Yes, Billion – Per Year[1]

I suppose you can call this the economic reason why I still have a job.

The Economic Research Service of the United States Department of Agriculture recently provided Cost Estimates of Foodborne Illnesses for the major foodborne illnesses in the United States as of 2013.  This data includes:

  • Detailed identification of specific disease outcomes for foodborne infections caused by 15 major pathogens in the United States
  • Associated outpatient and inpatient medical care expenditures
  • Associated lost wages/productivity losses
  • Cost of premature deaths

Disease outcomes include both acute illness and chronic disease that sometimes follow these acute illnesses. The 15 pathogens studied account for over 95 percent of the illnesses and deaths from foodborne illnesses acquired in the United States.

The Economic Research Service estimates build on the foodborne disease estimates from the Centers for Disease Control and Prevention; peer-reviewed synthesis of data on medical costs, and economic, medical and epidemiological literature; and publicly available data on wages.

I decided to focus on 7 of the pathogens – Campylobacter, E. coli O157:H7, non-E. coli O157:H7 – shiga-toxin producing E. coli, Listeria, Norovirus, Salmonella and Shigella.

Campylobacter [2]– Total yearly cost – $1,928,787,166:

The CDC estimates yearly cases of illness at 845,024.  Of those, 45,631 saw a physician and 8,463 were hospitalized.  Of those hospitalized, 76 died.  Long-term complication – primarily Guillan Barre Syndrome (GBS) – accounted for 1,916 people and of those 86 died.

  • Medical costs of those just visiting a physician – $20,318,753.  Hospitalization costs – $121,332,675 and post-hospitalization costs – $1,140,269.  Medical costs for those with GBS – $320,416,057.  Premature death costs for those hospitalized – $657,959,135 and for those with GBS – $748,428,516.
  • Wage loss and productivity loss for those that were ill but did not visit a physician – $44,709,190; for those who visited a physician and recovered – $8,043,747; for those hospitalized – $4,305,437; and, for post-hospitalization recovery – $2,133,387.
  • Cost of premature deaths – $748,428,516.

E. coli O157:H7 [3]– Total yearly cost – $271,418,690:

The CDC estimates yearly cases of illness at 63,153.  Of those, 11,737 sought a physician’s assistance.  1,806 were hospitalized and 10 died, but did not develop hemolytic uremic syndrome (HUS).  302 did develop HUS and recovered with 12 dying acutely and 10 dying a premature death at a later point.

  • For those that did not seek medical care, medical expenses were modest at $135,960.  For those that sought medical care, but were not hospitalized, medical expenses were $4,929,205.  Hospitalized, non-HUS – $16,485,464.  Hospitalized, HUS – $2,854,946.  Hospitalized HUS and end stage renal disease (ESRD) with later premature death – $8,917,815.  Medical expenses for those hospitalized who died without HUS – $72,955; for those who died with HUS – $667,360.
  • Wage loss/productivity loss for those who did not seek medical attention – $1,431,031; for those who sought medical attention – $2,477,897; hospitalized, non-HUS – $1,110,585; hospitalized, HUS – $22,515; Hospitalized HUS and ESRD with later premature death – $588,895; hospitalized, non-HUS, death – $7,678; hospitalized, HUS, death – $4,431.
  • The cost of the premature deaths were as follows:  Hospitalized HUS and ESRD with later premature death – $558,008,517; hospitalized, non-HUS, death – $69,258,856; hospitalized, HUS, death – $103,888,284.

non-E. coli O157:H7 [4]– Total yearly cost – $27,364,561:

The CDC estimates yearly cases of illness at 112,752[5].  91,526 did not seek medical attention; 20,955 did.  271 people were hospitalized.  231 did not develop HUS; 39 developed HUS and recovered; and, there was 1 death.

  • Medical expenses for those who did not seek medical care – $252,525.  It was $8,800,355 for those who sought medical care, but were not hospitalized.  For those hospitalized, non-HUS – $2,108,605; hospitalized, HUS – $2,169,066; Hospitalized HUS and ESRD with later premature death – $947,410.
  • Wage and productivity loss for those who did not seek medical attention – $2,657, 911; for those who sough medical attention, but were not hospitalized – $4,423,987; for those hospitalized, non-HUS – $142,053; hospitalized, HUS – $2,908; hospitalized HUS and ESRD with later premature death – $58,889.
  • The cost of the 1 premature death – $5,800,852.

Listeria [6]– Total yearly cost – $2,834,444,202:

The CDC estimates yearly cases of illness at 1,591.  Only 136 were sickened and did not visit a physician and all others – 1,173 were hospitalized.  Mothers hospitalized – 189; others hospitalized with moderate illness – 33.  Severe illnesses were 697 with 247 deaths.

