The Burden of Foodborne Illness in the United States

M. DuBose
Apr 22
5 min read

Foodborne illnesses are a persistent public health challenge in the United States, affecting millions annually and imposing significant economic and health burdens.

We at D.L. Newslow & Associates, Inc. looked into the top seven foodborne pathogens, their impacts, and the strategies needed to address future challenges. Foodborne illnesses remain a significant public health challenge in the United States, affecting millions annually. Despite advancements in food safety protocols, the complexity of the food supply chain and emerging pathogens continue to pose risks. This blog explores the current burden of foodborne illness, its economic and health impacts, and the strategies needed to mitigate future challenges.

Top Seven Foodborne Pathogens

The Centers for Disease Control and Prevention (CDC) identifies the following seven pathogens as major contributors to foodborne illnesses in the United States (CDC):

Norovirus: Responsible for approximately 5.5 million cases annually, norovirus is the leading cause of foodborne illness. It spreads through contaminated food, water, and surfaces, causing symptoms like vomiting and diarrhea. Future impacts may include increased outbreaks due to climate change and globalization of the food supply chain.
Salmonella: This pathogen causes around 1.35 million infections annually, leading to severe gastrointestinal symptoms and, in some cases, death. Salmonella outbreaks are often linked to poultry, eggs, and fresh produce. Enhanced surveillance and stricter food safety regulations are crucial to mitigating its impact.
Campylobacter: Campylobacter infections result in approximately 1.5 million cases annually. It is commonly associated with undercooked poultry and unpasteurized milk. Future challenges include antibiotic resistance, which could complicate treatment.
Clostridium perfringens: This bacterium causes nearly 1 million cases annually, primarily through improperly cooked or stored food. Innovations in food storage and preparation methods are essential to reduce its prevalence.
Shiga toxin-producing Escherichia coli (STEC): STEC, including E. coli O157:H7, causes severe gastrointestinal illness and can lead to kidney failure. It is often linked to contaminated beef and leafy greens. Future impacts may include increased outbreaks due to changes in agricultural practices.
Listeria monocytogenes: Though less common, Listeria infections are severe and often fatal, particularly among pregnant women, newborns, and the elderly. It is associated with ready-to-eat foods and unpasteurized dairy products. Improved detection methods and public awareness campaigns are vital to address its impact.
Toxoplasma gondii: This parasite causes toxoplasmosis, which can lead to severe complications in immunocompromised individuals and pregnant women. It is often transmitted through undercooked meat and contaminated water. Future strategies should focus on education and prevention.

Current Impacts, Statistics and Trends

Foodborne illnesses continue to impose a significant burden on public health and the economy in the United States. Each year, an estimated 48 million people, roughly one in six

Americans, fall ill due to contaminated food. Of these, 128,000 are hospitalized, and 3,000 lose their lives (CDC), and approximately 38.4 million cases of foodborne illness go unreported in the United States due to unspecified agents, as reported by the Centers for Disease Control and Preventions (CDC) (CDC). Many of these instances go unreported, often because symptoms are mild, or individuals do not seek medical care. Our colleague Jon Porter used to emphasize the prevalence of foodborne illness with his saying: "Expect to get food poisoning every 200th meal." His remark highlights the common tendency to overlook mild symptoms, such as a simple stomachache, which could actually stem from foodborne pathogens. These figures highlight the pervasive nature of foodborne diseases and their far-reaching consequences.

According to the Centers for Disease Control and Prevention (CDC), foodborne illnesses caused by major pathogens resulted in approximately 9.9 million domestically acquired cases in 2019 (CDC). These illnesses led to 53,300 hospitalizations and 931 deaths (CDC) Norovirus, Salmonella, and Campylobacter were among the top contributors to these statistics (CDC).

The economic burden is equally staggering. Costs associated with medical care, lost productivity, and premature deaths amount to billions annually. Surveillance systems, such as PulseNet, have improved the detection and response to outbreaks, but underreporting remains a challenge (CDC).

Future Challenges

The evolving landscape of food production and distribution presents several challenges:

Globalization: Increased importation of food products introduces new risks due to varying regulatory standards.
Climate Change: Rising temperatures and extreme weather events can exacerbate the spread of pathogens.
Antibiotic Resistance: The growing resistance of pathogens to antibiotics poses a significant threat to public health.

There are also some government decisions in 2025 that could potentially have negative impacts on foodborne illness prevention:

FDA Workforce Reductions: The U.S. Department of Health and Human Services (HHS) announced plans to cut 3,500 FDA staff, including over 170 personnel from the Office of Inspections and Investigations. This reduction could undermine the FDA's ability to monitor food safety effectively, as the agency was already operating with fewer inspectors than needed to oversee food processing facilities.
Delayed Implementation of Food Traceability Rule: The FDA has extended the compliance date for the Food Traceability Rule by an additional 30 months resulting in a current compliance date of July 20th, 2028. While the rule aims to improve food safety by enhancing traceability across the supply chain, the delay means that contaminated food may not be identified and removed from the market as quickly, potentially leading to more foodborne illnesses.
Paused Pathogen Standards: The USDA's Food Safety and Inspection Service (FSIS) has paused work on several proposed standards for pathogens like Salmonella and Campylobacter in meat and poultry products. This delay could hinder efforts to reduce contamination and improve food safety.

These decisions highlight the need for continued advocacy and investment in food safety measures to protect public health.

Innovations and Strategies

To address these challenges, the CDC and other agencies are investing in advanced surveillance technologies, such as whole genome sequencing, to identify and track pathogens more effectively (FDA). Public health campaigns emphasizing safe food handling practices are also crucial (FDA).

Moreover, the FDA's Foodborne Outbreak Response Improvement Plan aims to streamline investigations and enhance coordination among stakeholders (FDA). These efforts are expected to reduce the incidence of foodborne illnesses and improve the overall safety of the food supply.

While significant progress has been made in understanding and preventing foodborne illnesses, the evolving landscape of food production and distribution requires continuous vigilance. By leveraging technology, fostering international collaboration, and promoting public awareness, the United States can mitigate the burden of foodborne illness and safeguard public health for future generations.