Foodborne diseases are an important cause of morbidity and mortality, and a significant impediment to socioeconomic development worldwide, but the full extent and burden of unsafe food, has been largely unknown.
In 2006 the WHO Initiative to Estimate the Global Burden of Foodborne Diseases was launched, leading to the establishment of the first WHO Foodborne Disease Burden Epidemiology Reference Group (FERG) in 2007. The FERG for 2007-2015 was a technical advisory group that advised WHO on the methodology to estimate the burden of foodborne diseases.
New global estimates to be published by WHO in 2025
In 2020, the World Health Assembly, through resolution WHA73.5(PDF), mandated WHO to monitor regularly and to report to Member States on, the global burden of foodborne and zoonotic diseases at national, regional, and international levels, and in particular to prepare, by 2025, a new report on the global burden of foodborne diseases with up-to-date estimates of global foodborne disease incidence, mortality and disease burden in terms of disability-adjusted life years (DALYs).
For more information, please visit: Estimating the burden of foodborne diseases | WHO
In 2015, WHO published the first global report, “WHO estimates of the global burden of foodborne diseases: foodborne disease burden epidemiology reference group 2007-2015”. The report estimated that more than 600 million cases of foodborne illnesses and 420 000 deaths occurred in a year (reference year 2010). It was also evident that the burden of foodborne diseases falls disproportionately on children under 5 years of age, and in low- and middle-income countries.
The report was also supplemented by a series of scientific papers published in journals from the Public Library of Science (PLOS ONE). In order to produce these final estimates, WHO commissioned various works to academic and technical institutions to inform the estimation process. These scientific papers, containing input data for the final estimates, are compiled here.
Methodology papers
This section contains scientific papers related to the methodology and computation of the global and regional burden of foodborne diseases was quantified for 31 foodborne hazards using hazard- and incidence-based approach to generate estimates in the form of Disability-Adjusted Life Years (DALYs).
| Type | Title | Authors | Journal |
|---|---|---|---|
| Methodology paper | Data-driven methods for imputing national-level incidence in global burden of disease studies. | McDonald, S.A., Devleesschauwer, B., Speybroeck, N., Hens, N., Praet, N., Torgerson, P.R., Havelaar, A.H., Wu, F., Tremblay, M., Amene, E.W. & Döpfer, D. | Bulletin of the World Health Organization, 93(4): 228– 236. |
| Methodology paper | Calculating disability-adjusted life years to quantify burden of disease. | Devleesschauwer, B., Havelaar, A.H., Maertens de Noordhout, C., Haagsma, J.A., Praet, N., Dorny, P., Duchateau, L., Torgerson, P.R., Van Oyen, H. & Speybroeck, N. | International Journal of Public Health, 59(3): 565– 569. |
| Methodology paper | DALY calculation in practice: a stepwise approach. | Devleesschauwer, B., Havelaar, A.H., Maertens de Noordhout, C., Haagsma, J.A., Praet, N., Dorny, P., Duchateau, L., Torgerson, P.R., Van Oyen, H. & Speybroeck, N. | International Journal of Public Health, 59(3): 571– 574. |
Enteric hazards
This section contains the collection of papers generated through commissioned scientific teams with a focus on enteric hazards.
| Hazard name | Title | Authors | Journal |
|---|---|---|---|
| Brucella spp | Clinical manifestations of human brucellosis: a systematic review and meta-analysis. | Dean, A.S., Crump, L., Greter, H., Hattendorf, J., Schelling, E. & Zinsstag, J. | PLOS Neglected Tropical Diseases, 6(12): Art. e1929. |
| Brucella spp | Global burden of human brucellosis: a systematic review of disease frequency. | Dean, A.S., Crump, L., Greter, H., Schelling, E. & Zinsstag, J. | PLOS Neglected Tropical Diseases, 6(10): Art e1865. |
| Diarrhoeal disease | Etiology of diarrhoea in older children, adolescents and adults: a systematic review. | Fischer Walker, C.L., Sack, D. & Black, R.E. | PLOS Neglected Tropical Diseases, 4(8): Art e768. |
| Diarrhoeal disease | Diarrhoea morbidity and mortality in older children, adolescents, and adults. | Fischer Walker, C.L., & Black, R.E. | Epidemiology and Infection, 138(9): 1215–1226. |
