The Economic Burden of Foodborne Illnesses- How Much Does Campylobacter Contribute?

A 2015 USDA publication estimated the yearly economic burden of 15 foodborne illnesses on the U.S. population at $15.5 billion. Right off the bat it should be clarified that economic burden is NOT the same thing as out-of-pocket expenses. The economic burden is a result of factors such as the illness’ “frequency, severity, and health impact”1. The report states that “Conceptually, economists measure the economic burden of a disease as the sum of the willingness to pay by all individuals in society to reduce its incidence or likelihood”1. Campylobacter spp. ranks 5th in this list for the greatest contributor to economic burden at $1.9 billion.

Campylobacter accounts for 9% of illnesses where a biological agent can be identified. Illnesses are self-limiting, but ~1% of illnesses will require hospitalization. 15% of all foodborne illnesses that require hospitalization are caused by Campylobacter. Mild cases may go away in two to five days. However, severe cases are assumed to take six days in the hospital and three days of at-home recuperation. Guillain-Barre Syndrome (GBS) is a rare but severe autoimmune disease that may follow illnesses with certain pathogens. And, an estimated 40% of GBS cases are triggered by Campylobacter. Approximately 56% of the $1.9 billion economic burden from Campylobacter is actually a result of GBS. GBS occurs in less than 0.25% of Campylobacter cases, but those cases account for over 50% of the economic burden. Campylobacter deaths result in 34% of the burden, and 10% is from both non-hospitalized and hospitalized illnesses.

While Campylobacter may not be as well-known as other foodborne pathogens, the costs of the illness are staggering. Handling or eating raw or undercooked poultry is still a major risk-factor for developing campylobacteriosis. Handwashing and avoiding cross-contamination are the best ways to keep oneself from developing this illness.

 

 

  1. Hoffmann, Sandra, Bryan Maculloch, and Michael Batz. Economic Burden of Major Foodborne Illnesses Acquired in the United States, EIB-140, U.S. Department of Agriculture, Economic Research Service, May 2015.

Why Isn’t Campylobacter Better Known? – By Hannah Bolinger

If you have read What is Campylobacter, you will know that it is a top five foodborne pathogen for illness, hospitalization, and death. With that being the case it is remarkable that Campylobacter is still an relatively unknown pathogen. However, there are a few reasons for this including the self-limiting and sporadic nature of the disease, and under reporting of illnesses.

Campylobacteriosis most often occurs as a sporadic illness i.e. a common source for an outbreak is not noted. This tends to draw less attention from both the media and government agencies than the large multi-state outbreaks that we sometimes hear about.  However, larger outbreaks of Campylobacter can occur and are often the result of unpasteurized milk or untreated water.

Campylobacteriosis is also known as being a relatively minor illness. This is true in the sense that most people will recover from their gastrointestinal discomfort without needing to see a doctor. However, illness can also be extremely acute with the pains sometimes mimicking appendicitis. Campylobacter also has the potential of causing more serious infections in the very young, old, pregnant, or immunocompromised. After a Campylobacter infection there is the potential for autoimmune complications such as Guillain-Barré syndrome, a form of reversible paralysis. Those suffering from Guillain-Barré may take months to recover and may require respiratory support. Another autoimmune complication that can follow a Campylobacter infection is reactive arthritis, characterized by painful joints, eye, and urinary tract problems.

Finally, under reporting is another contributor as to why this disease is not discussed more. Because most healthy adults will recover on their own, it is estimated that only about 1 in 31 cases is reported. Many patients do not seek medical care. Even if a patient does seek medical attention, it is not guaranteed that the doctor will perform a culture-based diagnosis. So, there may not be a definitive conclusion as to what caused the illness. Doctors may treat a patient based on one’s symptoms, and because the symptoms of Campylobacter are nearly indistinguishable from other agents that may cause gastroenteritis e.g., diarrhea and/or cramping, doctors may prescribe antibiotics that may not be optimal for treating campylobacteriosis.

It is likely that Campylobacter infections occur much more often than reported. Because the illness can be mild and of relatively short duration patients do not always seek medical care. However, even if they do it is not guaranteed that a specific etiologic agent will be identified. And, because large outbreaks are rare the media does not give this pathogen the same coverage as others which may cause more severe illness or larger outbreaks. But, because of the high number of illnesses, and the potential for severe infections and autoimmune sequelae Campylobacter should be treated as a much more important foodborne pathogen.

Scotland, Thank You for the Big Pink Chicken

This is perhaps my favorite campaign to raise awareness about Campylobacter. A man in a pink chicken suit runs around ruining others’ summer activities as a reminder that nothing ruins a good BBQ like a couple of cases of campylobacteriosis. Remember that cross-contamination after handling raw poultry is a big risk factor for getting this food-borne illness. After you touch raw poultry wash your hands. As Campylobacter researchers it is also nice to see Campy getting some attention. We hope that this campaign will help to make Campylobacter a better known food borne pathogen. We recently posted an article on some of the reasons why Campylobacter isn’t better known if you would like to check that out.

 

 

Latest on the May 2016 Campylobacter Outbreak in California

An update to the previously reported Campylobacter outbreak!

Food Safety News reports that the restaurant implicated in last month’s Campylobacter outbreak is being sued by two individuals who tested positive for the bacterium just days after dining at the restaurant. The results from cooked food samples taken from the restaurant will likely not come back until July the report states, but we will try our best to report them when they do.

32 Sickened by Campylobacter Outbreak in California

Usually Campylobacter causes sporadic cases of illness, so having an outbreak is unusual and interesting for Campylobacter researchers. The article, from Food Safety News, states that the cause of the outbreak is still unknown.

“County health officials are not certain what food item might have caused the illnesses. They are still checking samples of cooked foods taken from the restaurant on June 8 and also continuing to investigate the reports of those sickened.”

Poultry, unpasteurized milk, and untreated water are the most common vehicle for Campylobacter transmission. Additionally, cheeses made from raw milk can be sources of infection. While the researchers are testing the cooked food, we also hope that the raw ingredients are being tested as well.