World Health Organization Estimates of the Global and Regional Disease Burden of 22 Foodborne Bacterial, Protozoal, and Viral Diseases, 2010: A Data Synthesis

Martyn D. Kirk, Sara M. Pires, Robert E Black, Marisa Caipo, John A. Crump, Brecht Devleesschauwer, Dörte Döpfer, Aamir Fazil, Christa L. Fischer-Walker, Tine Hald, Aron J. Hall, Karen H. Keddy, Robin J. Lake, Claudio F. Lanata, Paul R. Torgerson, Arie H. Havelaar, Frederick J. Angulo

Research output: Contribution to journalArticle

Abstract

Background: Foodborne diseases are important worldwide, resulting in considerable morbidity and mortality. To our knowledge, we present the first global and regional estimates of the disease burden of the most important foodborne bacterial, protozoal, and viral diseases. Methods and Findings: We synthesized data on the number of foodborne illnesses, sequelae, deaths, and Disability Adjusted Life Years (DALYs), for all diseases with sufficient data to support global and regional estimates, by age and region. The data sources included varied by pathogen and included systematic reviews, cohort studies, surveillance studies and other burden of disease assessments. We sought relevant data circa 2010, and included sources from 1990–2012. The number of studies per pathogen ranged from as few as 5 studies for bacterial intoxications through to 494 studies for diarrheal pathogens. To estimate mortality for Mycobacterium bovis infections and morbidity and mortality for invasive non-typhoidal Salmonella enterica infections, we excluded cases attributed to HIV infection. We excluded stillbirths in our estimates. We estimate that the 22 diseases included in our study resulted in two billion (95% uncertainty interval [UI] 1.5–2.9 billion) cases, over one million (95% UI 0.89–1.4 million) deaths, and 78.7 million (95% UI 65.0–97.7 million) DALYs in 2010. To estimate the burden due to contaminated food, we then applied proportions of infections that were estimated to be foodborne from a global expert elicitation. Waterborne transmission of disease was not included. We estimate that 29% (95% UI 23–36%) of cases caused by diseases in our study, or 582 million (95% UI 401–922 million), were transmitted by contaminated food, resulting in 25.2 million (95% UI 17.5–37.0 million) DALYs. Norovirus was the leading cause of foodborne illness causing 125 million (95% UI 70–251 million) cases, while Campylobacter spp. caused 96 million (95% UI 52–177 million) foodborne illnesses. Of all foodborne diseases, diarrheal and invasive infections due to non-typhoidal S. enterica infections resulted in the highest burden, causing 4.07 million (95% UI 2.49–6.27 million) DALYs. Regionally, DALYs per 100,000 population were highest in the African region followed by the South East Asian region. Considerable burden of foodborne disease is borne by children less than five years of age. Major limitations of our study include data gaps, particularly in middle- and high-mortality countries, and uncertainty around the proportion of diseases that were foodborne. Conclusions: Foodborne diseases result in a large disease burden, particularly in children. Although it is known that diarrheal diseases are a major burden in children, we have demonstrated for the first time the importance of contaminated food as a cause. There is a need to focus food safety interventions on preventing foodborne diseases, particularly in low- and middle-income settings.

LanguageEnglish (US)
Article numbere1001921
JournalPLoS Medicine
Volume12
Issue number12
DOIs
StatePublished - 2015

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Foodborne Diseases
Virus Diseases
Uncertainty
Quality-Adjusted Life Years
Salmonella enterica
Mortality
Salmonella Infections
Food
Global Burden of Disease
Morbidity
Norovirus
Mycobacterium Infections
Campylobacter
Stillbirth
Food Safety
Information Storage and Retrieval
Mycobacterium bovis
Infection
HIV Infections
Cohort Studies

ASJC Scopus subject areas

  • Medicine(all)

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World Health Organization Estimates of the Global and Regional Disease Burden of 22 Foodborne Bacterial, Protozoal, and Viral Diseases, 2010 : A Data Synthesis. / Kirk, Martyn D.; Pires, Sara M.; Black, Robert E; Caipo, Marisa; Crump, John A.; Devleesschauwer, Brecht; Döpfer, Dörte; Fazil, Aamir; Fischer-Walker, Christa L.; Hald, Tine; Hall, Aron J.; Keddy, Karen H.; Lake, Robin J.; Lanata, Claudio F.; Torgerson, Paul R.; Havelaar, Arie H.; Angulo, Frederick J.

In: PLoS Medicine, Vol. 12, No. 12, e1001921, 2015.

