Foodborne outbreaks: managing the risks

Abstract

Q: What have we learnt about comnunicating the risk of a health threat to the public following the E. coli infection outbreak in Germany? Was it necessary to issue a warning on certain types of food before the source of the outbreak was confirmed? A: It will take time to fully assess all of the lessons to be gleaned from the events in Germany, but a few points can be highlighted. Outbreaks of foodborne disease are particularly likely to have economic implications as they often involve commercially produced products. Consumers will often react to concerns about a particular food by avoiding consumption of similar products, even if there is no evidence to warrant it. To manage the risk of harming the public, governments must assess the evidence and make decisions to protect people's health, even if there may be economic consequences. What was unusual about this event was the broad recommendation to avoid eating three entire groups of foods. There are many varieties of lettuce, tomatoes and cucumbers and it would be very unlikely that all types of all three groups of foods would be the source of the outbreak. While such broad warnings can be justified, having them in place for an extended period of time can inflict economic damage and destroy livelihoods, even outside the affected country, as seen in this case. However, it must be stressed that public health authorities must always balance the health risk to the population against other undesirable consequences. What is also important is that the German authorities have shared all the information they had with the appropriate WHO channels. Q: Following the E. coli infection outbreak in Germany, the Russian Federation banned the import of European Union faod products and Spanish farmers had to give away their produce. How can governrnents communicate the risks that people face during faod poisoning outbreaks, while avoiding unnecessary economic damage? A: The priority must always be on protecting public health and thus economic considerations should never compromise public safety. The solutions to minimizing economic damage and protecting public health are the same. Both require a rapid coordinated response involving epidemiologists, microbiologists and food safety authorities to assemble the evidence, pinpoint the source of the outbreak and remove it from the marketplace as quickly as possible. The faster and the more accurately the source can be narrowed down, the more precise the advice for consumers can be and the more targeted the action to remove the offending food. Q: Are there mechanisms for coordinating communications surrounding such outbreaks to avoid mixed messages? A: Each country will be organized a little differently in terms of the way it coordinates these communications at a national level. On an international level, there are very clear mechanisms for sharing information. One is through the International Health Regulations (IHR) and the other is through a technical network of food safety authorities called the International Food Safety Authorities Network (INFOSAN). These two mechanisms often work in a complementary way. For example in December of 2009, iodine toxicity was identified in Australia linked to high levels of iodine in a soy milk product produced in Japan. The same product had, been exported to several other countries. Australia notified WHO of the problem, under the IHR, and this information was shared with other governments to ensure that they were aware of the potential impact on people's health in their countries. Information was also sent out to INFOSAN members to ensure that appropriate and timely action was taken to remove the offending food product. Q: What is the role of INFOSAN? A: INFOSAN is a voluntary technical network managed by the Food and Agriculture Organization (FAO) and WHO that brings together national authorities playing a role in food safety. Food safety is a shared responsibility in most countries: there is no single agency that does it all. …