Emerging of Food Pathogen

8/2/2019 Emerging of Food Pathogen

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EMERGING FOODBORNE

PATHOGENSProf. Dr. rfan EROL, DVM, Ph.D.Turkish Representative of World Vet. Assoc.

Department of Food Hygiene and TechnologySchool of Veterinary MedicineAnkara University


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Despite advances in hygiene, consumerknowledge, food treatment and processing,foodborne diseases mediated by pathogenicmicroorganisms or microbial toxins still

represent a significant treat to public healthworldwide.


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Globally, the WHO hasestimated that

approximately 1.5 billionepisodes of diarrhea andmore than 3 million deathsoccurred in children under

5 years of age, and asignificant proportion ofthese results fromconsumption of foodmainly food of animalorigin with microbialpathogens and toxins


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Emerging & Reemerging Zoonotic

Diseases

60 % of the human pathogens are zoonotic

75 % of emerging zoonotic


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Emerging Foodborne Pathogens

Definition:

those causing illnesses that have onlyrecently appearedor been recognised in a

population or that are well recognised but arerapidly increasingin incidence or geographicrange


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Appeared recently

Extended to new vehicles of transmission

Started to increase rapidly in incidence orgeographic range

Been widespread for many years but onlyrecently identified through new or increased

knowledge or methods of identification andanalysis of the disease agent

Emerging Foodborne Diseases


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Pose a threat to all persons; no matter onage, sex, lifestyle or socio-economic statusetc.

Feel pain and death

Economic impact



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Changes in environment (technology, climate, etc)

Mass production and globalisation of food supply

Economic development

International travel and trade

Changing character of the population

Breakdown in public health Lifestyle changes

Microbial adaptation


Major trends


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Emerging Foodborne Pathogens

Bacteria

Viruses

Parasites Prion


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Emerging foodborne bacteria

Salmonella(multidrug resistant strain)

Campylobacter jejuni

E. coliO157:H7

Listeria monocytogenes

S. aureusMRSA

Vibrio vulnificus

Yersinia enterocolitica

Arcobacterspp.

Mycobacterium paratuberculosis


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Emerging foodborne viruses

Hepatit A and E

Norovirus

(Avian influenza, AI)
http://images.google.com.tr/imgres?imgurl=www.news.harvard.edu/gazette/2000/01.27/images/virusred.jpg&imgrefurl=http://www.news.harvard.edu/gazette/2000/01.27/polio_story.html&h=200&w=200&prev=/images%3Fq%3Dpolio%2Bvirus%26svnum%3D10%26hl%3Dtr%26lr%3D%26ie%3DUTF-8%26oe%3DUTF-8http://images.google.com.tr/imgres?imgurl=www.montana.edu/wwwpb/ag/norwalkcolorsm.jpg&imgrefurl=http://www.montana.edu/wwwpb/ag/norwalk.html&h=218&w=216&prev=/images%3Fq%3Dnorwalk%26svnum%3D10%26hl%3Dtr%26lr%3D%26ie%3DUTF-8%26oe%3DUTF-8


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Emerging foodborne parasites

Cryptosporidium parvum

Cyclospora cayetanensis

Anisakisspp.


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Foodborne outbreaks 1996 - 2006

Cryptosporidiosis, Leptospirosis, Lyme borreliosis

Brucellosis, E. coli0157, Salmonellosis

BSE

Reference: WHO


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Reference: CDC


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WHO Surveillance Programme for Control of Foodborne Infections and Intoxications inEurope 8th Report 1999-2000 Country Reports: Turkey


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Pathogen Emerging foodborne diseaesesestimated annually

Cases No. of No. ofIlnesses Deaths

Economiclosses fromfoodbornediseasesestimatedannualy

$ billion

Campylobacterspp.

