the global burden of foodborne diseases · exploding the myths . myth no 1: 'foodborne...
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The Global Burden of Foodborne Diseases
Results for action
Dr Claudia Stein
Director Division of Information, Evidence, Research and Innovation
WHO Regional Office for Europe
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Food: The good, the bad and the misreported
–
Why we needed to estimate the burden of foodborne diseases
…and the under- and un-reported
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What are "Foodborne Diseases"?
• Diseases transmitted through the ingestion of contaminated food
• Caused by bacteria, viruses, parasites, prions and chemicals/toxins (incl. allergens)
• …and they are everywhere
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Reporting on foodborne
diseases and food safety:
Exploding the myths
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Myth No 1:
'Foodborne diseases are mostly a problem of developing countries'
USA:
76 million cases of foodborne illness
from pathogens alone each year
(Mead et al, Emerg Infec Dis, 1999)
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Myth No 2:
'Foodborne diseases in rich countries
are mostly travel-related'
United States and EU:
In most countries majority of cases is
domestically acquired
(CDC & European Food Standards Agency)
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Myth No 3 – the convenient one:
'It's imported foods from poor
countries (aka 'poor hygiene')
that cause our foodborne diseases'
Rich countries have
exported new foodborne diseases to poor countries:
Salmonella enteritidis Salmonella typhimurium
Dioxin BSE
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Myth No 4:
'Foodborne diseases are getting less & less frequent'
335 newly emerging infectious diseases:
• 95 pathogens transmitted through food (~30%) • 50 (15%) due to "changes in agricultural or food industry"
• many resistant to antibiotics
Compounded by effects of climate change
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Myth No 5:
'Foodborne diseases are mild, self-limited and short'
2.2 million deaths from diarrhoeal diseases
each year world-wide
(World Health Organization, 2008)
USA:
5,000 deaths from foodborne illness from pathogens alone
each year
(Mead et al, Emerg Infec Dis, 1999)
Campylobacter: Guillain Barré Syndrome Reactive arthritis Salmonella spp: Guillain Barré Syndrome Reactive arthritis Septicaemia Meningitis Listeria: Meningitis Septicaemia Perinatal loss E.coli: Renal failure Pork tapeworm: Epilepsy Toxoplasma: Retinopathy Trichinella: Multi-organ failure Acrylamide: Cancer Arsenic: Cancer Aflatoxin: Cancer Lead: Mental retardation Dioxins: Cancer Allergens: Anaphylactic shock
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Myth No 6 – the hopeful one:
' As a vegetarian I am less likely to get foodborne diseases'
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Myth No 7 – the easy one:
'Governments hold the sole responsibility for making food safer'
Processing
Storage
CookingLivestock
Crops
Seafood
Distribution
Retail
Industrial emissionsand effluents
Sewage
Vehicleemission
Agriculturalpractices
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Myth No 8 – the dangerous one:
'Food security is more important than food
safety'
Food security without food safety can cause
great harm • Malnourished people are more vulnerable to foodborne diseases & more likely to die
• Contaminated food is rarely discarded in famine situations
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Myth No 9 – the big one:
'Our food is perfectly safe'
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How big is the burden of foodborne diseases?
Reported human cases
What we know from surveillance data
What we need to know
Actual human disease burden
Reported human cases
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Myth No 10 – the understandable one:
'We can never estimate the burden of foodborne diseases'
Yes, we
can.
And we
have.
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"What doesn't get measured, doesn't
get done"
"How else to assess effectiveness of food
safety policies & interventions?"
Establish Foodborne
Disease Burden Epidemiology
Reference Group (FERG)
Pictures awaited:
Dr John C LarssenDr Josef SchlatterProf Rolaf van Leeuwen
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WHO Initiative to Estimate the
Global Burden of Foodborne Diseases
• Why? – Because information on burden of FBD from all causes is poor – Policy makers require information to assess effectiveness of
prevention and interventions (incl. Codex)
– Foster international development and global health security
• What? – Estimation of morbidity, disability and mortality of FBD – Development of tools for countries to conduct BoD studies
• Outcome – Global and regional report – Country Burden of Disease studies
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What is the % foodborne?
Burden of disease
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Thank you
Meat hanging out to dry, Cambodia
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Extra slides
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DALY = YLL + YLD
Interpretation of DALYs
High number deaths
Young adult deaths
High LE assumed
High incidence
Sequela +++
High DW
Long duration
Incidence x duration x DW No deaths x yrs lost against standard