Estimating Foodborne Gastroenteritis, Australia

National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia.
Emerging infectious diseases (Impact Factor: 6.75). 09/2005; 11(8):1257-64. DOI: 10.3201/eid1108.041367
Source: PubMed


We estimated for Australia the number of cases, hospitalizations, and deaths due to foodborne gastroenteritis in a typical year, circa 2000. The total amount of infectious gastroenteritis was measured by using a national telephone survey. The foodborne proportion was estimated from Australian data on each of 16 pathogens. To account for uncertainty, we used simulation techniques to calculate 95% credibility intervals (CrI). The estimate of incidence of gastroenteritis in Australia is 17.2 million (95% confidence interval 14.5-19.9 million) cases per year. We estimate that 32% (95% CrI 24%-40%) are foodborne, which equals 0.3 (95% CrI 0.2-0.4) episodes per person, or 5.4 million (95% CrI 4.0-6.9 million) cases annually in Australia. Norovirus, enteropathogenic Escherichia coli, Campylobacter spp., and Salmonella spp. cause the most illnesses. In addition, foodborne gastroenteritis causes approximately 15,000 (95% CrI 11,000-18,000) hospitalizations and 80 (95% CrI 40-120) deaths annually. This study highlights global public health concerns about foodborne diseases and the need for standardized methods, including assessment of uncertainty, for international comparison.

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    • "According to recent estimates foodborne illness affects a quarter of the population in the developed world (Food Safety Information Council, 2014; McKercher, 2012; Scallan et al., 2011), which corresponds to nearly 6 million people in Australia. The consequences of food poisoning can be severe, with an average of 120 deaths annually in Australia, at a cost of $1.25 billion (Hall et al., 2005; NSW Food Authority, 2015). Similar statistics have been reported in the United Kingdom (Adak, Meakins, Yip, Lopman, & O'Brien, 2005; Food Standards Agency, 2002; Redmond & Griffith, 2006) and the United States of America (Mead et al., 1999). "
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    ABSTRACT: Purpose: To apply the protection motivation theory to safe food handling in order to determine the efficacy of this model for four food handling behaviours: cooking food properly, reducing cross-contamination, keeping food at the correct temperature and avoiding unsafe foods. Design: A cross-sectional approach was taken where all protection motivation variables: perceived severity, perceived vulnerability, self-efficacy, response efficacy, and protection motivation, were measured at a single time point. Findings: Data from 206 participants revealed that the model accounted for between 40 and 48% of the variance in motivation to perform each of the four safe food handling behaviours. The relationship between self-efficacy and protection motivation was revealed to be the most consistent across the four behaviours. Implications: While a good predictor of motivation, it is suggested that protection motivation theory is not superior to other previously applied models, and perhaps a model that focuses on self-efficacy would offer the most parsimonious explanation of safe food handling behaviour, and indicate the most effective targets for behaviour change interventions. Originality: This is the first study to apply and determine the efficacy of protection motivation theory in the context of food safety.
    • "Moreover, noroviruses infect people of all ages (Widdowson et al., 2005). Worldwide, noroviruses cause over 90% of all viral gastroenteritis cases (Patel et al., 2009), and in Australia they are the most common cause of gastroenteritis, causing an estimated 1.8 million cases per annum (Hall et al., 2005). "
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    ABSTRACT: Background: Quantitative microbial risk assessment (QMRA), the current method of choice for evaluating human health risks associated with disease-causing microorganisms, is often constrained by issues such as availability of required data, and inability to incorporate the multitude of factors influencing risk. Bayesian networks (BNs), with their ability to handle data paucity, combine quantitative and qualitative information including expert opinions, and ability to offer a systems approach to characterisation of complexity, are increasingly recognised as a powerful, flexible tool that overcomes these limitations. Objectives: We present a QMRA expressed as a Bayesian network (BN) in a wastewater reuse context, with the objective of demonstrating the utility of the BN method in health risk assessments, particularly for evaluating a range of exposure and risk mitigation scenarios. As a case study, we examine the risk of norovirus infection associated with wastewater-irrigated lettuce. Methods: A Bayesian network was developed following a QMRA approach, using published data, and reviewed by domain experts using a participatory process. Discussion: Employment of a BN facilitated rapid scenario evaluations, risk minimisation, and predictive comparisons. The BN supported exploration of conditions required for optimal outcomes, as well as investigation of the effect on the reporting nodes of changes in 'upstream' conditions. A significant finding was the indication that if maximum post-treatment risk mitigation measures were implemented, there was a high probability (0.84) of a low risk of infection regardless of fluctuations in other variables, including norovirus concentration in treated wastewater. Conclusion: BNs are useful in situations where insufficient empirical data exist to satisfy QMRA requirements and they are exceptionally suited to the integration of risk assessment and risk management in the QMRA context. They allow a comprehensive visual appraisal of major influences in exposure pathways, and rapid interactive risk assessment in multifaceted water reuse scenarios.
    Science of The Total Environment 10/2015; 541:1393-1409. DOI:10.1016/j.scitotenv.2015.10.030 · 4.10 Impact Factor
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    • "Estimates of the number of episodes of illness and resulting hospitalizations and deaths are important for public health decision makers. Previous estimates of hospitalizations and deaths related to foodborne illnesses have been made by other countries but this is the first time these values have been estimated for Canada (Mead et al., 1999; Adak et al., 2005; Hall et al., 2005; Vaillant et al., 2005; Helms et al., 2006; Cressey et al., 2011; Scallan et al., 2011a, b; Havelaar et al., 2012; Kirk et al., 2014). "
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    ABSTRACT: Foodborne illness estimates help to set food safety priorities and create public health policies. The Public Health Agency of Canada estimates that 4 million episodes of foodborne illness occur each year in Canada due to 30 known pathogens and unspecified agents. The main objective of this study was to estimate the number of domestically acquired foodborne illness-related hospitalizations and deaths. Using the estimates of foodborne illness for Canada along with data from the Canadian Hospitalization Morbidity Database (for years 2000-2010) and relevant international literature, the number of hospitalizations and deaths for 30 pathogens and unspecified agents were calculated. Analysis accounted for under-reporting and underdiagnosis. Estimates of the proportion foodborne and the proportion travel-related were incorporated for each pathogen. Monte Carlo simulations were performed to account for uncertainty generating mean estimates and 90% probability intervals. It is estimated that each year there are 4000 hospitalizations (range 3200-4800) and 105 (range 75-139) deaths associated with domestically acquired foodborne illness related to 30 known pathogens and 7600 (range 5900-9650) hospitalizations and 133 (range 77-192) deaths associated with unspecified agents, for a total estimate of 11,600 (range 9250-14,150) hospitalizations and 238 (range 155-323) deaths associated with domestically acquired foodborne illness in Canada. Key pathogens associated with these hospitalizations or deaths include norovirus, nontyphoidal Salmonella spp., Campylobacter spp., VTEC O157 and Listeria monocytogenes. This is the first time Canada has established pathogen-specific estimates of domestically acquired foodborne illness-related hospitalizations and deaths. This information illustrates the substantial burden of foodborne illness in Canada.
    Foodborne Pathogens and Disease 08/2015; 12(10). DOI:10.1089/fpd.2015.1966 · 1.91 Impact Factor
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