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

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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)