Introduction and clinical considerations

Foodborne illnesses have a major public health impact in the United States. It is estimated that each year in the United States, 76 million people get sick, more than 300,000 are hospitalized, and 5,000 die as a result of foodborne illnesses, primarily the very young, elderly, and the immunocompromised. Unfortunately, substantial progress in preventing certain foodborne illnesses such as typhoid and cholera has led to complacency in both the public and the medical profession. This, coupled with recent changes in human demographics and eating behavior, technology and industry, international travel and commerce, microbial adaptation, economic development and land use, and the breakdown of public health measures, has resulted in new and reemerging foodborne illnesses. As such, there is now a critical need for education and awareness on the diagnosis and prevalence of new foodborne illnesses and on the treatment of such diseases. Additionally, physicians and other health care professionals should be aware of the critical role they play in the public health arena in terms of surveillance for, and identification and prevention of, potential outbreaks of foodborne illness in the United States.

To help increase awareness of foodborne illnesses among physicians, nurses and consumers a new edition of Diagnosis and Management of Foodborne Illness: A Primer for Physicians and Other Health Care Professionals is being released.  The primer includes new sections on hepatitis A, noroviruses, antibiotic-resistant salmonella, congenital toxoplasmosis and intentional contamination.

The Primer was produced collaboratively by the American Medical Association (AMA), the American Nurses Association (ANA), the Centers for Disease Control and Prevention (CDC), the Center for Food Safety and Applied Nutrition-Food and Drug Administration (CFSAN-FDA), and the Food Safety and Inspection Service (FSIS) of the United Sates Department of Agriculture.

This primer is intended to provide health care professionals with current and accurate information for the diagnosis, treatment and reporting of foodborne illnesses. The primer also provides health care professionals with patient education materials on prevention of foodborne illness.

The primer offers 2.75 hours of Category I Continuing Medical Education credit for physicians, 3.3 hours of Continuing Nursing Education credit for nurses, 3.0 hours of CHES credit for health care educators, or 0.5 Continuing Education Units. Specific objectives of this primer are to educate health professionals to:

• Recognize the potential for a foodborne illness to be responsible for a patient’s illness
• Realize that many but not all cases of foodborne illness have gastrointestinal tract symptoms
• Obtain stool cultures in appropriate settings, and recognize that testing for some specific pathogens must be requested
• Appreciate the context in which a foodborne illness may be due to intentional contamination
• Report all suspect cases to appropriate public health officials
• Talk with patients about ways to prevent food-related diseases
• Recognize the vulnerable populations that may suffer more severe adverse events from foodborne illness
• Appreciate that any patient with foodborne illness may represent the first case of a more widespread outbreak