In this article we will discuss about the significance of foodborne disease.
Foodborne disease has been defined by the World Health Organization (WHO) as a disease of an infectious or toxic nature caused by, or thought to be caused by, the consumption of food or water’.
The essential message of this section can be summarized by the conclusions of a WHO Expert Committee which pointed out that foodborne diseases, most of which are of microbial origin, are perhaps the most widespread problem in the contemporary world and an important cause of reduced economic productivity.
A number of assessments of the relative significance of hazards associated with food have concluded that micro-organisms are of paramount importance. A study conducted in the United States found that, although the attention given to different food hazards by the media, pressure groups and regulatory authorities might differ, as far as the food industry was concerned microbial hazards were the highest priority.
Similarly, it has been estimated that the risk of becoming ill as a result of microbial contamination of food was 100 000 times greater than the risk from pesticide contamination.
For otherwise healthy, well-nourished people in the developed world, most food poisoning is an unpleasant episode from which recovery is normally complete after a few days. For society as a whole though, it is increasingly being recognized as a largely avoidable economic burden.
Costs are incurred in the public sector from the diversion of resources into the treatment of patients and the investigation of the source of infection. To the individual the costs may not always be calculable in strictly financial terms but could include loss of income, costs of medication and treatment.
Studies conducted by the Communicable Disease Surveillance Centre (CDSC) in London have even identified as a cost the ‘trousseau effect’, where an individual who is hospitalized incurs additional expense as a result of having to purchase items such as new night-attire for the occasion. On the larger scale, absence from work will also constitute a cost to the national economy.
A number of attempts have been made to quantify these costs and, while the errors must be large, they do at least give an idea of the magnitudes involved.
Thus a study in the United States has estimated that the total annual cost to the US economy of bacterial food poisoning is approaching US$ 7 billion. Substantially lower, but still considerable, costs of almost £1 million have been associated with 1482 salmonella cases in the UK in the year 1988/9 (Table 6.3).
For the food industry, the costs can be huge and it is not unusual for the company producing a product implicated in an outbreak of food poisoning to go bankrupt as a result. Companies not directly involved in an outbreak can also suffer.
There is often a general decline in demand for a product prompted by public concern that the same problem could occur with similar products from other manufacturers. There was, for instance, a marked downturn in all yoghurt sales after the hazelnut yoghurt botulism outbreak in England in 1989.
Increased vigilance by companies to ensure that the same process failures responsible for an outbreak do not occur elsewhere, also has its attendant costs. For instance, it was estimated that the costs of checking the integrity of spray-drier cladding by dried-milk manufacturers following a salmonella outbreak caused by dried milk were of the order of hundreds of thousands of pounds.
Food retailers can also be affected as a result of a decline in sales, particularly if a suspect product is associated with one particular store. In the less developed world the consequences of foodborne illness are even more serious. Diarrhoeal disease is a major cause of morbidity and mortality in poor countries, particularly among children.
An estimated billion (109) episodes occur each year and nearly five million children under 5 die as a result. Diarrhoea can occur repeatedly in the same individual leading to malnutrition which in turn predisposes them to more severe diarrhoeal episodes and other serious infections.
Weaning is a particularly hazardous time for the infant. The anti-infective properties of maternal breast milk are lost or diluted and are replaced by foods which often have a low nutrient density. At the same time, the immature immune system is exposed to new sources of infection in the environment.
Poor hygienic practices in the preparation of weaning foods and the use of contaminated water are often implicated in weaning diarrhoea and it has been estimated that 15-70% of all diarrhoea episodes in young children are food associated.