According to the World Health Organization, serious outbreaks of foodborne disease have been documented on every continent in the past decade, and in many countries rates of related illnesses are increasing significantly.

– The International Union of Food Science and Technology

World Health Organization

While many countries around the world continue to make progress in mitigating foodborne illnesses, numerous problems remain. To illustrate, the World Health Organization (WHO) recently reported an increase in the rate of foodborne illness in many areas around the globe, a trend that the organization considers to be a public health priority.

Addressing the inordinately complex issue of global food safety—hence, foodborne illness—requires expertise from a multidisciplinary approach, along with effective domestic, regional, and international collaboration. To this end, food safety and foodborne illness specialists from a variety of fields have noted the importance of prioritizing global food safety. They cite the humanitarian, economic, diplomatic, and public health implications of addressing the problem.

The following specifically discusses the recent WHO report, “WHO Estimates of the Global Burden of Foodborne Diseases,” including the background, objectives, findings, and recommendations within the publication.

Background of the report

The “Executive Summary” of the report includes this rationale:

“Foodborne diseases are an important cause of morbidity and mortality, and a significant impediment to socio-economic development worldwide, but the full extent and burden of unsafe food, and especially the burden arising from chemical and parasitic contaminants, has been unknown.”

The report is a byproduct of the “WHO Initiative to Estimate the Global Burden of Foodborne Diseases.” The research, analyses, and construction of the report was undertaken by the WHO Foodborne Disease Burden Epidemiology Reference Group (FERG). WHO says FERG’s research “provides the first estimates of global foodborne disease incidence, mortality, and disease burden in terms of Disability Adjusted Life Years (DALYs).”

Quantitative measures

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In order to provide the required quantitative data, FERG researched 31 “foodborne hazards” that caused 32 known foodborne-related diseases. Hazards, which are categorized according to the instigating agent, are as follows: seven invasive infectious disease agents (5 bacteria, 1 virus, 1 protozoan), 11 diarrheal agents (7 bacteria, 1 virus, 3 protozoa), three chemicals, and 10 helminths.

The report cites a 95% uncertainty interval (UI), also known as a confidence interval (CI), for each hazard and the reported outcome (e.g. illness, death). The results presented, therefore, will account for UI, per the report’s methodology.

Main findings

The report cites diarrheal disease agents as the leading cause of foodborne illness. The agents’ norovirus and Campylobacter accounted for a disproportionate number of reported illnesses. Furthermore, diarrheal disease agents accounted for 230,000 (95% UI: 160,000-320,000) fatalities. Non-typhoidal Salmonella enterica (NTS) is cited as the predominant agent in this regard.

Aflatoxin, hepatitis A virus, Salmonella Typhi, and Taenia solium are each listed as a “major cause of foodborne deaths”). The aforementioned hazards unduly affected children under the age of 5 years old, with this demographic accounting for 40% of all reported cases.

Burden of foodborne disease greater in certain areas

Researchers observed various geographic sub-regions as carrying the “highest burden” in terms of adult and child mortality: two regions of Africa; two in Southeast Asia, and one Eastern Mediterranean sub-region. The two regions of Africa were observed as having the highest adult and child mortality rates.

The authors of the study also observed a considerably disproportionate rate of foodborne illnesses and deaths in low-income sub-regions, particularly among children under the age of 5 living in these areas.

Diarrheal disease agents predictably accounted for most diseases in all regions. NTS-induced illness was common across all regions, “particularly in Africa.” Enterotoxigenic E. coli and Vibrio cholera were prominent agents in regions with low incomes, and Campylobacter was most commonly observed in regions with high incomes.

Young children and those in need carry the “highest burden”

The authors adamantly propose some type of solution for at-risk demographics, particularly children living in underdeveloped regions of the world. While the researchers profess to “data gaps and limitations of these initial estimates,” the development of a policy to address the food safety needs of those facing the “highest burden” should be considered a national and international priority.

The study’s recommendations

As previously mentioned, WHO cites this report as the first quantitative measurement and analyses of foodborne illness and its effects on a global scale. With this valuable data now available, WHO and FERG have made the following recommendations:

  • The integration of global estimates and national data for countries seeking to enhance their food safety strategies.
  • The development of national laboratory-based surveillance programs.
  • The use of the report, including its data and observations, by countries to provide further insight into their food safety apparatuses or lack thereof.
  • Advancing the means and quality of food safety data collection and mining it for various purposes, such as validation for potential local, regional, national, and global food safety policy.
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