M A J O R A R T I C L E
Deaths Associated With Bacterial Pathogens
Transmitted Commonly Through Food:
Foodborne Diseases Active Surveillance Network
Casey Barton Behravesh,1,2Timothy F. Jones,4Duc J. Vugia,5Cherie Long,1Ruthanne Marcus,6Kirk Smith,7
Stephanie Thomas,3Shelley Zansky,8Kathleen E. Fullerton,1Olga L. Henao,1Elaine Scallan,1and FoodNet Working
1Enteric Diseases Epidemiology Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging Zoonotic and
Infectious Diseases, and2Epidemic Intelligence Service Program Office for Scientific Education and Professional Development, Division of Applied
Sciences, Centers for Disease Control and Prevention, and3Georgia Emerging Infections Program, Division of Public Health, Atlanta;4Tennessee
Department of Health, Nashville;5California Department of Public Health Infectious Diseases Branch, Richmond;6Connecticut Emerging Infections
Program, New Haven and Hartford;7Minnesota Department of Health, Minneapolis;8New York Emerging Infections Program, New York State
Department of Health, Albany
Background. Foodborne diseases are typically mild and self-limiting but can cause severe illness and death. We
describe the epidemiology of deaths associated with bacterial pathogens using data from the Foodborne Diseases
Active Surveillance Network (FoodNet) in the United States.
Methods. We analyzed FoodNet data from 1996–2005 to determine the numbers and rates of deaths occurring
within 7-days of laboratory-confirmation.
Results. During 1996–2005, FoodNet ascertained 121,536 cases of laboratory-confirmed bacterial infections,
including 552 (.5%) deaths, of which 215 (39%) and 168 (30%) were among persons infected with Salmonella and
Listeria, respectively. The highest age-specific average annual population mortality rates were in older adults
(R65years) for all pathogens except Shigella, for whichthe highest age-specific average annual population mortality
rate was in children ,5 years (.2/1 million population). Overall, most deaths (58%; 318) occurred in persons
R65 years old. Listeria had the highest case fatality rate overall (16.9%), followed by Vibrio (5.8%), Shiga
toxin–producing Escherichia coli O157 (0.8%), Salmonella (0.5%), Campylobacter (0.1%), and Shigella (0.1%).
Conclusions. Salmonella and Listeria remain the leading causes of death in the United States due to bacterial
pathogens transmitted commonly through food. Most such deaths occurred in persons R65 years old, indicating
that this age group could benefit from effective food safety interventions.
Foodborne diseases are an important public health
problem in the United States, resulting in an estimated
48 million illnesses annually [1, 2]. Although most are
mild and self-limiting, more serious illness does occur,
resulting in an estimated 128,000 hospitalizations and
3000deaths. Serious illness leading todeath can occurin
patients who develop neurologic, hepatic, and renal
syndromes, those who become bacteremic, or have
complications from surgery. Young children, older
persons, and persons with immunocompromising
of complications. Additionally, foodborne infections
may exacerbate life-threatening illnesses in persons with
preexisting medical conditions. Though uncommon,
deaths account for most of the costs, including medical
care, associated with foodborne infections [3, 4].
Moreover, these deaths may be preventable. To better
Received 1 December 2010; accepted 10 March 2011.
Potential conflicts of interest: none reported.
Correspondence: Casey Barton Behravesh, MS, DVM, DrPH, Outbreak Response
Team, Outbreak Response and Prevention Branch, Division of Foodborne,
Waterborne, and Environmental Diseases, Centers for Disease Control and
Prevention, 1600 Clifton Rd, MS A-38, Atlanta, GA 30340 (firstname.lastname@example.org).
The Journal of Infectious Diseases
Published by Oxford University Press on behalf of the Infectious Diseases Society
of America 2011.
0022-1899 (print)/1537-6613 (online)/2011/2042-0015$14.00
FoodNet Deaths, 1996–2005
d JID 2011:204 (15 July)
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