Results for action. The Global Burden of Foodborne Diseases. Dr Claudia Stein

Transcription

1 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

2 Food: and the underand un-reported The good, the bad and the misreported Why we needed to estimate the burden of foodborne diseases

3 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

4 Reporting on foodborne diseases and food safety: Exploding the myths

5 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)

6 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)

7 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

8 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

9 Myth No 5: 'Foodborne diseases are mild, self-limited and short' Campylobacter: Salmonella spp: Listeria: E.coli: Pork tapeworm: Toxoplasma: Trichinella: Acrylamide: Arsenic: Aflatoxin: Lead: Dioxins: Allergens: Guillain Barré Syndrome Reactive arthritis Guillain Barré Syndrome Reactive arthritis Septicaemia Meningitis Meningitis Septicaemia Perinatal loss Renal failure Epilepsy Retinopathy Multi-organ failure Cancer Cancer Cancer Mental retardation Cancer Anaphylactic shock USA: 2.25,000 million deaths deaths from diarrhoeal foodborne diseases illness from each pathogens year world-wide alone (World each Health Organization, year 2008) (Mead et al, Emerg Infec Dis, 1999)

10 Myth No 6 the hopeful one: ' As a vegetarian I am less likely to get foodborne diseases'

11 Myth No 7 the easy one: 'Governments hold the sole responsibility for making food safer' Vehicle emission Crops Processing Agricultural practices Livestock Retail Cooking Sewage Storage Seafood Industrial emissions and effluents Distribution

12 Myth No 8 the dangerous one: 'Food security is more important than food safety' Malnourished people are more vulnerable to foodborne diseases & more likely to die Contaminated food is rarely discarded in famine situations Food security without food safety can cause great harm

13 Myth No 9 the big one: 'Our food is perfectly safe'

14 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

15 Myth No 10 the understandable one: 'We can never estimate the burden of foodborne diseases' Yes, we can. And we have.

16 Pictures awaited: "What doesn't get measured, doesn't get done" Dr John C Larssen Dr Josef Schlatter Prof Rolaf van Leeuwen "How else to assess effectiveness of food safety policies & interventions?" Establish Foodborne Disease Burden Epidemiology Reference Group (FERG)

17 Why? WHO Initiative to Estimate the Global Burden of Foodborne Diseases 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

18 What is the % foodborne? Burden of disease

19 Thank you Meat hanging out to dry, Cambodia

20 Extra slides

21 Interpretation of DALYs No deaths x yrs lost against standard Incidence x duration x DW DALY = YLL + YLD High number deaths Young adult deaths High LE assumed High incidence Sequela +++ High DW Long duration