Brazilian Foodborne Disease National Survey: Evaluating the Landscape after 11 Years of Implementation to Advance Research, Policy, and Practice in Public Health

Abstract

The poor control of public and private agencies regarding the quality of foods offered to populations has a significant impact on the occurrence of foodborne diseases. Precise information about foodborne diseases (FBD) can adequately inform policy-makers and help to allocate appropriate resources for the control of food safety. This study aimed to evaluate the Brazilian foodborne disease landscape after 11 years of implementation of the Epidemiological Surveillance System of Foodborne Diseases. The study analyzed secondary data from the National System of Injuries and Notifications (SINAN-NET), available from the Health Department. We evaluated the characteristics of FBD, such as the food involved, the location of ingestion, the total time to the outcome investigation, the microorganism involved and deaths. We also calculated the global incidence, mortality and lethality rates of the country. There were 7630 FBD outbreaks in the National Epidemiological Surveillance System of Foodborne Diseases (VE-DTA). Of the registered reports, a total of 134,046 individuals were sick with FBD; 19,394 were hospitalized, and there were 127 registered deaths. We found a coefficient of incidence of FBD of 67.57 per 100,000 inhabitants; a mortality coefficient of 0.06 per 100,000 inhabitants and lethality of 0.09% over the 11 years investigated. Data are probably underreported since the VE-DTA system lacks completeness, and because FBD symptoms are mostly mild, a large part of the population does not seek care from health services.

Overview of Foodborne Disease Outbreaks in Brazil from 2000 to 2018

“…Despite the lack of data on the occurrence of FBD, many studies point to an increase in the number of cases worldwide. Several factors may result in a higher number of cases, such as population growth, increased population of susceptible individuals, disorderly urbanization processes and the need for large-scale production of foods [9,10,11]. According to the World Health Organization, most cases of FBD could be avoided if preventive measures were taken in place throughout the food production chain, requiring efforts by governments, the food industry and consumers [5,12].…”

“…Delayed notification, lack of clinical and/or food sample collection, inadequate laboratory tests and even a difficulty in contacting involved individuals generate gaps in obtaining more detailed and reliable data on the FBD outbreaks [14]. Consequently, the absence of the real dimension on the occurrence of these FBD limits the understanding of their importance for public health [9,15].…”

“…Most of the studies and reports on the FBD outbreaks registered in Brazil pointed to water, multiple/mixed foods and eggs/egg products as the main sources of foodborne pathogens. Mixed foods are characterized as multi-ingredient preparations, which are more susceptible to contamination due intense manipulation [9]. Water has also a significant role on the occurrence of FBD outbreaks and its contamination is directly related to the precariousness of water treatment.…”

Health Outcomes of an Integrated Behaviour-Centred Water, Sanitation, Hygiene and Food Safety Intervention–A Randomised before and after Trial

“…Diarrhoeal disease continues to be a leading cause of mortality and morbidity in low and middle income countries, with 62.2% of diarrhoeal disease deaths in children under five attributed to poor water, sanitation and hygiene (WASH) and the associated consumption of contaminated foods in household settings [1][2][3]. A range of recent studies have examined our current understanding and the efficacy of control measures taken to reduce exposure to enteric pathogens, including attempts to introduce multiple barriers to exposure pathways: enclosed sanitation, household water treatment, hand washing with soap, clean play spaces, domestic animal control and hygiene of complementary foods [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”

Foodborne Diseases

“…Both Brazilian studies highlighted the households as the primary site of FBD occurrence (38.3% [4], and 12.5% [5]). It is essential to consider that reports showed that most cases of FBD are not notified to health authorities; because many foodborne pathogens cause mild symptoms.…”