title: Estimates of enteric illness attributable to contact with animals and their environments in the United States.
abstract: BACKGROUND
  Contact with animals and their environment is an important, and often preventable, route of transmission for enteric pathogens. This study estimated the annual burden of illness attributable to animal contact for 7 groups of pathogens: Campylobacter species, Cryptosporidium species, Shiga toxin-producing Escherichia coli (STEC) O157, STEC non-O157, Listeria monocytogenes, nontyphoidal Salmonella species, and Yersinia enterocolitica.
  
  
  METHODS
  By using data from the US Foodborne Diseases Active Surveillance Network and other sources, we estimated the proportion of illnesses attributable to animal contact for each pathogen and applied those proportions to the estimated annual number of illnesses, hospitalizations, and deaths among US residents. We established credible intervals (CrIs) for each estimate.
  
  
  RESULTS
  We estimated that 14% of all illnesses caused by these 7 groups of pathogens were attributable to animal contact. This estimate translates to 445 213 (90% CrI, 234 197-774 839) illnesses annually for the 7 groups combined. Campylobacter species caused an estimated 187 481 illnesses annually (90% CrI, 66 259-372 359), followed by nontyphoidal Salmonella species (127 155; 90% CrI, 66 502-219 886) and Cryptosporidium species (113 344; 90% CrI, 22 570-299 243). Of an estimated 4933 hospitalizations (90% CrI, 2704-7914), the majority were attributable to nontyphoidal Salmonella (48%), Campylobacter (38%), and Cryptosporidium (8%) species. Nontyphoidal Salmonella (62%), Campylobacter (22%), and Cryptosporidium (9%) were also responsible for the majority of the estimated 76 deaths (90% CrI, 5-211).
  
  
  CONCLUSIONS
  Animal contact is an important transmission route for multiple major enteric pathogens. Continued efforts are needed to prevent pathogen transmission from animals to humans, including increasing awareness and encouraging hand hygiene.
authors.affiliation: Epidemic Intelligence Service Program, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. crhale@cdc.gov
authors.forename: Christa R
authors.initials: CR
authors.lastname: Hale
authors.forename: Elaine
authors.initials: E
authors.lastname: Scallan
authors.forename: Alicia B
authors.initials: AB
authors.lastname: Cronquist
authors.forename: John
authors.initials: J
authors.lastname: Dunn
authors.forename: Kirk
authors.initials: K
authors.lastname: Smith
authors.forename: Trisha
authors.initials: T
authors.lastname: Robinson
authors.forename: Sarah
authors.initials: S
authors.lastname: Lathrop
authors.forename: Melissa
authors.initials: M
authors.lastname: Tobin-D'Angelo
authors.forename: Paula
authors.initials: P
authors.lastname: Clogher
mesh_terms: D000818:Animals; D000829:Animals, Domestic / Q000382:microbiology*; D000836:Animals, Zoo / Q000382:microbiology*; D002487:Centers for Disease Control and Prevention, U.S.; D004197:Disease Reservoirs; D004755:Enterobacteriaceae / Q000302:isolation & purification*; D004756:Enterobacteriaceae Infections / Q000635:transmission* / Q000662:veterinary*; D005517:Foodborne Diseases / Q000453:epidemiology / Q000382:microbiology*; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D006920:Hygiene / Q000193:education / Q000592:standards; D014481:United States / Q000453:epidemiology