Research output: Contribution to journalArticle

Kirk, MD, Pires, SM, Black, RE, Caipo, M, Crump, JA, Devleesschauwer, B, Döpfer, D, Fazil, A, Fischer-Walker, CL, Hald, T, Hall, AJ, Keddy, KH, Lake, RJ, Lanata, CF, Torgerson, PR, Havelaar, AH & Angulo, FJ 2015, 'World Health Organization Estimates of the Global and Regional Disease Burden of 22 Foodborne Bacterial, Protozoal, and Viral Diseases, 2010: A Data Synthesis', PLoS Medicine, vol. 12, no. 12, e1001921. https://doi.org/10.1371/journal.pmed.1001921
Kirk, Martyn D. ; Pires, Sara M. ; Black, Robert E ; Caipo, Marisa ; Crump, John A. ; Devleesschauwer, Brecht ; Döpfer, Dörte ; Fazil, Aamir ; Fischer-Walker, Christa L. ; Hald, Tine ; Hall, Aron J. ; Keddy, Karen H. ; Lake, Robin J. ; Lanata, Claudio F. ; Torgerson, Paul R. ; Havelaar, Arie H. ; Angulo, Frederick J. / World Health Organization Estimates of the Global and Regional Disease Burden of 22 Foodborne Bacterial, Protozoal, and Viral Diseases, 2010 : A Data Synthesis. In: PLoS Medicine. 2015 ; Vol. 12, No. 12.
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abstract = "Background: Foodborne diseases are important worldwide, resulting in considerable morbidity and mortality. To our knowledge, we present the first global and regional estimates of the disease burden of the most important foodborne bacterial, protozoal, and viral diseases. Methods and Findings: We synthesized data on the number of foodborne illnesses, sequelae, deaths, and Disability Adjusted Life Years (DALYs), for all diseases with sufficient data to support global and regional estimates, by age and region. The data sources included varied by pathogen and included systematic reviews, cohort studies, surveillance studies and other burden of disease assessments. We sought relevant data circa 2010, and included sources from 1990–2012. The number of studies per pathogen ranged from as few as 5 studies for bacterial intoxications through to 494 studies for diarrheal pathogens. To estimate mortality for Mycobacterium bovis infections and morbidity and mortality for invasive non-typhoidal Salmonella enterica infections, we excluded cases attributed to HIV infection. We excluded stillbirths in our estimates. We estimate that the 22 diseases included in our study resulted in two billion (95{\%} uncertainty interval [UI] 1.5–2.9 billion) cases, over one million (95{\%} UI 0.89–1.4 million) deaths, and 78.7 million (95{\%} UI 65.0–97.7 million) DALYs in 2010. To estimate the burden due to contaminated food, we then applied proportions of infections that were estimated to be foodborne from a global expert elicitation. Waterborne transmission of disease was not included. We estimate that 29{\%} (95{\%} UI 23–36{\%}) of cases caused by diseases in our study, or 582 million (95{\%} UI 401–922 million), were transmitted by contaminated food, resulting in 25.2 million (95{\%} UI 17.5–37.0 million) DALYs. Norovirus was the leading cause of foodborne illness causing 125 million (95{\%} UI 70–251 million) cases, while Campylobacter spp. caused 96 million (95{\%} UI 52–177 million) foodborne illnesses. Of all foodborne diseases, diarrheal and invasive infections due to non-typhoidal S. enterica infections resulted in the highest burden, causing 4.07 million (95{\%} UI 2.49–6.27 million) DALYs. Regionally, DALYs per 100,000 population were highest in the African region followed by the South East Asian region. Considerable burden of foodborne disease is borne by children less than five years of age. Major limitations of our study include data gaps, particularly in middle- and high-mortality countries, and uncertainty around the proportion of diseases that were foodborne. Conclusions: Foodborne diseases result in a large disease burden, particularly in children. Although it is known that diarrheal diseases are a major burden in children, we have demonstrated for the first time the importance of contaminated food as a cause. There is a need to focus food safety interventions on preventing foodborne diseases, particularly in low- and middle-income settings.",
author = "Kirk, {Martyn D.} and Pires, {Sara M.} and Black, {Robert E} and Marisa Caipo and Crump, {John A.} and Brecht Devleesschauwer and D{\"o}rte D{\"o}pfer and Aamir Fazil and Fischer-Walker, {Christa L.} and Tine Hald and Hall, {Aron J.} and Keddy, {Karen H.} and Lake, {Robin J.} and Lanata, {Claudio F.} and Torgerson, {Paul R.} and Havelaar, {Arie H.} and Angulo, {Frederick J.}",
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T1 - World Health Organization Estimates of the Global and Regional Disease Burden of 22 Foodborne Bacterial, Protozoal, and Viral Diseases, 2010

T2 - Nature Reviews Clinical Oncology

AU - Kirk, Martyn D.

AU - Pires, Sara M.

AU - Black, Robert E

AU - Caipo, Marisa

AU - Crump, John A.

AU - Devleesschauwer, Brecht

AU - Döpfer, Dörte

AU - Fazil, Aamir

AU - Fischer-Walker, Christa L.

AU - Hald, Tine

AU - Hall, Aron J.

AU - Keddy, Karen H.

AU - Lake, Robin J.

AU - Lanata, Claudio F.

AU - Torgerson, Paul R.

AU - Havelaar, Arie H.

AU - Angulo, Frederick J.

