Disease burden and costs fall in the Netherlands due to COVID-19 measures – Community News
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Disease burden and costs fall in the Netherlands due to COVID-19 measures

A large decrease in the disease burden of 14 pathogens in the Netherlands in 2020 is attributed to the COVID-19 pandemic.

The National Institute for Public Health and the Environment (RIVM) analyzed how many years are lost on average due to illness or death as a result of gastrointestinal disorders and what the costs of the disease burden are.

The 14 pathogens that cause infections are primarily foodborne. They are Campylobacter; Shigatoxin-producing E. coli (STEC) 0157; salmonella; Listeria monocytogenes; Toxoplasma gondii; hepatitis A and E viruses; Bacillus cereus; Clostridium perfringens; Staphylococcus aureus; norovirus; rotavirus; cryptosporidium; and Giardia.

The burden of disease in 2020 was much lower than in 2019. This is probably due to measures in the Netherlands since March 2020 to halt the spread of the COVID virus, the report shows.

Examples of such actions are the closure of restaurants and cafes, bans on face-to-face meetings, restrictions on international travel and increased attention to hygiene, including hand washing. Fewer people may have sought or received medical attention for foodborne illnesses, which require a lab diagnosis and other items to be registered.

Half the burden of food
Disability Adjusted Life Years (DALYs) are used to quantify the burden of disease. The estimated food burden in 2020 was 3,600 DALYs, which was less than 4,600 DALYs in 2019. For the 14 pathogens combined, the number of DALYs was 7,300, which is much less than the figure for 2019.

A reduction in burden was observed for Campylobacter, Salmonella, norovirus, rotavirus, hepatitis A and E viruses, Cryptosporidium and Giardia spp. Top was Campylobacter, followed by Toxoplasma gondii and Salmonella.

The estimated number of cases attributed to the 14 pathogens fell from 1.57 million in 2019 to 963,000 in 2020 with 553,000 infections and 76 food-related deaths.

The cost of this burden of disease in 2020 was estimated at €282 ($318) million in total, which was less than €423 ($477) million in 2019. Estimates include direct medical costs in hospitals, as well as those of patients and families, such as travel costs. It also covers costs in other sectors due to disability.

Pathogens that caused the greatest health costs were Staphylococcus aureus toxin, norovirus and Campylobacter. The main changes from 2019 were all down and were for norovirus, rotavirus and Campylobacter.

The lowest contribution to health care costs was made by the hepatitis A virus at €400,000 ($451,000). The mean cost per case was highest for perinatal Listeria monocytogenes infections at €292,000 ($329,000).

Foodborne illness part of the cost
Contribution from the food-borne route accounted for more than half of the burden, compared to about 43 percent in 2019. This is also an effect of the pandemic, as international travel declined, increasing the relative importance of other sources, according to the analysis.

Costs due to contaminated food fell to €153 ($172) million compared to €181 ($204) million in 2019. The largest contributors came from Staphylococcus aureus, followed by Clostridium perfringens and Campylobacter.

About 61 percent of the food tax was associated with meats such as poultry, pork, beef and lamb. These products caused nearly half of all food-related deaths. Dairy, fish and shellfish and grains also contributed to the burden.

As of 2019, the burden and cost of disease for the toxin-producing bacteria Bacillus cereus, Clostridium perfringens and Staphylococcus aureus were not estimated due to a lack of national surveillance data. However, to ensure comparability with prior years, they have been included in the overall estimates using historical data.

For Cryptosporidium and Giardia, no current national-level incidence data were available for 2020. For Toxoplasma gondii, there was no trend information, but an update of the incidence estimates is planned for the coming year.

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