Attribution of global foodborne disease to specific foods: Findings from a World Health Organization structured expert elicitation

Abstract

BackgroundRecently the World Health Organization, Foodborne Disease Burden Epidemiology Reference Group (FERG) estimated that 31 foodborne diseases (FBDs) resulted in over 600 million illnesses and 420,000 deaths worldwide in 2010. Knowing the relative role importance of different foods as exposure routes for key hazards is critical to preventing illness. This study reports the findings of a structured expert elicitation providing globally comparable food source attribution estimates for 11 major FBDs in each of 14 world subregions.Methods and findingsWe used Cooke’s Classical Model to elicit and aggregate judgments of 73 international experts. Judgments were elicited from each expert individually and aggregated using both equal and performance weights. Performance weighted results are reported as they increased the informativeness of estimates, while retaining accuracy. We report measures of central tendency and uncertainty bounds on food source attribution estimate.For some pathogens we see relatively consistent food source attribution estimates across subregions of the world; for others there is substantial regional variation. For example, for non-typhoidal salmonellosis, pork was of minor importance compared to eggs and poultry meat in the American and African subregions, whereas in the European and Western Pacific subregions the importance of these three food sources were quite similar. Our regional results broadly agree with estimates from earlier European and North American food source attribution research. As in prior food source attribution research, we find relatively wide uncertainty bounds around our median estimates.ConclusionsWe present the first worldwide estimates of the proportion of specific foodborne diseases attributable to specific food exposure routes. While we find substantial uncertainty around central tendency estimates, we believe these estimates provide the best currently available basis on which to link FBDs and specific foods in many parts of the world, providing guidance for policy actions to control FBDs.

Multiplex polymerase chain reaction detection of Shiga toxin genes and antibiotic sensitivity of Escherichia coli O157:H7 isolated from beef meat in Quetta, Pakistan

“…Foodborne infections have large effects on public health and on the economy worldwide (Havelaar et al, ; Hoffmann et al, ; Kirk et al, ; Yang, Lin, Aljuffali, & Fang, ). Indeed, microbial contamination of meat due to improper handling and processing poses great health risks around the globe (Ahmed & Sarangi, ; Antwi‐Agyei & Maalekuu, ; Bakhtiary et al, ; Hassan Ali, Farooqui, Khan, Khan, & Kazmi, ; Jayathilakan, Sultana, Radhakrishna, & Bawa, ; Kim & Yim, ).…”

Food-borne and water-borne diseases under climate change in low- and middle-income countries: Further efforts needed for reducing environmental health exposure risks

“…Other estimates have been made for different regions of the world Gibb et al, 2015;Hoffmann et al, 2017;Park et al, 2015;Torgerson et al, 2015). For example, Kirk et al (2015) conducted an estimate for 22 diseases that contributed in 2010 for 2 billion (95% uncertainty interval [UI] 1.5-2.9 billion) cases, over one million (95% UI 0.89-1.4 million) deaths and 78.7 million (95% UI 65.0-97.7 million) DALYs .…”

A Review of Potential Public Health Impacts Associated With the Global Dairy Sector

“…By contrast, approximately 44–75% of total brucellosis cases, 40–60% of total STEC cases, 51–76% of total campylobacteriosis cases, and 46–73% of total nontyphoidal salmonellosis cases were estimated to be foodborne across all regions (Hald et al, ; Hoffmann et al, ). These estimates have broad uncertainty bounds due to a lack of data in many countries and the results are difficult to compare to other studies, especially as prior studies have used different points of attribution (Hoffmann et al, ). However, several smaller scale studies conducted in North America and Europe have provided fairly similar estimates for percentages of foodborne illnesses attributable to dairy products (Davidson et al, ; Havelaar et al, ; Hoffmann et al, ; Hoffmann et al, ; Painter et al, ).…”