FOOD SAFETY
Disease trends and estimated cost of foodborne illness in Australia Words by Dr Craig Shadbolt
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n reviewing trends, climate change stands out as having an observable effect on foodborne illness and increased risk of outbreaks, which the food industry and regulators are increasingly forced to grapple with. What was less predictable (and unforeseen) in 2020 was the impact of COVID-19 on health systems, supply chains, workforces and trends in foodborne disease notifications (in Australia and internationally). These issues pose real challenges for epidemiologists when interpreting and attributing potential cause and effect of food safety interventions and the impact of other events on disease statistics.
Revised cost of foodborne illness in Australia Food Standards Australia New Zealand1 have recently published updated estimates for the number of foodborne illness cases and their cost, based on 2019 data (as shown in Table 1). Key figures to note are the total estimates for the number of foodborne illness cases per annum (4.68 million) and costs associated with this ($2.44b per annum). The
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previous estimated cost of illness was $1.25b, based on 2006 data. Campylobacter is one of the leading causes of bacterial foodborne diseases, and is estimated to be the single most expensive pathogen in Australia, with an associated cost burden of $375m. By comparison, Salmonella (the most common pathogen associated with foodborne outbreaks) has an annual cost burden of $140m. While there are few notified cases, listeriosis is by far the most expensive foodborne disease with an estimated cost per case of $785,000, due to the severity of associated illness and fatality rate (compared with a cost of $1,390 per case for Campylobacter).
Foodborne disease trends in Australia Australian notifications for nontyphoidal Salmonella, Campylobacter and Listeria in the period 2015-2021 are shown in Table 2. These figures represent laboratory confirmed detections of illness across Australian jurisdictions, but do not account for underreporting of cases which are estimated in the above
FSANZ report. Campylobacter became notifiable in NSW (Australia’s most populous state) from April 2017, which accounts for a significant rise in notifications around this time. Irrespective of this, total notifications of this pathogen remain stubbornly high and are of major concern for regulators and food industry commodities that are major sources of Campylobacter. Listeriosis notifications declined steadily over 2015-2021. Improvements in understanding and education of the risks to pregnant women and the immunocompromised, along with improved practices in sectors such as the melon industry, may have contributed to this decrease. Another potential success story is the decline in salmonellosis notifications from 2015-2021. Several state and territory food safety regulators developed specific interventions targeting causes of Salmonella outbreaks. Improvements across various industry sectors also contributed to the salmonellosis decrease. For example, the majority
