global burden of foodborne diseases kowalcyk.pdf · the center for foodborne illness research and...

THE CENTER FORFOODBORNE ILLNESSRESEARCH AND PREVENTION

GLOBAL BURDEN OF FOODBORNE DISEASESFROM DATA TO ACTION

Stakeholder Panel Discussion

December 16, 2015

Barbara Kowalcyk, Ph.D.


RTI International is an independent, 501(c)(3) non‐profit research institute.

Our mission is to improve the human condition by turning knowledge into practice.

We provide research, development, and technical services worldwide.

This presentation represents my views and not necessarily the views of my employer.


The Center for Foodborne Illness Research & Prevention (CFI)

A non‐profit health organization dedicated

to advancing a stronger, science‐based food safety system

that prevents foodborne illness and protects public health.


Defining Advocacy

Advocacy is the act of supporting a cause or issue.

Lobbying is the act of attempting to influence public

officials to secure the passage of specific legislation.


• Science helps us understand the nature of problems and the realms of potential solutions.

• Science‐based advocacy seeks to bridge the “know‐do gap” by using research and analysis to provide objective information, develop science‐based solutions and implement evidence‐informed public policies.

Turning Knowledge into Practice


Different Communities

Researchers

Policy‐makers

Scientific (context free)

• Proven empirically

Colloquial (contextual)

• As long as it takes

• Caveats

• Anything that seems reasonable

• Policy relevant

• Timely

• Clear messages

• Theoretically driven

Source: Stein C and Kuchemuller T. FERG Foodborne Diseases Stakeholder Day, Geneva, Switzerland, November 11, 2010


The Elbow Joint

Source: Stein C and Kuchemuller T. FERG Foodborne Diseases Stakeholder Day, Geneva, Switzerland, November 11, 2010


What We Do

Increase awareness and make the impact meaningful.

Build collaborative relationships with other stakeholders.

Identify high‐priority food safety issues and promote science‐based solutions.

Encourage decision makers to develop and implement stronger food safety protections designed to improve public health.

Identify barriers to implementation and work collaboratively to overcome them.


The Risk‐Based Approach

Step 1: Strategic Planning

Step 2: Public Health Risk Ranking

Step 3: Targeted Information Gathering

Step 4: Analysis and Selection of Interventions

Step 5: Design of Intervention Plan

Step 6: Monitoring and Review

Risk‐based Food Safety System


Foundation for evidence‐informed policy making

Set public health goals (Healthy People 2020)

Attribute and rank risks

Economic assessments

Prioritize interventions

Allocate resources

Measure success

Step 1: Strategic Planning

Step 2: Public Health Risk Ranking

Step 3: Targeted Information Gathering

Step 4: Analysis and Selection of Interventions

Step 5: Design of Intervention Plan

Step 6: Monitoring and Review

Role of Burden of Disease

Risk‐based Food Safety System


The Population Burden

• 1.8 billion diarrheal illnesses/year globally

• 48 million illnesses, 3,000 deaths/year in U.S.

• Vulnerable populations – children, pregnant/post‐partum women, senior citizens and those with compromised immune systems – are at high risk for serious illness.

• Significant economic impact – public health and trade.


The Population Burden

• 600 million illnesses, 400,000 deaths/year globally

• 48 million illnesses, 3,000 deaths/year in U.S.

• Vulnerable populations – children, pregnant/post‐partum women, senior citizens and those with compromised immune systems – are at high risk for serious illness.

• Significant economic impact – public health and trade.


The Long‐term BurdenSelect Long‐term Health Outcomes (LTHOs) Associated with Foodborne IllnessAutoimmuneDisorders

Reactive Arthritis – associated with many foodborne pathogens; rates vary from 2.3% to 15%.Guillain‐Barre Syndrome – Campylobacter is common trigger and accounts for 40% of cases in U.S.

DigestiveDisorders

Irritable Bowel Syndrome – associated with many foodborne pathogens; causes estimated 17% of cases.Irritable Bowel Disease – includes Crohn’s Disease and Ulcerative Colitis.

Neurological Disorders

Sepsis, Meningitis, Respiratory distressParalysis, palsies, seizures, epilepsyCognitive impairment, visual/hearing impairment

Renal Failure & Associated Sequelae

Hemolytic Uremic Syndrome (HUS) – severe, life‐threatening illness; leading cause of acute kidney failure in children under age 5 in U.S.; associated with STEC, Shigella.Chronic kidney disease, End stage renal failure, Chronic hypertension,Pancreatitis, Diabetes mellitus – often secondary to HUS.

Emerging Issues

Schizophrenia, psycho‐social disorders – recent studies have found increased risk for toxoplasmosis but not well understood.Urinary tract infections, antimicrobial resistance, stress/anxiety


Making the Impact Meaningful

http://www.nytimes.com/2015/12/06/opinion/the‐arithmetic‐of‐compassion.html?_r=1


The Individual Burden

AbbyDied, Age 7

E. coli O157:H7

KevinDied, Age 2

E. coli O157:H7

RubyDied, Age 81

E. coli O157:H7

JosephDied, Age 8

E. coli O157:H7

KaylaDied, Age 14E. coli O111

AshleyE. coli O157:H7

RyanSalmonella

MariahE. coli O157:H7

JakeSalmonella

TammySalmonella


Havelaar et al., Zoon Publ Health 2007;54:103-117

Making Sense of the Risks


An integrated, holistic, systems approach to food… proactive, preventive and anticipatory; addresses human, animal and environmental health needs (One Health); and

delivers sufficient, safe and nutritious food to all.

What Do We Want to Achieve?


What Do We Need To Do? Engage stakeholders to improve national standards, laws, regulations, surveillance, control measures.

Develop comprehensive risk communication strategy

− Put BOD estimates into perspective

1.8M new cases, 464,000 deaths, 13.1M DALYs in 2013 due to breast cancer

− Use compelling messages that motivate


What Do We Need To Do?

Integrate food safety, nutrition and food security

Focus on continuous improvement

− Improve data collection and sharing

− Conduct epidemiologic studies to better understand chronic sequelae and fill data gaps

− Develop better source attribution estimates –requires collecting data from across the system

− Establish incentives for improvement


Who Do We Need to Achieve This? Government agencies – national and local

Food Industry

Researchers

Consumer groups/NGOs

International organizations

Funding agencies – public and private


Source: National Research Council. Spurring Innovation in Food and Agriculture: A Review of the USDA Agriculture and Food Research Initiative Program. Washington, DC: The National Academies Press, 2014; p. 24

Food and Agriculture R&D Landscape


Who Do We Need to Achieve This? Government agencies – national and local

Food Industry

Researchers

Consumer groups/NGOs

International organizations

Funding agencies – public and private

FERG – statement from symposium participants

Food safety is a shared responsibility!


A Personal Story

Kevin Michael Kowalcyk, age 2 1/212/10/98 - 8/11/01


“As for the future, your task is not to foresee it, but to

enable it.”‐ Antoine de Saint‐ExuperyFrench Writer, 1900‐1944

Thank [email protected]

[email protected]‐ Guiseppe Arcimboldo

www.foodborneillness.org

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