Monday, November 09, 2009

Counting the global burden of foodborne disease - more than 1 million deaths a year

Susan Jones, “Counting the global burden of foodborne disease,” Speaking of Medicine (Nov. 2, 2009) at:

“[Y]ou may be surprised to find that the global burden of disease attributable to foodborne illness, which is perhaps the most basic information needed to push forward research and action on foodborne illness, is not known. Why is there such an apparent lack of interest in documenting the scope of illnesses that affect people from all countries? One reason may be a common misconception that foodborne diseases are mild and self-limiting. A second and very important reason is that it’s often incredibly difficult to attribute foodborne illnesses and deaths to a specific foodstuff. And a third reason is that there is no well-heeled funder providing the impetus and cash to tackle foodborne illness, unlike other global problems such as HIV, malaria and TB.

“In 2007, the WHO launched an international initiative to tackle foodborne disease. The WHO Initiative to Estimate the Global Burden of Foodborne Diseases aims to quantify how many people die from, or are affected by, all major foodborne causes each year. The FERG (Foodborne Disease Burden Epidemiology Reference Group) initiative, led by Claudia Stein and Jorgen Schlundt from the WHO, aims to set the problem of foodborne illness in context. . . .

“FERG has commissioned research seeking to quantify burdens of different foodborne diseases. Early reports were presented at the meeting and revealed the shocking level of the problem. A systematic review by Christa Fischer-Walker and Robert Black from Johns Hopkins School of Public Health in the US revealed that there are a whopping 5 billion episodes of diarrhea in children aged > 5 annually, with 3.2 billion cases in South-East Asia. Specific inspection of papers reporting deaths revealed that there were more than 1.15 million estimated deaths from diarrhea in South East Asia and Africa each year in children >5 — this is almost a million more deaths than was previously estimated. The paucity of data was laid bare by these preliminary results, with no data for China, Latin America, the Middle East. Pathogens in the spotlight in these systematic reviews were the usual suspects, including E. coli, Shigella, Vibrio cholerae, Campylobacter and Salmonella. This is not a burden solely borne by those living in poverty — 455 million episodes of diarrhea each year in the Americas and 419 million episodes each year in Europe. The data are so limited that these global estimates are virtually bound to underreport the problem. . . .”

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