1,963,141 10,539 99 1.2

Salmonellanon-typhoidal

1,341,873 15,608 553 2.4

E. coliO157:H7 62,458 1,843 52 .7

E. colinon-O157-

STEC

31,229 921 26 .3

L. monocytogenes 2,493 2,298 499 2.3

Total 3,401,194 31,209 1,229 6.9

Reference: USDAs Economic Research Service & CDC


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Year Country Food Serotype/Phagetype

No. ofcases

No. ofdeaths

1991 Germany Orange cream S.Enteritidis PT4 109 4

1991 Germany Puding (egg) S.Enteritidis 87 10

1994 U.S.A Ice cream S.Enteritidis 224000 -

2003 U.S.A Chicken S. Typhimurium 38 -

2005 Spain Processed

chicken

S. Hadar 2138 1

2006 Norway Salami S. Kedougou 54 1

2008 Ireland&U.K Beef, chicken S. Agona 119 -

Some Important Salmonella Outbreaks in the World


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Salmonella serotype distribution in Turkey(Erol et al., 2009)

S. Agona

S. Kentucky Spices

S. Bredeney


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Some Important CampylobacterOutbreaks in the World

Year Country Food No. ofcases

2000 U.K & Wales Raw milk 333

2001-2002 Australia Chicken 601

2005 Denmark Chicken salad 4

2005 Scotland Chicken pate 82

2005-2006 U.S.A Water 32

2007 U.S.A Cheese (fromunpasteurized milk)

67

2007 Denmark Water 16


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Quinolone- and fluoroquinolone-resistant Campylobacter jejuniin the United

States, 19822001


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Thermophilic Campylobacter spp. in turkey meat (n=270)

(Cakmak and Erol, 2009)

Thermophilic Camylobacterspp. 123 (45.5%)

C. jejuni109 (40.3 %)

C. coli 11 ( 4.0 %)

Not typed 3100 bp

500 bp

735 bp


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Antibiotic resistance profile ofC. jejuni isolates in

turkey meat (Cakmak and Erol, 2009)

Antibiotics Resistant % Intermediate % Sensitive %

Azithromycin 104 (95.4) 2 (1.8) 3 (2.7)

Erythromycin 103 (94.4) 0 6 (5.5)

Gentamicin 0 0 109 (100.0)

Chloramphenicol 0 3 (2.7) 106 (97.2)

Nalidixic acid 10 (9.1) 0 99 (90.8)

Ciprofloxacin 19 (17.4) 0 90 (82.5)

Tetracycline 40 (36.6) 2 (1.8) 67 (61.4)


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Country Year No of

cases(age)

Complications Infection

source

Japan 1996 >5499(students)

12 deaths Alfalfa

U.S.A 1999 321 - Beef

Canada 2000 27 5 deaths Water

Sweden 2002 39 - Fermentedsausage

U.S.A 2002 34 5 HUS Ground beef

Netherlands 2005 32 - Steak tartare

U.S.A 2006 376 3 deaths Freshspinach

Some importantE. coli O157:H7 Outbreaks in the World


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E. coliO157:H7 isolates found in fecal samples of cattle and

sheep at slaughter in Turkey (Erol et al., 2008)

Sheep CattleCattle(male)

Cattle(female) Total

Number

of

samples

218 282 207 75 500

Number

of

positive

samples

14 11 7 4 25

Percent

(%)

6.42 3.90 3.38 5.33 5.00


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Positive Negative Total

stx1 7 4 11

stx2 9 2 11

eaeA 11 - 11

hly 11 - 11

H7 11 - 11

Toxin profiles ofE. coliO157:H7 isolated in Turkey (Erol et al., 2008)


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Toxin profiles of 11 E. coliO157:H7 isolates within the PFGE

groups in cattle in Turkey (Erol et al., 2008)

PFGE groups N Toxin profiles

A 1 stx2

B 2 stx2

C 1 stx1and stx2

D4 stx1and stx22 stx1

1 stx2


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Some Important Listeriaoutbreaks in the WorldCountry Year Food Serotype No. of

casesNo. ofdeaths

U.S.A. 1998 Turkeyproducts 4b 108 18

Finland 1998 Butter 3a 25 24

France 2000 Pork meat 4b 32 31

U.S.A. 2000 Turkeyproducts 1/2a 30 7

U.S.A. 2002 Turkeyproducts

- 54 11

U.S.A. 2003 Mexican

cheese

4b 12 2

Switzerland 2005 Softcheese

- 11 2

Norway 2007 Cheese - 12 2

Canada 2008 Red meat - 53 20


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Contamination level of turkey meat with

