Initiative to estimate the Global Burden of Foodborne Diseases
The Unknown Burden
Data from surveillance systems and sentinel sites indicate a high disease burden for foodborne diseases caused by microorganisms alone. Such data, however, tend to show only the tip of the clinical iceberg and cannot sufficiently describe true disease burden. For affected persons to feature in such health statistics, they not only have to seek medical care, provide a specimen for laboratory investigation, and test positive on laboratory methods but must also be reported to the relevant health authorities.
To circumvent the problems posed by such under-reporting and describe disease burden more adequately, a number of innovative and creative approaches have been used in recent years for some foodborne diseases from various causes. These include the use of active surveillance and field studies, risk assessment methods, and epidemiological disease modelling. For many other foodborne diseases, however, including some zoonoses and diseases caused by chemical hazards, no such data or studies exist.
In order to estimate disease burden comprehensively and provide more complete information for policy makers it is important to move beyond the mere quantification of morbidity and mortality and describe burden in a summary measure that includes elements of severity and duration of disease, as well as resulting disability. One such summary indicator is the Disability Adjusted Life Years (DALY) which has been widely used by WHO and others in the field of burden of disease estimation.