Burden of Disease Estimates of Seven Pathogens Commonly Transmitted Through Foods in Denmark, 2017
Publication: Foodborne Pathogens and Disease
Volume 17, Issue Number 5
Abstract
Burden of disease metrics are increasingly established to prioritize food safety interventions. We estimated the burden of disease caused by seven foodborne pathogens in Denmark in 2017: Campylobacter, Salmonella, Shiga toxin–producing Escherichia coli, norovirus, Yersinia enterocolitica, Listeria monocytogenes, and Toxoplasma gondii. We used public health surveillance data and scientific literature to estimate incidence, mortality, and total disability-adjusted life year (DALY) of each, and linked results with estimates of the proportion of disease burden that is attributable to foods. Our estimates showed that Campylobacter caused the highest burden of disease, leading to a total burden of 1709 DALYs (95% uncertainty interval [UI] 1665–1755), more than threefold higher than the second highest ranked pathogen (Salmonella: 492 DALYs; 95% UI 481–504). Campylobacter still led the ranking when excluding DALYs attributable to nonfoodborne routes of exposure. The total estimated incidence was highest for norovirus, but this agent ranked sixth when focusing on foodborne burden. Salmonella ranked second in terms of foodborne burden of disease, followed by Listeria and Yersinia. Foodborne congenital toxoplasmosis was estimated to cause the loss of ∼100 years of healthy life, a burden that was borne by a low number of cases in the population. The ranking of foodborne pathogens varied substantially when based on reported cases, estimated incidence, and burden of disease estimates. Our results reinforce the need to continue food safety efforts throughout the food chain in Denmark, with a particular focus on reducing the incidence of Campylobacter infections.
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References
Ahmed SM, Hall AJ, Robinson AE, Verhoef L, Premkumar P, Parashar UD, et al. Global prevalence of norovirus in cases of gastroenteritis: A systematic review and meta-analysis. Lancet Infect Dis 2014;14:725–730.
Anonymous. Annual Report on Zoonoses in Denmark 2017. Lyngby, Denmark: DTU Food/National Food Institute, 2018.
Boysen L, Rosenquist H, Larsson JT, Nielsen EM, Sørensen G, Nordentoft Set al,. Source attribution of human campylobacteriosis in Denmark. Epidemiol Infect 2013:1–10.
Brookes V, Del Rio Vilas V, Ward M. Disease prioritization: What is the state of the art? Epidemiol Infect 2015;43:2911–2922.
Cassini A, Colzani E, Kramarz P, Kretzschmar ME, Takkinen J. Science direct impact of food and water-borne diseases on European population health. Curr Opin Food Sci 2016;12:21–29.
Christensen T, Dejgård JJ. Calculation of the costs of illness of of salmonella, campylobacter, listeria and VTEC in Denmark, 2017.
Devleesschauwer B, Havelaar AH, Maertens De Noordhout C, Haagsma JA, Praet N, Dorny P, et al. DALY calculation in practice: A stepwise approach. Int J Public Health 2014;59:571–574.
Commission Regulation (EC) No 2073/2005 of 15 November 2005 on microbiological criteria for foodstuffs (Text with EEA relevance). 2005.
Danish Food and Veterinary Administration, 2018. Action plan for campylobacter in broilers, food and the surrounding environment. Copenhagen, 2018. Available at: https://www.foedevarestyrelsen.dk/SiteCollectionDocuments/Foder-%20og%20foedevaresikkerhed/Mikrozoonoser/Handlingsplan%20for%20campylobacter%202018-2021%20(3).pdf, accessed November 18, 2019.
ECDC. ECDC BCoDE toolkit [software application]. Version 1.4 Stockholm: European Centre for Disease Prevention and Control 2015. 2015. Available at: https://ecdc.europa.eu/en/publications-data/toolkit-application-calculate-dalys, accessed December 5, 2018.
EFSA. Monitoring and identification of human enteropathogenic Yersinia spp.—Scientific opinion of the panel on biological hazards. EFSA J 2007;5:595.
