HEALTH: Foodborne Infections Massively Under-Reported

By Gustavo Capdevila Reprint | | Print |

Gustavo Capdevila

GENEVA, Aug 13 1997 (IPS) - The actual number of cases of foodborne infections throughout the world is up to 350 times higher than the number reported, says a World Health Organisation (WHO) report.

The latest WHO Quarterly Statistical Report points out that diseases transmitted by contaminated food affect hundreds of millions of people in both developing and industrialised countries.

The U.N. agency highlights the human costs of foodborne illnesses, pointing out that diarrhea – usually caused by contaminated food or water – attacks 1.5 billion children aged five and under and kills more than three million every year.

But the report also stresses the economic costs. It cites, for instance, the 1991 cholera epidemic in Peru, which in the first three months alone led to the loss of 70 million dollars due to the closing of food establishments and the drop in tourism, and more than 700 million dollars in losses for the fishing industry.

A broad range of foodborne infections are present in developing countries, including cholera, campylobacteriosis, escherichia coli infections, salmonellosis, shigellosis, brucellosis and hepatitis A.

But the incidence of such diseases is also on the rise in the industrialised world, in spite of universal availability of potable water, adequate levels of sanitation and hygiene and widespread use of technologies such as pasteurisation.

According to studies cited by WHO, five to 10 percent of the population of developed countries suffers from foodborne infections annually.

The list of illnesses present in rich countries is headed by the increasingly widespread listeria monocytogenes, escherichia coli 0157 and salmonella typhimurium, which is resistent to a number of antibiotics. The report describes the three diseases as “a new and significant public health threat.” Both Japan and Scotland suffered outbreaks of escherichia coli 0157 last year, for example.

In the United States, up to 12 million people fall ill and several thousand are killed every year by seven pathogens – camplyobacter jejuni, clostridium perfringens, escherichia coli 0157:H7, listeria monocytogenes, salmonella, staphyloccocus aureus and toxoplasma gondii – which cost the country up to 35 billion dollars in healthcare.

Fritz Kaferstein, the director of WHO’s Food Security and Aid Programme, said health authorities frequently “fail to recognise the significance of food security for the health and development of the community.” He added that food security could only be reached through comprehensive efforts in research, controls, development of infrastructure, epidemiology, training and education.

WHO advocates the concept of “shared responsibility” by government authorities, business and consumers in the fight against foodborne infections.

In many Latin American and Caribbean countries, mandatory reporting systems have been implemented in an attempt to curb the spread of such diseases.

The 1991 cholera epidemic that broke out in Peru and spread to neighbouring countries had infected more than one million people and caused 10,000 deaths by 1994. The disease was found to be frequently transmitted through contaminated food sold at street stalls and beverages served with contaminated ice. It also spread through raw fish and insufficiently cooked food.

The report adds that few preventive measures have been taken in Asia. Although Japan represents an exception to that rule, salmonella has made more frequent appearances there due to widespread dietary changes, including the icreased consumption of eggs, and last year close to 9,600 people fell ill and 11 were killed in an outbreak of escherichia coli 0157:H7. The foods responsible for the outbreak were identified in only a few isolated cases.

Scarce information is available on foodborne diseases in Africa, because there are few controls, the report underlines. However, it cites a 1991 outbreak of botulism in Tanzania spread through the consumption of fish, which caused 18 deaths.

A 1994 epidemic of escherichia coli 0157 in Egypt was traced to hamburgers and contaminated dairy products. An investigation of supermarkets, butchershops and farms found the bacteria present in six percent of unpasteurised milk, six percent of beef, four percent of de-boned chicken and four percent of lamb.