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Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 1
Improving the Safety of Food International aspects
Jørgen Schlundt,Department of Food safety, Zoonoses and Foodborne Diseases,
Seattle, April 2008
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 2
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 3
Food Safety, Zoonoses, Foodborne diseases Mission:
To lower the burden of disease from food and animals through the communication of sound science and the provision of effective tools to all levels of society
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 4
Within group causedistribution
A RIDiarrhoeaMeas lesMalariaHIVPerinatalOther
Mortality and cause of death attribution
Lifetables
Partial vital registration
Sample registration systems
Population laboratories Registries
Household surveys
Epidemiologicalmodels/estimates
Total number of
global child deaths10.9 Mio
CoDMod
Groups 1,2,3What is "Foodborne Disease Burden"?
• Diseases commonly transmitted through food • All causes - pathogens, chemicals, parasites• Acute and chronic diseases• Long-term complications• Morbidity, disability and mortality
Diarrhoea Cancers
Within group causedistribution
A RIDiarrhoeaMeas lesMalariaHIVPerinatalOther
Mortality and cause of death attribution
Lifetables
Partial vital registration
Sample registration systems
Population laboratories Registries
Household surveys
Epidemiologicalmodels/estimates
Total number of
global child deaths10.9 Mio
CoDMod
Groups 1,2,3
1.8 mio deaths/year
7.3 mio deaths/year% foodborne?
Multi-organ failure
Hepatitis
Peptic ulcer
Morbidity? Disability?
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 5
Foodborne disease
Is a problem in both developing and developed countries
Is a strain on health care systems
Creates a vicious cycle of diarrhoea and malnutrition
Hurts the national economy and development, and international trade.
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 6
WHO Surveillance Programme WHO Surveillance Programme for Control of Foodborne Diseases in Europefor Control of Foodborne Diseases in Europe
0
20
40
60
80
100
120
140
19
85
19
87
19
89
19
91
19
93
19
95
19
97
Inc
ide
nc
e (
ca
se
s/1
00
00
0)
England & WalesDenmarkSwitzerlandIsraelIcelandFinlandSwedenNorwaySlovakiaScotland
Campylobacteriosis trendsCampylobacteriosis trends
BgVV; BerlinBgVV; Berlin
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 7
FAO/WHO Codex Alimentarius Commission
- its mandate -
Dual objective:Protecting the health of consumersFacilitating fair practices in food trade
Non-mandatory in nature, Codex standards and related texts have since 1995 become international benchmarks for harmonization under the SPS and TBT Agreements of WTO
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 8
Codex Meeting Rome
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 9
Risk Analysis
Risk Assessment Risk Management
Risk Communication
FAO/WHO Expert Bodies
FAO/WHO Codex Alimentarius Commission
Interactive exchange of information and opinions
concerning risks
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 10
Codex Alimentarius- its scientific basis -
Codex – Risk management
FAO/WHO Expert Bodies JECFA – food additives, vet. drug residues,
contaminants in food JMPR – pesticide residues in food JEMRA – microbiological hazards in food ad hoc Expert Consultations
Liaison & Separation
Risk assessment
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 11
Outbreak Dose Response ModelSalmonella
Reasonable dose-response model based on “real world”
data
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 12
This means
the infection process should be viewed as
a probability of infection related to the dose ingested
For Salmonella10-20% probability for infection with a dose of 100 organisms,
50-90% probability for infection at 1,000,000 organisms.
For Listeria10-9 to 10-13 probability with a dose of 100 organisms, and a 10-6 to 10-9 probability with a dose of 1,000,000 organisms
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 13
Intervention: Prevalence Strategy for Salmonella in Poultry
Prevalence and expected risk has linear relationship
50% reduction in prevalence
results in
50% reduction in risk
Chicken
Prevalence
1%
5%
10%
20%
50%
90%
Annual expected human
case rate per 100,000
3
12
21
43
104
192
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 14
This means
a solution going to the Farm could work:
If your problem relates to chicken you can lower it
40 times
If you lower the prevalence in chicken 40 times
(unless you import US chicken)
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 15
Lot: 0.1% defectives
10 samples: Probability of detection ~ 1%
10 samples: Probability of detection ~ 1%
Scientific analysis – probabilistic modelingScientific analysis – probabilistic modelingSafety cannot be achieved by testing aloneSafety cannot be achieved by testing alone
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 16
JEMRA Output Codex use
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 17
What is needed to improve food safety?
National systems covering farm-to-fork seamlessly Based on the principle of reducing risk
International system building capacity in developing countries Significant proportion of food is imported Prevention at the source is the most efficient food safety measure
International system detecting contamination / outbreaks Rapid communication, capacity to verify and make decisions, Procedures to respond and capacity to assist One inter-linked system (covering both intentional and accidental contam)
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 18
''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
INFOSAN – The International Food Safety Authorities Network
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 19
What is INFOSAN?
INFOSAN is a global network of food safety authorities that:
• disseminates important global food safety information
• improves collaboration with a goal of preventing the international spread of contaminated food.
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 20
INFOSAN Emergency Actions
Local issue – NO ACTION
Reports
Surveillance
ActionFollow Up / Verification
Final Assessment
Criteria not met NO ACTION
1 or 2 per month
10 – 20 per month
Average of 200 per month
Initial Assessment
Request for Additional
Information
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 21
Examples of INFOSAN Emergency ALERTS"Information traveling faster than rumour"
● September 2006 E.coli 0157:H7 in spinach to all members of INFOSAN
Provided contact information for countries receiving primary distribution. For secondary distribution meant all INFOSAN member countries notified.
November 2006 Glass found in oatcakes exported to 3 countries All affected countries informed South Africa noted this enabled undertaking action to protect public health
September 2007 Shigella in baby corn exported to 3 countries
Distribution records identified three countries who received the affected product, INFOSAN members and National IHR Focal Points were notified
Department of Food Safety, Zoonoses and Foodborne Diseases, World Health Organization 22
Better than Development AidFood safety and Poverty Reduction
- from a developing country’s viewpoint-
Codex Standards(by 174 Member States)
Application to Domestic legislation
(by health sector)
Improvement of Health
Application to export products
(by trade sector)
Safety assuranceand improved access to Importing country 1
Increased foreignexchange earnings
Economic and Social Development & poverty reduction
Note: WTO/SPS Agreement requires its Members States to base
their sanitary measures on international
standards (i.e. Codex Standards on Food Safety)