Burden of disease metrics are increasingly established to prioritize food safety interventions. We estimated the burden of disease caused by seven foodborne pathogens in Denmark in 2017: Campylobacter, Salmonella, Shiga toxin–producing Escherichia coli, norovirus, Yersinia enterocolitica, Listeria monocytogenes, and Toxoplasma gondii. We used public health surveillance data and scientific literature to estimate incidence, mortality, and total disability-adjusted life year (DALY) of each, and linked results with estimates of the proportion of disease burden that is attributable to foods. Our estimates showed that Campylobacter caused the highest burden of disease, leading to a total burden of 1709 DALYs (95% uncertainty interval [UI] 1665–1755), more than threefold higher than the second highest ranked pathogen (Salmonella: 492 DALYs; 95% UI 481–504). Campylobacter still led the ranking when excluding DALYs attributable to nonfoodborne routes of exposure. The total estimated incidence was highest for norovirus, but this agent ranked sixth when focusing on foodborne burden. Salmonella ranked second in terms of foodborne burden of disease, followed by Listeria and Yersinia. Foodborne congenital toxoplasmosis was estimated to cause the loss of ∼100 years of healthy life, a burden that was borne by a low number of cases in the population. The ranking of foodborne pathogens varied substantially when based on reported cases, estimated incidence, and burden of disease estimates. Our results reinforce the need to continue food safety efforts throughout the food chain in Denmark, with a particular focus on reducing the incidence of Campylobacter infections.

中文翻译：

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2017 年丹麦常见通过食物传播的七种病原体的疾病负担估计。

越来越多地建立疾病负担指标以优先考虑食品安全干预措施。我们估计了 2017 年丹麦七种食源性病原体引起的疾病负担：弯曲杆菌、沙门氏菌、产志贺毒素大肠杆菌、诺如病毒、小肠结肠炎耶尔森氏菌、单核细胞增生李斯特菌和弓形虫。我们使用公共卫生监测数据和科学文献来估计每种疾病的发病率、死亡率和总残疾调整生命年 (DALY)，并将结果与​​食物引起的疾病负担比例的估计值联系起来。我们的估计表明，弯曲杆菌造成最高的疾病负担，导致总负担为 1709 DALYs（95% 不确定性区间 [UI] 1665-1755），比排名第二的病原体高三倍以上（沙门氏菌： 492 DALYs；95% UI 481-504 ）。在排除归因于非食源性接触途径的 DALY 后，弯曲杆菌仍处于领先地位。诺如病毒的估计总发病率最高，但在关注食源性负担时，该病原体排名第六。沙门氏菌在食源性疾病负担方面排名第二，其次是李斯特菌和耶尔森氏菌. 据估计，食源性先天性弓形虫病会导致约 100 年的健康寿命损失，而这一负担由人口中的少数病例承担。根据报告病例、估计发病率和疾病负担估计，食源性病原体的排名差异很大。我们的结果强调了在丹麦整个食物链中继续努力食品安全的必要性，特别关注降低弯曲杆菌感染的发生率。