Foodborne diseases - challenges in a globalized world. Dr. Hilde Kruse Programme Manager Food Safety

Transcription

1 Foodborne diseases - challenges in a globalized world Dr. Hilde Kruse Programme Manager Food Safety

2 FAO/WHO World Declaration on Nutrition (1992) access to nutritionally adequate and safe food is a basic individual right.

3 BUT - Foodborne diseases a challenge worldwide Globally million estimated deaths from food and waterborne infections per year Industrialized countries - Up to 20 per million die of foodborne infections per year

4 Globalisation: increasing risk of international food-safety crises

5 Globalisation of Trade : The World on your Plate Herb Butter: Salted butter Garlic puree Garlic salt Lemon Parsley Pepper Water Chicken Breast: Chicken Batter: Flour Water - Ireland - China, USA, Spain - China, USA, Spain - USA - France, UK - Indonesia - Ireland - Ireland, Belgium UK, France etc. - Belgium, France - Ireland Chicken Kiev Courtesy A. Reilly, FSAI, Ireland Bread Crumb: Bread crumb Rape-seed oil - Ireland, UK - EU, Australia, Eastern Europe

6 The world at my local grocery shop St. Genis-Pouilly, France. Population: 8000

7 Food safety is a particular complex form of the human-animal-environment interface

8 Where hazards arise in the food supply Vehicle emission Crops Processing Agricultural practices Livestock Retail Preparation Waste Storage Approach Seafood * Multisectoral Industrial emissions and effluents Distribution * Multidisciplinary

9 Adding to the food safety challenges: Infected animals often show no illness Public health initiatives must include apparently healthy animals Public health initiatives must include feed safety Contaminated food usually looks, smells and tastes normal Traditional (visual) food inspection is not sufficient

10 For instance: Thyrotoxicosis caused by the excess iodine in soy milk product originating in Japan Ireland United Kingdom Germany Spain Cyprus Japan Hong Kong Singapore Australia New Zealand

11 Foodborne outbreaks can have major economic/trade impacts A Farmer stands in his field of lettuce while it is destroyed in Hamburg, Germany.

12 Major Global Food Safety Threats Microorganisms Zoonotic microorganisms - Salmonella, Campylobacter, EHEC - Brucella, anthrax - Trichinella, Toxoplasma, Echinococcus Other bacteria - Botulism, Staphylococcus aureus, Shigella Foodborne viruses - Noroviruses, hepatitis A Other Chemical - e.g. Biotoxins, Toxic metals Radioactive isotopes New technologies - e.g. GMO Allergies

13 Global changes and emerging infectious diseases Frequency of all emerging infectious disease (EID) increased since 1940, reaching a peak in newly identified EID 60% zoonoses 27% (95 pathogens) transmitted through food Many resistant to antibiotics Jones Patel, Levy 2008

14 Global changes and emerging food safety threats Globalised food trade, travel and migration increased long-distance pathogen transmission Changes in agriculture and food industry e.g handling of infected domestic and wild animals during food production - related to 15% of new EID Changing human population e.g vulnerable, aging population Changing lifestyles e.g frequent consumption of food prepared outside the home (urban areas)

15 High temperatures Storms Flooding and contaminated water used for irrigation, food preparation spreading of contaminated waters from polluting sources, long range transport of persistent pollutants Droughts Population displacement Human behavior Salmonella Vibrio cholerae Protozoa Complicating factors Climate change Mycotoxins Biotoxins (algal blooms)

16 Complicating factors Antibiotic Resistance Rendering EPIDEMIOLOGY OF ANTIMICROBIAL RESISTANCE Antibiotic use in one ecological compartment, such as food animal production, can have consequences for the resistance situation in another ecological compartment, such as public health Dead stock Drinking water Farm Effluents and Manure Spreading Offal AQUACULTURE Rivers and Streams SOIL WILDLIFE Sea / Lakes Sewage Vegetation, Seed Crops, Fruit Drinking Water Swimming Industrial & Household Antibacterial Chemicals Animal Feeds SHEEP VEAL CALVES SWINE FOOD ANIMALS OTHER FARMED LIVESTOCK CATTLE POULTRY Commercial Abattoirs / Processing Plants Meat Handling Preparation Consumption HOSPITALIZED HUMAN EXTENDED CARE FACILITIES COMMUNITY - URBAN -RURAL COMPANION ANIMALS Direct Contact after Linton AH (1977), modified by Irwin RJ

17 Fighting antibiotic resistance is a priority for WHO European strategy adopted in 2011 Publication on food safety issued on occasion of the World Health Day Improve overall coordination 2. Improve regulatory framework 3. Reduce the need for and promote prudent use of antibiotics 4. Improve surveillance 5. Advocate and communicate 6. Build capacity and provide training 7. Address knowledge gaps and research needs

18 Control of Foodborne Diseases Information needed The source(s) The route(s) of transmission Efficient control strategies Public health burden Tools needed Diagnostic tools Epidemiological tools Mathematical modeling tools Decision support tools Predict forward Trace-back Feed Farm Slaughter Processing Retail Consumers

19 Risk analysis framework Risk Assessment Science based Risk Management Policy based Risk Communication Interactive exchange of information and opinions concerning risks

20 The International Health Regulations 2005 Preparedness requires international networks whereby national and international systems interact seamlessly IHR 2005 Calls for: Strengthened national capacity for surveillance and control, incl in travel and transport Prevention, alert and response to public health emergencies of international concern, incl food safety threats Global partnership and international collaboration Rights, obligations and procedures, and progress monitoring

21 What is unique about Food Safety Events? Requires collaboration of different partners in-country Requires different expertise than most infectious disease events Requires different types of questions to be asked Often multi-regional due to international distribution Sometimes treated with lower priority in the face of other infectious disease events Can have major economic and trade implications Multi-disciplinary, Multi-sectoral, Integrated, Collaborative

22 INFOSAN FAO-WHO joint International Food Safety Authorities Network Voluntary Global network of national food safety authorities from around the world (178 countries) Aims to prevent international spread of contaminated food and foodborne disease and strengthen food safety systems globally, by: promoting the rapid exchange of information during food safety events sharing information on important food safety issues of global interest promoting partnership and collaboration between countries helping countries strengthen their capacity to manage food safety risks

23 Outbreak of S. Oranienburg in Russia linked to internationally distributed powdered infant formula from Belgium January 2012 Haiti Belgium Russia Congo Burundi Mozambique INFOSAN Alert Russian media report (16 cases) picked up by WHO/Europe and relayed to INFOSAN Secretariat INFOSAN Secretariat contacted RASFF Secretariat and colleagues in Belgium Belgian Authorities subsequently launched an investigation into the Belgian producer Communicated to INFOSAN Secretariat that product was sent to additional countries INFOSAN notified national authorities in these countries 17

24 Melamine-contaminated Infant Formula Melamine added in primary production sector (milk collection centres) to disguise diluting milk with water 22/79 Chinese powdered infant formula producers affected Products from affected producers exported to 5 countries and other products contaminated and exported worldwide >294,000 children ill >50,000 hospitalized 6 deaths INFOSAN a key player in the communication and information-sharing

25 Conclusions Food-borne disease a considerable public health burden throughout the world Globalization increases the risk of widespread foodborne disease outbreaks WHO actions and partnerships seek to prevent, monitor, predict and respond to food safety threats

26 Thank you for your attention! Only if we act together can we respond effectively to international food safety problems and ensure safer food for everyone Dr Margaret Chan Director-General WHO