Risk analysis of food-pathogen combinations based on disease burden of bacterial foodborne disease outbreaks in Zhejiang Province, China

Bacterial foodborne disease outbreaks (FBDOs) pose significant public health risks. This study aimed to assess the risk of food-pathogen combinations in bacterial FBDOs in Zhejiang Province using Disability-Adjusted Life Years (DALYs) to inform targeted prevention and control strategies. Data from the Foodborne Disease Outbreak Surveillance System (FDOSS) between 2010 and 2022 were analyzed, focusing on outbreaks with identified food-pathogen combinations. DALYs were calculated for bacterial FBDOs and specific food-pathogen pairs. Over the 13-year period, 405 bacterial FBDOs involving 118 distinct food-pathogen combinations were reported, resulting in 112.32 (95 % CI: 110.42-114.51) DALYs. The top ten food-pathogen combinations, associated with 161 outbreaks, accounted for 110.36 (95 % CI: 109.22-111.71) DALYs. The DALYs caused by the same or different food-pathogen combination FBDOs varied across different outbreak settings. By integrating outbreak case numbers (representing risk likelihood) and DALYs (representing risk severity), this study identified high-priority food-pathogen combinations and their predominant outbreak settings. This study provides a relative risk basis for regulatory priority ranking, which will help prevent and reduce the occurrence of certain food-borne pathogen outbreaks.