PY - 2015

Y1 - 2015

N2 - Background: Foodborne diseases are important worldwide, resulting in considerable morbidity and mortality. To our knowledge, we present the first global and regional estimates of the disease burden of the most important foodborne bacterial, protozoal, and viral diseases. Methods and Findings: We synthesized data on the number of foodborne illnesses, sequelae, deaths, and Disability Adjusted Life Years (DALYs), for all diseases with sufficient data to support global and regional estimates, by age and region. The data sources included varied by pathogen and included systematic reviews, cohort studies, surveillance studies and other burden of disease assessments. We sought relevant data circa 2010, and included sources from 1990–2012. The number of studies per pathogen ranged from as few as 5 studies for bacterial intoxications through to 494 studies for diarrheal pathogens. To estimate mortality for Mycobacterium bovis infections and morbidity and mortality for invasive non-typhoidal Salmonella enterica infections, we excluded cases attributed to HIV infection. We excluded stillbirths in our estimates. We estimate that the 22 diseases included in our study resulted in two billion (95% uncertainty interval [UI] 1.5–2.9 billion) cases, over one million (95% UI 0.89–1.4 million) deaths, and 78.7 million (95% UI 65.0–97.7 million) DALYs in 2010. To estimate the burden due to contaminated food, we then applied proportions of infections that were estimated to be foodborne from a global expert elicitation. Waterborne transmission of disease was not included. We estimate that 29% (95% UI 23–36%) of cases caused by diseases in our study, or 582 million (95% UI 401–922 million), were transmitted by contaminated food, resulting in 25.2 million (95% UI 17.5–37.0 million) DALYs. Norovirus was the leading cause of foodborne illness causing 125 million (95% UI 70–251 million) cases, while Campylobacter spp. caused 96 million (95% UI 52–177 million) foodborne illnesses. Of all foodborne diseases, diarrheal and invasive infections due to non-typhoidal S. enterica infections resulted in the highest burden, causing 4.07 million (95% UI 2.49–6.27 million) DALYs. Regionally, DALYs per 100,000 population were highest in the African region followed by the South East Asian region. Considerable burden of foodborne disease is borne by children less than five years of age. Major limitations of our study include data gaps, particularly in middle- and high-mortality countries, and uncertainty around the proportion of diseases that were foodborne. Conclusions: Foodborne diseases result in a large disease burden, particularly in children. Although it is known that diarrheal diseases are a major burden in children, we have demonstrated for the first time the importance of contaminated food as a cause. There is a need to focus food safety interventions on preventing foodborne diseases, particularly in low- and middle-income settings.

AB - Background: Foodborne diseases are important worldwide, resulting in considerable morbidity and mortality. To our knowledge, we present the first global and regional estimates of the disease burden of the most important foodborne bacterial, protozoal, and viral diseases. Methods and Findings: We synthesized data on the number of foodborne illnesses, sequelae, deaths, and Disability Adjusted Life Years (DALYs), for all diseases with sufficient data to support global and regional estimates, by age and region. The data sources included varied by pathogen and included systematic reviews, cohort studies, surveillance studies and other burden of disease assessments. We sought relevant data circa 2010, and included sources from 1990–2012. The number of studies per pathogen ranged from as few as 5 studies for bacterial intoxications through to 494 studies for diarrheal pathogens. To estimate mortality for Mycobacterium bovis infections and morbidity and mortality for invasive non-typhoidal Salmonella enterica infections, we excluded cases attributed to HIV infection. We excluded stillbirths in our estimates. We estimate that the 22 diseases included in our study resulted in two billion (95% uncertainty interval [UI] 1.5–2.9 billion) cases, over one million (95% UI 0.89–1.4 million) deaths, and 78.7 million (95% UI 65.0–97.7 million) DALYs in 2010. To estimate the burden due to contaminated food, we then applied proportions of infections that were estimated to be foodborne from a global expert elicitation. Waterborne transmission of disease was not included. We estimate that 29% (95% UI 23–36%) of cases caused by diseases in our study, or 582 million (95% UI 401–922 million), were transmitted by contaminated food, resulting in 25.2 million (95% UI 17.5–37.0 million) DALYs. Norovirus was the leading cause of foodborne illness causing 125 million (95% UI 70–251 million) cases, while Campylobacter spp. caused 96 million (95% UI 52–177 million) foodborne illnesses. Of all foodborne diseases, diarrheal and invasive infections due to non-typhoidal S. enterica infections resulted in the highest burden, causing 4.07 million (95% UI 2.49–6.27 million) DALYs. Regionally, DALYs per 100,000 population were highest in the African region followed by the South East Asian region. Considerable burden of foodborne disease is borne by children less than five years of age. Major limitations of our study include data gaps, particularly in middle- and high-mortality countries, and uncertainty around the proportion of diseases that were foodborne. Conclusions: Foodborne diseases result in a large disease burden, particularly in children. Although it is known that diarrheal diseases are a major burden in children, we have demonstrated for the first time the importance of contaminated food as a cause. There is a need to focus food safety interventions on preventing foodborne diseases, particularly in low- and middle-income settings.

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