title: Estimating the burden of foodborne diseases in Japan.
abstract: OBJECTIVE
  To assess the burden posed by foodborne diseases in Japan using methods developed by the World Health Organization's Foodborne Disease Burden Epidemiology Reference Group (FERG).
  
  
  METHODS
  Expert consultation and statistics on food poisoning during 2011 were used to identify three common causes of foodborne disease in Japan: Campylobacter and Salmonella species and enterohaemorrhagic Escherichia coli (EHEC). We conducted systematic reviews of English and Japanese literature on the complications caused by these pathogens, by searching Embase, the Japan medical society abstract database and Medline. We estimated the annual incidence of acute gastroenteritis from reported surveillance data, based on estimated probabilities that an affected person would visit a physician and have gastroenteritis confirmed. We then calculated disability-adjusted life-years (DALYs) lost in 2011, using the incidence estimates along with disability weights derived from published studies.
  
  
  RESULTS
  In 2011, foodborne disease caused by Campylobacter species, Salmonella species and EHEC led to an estimated loss of 6099, 3145 and 463 DALYs in Japan, respectively. These estimated burdens are based on the pyramid reconstruction method; are largely due to morbidity rather than mortality; and are much higher than those indicated by routine surveillance data.
  
  
  CONCLUSIONS
  Routine surveillance data may indicate foodborne disease burdens that are much lower than the true values. Most of the burden posed by foodborne disease in Japan comes from secondary complications. The tools developed by FERG appear useful in estimating disease burdens and setting priorities in the field of food safety.
authors.affiliation: Department of Veterinary Medical Science, University of Tokyo, Tokyo, Japan .
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kumagai
authors.affiliation: Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan .
authors.forename: Stuart
authors.initials: S
authors.lastname: Gilmour
authors.affiliation: Department of Health Policy, National Centre for Child Health and Development, Tokyo, Japan .
authors.forename: Erika
authors.initials: E
authors.lastname: Ota
authors.affiliation: National Institute of Health Sciences, Tokyo, Japan .
authors.forename: Yoshika
authors.initials: Y
authors.lastname: Momose
authors.affiliation: Faculty of Economics, Kyushu University, Fukuoka, Japan .
authors.forename: Toshiro
authors.initials: T
authors.lastname: Onishi
authors.affiliation: Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan .
authors.forename: Ver Luanni Feliciano
authors.initials: VL
authors.lastname: Bilano
authors.affiliation: National Institute of Health Sciences, Tokyo, Japan .
authors.forename: Fumiko
authors.initials: F
authors.lastname: Kasuga
authors.affiliation: Research Centre for Food Safety, University of Tokyo, Tokyo, Japan .
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Sekizaki
authors.affiliation: Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan .
authors.forename: Kenji
authors.initials: K
authors.lastname: Shibuya
mesh_terms: D002167:Campylobacter; D002169:Campylobacter Infections / Q000453:epidemiology*; D017281:Cost of Illness; D054324:Enterohemorrhagic Escherichia coli; D004927:Escherichia coli Infections / Q000453:epidemiology*; D005516:Food Microbiology; D059022:Food Safety; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000382:microbiology; D005759:Gastroenteritis / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D009010:Monte Carlo Method; D011159:Population Surveillance; D019057:Quality-Adjusted Life Years; D012475:Salmonella; D012480:Salmonella Infections / Q000453:epidemiology*; D014944:World Health Organization