Control of Campylobacteriosis in

New Zealand: a whole-of food-chain approach

Neil Kennington, Steve Hathaway, Judi Lee

Campylobacteriosis in humans

• A priority foodborne disease world wide –primarily gastroenteritis

• A number of food pathways have been implicated, especially chicken meat, as well as water, animal contact and environmental sources

• Under-reporting in most countries

Epidemic of notified cases in NZ

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06Year

Notif

icat

ions

0

200

400

600

800

1,000

1,200

Hosp

italis

atio

ns

Notifications

Hospitalisations

2006: 15,873 notifications (379 / 100,000)

1,179 hospitalisations

0

200

400

600

800

1000

1200

1400

1600

1800

1 2 3 4 5 6 7 8 9 10 11 12

200420052006

Monthly cases trends showing consistent trend

Stakeholder pressure for formal NZFSA response

Epidemic study puts chicken in dog box Monday Jul 10, 2006By Simon O'Rourke

Food Safety Minister Annette King says she is seekingimmediate advice from officials on what action can be taken to address New Zealand's spiralling campylobacter epidemic.

• Formal partnership between NZFSA, industry and other stakeholders

• Strategic farm-to-plate plan

• Operational research

• Ongoing development of control measures; voluntary and regulatory

NZFSA CampylobacterStrategy: 2006

Strategy includes NZFSA Risk Management Framework

Monitoring and review

Preliminary risk management

activities

Identification and selection of risk

management options

Implementation of control measures

Key objectives of the Strategy

• Significantly reduce cases, with public health goal of 50% reduction over five years

• Invest in detailed food source attribution so as to target control measures

• Research, implement and validate a range of interventions farm-to-plate

• Develop risk model • Institute monitoring systems (food chain and

human) to chart progress

Sophisticated research to determinesource of human cases

Farm-to-plate risk-based approach

NZFSA performance target

• Necessary regulatory tool to achieve NZFSA public health goal

• Tested for a year on a voluntary basis to ensure that required level of control on chilled carcasses in all premises was practical and achievable

• Mandated February 2008 and monitored using National Microbiological Database

NZFSA performance target

• Effectively requires a one log reduction in level of contamination from 2007 baseline levels

• Moving window method, with a high count limit (5.88 log 10 CFU per carcass) and average carcass count below 3.78 log 10 CFU per carcass)

• Reducing flock prevalence through on-farm controls (biosecurity, boots, crates)

• Reducing cross-contamination in slaughterhouse through improved hygiene

• Better calibration of evisceration equipment

• Spray washing and chlorination of chill water

Validated control measures (1)

• Strategic use of chemical decontamination during primary processing (e.g. acidified sodium chlorite)

• Heat treatment of product

• Improving hygiene during packaging and distribution

• Improving consumer handling

Validated control measures (2)

Industry progress

Processor Results

0

10

20

30

40

50

Q12008

Q22008

Q32008

Q42008

Q12009

Q22009

Q32009

Q42009

Quarter

% P

reva

len

ce

2.12.22.32.42.52.62.72.8

Mea

n l

og

co

un

ts

% PrevalenceMean log counts

Individual processor performance against NZFSA target

Year-Quarter

2007-Q2

2007-Q3

2007-Q4

2008-Q1

2008-Q2

2008-Q3

2008-Q4

2009-Q1

2009-Q2

2009-Q3

2009-Q4

2010-Q1

2010-Q2

Perce

nt of

Rins

ates >

CPT

by C

ompa

ny

0

10

20

30

40

50

60

70

Non compliance with performance target

• NZFSA-led response team • 5 premises visits in 2008-2009

• Persistent problems with organic processors

• Freezing imposed until compliant with CPT

• No mandatory closures to date

Progress in human health trends

Strategyformalised

Calculation of food borne component: 2009

Total cases - 7176 (166.3/100,000)– 3836 food-related cases

– 505 travel-related cases

– 574 hospitalisations

40.00

60.00

80.00

100.00

120.00

140.00

160.00

180.00

200.00

220.00

240.00

260.00

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Year

Food

born

e P

ropo

rtion

(rate

per

100

,000

pop

ulat

ion)

Charting progress against NZFSA public health goal

Campylobacteriosis

0

50

100

150

200

250

NZ USA Australia UK EU Iceland Norway Denmark Sweden Czech

/100

,000

pop

n.

Country comparison 2009

Summary

• An integrated farm-to-plate strategic approach has resulted in considerable reduction in campylobacteriosis

• Partnership with industry (funding and operational research) has been critical to progress

Summary

• Continuing work on food source attribution and risk modelling will inform changes to control measures and regulatory performance target (increase stringency?)

• New Zealand and Sweden co-leading a new Codex standard for controlling Campylobacterand Salmonella in broiler chickens,

Acknowledgements

• NZFSA team: Judi Lee, Steve Hathaway, Sharon Wagener, Peter van der Logt, Donald Campbell, Carol Barnao

• Industry: Roy Biggs (Tegel Foods Ltd), PIANZ

• Research providers: Institute of Environmental Science and Research, Massey University (Nigel French and Petra Muellner),Otago University (Ann Sears)