title: Trends in indigenous foodborne disease and deaths, England and Wales: 1992 to 2000.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Gastrointestinal Diseases Division, PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, UK. badak@phls.org.uk
authors.forename: G K
authors.initials: GK
authors.lastname: Adak
authors.forename: S M
authors.initials: SM
authors.lastname: Long
authors.forename: S J
authors.initials: SJ
authors.lastname: O'Brien
mesh_terms: D002169:Campylobacter Infections / Q000453:epidemiology; D003015:Clostridium Infections / Q000453:epidemiology; D003016:Clostridium perfringens; D004739:England / Q000453:epidemiology; D004812:Epidemiologic Methods; D004927:Escherichia coli Infections / Q000453:epidemiology; D019453:Escherichia coli O157; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008088:Listeriosis / Q000453:epidemiology; D012478:Salmonella Food Poisoning / Q000453:epidemiology; D014195:Travel; D014481:United States / Q000453:epidemiology; D014852:Wales / Q000453:epidemiology