Sequelae of foodborne infections

Full project title

Beyond diarrhea, to disability and death: uncovering the hidden health consequences of foodborne infections

Canadian Institutes of Health Research (CIHR) project grant, 2018-2022

Principal investigators

Shannon Majowicz and Eleni Galanis


Jonathan Chan, Ashok Chaurasia, Steen Ethelberg, Gilaad Kaplan, Scott Leatherdale, Dimitra Panagiotoglou,  David Patrick

Project summary

Each year, more than four million Canadians develop a new infection because of the food they eat; short term symptoms, like diarrhea, alone result in two and a half million days of work missed, and $400,000,000 in health care and other costs. And although these infections can have serious consequences (referred to as sequelae), including miscarriage, arthritis, kidney failure, and death, just how many Canadians go on to experience such consequences, and what this costs our healthcare system, is unknown. Without this knowledge, policy makers struggle to protect Canadians, unable to adequately argue for sufficient investments to make food safer, and clinicians do not have the evidence they need to avert such serious consequences in their patients.

Previously, the approach required to accurately determine the serious consequences of foodborne infections across the population was lacking. Now, with decades of population wide electronic health records, including sufficient details on foodborne infections, we are finally able to address this issue. The province of British Columbia (BC) is uniquely positioned to support this novel work. BC’s rich collection of health records allows us to seamlessly explore the various medical consequences experienced by everyone in BC who tests positive for a foodborne infection. Thus, we will conduct a longitudinal cohort study, across the population of BC, determining what fraction of people develop serious consequences following a foodborne infection, what this costs the health system, and what risks infected Canadians face (e.g., of miscarriage, death), regardless of whether or not they are already vulnerable (e.g., young, old, pregnant).

This work will uncover the real risks faced by the more than four million Canadians infected from food each year. This knowledge will allow provincial and national policy makers to invest in making food safer, and physicians to better diagnose and treat patients, which will ultimately prevent foodborne infections, and their serious consequences, among Canadians.


Galanis E, Goshtasebi A, Hung Y.W., Chan J, Matsell D.G., Chapman K, Kaplan G.G., Patrick D.M., Zhang B.Y., Taylor M, Panagiotoglou D, Majowicz S.E. Developing International Classification of Disease code definitions for the study of enteric infection sequelae in Canada. Canada Communicable Disease Report, 2023; 49(7/8):299–309.

Gohari, M.R., Taylor, M., MacKinnon, M.C., Panagiotoglou, D., Galanis, E., Kaplan, G.G., Cook, R.J., Patrick, D.M., Ethelberg, S., Majowicz, S.E. Patterns of enteric infections in a population-wide cohort study of sequelae, British Columbia, Canada. Epidemiology and Infection, 2023, 151: e7

Majowicz, S.E., Panagiotoglou, D., Taylor, M., Gohari, M.R., Kaplan, G.G., Chaurasia, A., ...Galanis, E. Determining the long-term health burden and risk of sequelae for 14 foodborne infections in British Columbia, Canada: protocol for a retrospective population-based cohort study. BMJ Open, 2020, 10(8), e036560.

See our profile "Looking beyond diarrhea: Understanding the true impact of foodborne infections on Canadians" on CIHR's Faces of Health Research collection.