Espenhain LE, 2013. Epidemiology and surveillance of three diarrhoeagenic Escherichia coli in Denmark between 2000–2012. Master thesis, University of Copenhagen Department of Public Health. Available at: https://www.ssi.dk/English/HealthdataandICT/National%20Reference%20Laboratories/Bacteria/~/media/F8A5F6C1885A44149BDEA8387FD27BC2.ashx, accessed November 18, 2019.
Haagsma JA, Geenen PL, Ethelberg S, Fetsch A, Hansdotter F, Jansen A, et al. Community incidence of pathogen-specific gastroenteritis: Reconstructing the surveillance pyramid for seven pathogens in seven European Union member states. Epidemiol Infect 2012;141:1–15.
Hald T, Aspinall W, Devleesschauwer B, Cooke R, Corrigan T, Havelaar AH, et al. World Health Organization estimates of the relative contributions of food to the burden of disease due to selected foodborne hazards: A structured expert elicitation. PLoS One 2016;11:1–35.
Havelaar A, Bräunig J, Christiansen K, Cornu M, Hald T, Mangen M-J, et al. Towards an integrated approach in supporting microbiological food safety decisions. Zoonoses Public Health 2007a;54:103–117.
Havelaar A, Kemmeren J, Kortbeek L. Disease burden of congenital toxoplasmosis. Clin Infect Dis 2007b;44:1467–1474.
Havelaar A, Van Duynhoven Y, Nauta M, Bouwknegt M, Heuvelink A, De Wit G, Van de Kar N. Disease burden in The Netherlands due to infections with Shiga toxin-producing Escherichia coli O157. Epidemiol Infect 2004;132:467–484.
Havelaar AH, de Wit MA, van Koningsveld R, van Kempen E. Health burden in the Netherlands due to infection with thermophilic Campylobacter spp. Epidemiol Infect 2000;125:505–522.
Havelaar AH, Haagsma JA, Mangen MJJ, Kemmeren JM, Verhoef LPB, Vijgen SMC, et al. Disease burden of foodborne pathogens in the Netherlands, 2009. Int J Food Microbiol 2012;156:231–238.
Havelaar AH, Ivarsson S, Löfdhal M, Nauta MJ. Estimating the true incidence of campylobacteriosis and salmonellosis in the European Union, 2009. Epidemiol Infect 2013;141:293–302.
Havelaar AH, Kirk MD, Torgerson PR, Gibb HJ, Hald T, Lake RJ, et al. World Health Organization global estimates and regional comparisons of the burden of foodborne disease in 2010. PLoS Med 2015;12:1–23.
Jensen AK, Björkman JT, Ethelberg S, Kiil K, Kemp M, Nielsen EM. Molecular typing and epidemiology of human listeriosis cases, Denmark, 2002–2012. Emerg Infect Dis 2016;22:625–633.
Jess T, Simonsen J, Nielsen NM, Jørgensen KT, Bager P, Ethelberg S, et al. Enteric Salmonella or Campylobacter infections and the risk of inflammatory bowel disease. Gut 2011;60:318–324.
Kirk M, Ford L, Glass K, Hall G. Foodborne illness, Australia, circa 2000 and circa 2010. Emerg Infect Dis 2014;20:1857–1864.
Kubota K, Kasuga F, Iwasaki E, Inagaki S, Sakurai Y, Komatsu M, et al. Estimating the burden of acute gastroenteritis and foodborne illness caused by Campylobacter, Salmonella, and Vibrio parahaemolyticus by using population-based telephone survey data, Miyagi Prefecture, Japan, 2005 to 2006. J Food Prot 2011;74:1592–1598.
Lake RJ, Devleesschauwer B, Nasinyama G, Havelaar AH, Kuchenmüller T, Haagsma JA, et al. National studies as a component of the World Health Organization initiative to estimate the global and regional burden of foodborne disease. PLoS One 2015;10:1–10.
Van Lier A, McDonald SA, Bouwknegt M, Van Der Sande M, Bijkerk P, Van Benthem B, et al. Disease burden of 32 infectious diseases in the Netherlands, 2007–2011. PLoS One 2016;11:2007–2011.
