Abstract
A demographic shift towards a larger proportion of elderly in the Dutch population in the coming decades might change foodborne disease incidence and mortality. In the current study we focused on the age-specific changes in the occurrence of foodborne pathogens by combining age-specific demographic forecasts for 10-year periods between 2020 and 2060 with current age-specific infection probabilities for Campylobacter spp., non-typhoidal Salmonella, hepatitis A virus, acquired Toxoplasma gondii and Listeria monocytogenes. Disease incidence rates for the former three pathogens were estimated to change marginally, because increases and decreases in specific age groups cancelled out over all ages. Estimated incidence of reported cases per 100,000 for 2060 mounted to 12 (Salmonella), 51 (Campylobacter), 1.1 (hepatitis A virus) and 2.1 (Toxoplasma). For L. monocytogenes, incidence increased by 45% from 0.41 per 100,000 in 2011 to 0.60 per 100,000. Estimated mortality rates increased two-fold for Salmonella and Campylobacter to 0.5 and 0.7 per 100,000, and increased by 25% for Listeria from 0.06 to 0.08. This straightforward scoping effort does not suggest major changes in incidence and mortality for these food borne pathogens based on changes in de population age-structure as independent factor. Other factors, such as changes in health care systems, social clustering and food processing and preparation, could not be included in the estimates.
Highlights
Demographic forecasts show that, as in many industrialized countries, the population in TheNetherlands is aging [1]
The estimated incidence of toxoplasmosis increased among those aged 20 to 29 and 60 to 65 by 7% and 20% respectively, but decreased among those aged 30 to 65 and lead to the overall decrease of 10% by 2040. These results indicate that the change in age-structure of the population, as independent factor, does not lead to large changes in the overall incidence
The estimated excess mortality rate due to L. monocytogenes increased by 25% from 0.061 to 0.078 per 100,000 population
Summary
Demographic forecasts show that, as in many industrialized countries, the population in TheNetherlands is aging [1]. The number of immune cells does not decrease, functional alterations in some of the associated cell types occur [3] These alterations likely cause changes in the defense mechanism to pathogens in the elderly, either due to an increased probability of infection and/or an increased probability to disease following infection. Another mechanism related to aging that could play a role in increased susceptibility of the elderly to infectious diseases is an alteration in the gastric hydrochloric acid secretion [4]. Specific foodborne infectious diseases are observed more frequently in the elderly than in other age groups, such as Listeria meningitis [6]
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