The cost of foodborne illness in the United States is now estimated to be up to $77.7 billion a year, according to an analysis by Ohio State University researcher Robert Scharff.

Although the new estimate, published in the January 2012 issue of the Journal of Food Protection, is a significant reduction from the researcher's initial estimates in 2010, "these numbers are still big," said Scharff, an economist and researcher with the university's Ohio Agricultural Research and Development Center (OARDC). "The decrease doesn't necessarily reflect a decrease in foodborne illness. Primarily, it's due to methodological changes by the Centers for Disease Control and Prevention in how the incidence of foodborne illness is measured. Both the CDC numbers and my new estimates of related costs are more accurate -- that's the important thing."

In 2011, the CDC issued new figures for the incidence of foodborne illness, estimating that about 48 million people in the United States suffer from foodborne illnesses each year, resulting in 128,000 hospitalizations and 3,000 deaths. Previously, the CDC had used figures from a 1999 study, estimating 76 million illnesses, 325,000 hospitalizations and 5,000 deaths. Those were the figures Scharff used when he did his first economic analysis, estimating that foodborne illness cost the nation $152 billion a year.

Two economic cost estimates

Scharff's new analysis, "Economic Burden from Health Losses Due to Foodborne Illness in the United States," offers two economic cost estimates. Scharff arrived at the $77.7 billion figure by including values for medical costs, productivity losses, mortality, and pain and suffering. Estimates include costs attributable to both acute illnesses and resulting conditions, such as hemolytic uremic syndrome and reactive arthritis. While he believes the enhanced model offers the best estimate of true costs, he recognizes that many regulatory economists continue to use a method that does not include pain and suffering losses. This more conservative method yields a smaller, though still large, annual economic cost of foodborne illness of $51 billion.

Scharff's analysis includes a breakdown of costs associated with each of 31 different foodborne pathogens as well as foodborne illness from unknown causes.

"By looking at overall costs related to different pathogens, it's easier to determine where our priorities should be," said Scharff, who also is an associate professor of consumer science in Ohio State's College of Education and Human Ecology.

Take this example: Norovirus is a pathogen responsible for more than 5.4 million illnesses every year -- by far the highest number of illnesses associated with any one pathogen -- and puts an estimated 14,663 people in the hospital and causes 149 deaths.

Salmonella costs $11.4 billion yearly

However, norovirus does not result in the highest economic losses. While its $3.7 billion price tag in Scharff's enhanced cost is high, it doesn't come near the $11.4 billion cost associated with Salmonella (specifically Salmonella spp., Nontyphoidal). The difference is due to the fact that even though there are barely more than 1 million cases of Salmonella spp., Nontyphoidal a year, the bacteria causes more severe illness than norovirus, can lead to reactive arthritis, and results in an estimated 19,336 hospitalizations and 378 deaths.

Scharff also does a cost-per-case analysis, which he hopes might help in policy development. For example, although Vibrio vulnificus, a bacteria associated with contaminated seafood (particularly oysters), causes just 96 illnesses a year, the illness is quite severe, hospitalizing almost all who contract it, resulting in 36 deaths. Because of its severity, it has the highest cost of nearly $2.8 million per case. Knowing such figures would be helpful for public health officials, particularly in Gulf Coast states where the disease is more prevalent, Scharff said.

"By knowing the costs associated with foodborne illness, we can compare the cost of programs designed to reduce such illnesses to the economic benefits that accrue from these programs. If a particular program results in, say, a reduction of 1,000 cases of salmonellosis each year, this means the expected benefit to society is something over $4 million or $11 million, depending on which method is used. If this same program only costs $1 million, we can say with some confidence that the program makes society better off."

Scharff is working with colleagues in Ohio State University Extension who offer food safety education as part of the Expanded Food and Nutrition Education Program to analyze costs and benefit of those classes. He is also applying these results in an economic analysis of the CDC's PulseNet public health laboratory system.

OSU Extension and OARDC, the research and outreach arms, respectively, of Ohio State's College of Food, Agricultural, and Environmental Sciences, offer food safety guidance for consumers, educators and health professionals at http://foodsafety.osu.edu. Food safety experts suggest that the most effective ways to prevent foodborne illness are to:

For details, click "For Consumers" at http://foodsafety.osu.edu.