| Diarrhoeal disease | Aetiology-specific estimates of the global and regional incidence and mortality of diarrhoeal diseases commonly transmitted through food. | Pires, S.M., Fischer Walker, C.L., Lanata,C.F., Devleesschauwer, B., Hall, A.,Kirk, M.D., Duarte, A.S.R., Black, R.E.,& Angulo, F.J. | PLOS ONE, vol 10, iss 12. |
| Mycobacterium bovis | Zoonotic Mycobacterium bovis-induced tuberculosis in humans. | Muller, B., Durr, S., Alonso, S.,Hattendorf, J., Laisse, C.J., Parsons, S.D.,van Helden, P.D. & Zinsstag, J. | Emerging Infectious Diseases, 19(6): 899–908. |
| Mycobacterium bovis | Differences in primary sites of infection between zoonotic and human tuberculosis: results from a worldwide systematic review. | Durr, S., Muller, B., Alonso, S., Hattendorf, J., Laisse, C.J., van Helden, P.D. & Zinsstag, J. | PLOS Neglected Tropical Diseases, 7(8): Art e2399. |
| Shiga toxin-producing Escherichia coli | Global incidence of human Shiga toxinproducing Escherichia coli infections and deaths: a systematic review and knowledge synthesis. | Majowicz, S.E., Scallan, E., Jones-Bitton, A., Sargeant, J.M., Stapleton, J., Angulo, F.J., Yeung, D.H. & Kirk, M.D. | Foodborne Pathogens and Disease, 11(6): 447– 455. |
| Norovirus | Global prevalence of norovirus in cases of gastroenteritis: a systematic review and meta-analysis. | Ahmed, S.M., Hall, A.J., Robinson, A.E., Verhoef, L., Premkumar, P., Parashar, U.D., Koopmans, M. & Lopman, B.A. | Lancet Infectious Diseases, 14(8): 725–730. |
| Norovirus | Norovirus genotype profiles associated with foodborne transmission, 1999– 2012. | Verhoef, L., Hewitt, J., Barclay, L., Ahmed, S.M., Lake, R., Hall, A.J., Lopman, B., Kroneman, A., Vennema, H., Vinje, J. & Koopmans, M. | Emerging Infectious Diseases, 45: 95– 99. |
| Invasive non-typhoidal Salmonella enterica | Global burden of invasive non-typhoidal Salmonella disease, 2010. | Ao, T.T., Feasey, N.A., Gordon, M.A., Keddy, K.H., Angulo, F.J. & Crump, J.A. | Emerging Infectious Diseases,21(6): 941– 949 |
| Invasive non-typhoidal Salmonella enterica | Estimating the burden of febrile illnesses. | Crump, J.A. & Kirk, M.D. | PLOS Neglected Tropical Diseases, 3;9(12): Art e4040 |
| Listeria monocytogenes | The global burden of listeriosis: a systematic review and meta-analysis. | Maertens de Noordhout, C., Devleesschauwer, B., Angulo, F.J., Verbeke, G., Haagsma, J., Kirk, M., Havelaar, A. & Speybroeck, N. | Lancet Infectious Diseases, 14(11): 1073– 1082. |
Parasitic hazards
This section contains the collection of papers generated through commissioned scientific teams with a focus on parasitic hazards.
| Hazard name | Title | Authors | Journal |
|---|---|---|---|
| Taenia solium | Clinical manifestations associated with neurocysticercosis: a systematic review. | Carabin, H., Ndimubanzi, P.C., Budke, C.M., Nguyen, H., Qian, Y., Cowan, L.D., Stoner, J.A., Rainwater, E. & Dickey, M. | PLOS Neglected Tropical Diseases, 5(5): Art e1152. |
| Taenia solium | A systematic review of the frequency of neurocysticercosis with a focus on people with epilepsy. | Ndimubanzi, P.C., Carabin, H., Budke, C.M., Nguyen, H., Qian, Y.J., Rainwater, E., Dickey, M., Reynolds, S. & Stoner, J.A. | PLOS Neglected Tropical Diseases, 4(11): Art e870. |
| Trematodes (includes Echinostoma spp., Fasciolopsis buski, Heterophyes spp. and Metagonimus spp.) | Global burden of human food-borne trematodiasis: a systematic review and meta-analysis. | Furst, T., Keiser, J. & Utzinger, J. | Lancet Infectious Diseases, 12(3): 210– 221. |
| Echinococcus multilocularis | The global burden of alveolar echinococcosis. | Torgerson, P.R., Keller, K., Magnotta, M. & Ragland, N. | PLOS Neglected Tropical Diseases, 4: e722. |
| Trichinella spp | The low global burden of trichinellosis: evidence and implications. | Devleesschauwer B, Praet N, Speybroeck N, Torgerson P R, Haagsma J A, De Smet K, Murrell K D, Pozio E and Dorny P. | International Journal of Parasitology, 45(2-3): 95– 99. |
| Trichinella spp | Worldwide occurrence and impact of human trichinellosis, 1986– 2009. | Murrell, K.D. & Pozio, E. | Emerging Infectious Diseases, 17(12): 2194– 2202. |
| Toxoplasma gondii | The global burden of congenital toxoplasmosis: a systematic review. | Torgerson, P.R. & Mastroiacovo, P. | Bulletin of the World Health Organization, 91(7): 501– 508. |
Chemical and toxin hazards
This section contains the collection of papers generated through commissioned scientific teams with a focus on chemical and toxin hazards.
