The burden of disease in the Netherlands is almost back to pre-pandemic levels

According to an analysis, the disease burden and associated costs caused by selected pathogens in the Netherlands increased in 2022.

Each year, RIVM investigates how many people become sick or die from gastrointestinal infections by examining 14 pathogens. These are mainly transmitted through food, but people can also come into contact with them in the environment or through animals or other people.

The disease burden from the 14 pathogens was higher than in 2021 and 2020 but still lower than in 2019 when the COVID-19 pandemic began. This increase means the burden is nearly the same as pre-COVID-19 levels, said the National Institute for Public Health and the Environment (RIVM). 

The incidence of campylobacteriosis, salmonellosis, and Cryptosporidium was higher than in 2021. Campylobacter was linked to 38 deaths, and Salmonella to 20. In total, 230 fatal cases were estimated, of which 81 were linked to food.

STEC O157 caused 71 cases, of which 17 were hospitalized and four died. In 2021, 22 of 55 cases were hospitalized. Three hemolytic uremic syndrome (HUS) patients were recorded in 2022 compared to four in 2021.

In 2022, there were 94 Listeria infections compared to 82 in 2021. Fourteen people died compared to 15 deaths in 2021. With 93 reported cases and 30 hospitalizations, hepatitis A was up from 78 cases and 23 hospitalizations in 2021.

The number of cases due to the 14 pathogens increased to nearly 1.6 million from 1,287,000 in 2021, with 654,000 estimated to have been caused by food.

Foodborne role in total burden
The fraction attributed to foodborne transmission was 43 percent of the total burden, so 4,300 of the 10,000 DALYs per year and 42 percent of the total cost of illness, which was €478 million ($516 million).

The disease burden is expressed in Disability-Adjusted Life Years (DALYs). The disease burden attributable to foodborne pathogens was estimated to be 4,300 DALYs. This was higher than 4,200 DALYs in 2021 and 3,600 DALYs in 2020 but lower than 4,600 DALYs in 2019.

Campylobacter, Salmonella, norovirus, rotavirus, hepatitis A virus, Cryptosporidium, and Giardia had an increased disease burden compared with 2021.

About 56 percent of the foodborne burden was associated with meat such as poultry, pork, beef, and lamb. These items were also estimated to cause 42 percent of all food-related fatal cases. Other sources include dairy, eggs, produce, and fish and shellfish.

The cost of gastrointestinal infections resulting from foodborne pathogens was €201 million ($217 million). This was higher than €189 million ($204 million) in 2021 and €173 million ($187 million) in 2020 but lower than €208 million ($224 million) in 2019.

Staphylococcus aureus caused the highest cost burden, followed by Campylobacter and Clostridium perfringens.

RIVM said the results provide policymakers with insight into the burden of disease and the ways in which people can acquire an infection with food-related pathogens. They also allow trends in the burden of disease caused by foodborne infections and the associated costs to be monitored.

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