In addition to acute gastrointestinal symptoms characteristic of foodborne illness, it is increasingly recognized that foodborne illnesses can also contribute to other secondary long-term health complications.
There is little epidemiologic data on the long-term health outcomes associated with acute foodborne disease and many of these associations have come from case series and small-scale studies that have inconsistent follow-up and additional research is needed to understand the long-term burden of foodborne illness (Roberts 2009). For example, having a Salmonella infection is one of the leading predictors for developing reactive arthritis, a painful, chronic and potentially debilitating condition that causes joint inflammation. Campylobacter is a leading cause of Guillain-Barre Syndrome, an autoimmune disease that causes paralysis and kills five to ten percent of its victims. Listeria monocytogenes kills more than 1/3 of its perinatal victims and 20% of all its victims, making it one of the most lethal foodborne pathogens. E. coli O157:H7 and other Shiga toxin-producing foodborne pathogens are the primary cause of hemolytic uremic syndrome (HUS), the leading cause of acute kidney failure in children under five years of age in the United States.
Current CFI research on long-term health outcomes focuses on individuals affected by HUS among whom outcomes range from blood disorders, hypertension, and chronic or end-stage kidney disease to non-renal outcomes such as diabetes or cognitive sequelae. There is also a growing body of evidence for long-term health outcomes such as clinical post-traumatic stress disorder among the families of those affected by HUS.
Long-term Health Outcomes among Individuals and Families Affected by HUS (PI: Barbara Kowalcyk)
CFI recently completed a survey of families and individuals affected by HUS collecting information on acute and chronic illness history as well as epidemiological, sociodemographic, and genetic factors. Responses were collected for 74 cases comprising 71 families. Approximately 60% of the cases developed HUS when they were < 5 years old with some respondents reporting outcomes 30+ years following HUS onset. Preliminary descriptive analyses are ongoing and were presented in July at the 2019 Annual Meeting of the International Association for Food Protection.
Publications and Presentations
Kowalcyk B. Utilizing alternative data sources to assess the long-term health outcomes of foodborne disease. Accepted Symposium at the Annual Meeting of the International Association for Food Protection July 21-24, 2019 in Louisville, KY.
Riddle M, Kowalcyk B, Porter C. 2016. Post-infectious chronic health consequences of acute enteric infections. Reference Module in Food Science doi: 10.1016/B978-0-08-100596-5.03010-9
Porter C, Kowalcyk B, Riddle M. 2016. Chronic health consequences of acute enteric infections in the developed world. American Journal of Gastroenterology 3(2): 12 – 24.
Kowalcyk B, Smeets H, Succop P, DeWit N, Havelaar A. 2014. Relative Risk of Irritable Bowel Syndrome Following Acute Gastroenteritis and Associated Risk Factors. Epidemiology & Infection, 142(6), 1259-1268.
Batz M, Henke E, Kowalcyk B. 2013. Long-term consequences of foodborne infections. Infectious Disease Clinics 27(3):599-616.
Kowalcyk B, Havelaar A, Succop P et al. Assessing the Risk of Irritable Bowel Syndrome Following Acute Gastroenteritis in the Netherlands, 1998-2009. Accepted poster at the 19th United European Gastroenterology Week meeting in Stockholm, Sweden, October 22-26, 2011. Abstract to be published in Gut/Endoscopy.