Impact of food and water-borne diseases on European population health

Composite health measures are increasingly applied in studies aiming at describing the burden of diseases, and food and water-borne diseases (FWDs) are no exception. The Burden of Communicable Diseases in Europe (BCoDE) is a project led and funded by the European Centre for Disease Prevention and Control (ECDC) with the purpose of encouraging and empowering public health experts in the estimation of the impact of communicable diseases expressed in Disability Adjusted Life Years (DALYs). Calculation of DALYs and a critical assessment of burden of disease outputs require a thorough consideration of a number of methodological and epidemiological decisions ranging from modelling (e.g. incidence versus prevalence), disease model parameters (e.g. risks of developing complications or death) and the data feeding the number of cases. Burden of disease studies produce useful results for public health decision-making, in particular when they aim at informing preventive strategies. For this purpose, we attributed FWDs results from the BCoDE 2015 study to different exposure routes. We discuss these in the more general perspective of generating burden of disease evidence for planning and prioritisation, including the potentials and limitations of its methodology.