Majowicz SE, Musto J, Scallan E, Angulo FJ, Kirk M, O'Brien SJ, et al. The global burden of nontyphoidal salmonella gastroenteritis. Clin Infect Dis 2010;50:882–889.
Mead P. Food-related illness and death in the united states reply to Dr. Hedberg. Emerg Infect Dis 1999;5:841–842.
Müller L, Korsgaard H, Ethelberg S. Burden of acute gastrointestinal illness in Denmark 2009: A population-based telephone survey. Epidemiol Infect 2012;140:290–298.
Nissen J, Jokelainen P, Stensvold CR, Trevisan C, Fuchs J, Burgdorf KS, et al. The disease burden of congenital toxoplasmosis in Denmark, 2014. PLoS One 2017;12.
de Noordhout CM, Devleesschauwer B, Haagsma JA, Havelaar AH, Bertrand S, Vandenberg O, et al. Burden of salmonellosis, campylobacteriosis and listeriosis: A time series analysis, Belgium, 2012 to 2020. Euro Surveill 2017;22:6–18.
Pires SM, Evers EG, Van Pelt W, Ayers T, Scallan E, Angulo FJ, et al. Attributing the human disease burden of foodborne infections to specific sources. Foodborne Pathog Dis 2009;6:417–424.
Pires SM, Fischer-Walker CL, Lanata CF, Devleesschauwer B, Hall AJ, Kirk MD, et al. Aetiology-specific estimates of the global and regional incidence and mortality of diarrhoeal diseases commonly transmitted through food. PLoS One 2015;10:1–17.
Rosenquist H, Boysen L, Galliano C, Nordentoft S, Ethelberg S, Borck B. Danish strategies to control Campylobacter in broilers and broiler meat: Facts and effects. Epidemiol Infect 2009;137:1742–1750.
Salomon JA, Haagsma JA, Davis A, de Noordhout CM, Polinder S, Havelaar AH, et al. Disability weights for the Global Burden of Disease 2013 study. Lancet Glob Heal 2015;3:e712–e723.
Scallan E, Hoekstra RM, Angulo FJ, Tauxe R V., Widdowson MA, Roy SL, et al. Foodborne illness acquired in the United States—Major pathogens. Emerg Infect Dis 2011;17:7–15.
Schmidt DR. A neonatal screening programme for congenital toxoplasmosis: Including observations on disease development and its treatment in infants and children. University of Copenhagen, 2005.
Schmidt DR, Hogh B, Andersen O, Fuchs J, Fledelius H, Petersen E. The national neonatal screening programme for congenital toxoplasmosis in Denmark: Results from the initial four years, 1999–2002. Arch Dis Child 2006;91:661–665.
Tam CC, Rodrigues LC, Viviani L, Dodds JP, Evans MR, Hunter PR, et al. Longitudinal study of infectious intestinal disease in the UK (IID2 study): Incidence in the community and presenting to general practice. Gut 2012;61:69–77.
Wegener HC. Danish initiatives to improve the safety of meat products. Meat Sci 2010;84:276–283.
Wegener HC, Hald T, Wong DLF, Madsen M, Korsgaard H, Bager F, et al. Salmonella control programs in Denmark. Emerg Infect Dis 2003;9:774–780.
WHO. WHO methods and data sources for global burden of disease estimates 2000–2016. Global Health Estimates Technical Paper WHO/HIS/IER/GHE/2018.4. 2018.
WHO. WHO Estimates of the Global Burden of Foodborne Diseases. Geneva, Switzerland: WHO, 2015.
Wilson S-J, Ward MP, Garner MG. A framework for assessing the intangible impacts of emergency animal disease. Prev Vet Med 2013;111:3–4.
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Published In
Foodborne Pathogens and Disease
Volume 17 • Issue Number 5 • May 2020
Pages: 322 - 339
PubMed: 31755845
Copyright
Copyright 2020, Mary Ann Liebert, Inc., publishers.
History
Published online: 7 May 2020
Published in print: May 2020
Published ahead of print: 22 November 2019
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Disclosure Statement
No competing financial interests exist.
Funding Information
This study was funded by the Danish Ministry of Environment and Food through the Metrix project.
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