; and Listeria monocytogenes, $2.04 billion.

Scharff puts the overall burden from Escherichia coli O157:H7 infections at $635 million a year. Non-O157 strains of Shiga toxin–producing E coli , which have been the focus of increased concern in recent years, cost the nation an estimated $154 million, which is higher than Scharff's previous estimate, according to the report.

On a per-case basis, the most costly foodborne disease by far is Vibrio vulnificus infection, at $2.79 million, according to the enhanced model. Other highly expensive ones are Clostridium botulinum (botulism), $1.68 million, and L monocytogenes, $1.28 million.

Scharff's enhanced-model estimates for costs linked to two major foodborne pathogens differ considerably from those offered by the US Department of Agriculture (USDA) in May 2010. The USDA estimated that Salmonella infections from all sources cost the country about $2.65 billion a year, versus $11.39 billion in the new report. For E coli O157:H7, the USDA estimate was $478.4 million, compared with Scharff's estimate of $635 million.

In his report, Scharff offers a note of caution on the use of his numbers: "Total cost figures are useful as measures of the scope of the problem, but the numbers do not by themselves provide economic justification for any particular program aimed at reducing foodborne illness."

Scharff RL. Economic burden from health losses due to foodborne illness in the United States. J Food Protect 2012;75(1):123-31 [Abstract]

See also:

Mar 3, 2010, CIDRAP News story on earlier cost-estimate study

Dec 15, 2010, CIDRAP News story on revised CDC estimates of foodborne illness burden

May 2010 story about USDA estimate of E coli and Salmonella costs

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