L. monocytogenesis 17.8 % (32/180)

(Ayaz and Erol 2008)


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L. monocytogenesserotypedistribution

44.9 % 1/2a

37.2 % 4b

9.0 % 1/2b

9.0 % 1/2c


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Antibiotic resistance profiles ofL. monocytogenes in

turkey meat (n:24) (Ayaz and Erol, 2008)

Antibiotics Resistant (%) Intermediate(%)

Sensitive (%)

Ampicillin 18 (75.0) - 6 (25.0)

Chloramphenicol - - 24 (100)

Erythromycin - 9 (37.5) 15 (62.5)

Gentamicin - - 24 (100)

Penicillin 20 (83.3) - 4 (16.7)

Streptomycin - 8 (33.3) 16 (66.7)

Tetracycline - - 24 (100)

Vancomycin - - 24 (100)


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0

4.000

8.000

12.000

16.000

20.000

1999 2000 2001 2002 2003

Number of Brucella cases in Turkey, 1999-2003

(Ministry of Health)


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Occurrence ofCryptosporidiumspp. oocysts in Turkey

(Kursun and Erol, 2003)

Surface waterSewage watertreatment at

slaughterhouse

Ent. Exist.

Slaughtered

Cattle Sheep

Number of

samples 24 13 13 60 60

Number of

positivesamples 24 13 13 23 4

Percent

(%) 100 100 100 38.3 6.6


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Antibiotic resistance

Its a global concern of the antibioticresistance of major foodborne pathogenssuch as;

SalmonellaTyphimuriumDT 104Campylobacter spp.

Listeria monocytogenes

E. coliO157:H7Staphylococcus aureus(MRSA)

Enterococcus(VRE)

Foodborne Infections&Intoxications


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Lab.Confirmed

Cases

ReportedPositiveIsolates

Suspectible Cases

Unnotified Cases

HospitalisedNo sample taken

No medicalintervention

Known/ Unknown


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Farm to table; main contamination points


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Surveillance

Risk management Epidemiologicalevaluation /

Risk assessment

Research


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Control of Foodborne Disease

From farm to table approach

Implementation of GMP and HACCP


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Public Health Approach

Public health system

Surveillance

Epidemiology for earlier diagnosis

Early response to outbreaks

Provide to disease patterns changing Public health lab. support for rapid and accurate

diagnosis

Rapid communication links

Communication to public

Education on prevention and/or detection


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E-mail:

[email protected]

Factors contributing to the global incidence of foodborne


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Factors contributing to the global incidence of foodbornedisease

Poor sanitary conditions

Malnutrition

Changing demographics (increasing population of infants, elderly)

Inadequate public health infrastructure

Inadequate hygienic and technological conditions of food production

Inadequate cooking, reheating and storage conditions

Increasing tourism and international trade

Increasing animal movement and insufficient control of borders

Increasing international trade of animal and food

Inadequate legislation and official control system

Emerging/reemerging foodborne pathogens Acquisition of virulence and antibiotic genes by nonpathogenic bacteria

Adaptation and enhanced survival of pathogens in food

Inadequate consumer education


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Trichinellosis

outbreak in Turkey

Although there is a religious restriction on pork meatconsumption, in January 2004 there was a bigtrichinellosis outbreak occurred by consuming i

kfte (raw ground meat ball-traditional food) in Izmir

542 people were affected and samples were foundto be contaminated with T. britovi


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One World One Health (OWOH)

The medical and veterinary professions havea common interest in many diseases,primarily zoonotic diseases such as BSE,

SARS and, most recently, Avian Influenza(H5N1), have highlighted the need forinterprofessional collaboration not just locallyand nationally, but on a global scale.


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One World One Health (OWOH)

Improving animal and human health globallythrough collaboration among all the healthsciences, especially between the veterinary

and human medical professions to addresscritical needs.

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Emerging of Food Pathogen