WHO estimates of the global, regional, and national burden of 14 foodborne diarrhoeal enteric hazards, 2000–21: an updated data synthesis
Year: 2026
Type: article
Abstract: BACKGROUND: Foodborne diseases cause significant illness and death globally. We updated WHO estimates of the burden caused by diarrhoeal hazards commonly transmitted by food: Campylobacter jejuni, Campylobacter coli, and other thermotolerant Campylobacter species; Cryptosporidium spp; Cyclospora cayetanensis; Entamoeba histolytica; enteroaggregative Escherichia coli; enteropathogenic E coli; enterotoxigenic E coli; Giardia duodenalis; norovirus; rotavirus; non-typhoidal Salmonella enterica; Shiga toxin-producing E coli; Shigella spp; and Vibrio cholerae. METHODS: We estimated illnesses, deaths, and disability-adjusted life-years (DALYs) for 194 countries for the period 2000-21 using data from systematic reviews; the Global Burden of Diseases, Injuries, and Risk Factors Study 2021; a structured expert judgement study; and country consultations. We used disease-specific computational models, and a hierarchical meta-regression model with geographical clustering, a global linear time trend, and uncertainty propagation. FINDINGS: In 2021, the 14 diarrhoeal hazards caused 666 million (95% UI 483-884) illnesses, 265 000 deaths (196 000-351 000), and 15·2 million (11·6-19·1) DALYs from foodborne transmission. Shigella spp, Campylobacter, and rotavirus caused the most DALYs from foodborne transmission. The greatest burden was in the African region (773·5 DALYs [95% UI 559·7-1033·3] per 100 000 population due to foodborne transmission). Mortality rates were 7·1 times higher and DALY rates 18·9 times higher in children younger than 5 years than in people aged 5 years or older. While the overall foodborne burden decreased between 2000 (692·3 DALYs [517·9-938·1] per 100 000 population) and 2021 (193·6 [147·2-243·0] per 100 000), this trend was not consistent for all hazards. INTERPRETATION: Diarrhoeal hazards continue to cause a substantial foodborne disease burden, despite decreases over time. Children in low-income countries bear the greatest burden. Prevention requires concerted efforts, including expanding global diarrhoeal disease prevention efforts beyond water, sanitation, and hygiene and vaccination to include improvements in the safety of the food supply. FUNDING: WHO.
Source: The Lancet Global Health
Authors: Shannon E Majowicz, Josh M Colston, Martyn D Kirk, Sara M Pires, Yuki Minato, Luria L Founou, Brecht Devleesschauwer, Carlotta di Bari, Teresa Estrada-Garcia, Louise Vaes, Arie H Havelaar, Charlee Roberts, Tesfaye Gobena, Ashok Kumar, Fadi Al Natour, Robin J Lake, Gabriela F Nane, Lucy J Robertson, Kim Fernandez, Elaine Scallan Walter, Margaret Kosek, Antonio Agudo, Mohammed Al Huthiel, Fadi Al Natour, Li Bai, Beau Bruce, Brecht Devleesschauwer, Sithar Dorjee, Teresa Estrada-Garcia, Luria Leslie Founou, Tesfaye Gobena, Sandra Hoffmann, Lea Sletting Jakobsen, Karen Keddy, Martyn Kirk, Mirjam Kretzschmar, Kunihiro Kubota, Ashok Kumar, Rob Lake, Shannon Majowicz, Lapo Mughini-Gras, Sara Monteiro Pires, Tety Rachmawati, Lucy Robertson, Elaine Scallan Walter, Banchob Sripa, Fadi Al Natour, Teresa Estrada-Garcia, Luria Leslie Founou, Tesfaye Gobena, Martyn Kirk, Ashok Kumar, Shannon Majowicz, Sara Monteiro Pires, Elaine Scallan Walter
Institutions: University of Waterloo, University of Virginia, Australian National University, Technical University of Denmark, World Health Organization, University of St Andrews, University of KwaZulu-Natal, Ghent University, Sciensano (Belgium), Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, University of Florida, Haramaya University, Indian Council of Agricultural Research, Abu Dhabi Agriculture and Food Safety Authority, New Zealand Institute for Public Health and Forensic Science, Delft University of Technology, Norwegian University of Life Sciences, Colorado School of Public Health, University of Colorado Anschutz
Language: English
Subfield: Food Science
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $6,680
OpenAlex ID: W7164860342