Combatting foodborne illness

What physicians need to know about combatting foodborne illness

The Centers for Disease Control and Prevention estimate that 48 million people are sickened by contaminated foods each year in the United States. These illnesses result in an estimated 128,000 hospitalizations and 3,000 deaths each year.

The most common causes of foodborne illness in the United States, according to FoodSafety.gov, are norovirus, salmonella, campylobacter, E. coli, listeria, and clostridium perfringens.

Over the last several years, there have been significant foodborne disease outbreaks in the United States, including a listeriosis outbreak in 2011, a salmonellosis outbreak in 2008, and an E. coli outbreak in 2006. So far in 2018, public health officials have launched investigations into five foodborne disease outbreaks.

Combatting the spread of foodborne illness

After a national E. coli outbreak early in 2018, the American Medical Association and the U.S. Food and Drug Administration collaborated on two continuing medical education videos to help physicians combat the spread of foodborne illness.

While the two organizations acknowledge that physicians are generally familiar with illnesses caused by food contaminants, they feel that the globalization of the food supply and the continuing evolution of foodborne pathogens warrant updated medical education and patient counseling.

The videos use real-life cases to illustrate the severity of foodborne illness and explain the four-step process healthcare providers should use when evaluating a patient for foodborne illness: suspect, identify, treat, and report.

Suspect

Physicians may suspect that a patient has a foodborne illness if he or she presents with nausea, vomiting, abdominal pain, or diarrhea, but there are other, atypical symptoms associated with foodborne illness, such as fever, neurological symptoms, lethargy, paresthesia, and paralysis. Symptoms can vary widely depending on what caused the illness.

Identify

When a foodborne illness is suspected, a thorough history should be taken, especially as it pertains to the consumption of high-risk foods the patient has consumed—such as undercooked meat or seafood, unpasteurized dairy products, or unwashed produce—prior to the onset of the illness. Lab testing can confirm if foodborne illness is the cause of the illness.

Treat

Treatments for foodborne illnesses vary depending on the type and etiology of the illness, so a proper diagnosis is essential. According to the CDC, replacing lost fluids and electrolytes, oral rehydration, and antidiarrheal medication may be indicated for patients who experience diarrhea and vomiting. Severe dehydration may require intravenous hydration or hospitalization. And while some types of foodborne illnesses are appropriately treated with antibiotics such as penicillin, others are not.

Researchers from the University of Texas Medical Branch at Galveston have developed an oral vaccine for salmonella poisoning. Human vaccines for norovirus, and E. coli are also in development.

Report

Once a pathogen has been identified, physicians have a responsibility to report the foodborne disease to their local health departments. State and local agencies, in turn, report the case to the CDC.

Perhaps not surprisingly, digital reporting of foodborne illness in the United States follows a clear seasonal pattern, with more reports of foodborne illness in the summer. Regardless of season, prompt reporting of foodborne illness can help to reduce wider transmission and prevent future outbreaks.

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