U.S – The National Institute of Food and Agriculture (NIFA) of the U.S. Department of Agriculture recently financed a study that assessed the cost of foodborne diseases associated with flour and flour-based food products in the United States from 2001 to 2021 to be as high as U.S$258 million.

The study, which was carried out by experts at Ohio State University (OSU) and Michigan State University (MSU), estimates that the total economic cost of foodborne illnesses in the United States might reach U.S$97.4 billion every year.

However, the incidence and cost estimates are only useful when they can be linked to specific foods. As such, the study concentrated on wheat flour and flour-based foods to fill a knowledge gap because of the commodity’s association with cases of foodborne illness.

To better understand why people are becoming sick from flour and flour-based items that are supposed to go through a final kill-step by the customer, the study sought to identify the bacteria that cause outbreaks and the primary source of contamination.

By combining initial health burden estimates based on outbreaks with existing economic cost estimates from the literature, it also sought to characterize the public health and economic burdens associated with the epidemics.

The researchers examined the scientific literature and gathered information from official sources to identify and critically evaluate all instances of foodborne illness outbreaks linked to flour and foods containing flour.

According to the researchers, “outbreaks” are any instances of two or more related illnesses that are brought on by consuming a typical flour-based food product.

The total health burden was then calculated by adding annualized outbreak case counts to Centers for Disease Control and Prevention (CDC) multipliers. The total economic burden was then calculated using two alternative models based on this value.

In the U.S., there were nine outbreaks connected to flour and items made with it between 2001 and 2021.

Wheat flour, pot pies, breakfast cereal, prepared cookie dough and cake batter, and ice cream containing cake batter were only a few of the foods linked to the outbreaks.

All of the outbreaks, which were confirmed by lab or culture tests, were due to Salmonella, Escherichia coli O157:H7, and E. coli O121. There were 752 cases of disease linked to the outbreaks, 223 hospitalizations, and 0 fatalities. Salmonella was the source of four of the nine outbreaks, accounting for 75% of all cases. E. coli caused the remaining outbreaks and cases.

Using the value of the U.S. dollar in July 2022, the study generated two separate estimates for the economic burden of foodborne illnesses linked to flour and flour-based products in the U.S. during the reporting period: U.S$108 million using the basic model and U.S$258 million using the advanced model.

SalmonellaE. coli O157:H7, and E. coli o121 were the pathogens that resulted in the biggest financial losses (U.S$90 or U.S$225 million), respectively.

The majority of patients in the outbreaks who disclosed their eating habits admitted to tasting or ingesting raw or inadequately cooked flour or products made from flour. According to the researchers, this discovery highlights the need for increased public awareness through outreach efforts and behavioral interventions.

The study was restricted in that it only took into account consumer health expenditures (medical expenses, lost productivity, decreased life expectancy, and quality-adjusted life year (QALY) loss).

The upgraded model took into account QUALY loss while the basic approach for calculating economic hardship did not. The analysis did not take into account the expenses to businesses and government associated with foodborne illnesses.

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