Adak G K, Long S M, O'Brien S J
Gastrointestinal Diseases Division, PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, UK.
Gut. 2002 Dec;51(6):832-41. doi: 10.1136/gut.51.6.832.
Commitment to food safety is evidenced by high profile governmental initiatives around the globe. To measure progress towards targets, policy makers need to know the baseline from which they started.
To describe the burden (mortality, morbidity, new presentations to general practice, hospital admissions, and hospital occupancy) and trends of indigenous foodborne disease (IFD) in England and Wales between 1992 and 2000.
Routinely available surveillance data, special survey data, and hospital episode statistics were collated and arithmetic employed to estimate the burden and trends of IFD in England and Wales. Adjustments were made for underascertainment of disease through national surveillance and for foreign travel. The final estimates were compared with those from the USA.
In 1995 there were an estimated 2,365,909 cases, 21,138 hospital admissions, and 718 deaths in England and Wales due to IFD. By 2000 this had fallen to 1,338,772 cases, 20,759 hospital admissions, and 480 deaths. In terms of disease burden the most important pathogens were campylobacters, salmonellas, Clostridium perfringens, verocytotoxin producing Escherichia coli (VTEC) O157, and Listeria monocytogenes. The ratio of food related illness in the USA to IFD in England and Wales in 2000 was 57:1. Taking into account population rates, this ratio fell to 11:1 and converged when aetiology and disease severity were considered.
Reducing IFD in England and Wales means tackling campylobacter. Lowering mortality rates however also requires better control and prevention of salmonellas, Cl perfringens, L monocytogenes, and VTEC O157.
全球范围内备受瞩目的政府举措证明了对食品安全的重视。为衡量朝着目标取得的进展，政策制定者需要了解起始基线。
描述1992年至2000年间英格兰和威尔士本土食源性疾病（IFD）的负担（死亡率、发病率、全科医疗新就诊病例、住院人数和住院床位占用情况）及趋势。
整理常规可得的监测数据、专项调查数据和医院就诊统计数据，并运用算术方法估算英格兰和威尔士IFD的负担及趋势。针对通过国家监测未完全查明的疾病以及境外旅行情况进行了调整。将最终估算结果与美国的估算结果进行了比较。
1995年，英格兰和威尔士因IFD估计有2,365,909例病例、21,138例住院和718例死亡。到2000年，这一数字降至1,338,772例病例、20,759例住院和480例死亡。就疾病负担而言，最重要的病原体为空肠弯曲菌、沙门氏菌、产气荚膜梭菌、产志贺毒素大肠杆菌（VTEC）O157和单核细胞增生李斯特菌。2000年美国与英格兰和威尔士食源性疾病的发病比例为57:1。考虑到人口发病率，这一比例降至11:1，在考虑病因和疾病严重程度时趋于一致。
在英格兰和威尔士减少IFD意味着应对弯曲菌。然而，降低死亡率还需要更好地控制和预防沙门氏菌、产气荚膜梭菌、单核细胞增生李斯特菌和VTEC O157。
