dispatches from WHO/RIVM FERG symposium

Foodborne disease estimates ‘instrumental’ - WHO

By Joseph James Whitworth contact

- Last updated on GMT

FQN was present during the WHO/RIVM FERG symposium
FQN was present during the WHO/RIVM FERG symposium
Results of the first ever estimates of the global burden of foodborne disease revealed earlier this month could be ‘instrumental in changing the field’, according to experts.

Each year 600 million, or almost one in 10 people in the world, fall ill after eating contaminated food, according to the World Health Organization (WHO).

Of these, 420,000 people die, including 125,000 children under five years​.

Raising awareness

Keiji Fukuda, assistant director-general of health security at WHO, said the number of illnesses and deaths and disproportionate number of children affected has caught the attention and struck a nerve.

“One discussion is it is paradoxical that food safety has remained so hidden, a public health issue remained below the radar, the impact has never been clear it only comes up when there are outbreaks which is not a good way to measure burden,” ​he told attendees.

“This establishes the information needed...The critical thing is to raise awareness in the general public, scientific groups and policy makers and this body of work has opened the door.”

Speaking as part of a general debate, Fukuda asked the question of what to do with the data they have and do not have.

“Some issues are low hanging fruit. Chemicals are a tiny amount of the burden. Look at data points to squeeze the value out of them for trade issues, agricultural issues, economic issues, they are all important but not enough by themselves. Policy without action doesn’t go anywhere.”

The burden caused by 31 agents—bacteria, viruses, parasites, toxins and chemicals was estimated.

Comments were made during a symposium organised by WHO and the Dutch National Institute for Public Health and the Environment (RIVM) in Amsterdam.

Start of work

The estimates come from work started in 2007 by the Foodborne Epidemiology Research Group (FERG).

who ferg infographic
Picture: WHO/FERG infographic

FERG task force members presented at the event, including Tine Hald of the source attribution task force and from the National Food Institute, Technical University of Denmark.

Hald said source attribution was difficult as there are many hazards, exposures, routes and transmission pathways and it can be along various points along the food distribution chain.

The task force used expert elicitation, intervention studies and epidemiological approaches but expert elicitation was the only option for the majority of hazards due to lack of data.

Metrics used as part of the estimation were disability adjusted life years (DALY) which are the sum of the Years of Life Lost (YLL) due to premature mortality and the Years Lost due to Disability (YLD) for people living with the health condition or its consequences.

The Computational Task Force, presented by Brecht Devleesschauwer, published a study in PLOS ONE​ about the methods.

Martyn Kirk, Australian National University led the Enteric Diseases task force talk, Paul Torgerson, Vetsuisse Faculty in Zurich spoke about the Parasitic Diseases task force’s work and Phillippe Verger presented on the Chemicals and Toxins task force.

Diarrhoeal diseases are responsible for more than half of the global burden, causing 550 million people to fall ill and 230,000 deaths every year. 

Children are at risk, with 220 million falling ill and 96,000 dying every year. 

Diarrhoea is often caused by eating raw or undercooked meat, eggs, fresh produce and dairy products contaminated by norovirus, Campylobacter, non-typhoidal Salmonella and pathogenic E. coli.

Other contributors are typhoid fever, hepatitis A, Taenia solium​ (a tapeworm), and aflatoxin (produced by mould on grain that is stored inappropriately).

Colin Mathers told attendees of the challenges trying to get consistent and comparable estimates and why they used the tools they did such as comparative risk assessment (CRA), DALYS and time as a metric.

A discussion after the presentations raised numerous issues such as why some infections are not notifiable in some countries, the lack of surveillance, lab capacity, data and quality of such data and how the data at a global level can help prioritise needs for agencies at a national level.

Related topics: Track and trace, Food Outbreaks

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