  • The medical cost for hospitalized mothers – $6,434,883; including infants – $31,208,947.  Other adult medical costs for moderate illness – $1,078,656; for severe illness for those who recovered – $68,513,832; medical costs for those that died – $16,181,967.
  • Productivity and wage loss was modest across all categories at $2,016,273
  • The cost of premature deaths – $2,138,172,640.

Norovirus [7]– Total yearly cost – $2,255,827,318:

The CDC estimates yearly cases of illness at 5,461,731.  4,906,357 did not require a visit to a physician.  540,711 saw a physician.  14,663 were hospitalized and 149 people died.

  • Medical expenses for those who visited a physician only – $240,768,547.  For those hospitalized – $355,175,098.
  • Wage and productivity loss totaled $367,964,198.
  • The cost of premature deaths – $1,289,946,198.

Salmonella [8]– Total yearly cost – $3,666,600,031:

The CDC estimates yearly cases of illness at 1,027,561.  934,241 did not seek medical attention.  73,984 were seen by a physician – with 19,336 being hospitalized.  There were 378 deaths.

  • Medical costs for those seeing a physician – $32,943,851.  Hospital costs were $277,217,134 with post-hospitalization cases of $2,577,468.
  • Productivity and wage loss – $52,810,195 for those who did not seek medical care.  For those who only saw a physician – $13,911,195; hospitalized and post hospital recovery – $14,659,244.
  • Premature death costs – $3,272,480,959.

Shigella [9]– Total yearly cost – $137,965,962:

The CDC estimates yearly cases of illness at 131,254.  Most did not seek medical treatment – 120,348.  1,456 were hospitalized and there were 10 deaths.

  • Total medical expenses – $42,130,731.
  • Total wage and productivity loss – $9,261,661
  • Premature death costs – $86,573,570.

I guess I still have work to do.


[1] Of course this does not account for business losses that includes lost sales, recall cost, advertising costs, litigation costs, etc.

[2] See, www.about-campylobacter.com According to the CDC, Campylobacteriosis is an infectious disease caused by bacteria of the genus Campylobacter. Most people who become ill with campylobacteriosis get diarrhea, cramping, abdominal pain, and fever within two to five days after exposure to the organism. The diarrhea may be bloody and can be accompanied by nausea and vomiting. The illness typically lasts about one week. Some infected persons do not have any symptoms. In persons with compromised immune systems, Campylobacter occasionally spreads to the bloodstream and causes a serious life-threatening infection.

[3] See, www.about-ecoli.com According to the CDC, Escherichia coli (abbreviated as E. coli) are a large and diverse group of bacteria. Although most strains of E. coli are harmless, others can make you sick. Some kinds of E. coli can cause diarrhea, while others cause urinary tract infections, respiratory illness and pneumonia, and other illnesses. Still other kinds of E. coli are used as markers for water contamination—so you might hear about E. coli being found in drinking water, which are not themselves harmful, but indicate the water is contaminated. It does get a bit confusing—even to microbiologists.

[4] In 2012 E. coli O26, O11, O103, O121, O45 and O145 were declared adulterants by the USDA/FSIS – http://www.foodpoisonjournal.com/food-policy-regulation/fsis-to-declare-the-big-six-non-o157-stecs-adulterants/#.VFK5G9ZvZqI

[5] ERS Spreadsheet indicated 63,153, but that is incorrect.

[6] See, www.about-listeria.com  According to the CDC, Listeriosis, a serious infection usually caused by eating food contaminated with the bacterium Listeria monocytogenes, is an important public health problem in the United States. The disease primarily affects older adults, pregnant women, newborns, and adults with weakened immune systems.

[7] See, www.about-norwalk.com According to the CDC, Norovirus is a very contagious virus. You can get norovirus from an infected person, contaminated food or water, or by touching contaminated surfaces. The virus causes your stomach or intestines or both to get inflamed (acute gastroenteritis). This leads you to have stomach pain, nausea, and diarrhea and to throw up.

[8] See, www.about-salmonella.com According to the CDC, Salmonellosis is an infection with bacteria called Salmonella. Salmonella germs have been known to cause illness for over 100 years. They were discovered by an American scientist named Salmon, for whom they are named.  Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts 4 to 7 days, and most persons recover without treatment. However, in some persons, the diarrhea may be so severe that the patient needs to be hospitalized. In these patients, the Salmonella infection may spread from the intestines to the blood stream, and then to other body sites and can cause death unless the person is treated promptly with antibiotics. The elderly, infants, and those with impaired immune systems are more likely to have a severe illness

[9] See, www.about-shigella.com According to the CDC, Shigellosis is an infectious disease caused by a group of bacteria called Shigella. Most who are infected with Shigella develop diarrhea, fever, and stomach cramps starting a day or two after they are exposed to the bacteria. Shigellosis usually resolves in 5 to 7 days. Some people who are infected may have no symptoms at all, but may still pass the Shigella bacteria to others.