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Each year in the United States known foodborne pathogens are responsible for approximately 30.7 million illnesses, 228,144 hospitalizations, and 2,612 deaths.47 It is estimated that foodborne illness costs an annual burden to the American society of 36 billion dollars, which is estimated to be an average cost burden per illness of $3,630.143 Worldwide food distribution, large-scale national food preparation and distribution networks, limited food regulatory practices, and corporate greed place everyone at risk. Food poisoning causes morbidity and mortality by one or more of the following mechanisms: (bacteria, viruses and parasites) that can be transmitted in food; toxins that are produced by organisms, can be consumed in food; and xenobiotics can be inadvertently or purposefully used to contaminate food and ultimately be ingested.

This chapter is organized into four major types of food poisoning: foodborne poisoning with neurologic effects, food poisoning with gastrointestinal (GI) symptoms, foodborne poisoning with anaphylaxislike effects, and food poisoning used for bioterrorism.


In the United States, viruses are the most responsible cause of foodborne outbreaks (82%) followed by bacteria (12%), and parasites (6%). Norovirus was the most common cause of single, confirmed etiology outbreaks (54%). The bacteria that caused the largest number of food poisonings were Salmonella spp, Clostridium perfringens, Staphylococcus aureus enterotoxin, and Shigella spp. The estimated annual number of episodes of foodborne pathogen related illness, hospitalization and death in the United States is shown in Table 39–1.48

TABLE 39–1Estimated Annual Number of Episodes of Illness, Hospitalizations and Death Caused by Pathogens Transmitted Commonly by Food in the United States (2014)48

Globally, researchers estimated foodborne pathogens were found to cause 582 million cases of illnesses annually. The leading cause of foodborne illness was norovirus (125 million cases) followed by campylobacter (96 million). Most important, around 43% of the disease burden from contaminated food occurred in children younger than 5 years of age, ...

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