Efforts led by the World Health Organization (WHO) to update estimates of the burden of foodborne infections continue to progress; publication is expected next year.
In a webinar organized by the European Burden of Disease Network, two speakers shared insights into the work of the Foodborne Disease Burden Epidemiology Reference Group (FERG).
Figures published in 2015 show that 31 hazards caused 600 million foodborne illnesses and 420,000 deaths in 2010. Updated data is expected to be released in October 2025.
Most of the statistics in the revised edition will be the same as those from 2015, but national figures will also be included. The figures will be presented as a time series analysis from 2000 to 2020 or 2021.
New estimates will provide data on Trypanosoma cruzi, aflatoxin M1, inorganic arsenic, cadmium, lead, methylmercury, cyclospora, rotavirus and Enteroaggregative E. coli (EAEC). A comprehensive list of health outcomes will also be included.
The WHO approach
Yuki Minato, Technical Officer at the WHO Department of Nutrition and Food Safety, said: “Food safety is very complex because we face many different hazards, under-reporting and under-control. The whole vision is actually trying to understand what’s happening underwater.”
Minato was referring to a 2020 resolution of the World Health Assembly that directed WHO to monitor and report on the burden of foodborne diseases at national, regional and international levels.
“The transparency part is important for WHO because we want to ensure that countries will use these estimates, and that they don’t just sit on the shelf at WHO. We engaged Member States and asked governments to identify their national concerns for this estimate. Next year we will hold an official country consultation. They will receive draft estimates before official publication so they can review, comment and provide feedback,” she said.
The 2025 data collection teams include the University of Virginia for diarrheal diseases, Michigan State University for aflatoxin, and Gibb and O’Leary Epidemiology Consulting for inorganic arsenic.
FERG has seven task forces: enteric diseases, parasitic diseases, chemicals and toxins, source allocation, computational, impact measurement and country support.
Foodborne illness assessment
Sara Monteiro Pires, senior researcher at the Technical University of Denmark (DTU), said the 2015 report was important for raising global awareness of foodborne diseases.
“Our ultimate goal is to be able to prioritize food safety interventions. To do this, we need to answer a few questions. First, what are the public health implications of various foodborne diseases? Building on this, we want to know how to compare diseases based on their importance in different regions. After prioritizing the major diseases, we need to know what causes these problems. So how can we identify the main sources and routes of transmission and then prioritize our interventions? The third step is to identify the options for interventions throughout the food chain, and ultimately we want to ideally measure the effect of each intervention.”
Pires, who is also a member of FERG, said there are more than 250 causes of foodborne illness, including bacteria, viruses, parasites and chemicals.
“We typically have an under-reporting problem with foodborne illness; Although we have surveillance data on the number of cases in a population, we do not record all cases of the disease. Some diseases are not reported at all. Foodborne illness has a wide range of health effects, and these range in severity from mild to severe diarrhea, as well as neurological effects, cancer and reactive arthritis. These also have different durations and fatalities,” she said.
“Chronic diseases are difficult to attribute to a specific exposure; they are quite non-specific and can be caused by many different risk factors. They also appear long after exposure, so it is challenging to directly link this to the food safety hazard. There are also different routes of exposure, even for one disease, and these sources and their importance will vary depending on the disease, hazard and country.”
The purpose of the Foodborne Disease Study Burden is to rank and prioritize diseases based on the public health impacts caused in a specific population. Such work can help measure trends and the impact of food safety interventions, providing evidence for policymaking.
“We need to identify the main sources of transmission. In the case of Campylobacter, poultry is an important reservoir, but infections can also be caused by dairy products or beef or by contact with infected live animals and exposure to the environment,” Pires said.
“So if we want to use our disease burden estimates to prioritize interventions, we need to identify which sources and routes of transmission are most important. We usually use source references for this. The first step is attributing to food rather than environmental transmission, direct contact with animals and person-to-person transmission, and then we may want to attribute to specific foods.”
(To sign up for a free subscription to Food Safety News, click here.)