An estimated 68.7 to 275 million cases of diarrheal disease episodes from all causes occur annually in the United States, representing an average of 0.29 to 1.1 cases per person per year. The total number of cases of foodborne origin and subsequent person-to-person transfer was estimated to be at least 24 million and perhaps as many as 81 million or more cases per year. Updating previously published patient cost estimates, including lost wages as well as direct medical costs, the average estimate-based value for food-associated illness is in the billions of dollars per year. Scientifically established chronic sequellae to diarrheal disease further increase the total economic burden but cannot be estimated from available data. Other associated clinical problems that are likely to be related to acute diarrheal episodes would further increase costs.