KUALA LUMPUR, Feb 25 — A new study has estimated that the economic burden of foodborne diseases (FBD) cost Singapore SG$80.4 million a year.
The study by Jia Hao Wong et al, published in the March 2026 issue of the Value in Health: Regional Issues journal, found that in 2019, a total of 6,080 cases of FBD from known pathogens cost SG$15.1 million, while 184,000 cases of FBD from unspecified gastroenteritis cost SG$65.3 million.
Direct costs at SG$13.2 million contributed 87 per cent of the total SG$15.1 million cost of FBD from known pathogens, whereas direct costs (SG$33.4 million) contributed only 51 per cent of the total SG$65.3 million cost of FBD from unspecified gastroenteritis.
Unspecified gastroenteritis total costs (direct and indirect) comprised SG$31.1 million from inpatient cases and SG$34.1 million from outpatient cases.
“To the best of our knowledge, this is the first study to estimate the economic cost of FBD in Singapore,” researchers wrote.
Economic costs consisted of both direct and indirect costs. Direct costs comprised inpatient and primary health care costs incurred when patients seek treatment for FBD and medication costs incurred when patients undergo self-treatment.
Indirect costs comprised productivity losses due to absenteeism from work and wage loss due to premature mortality.
Non-Typhoidal Salmonella Highest Economic Cost At SG$8 Million
The study found that the top contributors to the economic cost of FBD were bacterial pathogens, with non-typhoidal Salmonella contributing the highest total cost at SG$8.12 million. The bulk of this cost was from direct costs at SG$7.3 million.
This was followed by other bacterial intestinal infections costing SG$2.66 million.
Non-typhoidal Salmonella was the leading cause of FBD with known pathogens in Singapore, contributing 2,050 cases in 2019.
Globally, non-typhoidal Salmonella is one of the leading causes of gastroenteritis in humans, with almost 94 million cases reported annually. The FBD is often transmitted through undercooked food or food contaminated by food handlers with diarrhoeal illness.
Campylobacter and typhoidal Salmonella were the second and third leading causes of FBDs due to known pathogens in Singapore, with both bacterial intestinal infections contributing a total cost of SG$1.07 million and SG$0.94 million in 2019 respectively.
Campylobacter infection often results from consuming contaminated food, such as unpasteurised milk and undercooked poultry. Typhoid and paratyphoid fevers are infections caused by the Salmonella typhi and paratyphi subspecies of bacteria; most cases are usually imported.
“Food safety is a joint responsibility. Public health agencies, consumers and the food industry should work together to reduce the transmission risk of Campylobacter and Salmonella in food by inculcating good food production and manufacturing practices, good hand hygiene, and safe handling, cooking, and consumption of food,” said researchers.
FBD Due To Listeria Monocytogenes Highest Cost Per Case At SG$49,900
The study also found that Listeria monocytogenes contributed up to SG$49,900 per case despite having the lowest number of cases, similar to Australia and Denmark.
FBD due to Listeria monocytogenes is one of the more severe FBD, with pregnant women, the elderly, and the immunocompromised having the most significant risk.
“With a high mortality rate and severe morbidity, this group of patients often requires hospitalisation and more aggressive treatment, leading to substantial health care costs,” researchers wrote.
Listeria monocytogenes is a legally notifiable pathogen in Australia and Denmark, but not in Singapore. However, the study noted that Singapore conducts food safety monitoring for Listeria monocytogenes to ensure that food contamination is detected at the earliest opportunity.
Following Listeria monocytogenes with the highest cost per case, typhoid and paratyphoid infections cost SG$10,100 per case. Other viral intestinal infections had the lowest cost per case at SG$750.
Productivity Losses From Unspecified Gastroenteritis Close To Half Of Total Cost
Researchers noted that although the average SG$352 cost per case of gastroenteritis appeared to have low economic impact, the sheer SG$65.3 million total cost in 2019 from 184,000 cases of unspecified gastroenteritis contributed significantly to the economic cost in Singapore.
“With productivity losses contributing close to 50 per cent of the total cost, this highlights the importance of surveillance and prevention efforts, mainly as Singapore’s economy is heavily dependent on the productivity of its workers.”
Singapore reported 22 deaths due to FBD in 2019. Seven of these cases contributed to indirect costs due to premature mortality as they had died before 70 years.
“Our study provides baseline cost estimates of FBDs in Singapore that serve as a foundation for evidence-based policy making,” researchers wrote.
“Although specific interventions require subsequent cost-benefit analyses, these estimates enable policy makers to identify priority diseases and evaluate various risk management options.
“The findings can also be used in public awareness campaigns and industry dialogues to emphasise the substantial economic burden of FBDs on consumers and food industry members.”
All cost estimates in the study were presented in 2019 SGD (USD 1 = SGD 1.39).
