Disease burden of foodborne pathogens in the Netherlands, 2009

• Published in: International journal of food microbiology Vol. 156; no. 3; pp. 231 - 238
• Main Authors: Havelaar, Arie H., Haagsma, Juanita A., Mangen, Marie-Josée J., Kemmeren, Jeanet M., Verhoef, Linda P.B., Vijgen, Sylvia M.C., Wilson, Margaret, Friesema, Ingrid H.M., Kortbeek, Laetitia M., van Duynhoven, Yvonne T.H.P., van Pelt, Wilfrid
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-06-2012
• Subjects: Adolescent; Adult; Aged; Attribution; bacteria; Bacterial Infections - complications; Bacterial Infections - mortality; Bacterial Infections - prevention & control; Burden of disease; Campylobacter; Cause of Death; Child; Child, Preschool; Cohort Studies; Cost of Illness; death; disability weights; disability-adjusted life year; Disabled Persons - statistics & numerical data; disease surveillance; food groups; food pathogens; Foodborne diseases; Foodborne Diseases - complications; Foodborne Diseases - mortality; Foodborne Diseases - prevention & control; Gastroenteritis; general practitioners; hospitals; Humans; Incidence; Infant; Listeriosis; longevity; Male; Middle Aged; Netherlands - epidemiology; Norovirus; patients; Population Surveillance; Public Health; Quality-Adjusted Life Years; respiratory system; Risk Assessment; risk management; Salmonella; Salmonella Infections; surveys; Toxoplasma gondii; toxoplasmosis; viruses; Netherlands; Burden of disease; Foodborne diseases; Gastroenteritis; Attribution
• ISSN: 0168-1605; 1879-3460
• DOI: 10.1016/j.ijfoodmicro.2012.03.029

To inform risk management decisions on control, prevention and surveillance of foodborne disease, the disease burden of foodborne pathogens is estimated using Disability Adjusted Life Years as a summary metric of public health. Fourteen pathogens that can be transmitted by food are included in the study (four infectious bacteria, three toxin-producing bacteria, four viruses and three protozoa). Data represent the burden in the Netherlands in 2009. The incidence of community-acquired non-consulting cases, patients consulting their general practitioner, those admitted to hospital, as well as the incidence of sequelae and fatal cases is estimated using surveillance data, cohort studies and published data. Disease burden includes estimates of duration and disability weights for non-fatal cases and loss of statistical life expectancy for fatal cases. Results at pathogen level are combined with data from an expert survey to assess the fraction of cases attributable to food, and the main food groups contributing to transmission.
Among 1.8 million cases of disease (approx. 10,600 per 100,000) and 233 deaths (1.4 per 100,000) by these fourteen pathogens, approximately one-third (680,000 cases; 4100 per 100,000) and 78 deaths (0.5 per 100,000) are attributable to foodborne transmission. The total burden is 13,500 DALY (82 DALY per 100,000). On a population level, Toxoplasma gondii, thermophilic Campylobacter spp., rotaviruses, noroviruses and Salmonella spp. cause the highest disease burden. The burden per case is highest for perinatal listeriosis and congenital toxoplasmosis. Approximately 45% of the total burden is attributed to food. T. gondii and Campylobacter spp. appear to be key targets for additional intervention efforts, with a focus on food and environmental pathways. The ranking of foodborne pathogens based on burden is very different compared to when only incidence is considered. The burden of acute disease is a relatively small part of the total burden. In the Netherlands, the burden of foodborne pathogens is similar to the burden of upper respiratory and urinary tract infections.
► DALYs are proposed for risk ranking of foodborne pathogens. ► The burden of T. gondii and Campylobacter spp. is highest in the population. ► The burden of Listeria spp. and T. gondii is highest for individuals. ► Foodborne accounts for approximately half of the total disease burden. ► Foods of animal origin cause two-thirds of the burden by foods.