Colorado State University Extension
SafeFood Rapid Response Network
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Elderly at Higher Risk of Foodborne Illness
Edited by: Mary Schroeder, M.S., R.D. & Pat Kendall, Ph.D., R.D., Colorado State - Spring 2004
Elderly at Higher Risk of Foodborne Illness
Foodborne illness, especially among people of certain lifecycle stages, is an issue of increasing concern. Most often we hear about the risk of listeriosis and toxoplasmosis during pregnancy or E. coli infection among young children. However, older persons (age 65 and older) also are at higher risk of becoming ill from certain foodborne pathogens. According to recent government statistics, 35 million people (13% of the total population) are over age of 65 in the United States. By 2030, projections show that 20% of the population is likely to be over age 65 - about 70 million people. Therefore, foodborne illness in this population is a very important issue to address.
How Aging affects Risk of Foodborne Illness
As we age, our immune systems experience gradual changes. Immune cells respond more slowly, and we end up with decreased immunity against foreign pathogens. The gastrointestinal tract also changes during aging; motility and gastric acid production decrease, and the GI tract is more easily inflamed. These changes increase susceptibility to Vibrio infections, salmonellosis, and other illnesses. In addition, other factors associated with aging may increase risk of foodborne illness among the elderly, including disease, diabetes, slower digestion, a declined sense of taste and smell, decreased effectiveness of antibiotics, and the likelihood of malnutrition.
Pathogens of Special Importance
Pathogens that older persons are especially vulnerable to include Salmonella species, E. coli O157:H7, Vibrio species, Clostridium perfringens, Staphylococcus aureus and Campylobacter jejuni. Salmonella Enteritidis is of particular concern, as consumption of undercooked eggs is considered the most common risky food safety behavior among those over age 65. E. coli is another concern, as the mortality rate in nursing home outbreaks can reach 35%. Infections from Vibrio species occur at the highest rate in 65-74 year olds, with 5,500 cases per year according to FoodNet data. Finally, although elderly are not more susceptible to illness caused by Campylobacter jejuni, they are more at risk for serious complications and even death as a result of infection.
Preventative Behaviors of Special Importance
There are also certain behaviors of particular importance in preventing foodborne illness among the elderly. Because of their higher risk for Salmonella Enteritidis, the most important involves cooking eggs until both the yolks and whites are firm, and using a thermometer when preparing egg dishes. Other important behaviors for this population are similar to those critical for all high-risk groups, such as avoiding raw seafood, raw sprouts, unpasteurized milk and soft cheeses made from raw milk, washing hands thoroughly before food preparation, avoiding cross-contamination, cooking foods properly, washing fresh produce and refrigerating foods promptly.
The important issue of foodborne illness among the elderly will be a highlight of the 2004 Lillian Fountain Smith Conference scheduled for June 10 and 11 at the Marriott Hotel in Fort Collins, Colorado. Dr. Lydia Medeiros, Associate Professor at Ohio State University, will present "The Role of Food Safety in Protecting the Health of Older Adults" on Friday morning, June 11. More information about the conference is available at www.cahs.colostate.edu/fshn/lfsc.
Sources:
- U.S. Census Bureau, Population Projections at www.agingstats.gov
- Smith, JL. Foodborne illness in the elderly. J. Food Prot. 1998;61:1229-1239.
- Kendall, P., Medeiros, L.C., Hillers, V., Chen, G., DiMascola, S. 2003. Food handling behaviors of special importance to pregnant women, infants and young children, the elderly and immune-compromised persons. J. Am. Dietetic Assoc.. 103:1647-1649.
