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Foodborne diseases are caused by agents that enter the body through the consumption of food or beverages. Many cases of foodborne illness are not reported, so it is impossible to get an exact count of the incidence of foodborne illness; however, the Centers for Disease Control and Prevention (CDC) estimates that about 76 million cases of foodborne disease occur in the United States each year, resulting in 325,000 hospitalizations and 5,000 deaths. The incidence of foodborne disease is believed to be much higher in developing countries, where the World Health Organization estimates that in 2000 alone, 2.1 million people died from diarrheal diseases. Outbreaks of foodborne illness occur in both developing and industrialized countries and can affect large numbers of people. For instance, an outbreak of hepatitis A in China, caused by the consumption of contaminated clams, affected more than 300,000 individuals, and an outbreak of salmonellosis in the United States in 1994, caused by consumption of contaminated ice cream, affected 224,000 people.

Most cases of foodborne disease are caused by microorganisms, including bacteria, viruses, and parasites. Other agents that can cause foodborne disease include mycotoxins, marine biotoxins, and the toxins occurring in poisonous mushrooms; metals such as lead, mercury, and cadium, which may contaminate food through air, water, or soil pollution; organic pollutants such as dioxin and polychlorinated biphenyls, which are by-products of some industrial processes; and other agents such as the agent causing BSE (bovine spongiform encephalopathy, also known as ‘mad cow disease’), which appears to be transmissible through the consumption of tainted beef.

Common Foodborne Diseases Caused by Microorganisms

Salmonellosis is caused by the Salmonella bacteria, which is commonly found in the intestines of mammals, reptiles, and birds and is usually spread to humans through consumption of foods of animal origin, including eggs, meat, and milk. Symptoms of salmonellosis include fever, headache, nausea, vomiting, abdominal pain, and diarrhea; in persons with weakened immune systems or poor health, it can be life threatening. The CDC estimates that 1.4 million cases of salmonellosis occur in the United States annually, with approximately 500 fatal cases.

Campylobacteriosis is caused by Campylobacter bacteria. In some countries, campylobacteriosis is more common than salmonellosis, and worldwide it is the most commonly identified bacterial cause of diarrheal illness. Campylobacteriosis is transmitted mainly through drinking water, undercooked poultry, and raw milk; because Campylobacter bacteria live in the intestines of healthy birds, most raw poultry can be assumed to be contaminated with it. The symptoms of campylobacteriosis include fever, nausea, severe abdominal pain, and diarrhea; major health consequences may develop in 2% to 10% of cases, including neurological disorders and reactive arthritis. The CDC estimates that there are more than 1 million cases of campylobacteriosis annually in the United States, with approximately 100 fatal cases.

Escherichia coli isatypeofbacterialivinginthe intestines of many animals, including humans and cattle. Most strains of E. coli are not harmful to humans; an exception is E. coli 0157:H7, which lives in the intestines of cattle and can have serious health effects when ingested by humans. This type of E. coli is usually ingested in undercooked ground beef, although it may also be transmitted through unpasteurized milk and fruit juice, contaminated water, uncooked produce, and person-to-person contact. Symptoms of E. coli 0157:H7 poisoning include severe abdominal cramps and bloody diarrhea; in 3% to 5% of the cases, hemolytic uremic syndrome may develop, which can result in kidney failure and death. The CDC estimates that about 73,000 people in the United States became ill from E. coli in 1999 and about 60 died.

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