Scientists are beginning to take note of a troubling pattern of long-term health consequences for those who suffer food borne illnesses. Considering the high number of food recalls taking place in recent months, understanding these consequences has taken on a new sense of urgency.
In interviews with the Associated Press, people who had suffered food poisoning from E. coli infections as children described high blood pressure, kidney damage, and even full kidney failure as much as 10 to 20 years later. Some who suffered a case of salmonella or shigella went on to develop arthritis, and a mysterious paralysis was seen that could attack people who had only mild symptoms of campylobacter.
While these long-term effects are believed to make up only a small fraction of the 76 million who suffer food poisonings each year in the U.S., no one can say for sure how many people are truly at risk. An even more important question may be what other illnesses have yet to be linked to food poisoning.
Food borne illnesses cause 325,000 hospitalizations and 5,000 deaths a year, according to the Centers for Disease Control (CDC). Some of the survivors’ long-term consequences are obvious from the outset. Some required kidney transplants, or have scarred intestines that promise lasting digestive difficulty. However, many of the long-term effects are still not completely understood.
“Folks often assume once you’re over the acute illness, that’s it, you’re back to normal and that’s the end of it,” said Dr. Robert Tauxe of the Centers for Disease Control and Prevention, in an AP article. The long-term consequences are “an important but relatively poorly documented, poorly studied area of food borne illness.”
Donna Rosenbaum heads the consumer advocacy group STOP, Safe Tables Our Priority. “We’re drastically underestimating the burden on society that food borne illnesses represent,” Ms. Rosenbaum said in an AP interview.
Every week, STOP hears from patients with health complaints they suspect or have been told are related to food poisoning years earlier. Rosenbaum spoke of a woman who survived severe E. coli at age 8. Years later while in her 20s, the woman had to have her colon removed. Others have developed diabetes after food poisoning inflamed their pancreas.
She also spoke of parents who wonder if a child’s learning problems might stem from food poisoning that required dialysis as a toddler.
“There’s nobody to refer them to for an answer,” says Rosenbaum.
So starting this month Rosenbaum’s group is initiating the first national registry of food-poisoning survivors with long-term health problems. STOP hopes by sharing these stories with scientists it will drive much-needed research in this area.
In the case of Alyssa Chrobuck, who 15 years ago at age 5 was hospitalized as part of the Jack-in-the-Box hamburger outbreak that made a deadly E. coli strain notorious, she now suffers a host of health problems unusual for a 20-year-old. These include high blood pressure, recurring hospitalizations for colon inflammation, a hiatal hernia, thyroid removal, and endometriosis.
“I can’t eat fatty foods. I can’t eat things that are fried, never been able to eat ice cream or milkshakes,” Chrobuck told AP.
“Would I have this many medical problems if I hadn’t had the E. coli? Definitely not. But there’s no way to tie it definitely back.”
But when people appear to recover, it is difficult to prove that later problems are related to a previous food poisoning and not something else. It may be that people prone to certain gastrointestinal conditions, for instance, also are genetically more vulnerable to germs that cause food borne illness.
For now, some of the best evidence comes from the University of Utah, which has long tracked children with E. coli. The research found that about 10 percent of E. coli sufferers develop a life-threatening complication called hemolytic uremic syndrome, or HUS, where the kidneys and other organs fail.
Ten to 20 years after these children recover, between 30 percent and half of HUS survivors will have some kidney-caused problem, said Dr. Andrew Pavia, the university’s pediatric infectious diseases chief, in an AP article. That includes high blood pressure caused by scarred kidneys, slowly failing kidneys, even end-stage kidney failure that requires dialysis.
Additionally, HUS might trigger a variety of other organ problems because it causes blood clots all over the body that could leave a trail of damage, said Pavia.
“I don’t want to leave the message that everyone who had symptoms … is in trouble,” stresses Pavia. E. coli doesn’t seem to trigger long-term problems unless it started shutting down the kidneys the first time around, he said. “People with uncomplicated diarrhea, by and large we don’t have evidence yet that they have complications,” he said.
Although research is scarce, there are some proven long-term consequences of various food borne illnesses.
About 1 in 1,000 who suffer of campylobacter, an infection spread by raw poultry, develop far more serious Guillain-Barre syndrome a month or so later. Their body attacks their nerves, causing paralysis that usually requires intensive care and a ventilator to breathe.
Over 30% of the nation’s Guillain-Barre cases have been linked to previous campylobacter, even if the diarrhea was very mild, and they typically suffer a more severe case than patients who never had food poisoning.
While they eventually recover, “We don’t know a great deal about what happens to those people five years later. What does ‘normal’ look like?” Tauxe says.
In the case of salmonella, a small number of people with the illness will go on to develop something called reactive arthritis six months or longer after the acute illness. Reactive arthritis causes joint pain, eye inflammation, sometimes painful urination, and can lead to chronic arthritis. Certain strains of shigella and yersinia bacteria trigger this reactive arthritis too, according to Tauxe.
Among his most pressing questions is whether HUS can increase the risk of diabetes later in life, since HUS patients often suffer pancreatitis. However, he said proving a direct connection will require tracking a lot of patients who can provide very good medical records documenting their initial food borne illness.
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