To infor
m risk
manage
ment decisions on control, prevention and surveillance of foodborne disease, the disease burden of foodborne pathogens is esti
mated using Disability Adjusted Life Years as a su
mmary
metric of public health. Fourteen pathogens that can be trans
mitted by food are included in the study (four infectious bacteria, three toxin-producing bacteria, four viruses and three protozoa). Data represent the burden in the Netherlands in 2009. The incidence of co
mmunity-acquired non-consulting cases, patients consulting their general practitioner, those ad
mitted to hospital, as well as the incidence of sequelae and fatal cases is esti
mated using surveillance data, cohort studies and published data. Disease burden includes esti
mates of duration and disability weights for non-fatal cases and loss of statistical life expectancy for fatal cases. Results at pathogen level are co
mbined with data fro
m an expert survey to assess the fraction of cases attributable to food, and the
main food groups contributing to trans
mission.
Among 1.8 million cases of disease (approx. 10,600 per 100,000) and 233 deaths (1.4 per 100,000) by these fourteen pathogens, approximately one-third (680,000 cases; 4100 per 100,000) and 78 deaths (0.5 per 100,000) are attributable to foodborne transmission. The total burden is 13,500 DALY (82 DALY per 100,000). On a population level, m>Toxoplasma gondiim>, thermophilic m>Campylobacterm> spp., rotaviruses, noroviruses and m>Salmonellam> spp. cause the highest disease burden. The burden per case is highest for perinatal listeriosis and congenital toxoplasmosis. Approximately 45%of the total burden is attributed to food. m>T. gondiim> and m>Campylobacterm> spp. appear to be key targets for additional intervention efforts, with a focus on food and environmental pathways. The ranking of foodborne pathogens based on burden is very different compared to when only incidence is considered. The burden of acute disease is a relatively small part of the total burden. In the Netherlands, the burden of foodborne pathogens is similar to the burden of upper respiratory and urinary tract infections.