| Hazard name | Title | Authors | Journal |
|---|---|---|---|
| Aflatoxins | Aflatoxins and growth impairment: A review. | Khlangwiset, P., Shephard, G.S. & Wu, F. | Critical Reviews in Toxicology, 41(9): 740– 755. |
| Aflatoxins | Global Burden of aflatoxin induced disease: Final Report for the World Health Organization (WHO) Foodborne Disease Burden Epidemiology Reference Group (FERG) Chemical Task Force. | Wu, F. | Department of Environmental and Occupational Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA. |
| Aflatoxins | Global burden of aflatoxin-induced hepatocellular carcinoma: a risk assessment. | Liu, Y. & Wu, F. | Environmental Health Perspectives, 118(6): 818– 824. |
| Aflatoxins | Population attributable risk of aflatoxin-related liver cancer: systematic review and meta-analysis. | Liu, Y., Chang, C.C., Marsh, G.M. & Wu, F. | European Journal of Cancer, 48(14): 2125– 2136. |
| Arsenic | The global burden of disease for skin, lung, and bladder cancer caused by arsenic in food. | Oberoi, S., Barchowsky, A. & Wu, F. | Cancer Epidemiology Biomarkers and Prevention, 23(7): 1187– 1194. |
| Cassava cyanide | Incidence and prevalence estimates of cassava-cyanide induced diseases. | Cliff, J. | Report for the FERG Chemicals and Toxins Task Force |
| Peanut Allergens | Parameters needed to estimate the global burden of peanut allergy: Systematic literature review. | Ezendam, J. & van Loveren, H. | RIVM Report National Institute for Public Health and the Environment (RIVM), Netherlands. |
| Dioxins | The disease burden of dioxins: A global perspective. | Zeilmaker, M.J., Devleesschauwer, B., Mengelers, M.J.B., Hoekstra, J., Brandon, E.F.A. & Bokkers, B.G.H. | RIVM report to WHO |
Source attribution studies
Source attribution studies aimed to identify the proportion of disease burden that is directly due to food contamination and to attribute the relevant fraction of disease burden to the responsible food source. This section contains the collection of papers generated through commissioned scientific teams with a focus on source attribution studies in support of this aim.
| Hazard name | Title | Authors | Journal |
|---|---|---|---|
| Source attribution studies | Assessing the applicability of currently available methods for attributing foodborne disease to sources, including food and food commodities. | Pires, S.M. | Foodborne Pathogens and Disease, 10(3): 206– 213. |
| Source attribution studies | Attributing the human disease burden of foodborne infections to specific sources. | Pires, S.M., Evers, E.G., van Pelt, W., Ayers, T., Scallan, E., Angulo, F.J., Havelaar, A. & Hald, T. and the Med- Vet-Net Workpackage 28 team. | Foodborne Pathogens and Disease, 6(4): 417– 424. |
| Source attribution studies | Research synthesis methods in an age of globalized risks: lesson from the global burden of foodborne disease expert elicitation. | Hoffman, S., Aspinall, W., Cooke, R., Cawthorne, A., Corrigan, T., Havelaar, A., Gibb, H., Torgerson, P., Kirk, M., Angulo, F, Lake R, Speybroeck N, Devleesschauwer B, Hald T. | Risk Anal. 36(2):191-202. |
| Source attribution studies | Science based global attribution of foodborne diseases: Findings of WHO expert elcitiation. | Aspinall, WP., Cooke, RM., Havelaar, AH., Hoffman, S., Hald, T. | PLoS One. 14;12(9):e0183641 |
Country studies
Alongside the global and regional estimates, pilot studies of the national burden of foodborne diseases were initiated in four countries. An overview paper, as well as papers from the individual countries were published, and are compiled here.
| Type | Title | Authors | Journal |
|---|---|---|---|
| Country Studies | Systematic review of general burden of disease studies using disability-adjusted life years. | Polinder, S., Haagsma, J.A., Stein, C. & Havelaar, A.H. | Population Health Metrics, 10: Art 21. |
| Country Studies | Systematic review of foodborne burden of disease studies: quality assessment of data and methodology. | Haagsma, J.A., Polinder, S., Stein, C.E. & Havelaar, A.H. | International Journal of Food Microbiology, 166(1): 34– 47. |
| Country Studies | Estimating the burden of foodborne diseases in Japan. | Kumagai, Y., Gilmour, S., Ota, E., Momose, Y., Onishi, T., Bilano, V.L.F., Kasuga, F., Sekizaki, T. & Shibuya, K. | Bulletin of the World Health Organization, 93(8): 540–549. |