Completing the Structure: Source Attribution in Foodborne Disease Burden Estimation

Abstract The final step of the burden of foodborne disease estimation is to attribute the estimated burden to foodborne transmission, and to specific foods. A variety of source attribution approaches and methods are available, including approaches that apply data from public health surveillance, food consumption, and food monitoring programs, epidemiological approaches, expert elicitations, and intervention studies. After reviewing available source attribution methods and their applicability to estimate the proportion of disease burden by foodborne hazards attributable to transmission pathways and to specific foods considering data requirements and availability at regional and country level, FERG1 concluded that expert elicitation is the preferred method for source attribution in a context of data heterogeneity across countries and pathogens. For the 2021-2025 iteration, the FERG recommended to the WHO that a new Structured Expert Elicitation is conducted for source attribution of 40 hazards. The WHO launched a call for experts in July 2023, and further identified experts in a snowball process. The update of the expert elicitation study will be able to capture recent changes in food consumption, food availability, economic conditions, and sanitation conditions in specific parts of the world. Improvements of methods leveraged on lessons learned and on technological developments for interviewing experts and data analysis. This presentation will describe the rational, methodology, and preliminary results of the source attribution study, and discuss estimates in light of underlying uncertainties and other sources of evidence.