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The Human Factor: Foodborne Illness Causes Uncovered

Posted in Our Blog on July 8, 2024

The cost of foodborne illness in the United States each year is staggering.

What is the driving cause?


While some foodborne illnesses are connected to product contamination or supply chain issues, many outbreaks come down to sick humans spreading illness.

In fact, 70% of foodborne illness outbreaks in 2021 were attributed to restaurant settings.

Rising Costs of Foodborne Illness

The Centers for Disease Control and Prevention (CDC) estimates that the 15 major foodborne pathogens (think heavy hitters like E. coli, Salmonella, Listeria, etc.) result in roughly 8.9 million cases of illness each year. That includes around 54,000 hospitalizations and 1,480 deaths each year due to acute and chronic health outcomes related to these pathogens.

Salmonella, Toxoplasma, Listeria, norovirus, and Campylobacter are the top five – in that order.

According to the United States Department of Agriculture’s (USDA) Economic Research Service (ERS), the costs of foodborne illness in the United States continue to rise. The cost of foodborne illness in 2013 was a whopping $15.5 Billion.

That is “billion.” With a capital B!

This number increased to a staggering $17.6 Billion in 2018.

This statistic includes the “costs of medical care, the value of lost earning, and a monetary measure of death linked to how much people are willing to pay to reduce the risk of dying from foodborne illness.”

The Spectrum of Foodborne Illness Is Vast

The severity of foodborne illness is determined by many different factors. Individual immune systems, risk factors, and the type of pathogen all influence whether an illness is mild, severe, or life-threatening.

Most Healthy Individuals Recover Quickly

Most people with a healthy immune system and no risk factors often feel bad for a few days and get better. This is the reason most cases of foodborne illness go unreported. No medical intervention is needed and most of the time the sick person doesn’t even know exactly what caused them to become ill.

In some cases, these people may feel well enough to continue through their normal activities. Even while still contagious.

Others in higher risk groups may not be so lucky.

Higher Risk Groups May Experience Complications

Those in the higher risk group often include children under 5 years, the elderly, and those with a weakened immune system. People who are pregnant have specific potential complications with certain pathogens, like Listeria monocytogenes.

Potential Complications

Most of the time pathogens remain within the gastrointestinal tract and cause a myriad of symptoms consistent to their location. Vomiting, diarrhea, stomach cramps, nausea. Even fever and headaches make sense with intestinal infections.

This is not to say that diarrheal symptoms cannot become serious. Dehydration is a huge concern when the body is losing more liquids than it can replace. This can lead to serious illness, organ failure, mental decline, and more.

However, significant damage can take place if the pathogen leaves the confines of the digestive system and enters the bloodstream. This can happen due to damage of the stomach or intestinal linings. Sometimes these breeches already exist. Though, some bacteria are good at burrowing through on their own.

These complications can lead to:

  • Hemolytic Uremic Syndrome (HUS) – HUS is a type of kidney failure that results when blood cells rupture and clog the filtering aspect of the kidney. Those with HUS must be hospitalized immediately as the kidneys may shut down completely, causing a series of downline health issues. Young children and the elderly are more likely to die from this complication.
  • Reactive Arthritis – Reactive arthritis occurs when the bacteria attack the collagen in the joints, resulting in inflammation in the knees, ankles, or feet. Additional symptoms may include problems with the eyes and painful urination. Reactive arthritis may last for up to six months, however some unfortunate patients may experience chronic reactive arthritis after infection.
  • Guillain-Barré Syndrome – Guillain-Barré Syndrome causes a type of paralysis that begins in the lower body and progresses to the upper body. This happens because the infection triggers an autoimmune response where the body’s immune system attacks the nerves. Most people recover from Guillain-Barré Syndrome in around six to twelve months.
  • Irritable Bowel Syndrome (IBS) – IBS involves a spectrum of symptoms including abdominal pain, bloating, diarrhea or constipation or both. It could take months or even years for normal bowel habits to return in some people following foodborne illness.
  • Meningitis – Meningitis is an inflammation of the membranes surrounding the brain. This type of complication can lead to seizures, paralysis, blindness, and deafness. This complication in babies can result in mental and developmental delays.
  • Additional complications – Other complications may affect the heart, blood vessels, and pregnancy (premature, stillbirth, serious infection of the newborn, etc.).

Some of these conditions have a high rate of recovery. Others have a high mortality rate – meaning people do not recover from their illness and die.

What Causes Foodborne Illness?

Transmission of most foodborne illnesses is spread through fecal-oral route.

Yes. It sounds as gross as it really is.

However, it only takes microscopic amounts to spread these germs.

Improper hand washing or poor hygiene can spread these bad bugs around to an unsuspecting person.

A significant number of foodborne illness outbreaks can be traced back to inadequate oversight, training, and food safety culture.

In addition to food safety awareness, a lack of paid sick leave is linked to higher incidence of norovirus outbreaks because in some cases, sick employees may feel compelled to work.

This is “the human factor.”

Lack of Paid Sick Leave in Food Workers Can Lead to Foodborne Illness Outbreaks

Less than half of food services workers in the United States have paid sick leave. In some cases, this attributes to the reason these workers may feel like they have to return to work, even if they do not feel well.

Some foodborne illnesses can continue to be contagious, even as the person begins to feel better. Norovirus, for example, can begin spreading before the person feels sick and even some time after all of their symptoms have resolved.

Paid sick leave could help reduce the spread of these illnesses.

Unfortunately, due to the nature of the food industry, most food workers do not have paid sick time.

Most Food Workers Do Not Have Paid Sick Time

According to the U.S. Bureau of Labor Statistics, about 78% of the private sector workforce has paid sick time.

That may sound like a lot. But that leaves almost 1 in 4 workers without a single paid sick day.

There is no federal law to guarantee the right to paid sick time. This I left up to the states to govern.

Some states have passed laws requiring employers to provide sick leave. There are fifteen states and Washington D.C. that currently have some sort of sick leave requirements on the books.

Those in the states of Arizona, California, Colorado, Connecticut, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, and Washington state, along with some city and county jurisdictions have some type of law on the books.

Unfortunately, this may still have limitations. For some, only full-time employment is a criterion. Sadly, most food workers fall into the contract or part-time category and are therefore not included in this requirement.

Food Safety Culture is Important

While paid sick leave that employees felt comfortable with using would be a significant help, a positive food safety culture is also important.

Management that helps enforce safe practices, communicate with food workers, provide appropriate equipment and supplies, and keep food safety at the front of every activity can help reduce incidences of foodborne illness outbreaks.

It takes more than just putting up signs in the back of the house. Regular inspections, positive reinforcement, and bringing problems to attention early can all make a difference.

Does Knowing that Restaurants are Responsible for a Significant Percentage of Foodborne Illness Affect Your Decision to Eat at Home Instead?

Knowing that a significant percentage of foodborne illness is linked to restaurant dining, does this impact your decision to eat out or stay home?

Many families are opting for homemade meals instead of dining out for a variety of reasons. Rising costs, decreased disposable income, and other factors come into play as well.

Stay in Touch with Make Food Safe!

If you’d like to know more about food safety topics in the news, like The Human Factor: Foodborne Illness Causes Uncovered, check out the Make Food Safe Blog. We regularly update trending topics, foodborne infections in the news, recalls, and more! Stay tuned for quality information to help keep your family safe, while The Lange Law Firm, PLLC strives to Make Food Safe!

By: Heather Van Tassell (contributing writer, non-lawyer)