Trends in the burden of foodborne disease in the Netherlands, 2006–11: a systematic analysis

Abstract Background Foodborne diseases are an important cause of morbidity and mortality in populations across the globe. Estimates of the burden of these diseases are scarce. As infectious diseases are highly dynamic, the trends in food-related disease incidence over a 6-year period and the associated variation in disease burden are examined. Methods We selected 14 food-related enteric and parasitic pathogens and estimated the burden of these pathogens in the Netherlands in 2009. The model estimates agent-based and incidence-based disability-adjusted life-years (DALYs) for acute illness and for major sequelae. Attribution to major exposure pathways (food, environment, human–human or animal–human transmission, and travel abroad) as well as 11 food groups within the food pathway was based on structured expert elicitation. Trend information, available for only six pathogens from national surveillance statistics, was used to evaluate changes in the incidence and burden from 2006 to 2011. Findings In 2009, the disease burden by 14 food-related pathogens was 13 500 DALYs (82 per 100 000 inhabitants). Of these, 6100 DALYs were related to foodborne exposure, while two-thirds of the foodborne burden was attributed to foods of animal origin. Incidence was highest for viral agents, while burden was highest for Toxoplasma gondii and Campylobacter spp., due to long-term sequelae. At the individual level, Listeria monocytogenes and T gondii caused the highest burden. Compared with the baseline year 2006, annual disease incidences varied with relative changes up to 30% while (foodborne) burden varied less substantially with relative changes up to 10%. Interpretation Presenting foodborne disease burden rather than trends in the incidence of individual pathogens has added value because it provides a more robust, integrated perspective. High-quality surveillance data are required. Funding Ministry of Health, Welfare, and Sports, The Hague, Netherlands.