Foodborne infections in the Netherlands increased from 2017 to 2018, according to a recent report.

The National Institute for Public Health and the Environment (RIVM) found a rise in norovirus, Cryptosporidium spp. and rotavirus. The total number of patients from 14 food-related pathogens went from 1.49 million in 2017 to 1.63 million in 2018.

The agency reported the increase falls within the range of natural fluctuations seen in disease incidence. Estimates show 71,000 Campylobacter cases in 2018, 27,000 for Salmonella, 2,100 for Shiga toxin producing E. coli (STEC) and 78 for Listeria monocytogenes.

Half of disease burden linked to meat

The number of estimated deaths due to foodborne disease in 2018 was similar to 2017, with 238 and 240, respectively. Norovirus caused 69 of these, 47 were from Campylobacter and 25 from Salmonella.

About 53 percent of the foodborne burden was associated with meat such as poultry, pork, beef and lamb. These foods caused 31 percent of all food-related cases. Dairy, fish and shellfish, produce, grains and eggs are other significant categories.

The 14 pathogens are Campylobacter spp., E. coli O157, Salmonella, Listeria monocytogenes, Bacillus Cereus, Clostridium perfringens, Staphylococcus aureus, norovirus, rotavirus, Hepatitis A, Hepatitis E, cryptosporidium, Giardia and Toxoplasma. The report can be read here.

Working out the disease burden

Disease burden is expressed in Disability Adjusted Life Years (DALYs) and cost-of-illness (COI) estimates for the 14 food-related pathogens includes healthcare, costs for the patient and family, such as travel expenses, as well as expenses in other sectors, for example due to productivity losses.

Total disease burden caused by these pathogens in 2018 was similar to 2017 at 11,000 DALYs. The share of foodborne transmission in this was comparable with earlier years, rising to 4,300 DALYs in 2018, or 39 percent of the total burden, from 4,200 DALYs in 2017.

The largest difference in burden of disease between 2017 and 2018 was for norovirus at 330 more DALYs. Biggest burden at population level was caused by Campylobacter spp. with 3,200 DALYs, Toxoplama gondii and norovirus both had 1,900 DALYs. Disease burden for Campylobacter spp. slightly increased in 2018.

Total COI caused by the 14 pathogens increased slightly from €397 million ($445 million) in 2017 to €426 million ($478 million) in 2018. Foodborne disease burden accounted for 40 percent of this at €171 million ($192 million) compared to €163 million ($183 million) in 2017. Healthcare costs made up 21 percent of total costs for the 14 pathogens, patient/family costs for 2 percent and costs in other sectors accounted for 77 percent.

The pathogens causing the most COI are norovirus at €109 million ($122 million), rotavirus at €66 million ($74 million), Staphylococcus aureus toxin with €61 million ($68 million), and Campylobacter €60 million ($67 million). Lowest was by hepatitis-A virus €1.5 million ($1.7 million). The biggest change compared to 2017 was for norovirus at plus €17 million ($19 million). Average cost per case was largest for perinatal Listeria monocytogenes infections at €212,000 ($238,000) per case.

Meanwhile, the Dutch Food and Consumer Product Safety Authority (NVWA) has published results of checks to see if importers of spices comply with food safety rules.

The control, from July 2017 to June 2018, included Dutch importers of pepper, nutmeg, ginger and paprika and chili powder, who imported at least 1,000 kilograms of these spices from countries outside the EU for the domestic market. Such spices are used as raw material in many products and microbiological and chemical risks may be present.

A total of 95 percent of those surveyed met food safety requirements. For two importers, issues were found in the execution or recording of controls as per the legal requirements.

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