[Food-borne infections: do we need further data collection for public health action and research].Rev Epidemiol Sante Publique. 2002 Jan; 50(1):67-79.RE
The data needed for controlling and preventing food-borne infectious diseases relied so far on surveillance of the main food-borne infections (Salmonella and listeria infections) to follow trends over time and detect outbreak. However, this systematic continuous data collection was not always sensitive enough to timely detect community outbreaks and did not take into account sporadic cases of food-borne infections which represent the majority of patients (such as Campylobacter infection for example). Therefore, the true burden of food-borne infections, including morbidity, mortality and the social and economic cost could not be assessed. As the issue of food-borne infections got more social attention, the need of further epidemiological data has increased including the implementation of large population studies (active surveillance and follow up studies) associated with analytical studies in the United States (Foodnet) and in some European countries (United Kingdom, The Netherlands, Denmark.). Meanwhile surveillance and detection of outbreaks have substantially improved through the use of new typing scheme, particularly those based on molecular techniques. Their routine use, now, allows an early identification of the clonal spread of food-borne bacteria. The application of automatic detection algorithm to surveillance data base has also improved the performance of outbreak detection and changes of trends. Furthermore, food-borne infection surveillance has become European which allows, by pooling of national database, to identify emergence that did not get noticed in any country. To foster the prevention of sporadic cases, the use of analytical epidemiology has become more and more frequent and has improved the knowledge of food vehicles and risk factors. The risk assessment approach has also been applied to the microbial contamination of food to answer to the increasing needs of expertise, particularly at the international level. This approach, however, needs further methodological development and the collection of extra information on the food chain. Last, but not the least, a wider public health research approach must also be considered, particularly on the social perception of food-borne risks and the cost-effectiveness analysis of the prevention measures that are taken.