Foodborne illness places heaviest burden on youngest kids

With the incidence of 9 major foodborne diseases not changing significantly since 2006-2008, according to a new preliminary report for 2013, the Centers for Disease Control and Prevention (CDC) says more needs to be done for prevention.

For 7 of the diseases the incidence was highest among children aged younger than 5 years. Those pathogens were: Campylobacter; Cryptosporidium; Salmonella; Shiga toxin-producing Escherichia coli (STEC) O157 and non-O157; Shigella; and Yersinia.

The data are from the “FoodNet” system, sponsored by the CDC, that monitors the incidence of 9 pathogens in 10 US sites, covering about 15% of the US population. In the total population in 2013, FoodNet found 19,056 infections, 4200 hospitalizations, and 80 deaths.

Professionals stress that the numbers are the tip of the iceberg for foodborne diseases because many people don’t seek care and the FoodNet system includes only laboratory-confirmed cases. Indeed, FoodNet’s surveillance cannot include the pathogens that cause the majority of foodborne illnesses, as estimated in a 2010 CDC comprehensive report. For example, Norovirus causes 58% of domestically acquired foodborne illness, but it is not routinely diagnosed by culture or other lab test. Clostridium perfringens causes another 10%.

Nevertheless, the FoodNet system shows a heavy illness burden for small children. Based on earlier FoodNet reports, a study from the University of Colorado estimated last year that 5 bacterial enteric pathogens alone cause almost 300,000 cases of illness a year in children aged younger than 5 years. These pathogens result in 102,746 physician visits, 7830 hospitalizations, and 64 deaths. Among those 5, nontyphoidal Salmonella causes 42% of the illness; Campylobacter, 28%; Shigella, 21%; Yersinia enterocolitica, 5%; and STEC O157, 3%.

The overall rates are higher in children than in the general population even after adjusting for underdiagnosis in both groups, according to the study led by Elaine Scallan, PhD, and published in the Pediatric Infectious Disease Journal.

Robert Tauxe, MD, MPH, deputy director of CDC’s Division of Foodborne, Waterborne, and Environmental Diseases, says Salmonella is a particular problem for children as they are being weaned. The rates are highest for those aged from 2 to 6 months, a time when children often start to get food other than mother’s milk or formula. Most of the Salmonella incidence is from food, he says, although some of it is from pets such as chickens or reptiles.

“Breastfeeding is the single best way to keep an infant from getting Salmonella,” says Tauxe.

If a child is on formula, he explains, there is a real hazard when the caregiver is preparing the formula and also preparing raw meat. It’s best, according to Tauxe, if the person preparing meat and poultry doesn’t prepare the formula, juice bottle, or whatever for the child. If it has to be the same person, he or she should do it at different times and “wash hands ever so carefully.”

“Food safety does take a little forethought,” says Olga Henao, PhD, team leader for FoodNet. It’s important, she says, to ensure that young children don’t come in contact with raw meat products, including taking care that when a child rides in a grocery cart, the cart is wiped down and packets of meat are placed away from the child.

The new FoodNet report was in CDC’s Morbidity and Mortality Weekly Report for April 18, 2014.

Ms Foxhall is a freelance writer in the Washington, DC, area. She has nothing to disclose in regard to affiliations with or financial interests in any organizations that might have an interest in any part of this article.