Worldwide Surveillance of Foodborne Disease: the Need to Improve†

Abstract

A foodborne-disease surveillance program is an essential part of a food safety program. Foodborne surveillance should be able to issue early alerts on contaminated food to which a large population is exposed; collate notifications of enteric diseases and laboratory isolations; report foodborne disease incidents on a regular basis; and use sentinel and specific epidemiological studies as required. Although most countries have some kind of reporting of notifiable diseases, few have foodborne-disease surveillance programs, and little is known of foodborne disease in general on a worldwide basis. However, in the last decade many European countries have generated annual reports to join those of Canada, England/Wales, Japan and the United States. In addition, a few other countries are attempting to develop foodborne-disease reporting programs but are hampered by lack of resources. However, it is apparent that staphylococcal intoxication has been decreasing in most nations, except in some Latin American countries where cheese from unpasteurized milk and cream-filled desserts are widely consumed. In contrast, salmonellosis has been increasing or remaining steady as the main foodborne disease in practically all other countries. Newly-recognized agents such as E. coli O157:H7 and other verotoxigenic E. coli, or previously-known agents in new food associations such as Clostridium botulinum, are also being documented in several countries. Although the socioeconomic impact of foodborne diseases is very high, there are at best limited effective control measures to reduce them, even in industrialized countries. One reason control is difficult to achieve is that surveillance is inadequate and the burden of foodborne disease is not fully understood by policy-makers. Another reason is that a consistent and coordinated effort by industry and government is required, as has been practiced in Sweden to reduce substantially the Salmonella contamination of poultry. Improvement of surveillance on a worldwide basis is all the more important with increasing world trade and travel, and international organizations need to take a lead role in accomplishing this.