FDA authors publish cost of foodborne illness: totals and per case estimates

There’s a lot of excitement around societal costs of foodborne illness as a justification for  research dollars, communication resources and measuring any impacts of risk-reduction activities.

In 2010, the Produce Safety Project supported by the Pew Charitable Trusts estimated the US societal cost of foodborne illness at $152 billion annually  A 2012 Journal of Food Protection paper by Robert Scharff estimated, with a couple of different base models, that the annual cost of illness was in between $51 billion to $77 billion. Last fall USDA ERS released updated cost estimates for 15 pathogens.dollar sign

An early release version of a Risk Analysis paper by U.S. FDA risk folks (Minor et al.) estimates the cost of foodborne illnesses (including some that have been omitted by others in previous models) at $36 billion, and the average cost burden per illness of $3,630.

From the methods:

The total cost of a foodborne illness combines mortality costs with the value of lost QALDs and medical costs for acute illnesses and sequelae. Each element in the measure is weighted by its frequency. For each known agent or disease that causes foodborne illness we estimate the full monetary cost of illness based on the expected severity of the acute illness, the expected severity of any sequelae, and the probability of premature death. Each of these estimates is derived from Monte Carlo simulations using the statistical package @Risk and full distributions, where available, as inputs.

The biggest surprise for me was the average annual monetary loss per case of Cronobacter is estimated to be $7,013,777. The authors explain that Cronobacter ‘is estimated to be significantly different from the other foodborne illnesses due to its associated duration and severity; it is also rare.’ There aren’t many cases of Cronobacter sakazakii, but they are almost all associated with infants being fed powdered formula – and they are devastating.

Clostridium botulinum, Vibrio vulnificus, L. monocytogenes, Ciguatoxin, and Trichinella spp. are the next most costly illnesses all representing over 10 QALDs lost per illness, with an associated total monetary loss between  $12,135 and $1.51 million. On the other extreme, B. cereus, Clostridium perfringens, Staphylococcus aureus, Norovirus, Sapovirus, and Scombrotoxin are all estimated to be the least burdensome individual illnesses; each case representing QALD losses of less than 0.29 or less than $381 in monetary losses.

The limitations of the public health cost estimates are that they do not attempt to include the costs to industry (things like management, loss of business, sales, reputation and others). Although norovirus has an estimated average annual monetary loss per case of only $363, an outbreak, like the one affecting Tycoons in Duluth is likely costing the business, including gift certificates, a lot more than that.

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About Ben Chapman

Dr. Ben Chapman is a professor and food safety extension specialist at North Carolina State University. As a teenager, a Saturday afternoon viewing of the classic cable movie, Outbreak, sparked his interest in pathogens and public health. With the goal of less foodborne illness, his group designs, implements, and evaluates food safety strategies, messages, and media from farm-to-fork. Through reality-based research, Chapman investigates behaviors and creates interventions aimed at amateur and professional food handlers, managers, and organizational decision-makers; the gate keepers of safe food. Ben co-hosts a biweekly podcast called Food Safety Talk and tries to further engage folks online through Instagram, Twitter, Facebook, YouTube and, maybe not surprisingly, Pinterest. Follow on Twitter @benjaminchapman.