Incidence Of Foodborne Disease Research Articles

Molecular Analysis of the Microbial Food Safety Implications of Food Reformulations for Improved Health

Food reformulation is commonly used as a strategy to produce foods for improved health; for example, replacing sugar with aspartame, and salt (NaCl) with KCl may help to reduce the incidence of obesity and heart disease. However, such reformulations will also change the intrinsic physicochemical properties of the food, which may in turn support the growth of foodborne pathogens and ultimately increase the incidence of foodborne disease. Thus, we need a better understanding of the microbiological food safety issues associated with product reformulation. Herein we review the most recent advances in our understanding of how microbial pathogens adapt to changes in the food composition, and how this information may ultimately be used for the design of effective pathogen control measures.

Comparison of Molecular Typing Methods for the Differentiation ofSalmonellaFoodborne Pathogens

Bacteria belonging to the genus Salmonella are among the leading causes of foodborne disease of bacterial etiology. These bacteria are also widely disseminated throughout the animal kingdom. The ability to identify the food source from which a human pathogen originated would be of great value in reducing the incidence of foodborne disease and the extent of disease outbreaks due to Salmonella. To date, efforts to identify the origin of these pathogens have centered on phenotypic and genotypic characterization of Salmonella isolates. This review focuses molecular or genotypic techniques that are currently being used for typing, and examines their strengths and weaknesses for determining the source of Salmonella foodborne infections.

A Multi-Factorial Risk Prioritization Framework for Food-Borne Pathogens

7 Abstract: To lower the incidence of human food-borne disease, experts and stakeholders have urged the development of a science- and risk-based management system in which food-borne hazards are analyzed and prioritized. A literature review shows that most approaches to risk prioritization developed to date are based on measures of health outcomes and do not systematically account for other factors that may be important to decision making. (Continued on next page)

Assessment of consumer food safety education provided by local authorities in the UK

PurposeThe purpose of this paper is to examine the extent, sources, diversity, costs, formats and content of food safety educational interventions for consumers provided by UK Local Authorities (LAs). Inadequate implementation of food safety practices in the home is known to contribute to the incidence of foodborne disease and therefore effective food safety education concerning risks and correct domestic food‐handling behaviours is essential.Design/methodology/approachA postal questionnaire was administered to all Environmental Health and Health Promotion departments in LAs in 2004 (n=436). The questionnaire assessed the extent of LA provision of consumer food safety advice, types, formats and content of interventions, rationale for information provision, methods used for design and delivery of information and participation in national initiatives.FindingsA considerable quantity of food safety advice is provided to UK consumers; in general this is variable between regions, variable in quality, infrequently evaluated and relatively uncoordinated. Overall, 95 per cent of UK LAs who responded to the questionnaire reported current provision of consumer food safety advice. The most common intervention used for provision of consumer hygiene information was leaflets (93 per cent of LAs) and data indicated that this is likely to continue. Hand‐washing (87 per cent), cross‐contamination (85 per cent) and cooking (77 per cent) were the most common issues reportedly addressed in hygiene initiatives. Less than a third of LAs reported evaluating the effectiveness of food hygiene advice.Originality/valueThis study has provided evidence of a large quantity of unique and diverse intervention materials across the UK, and suggests the need for the sharing of information materials and areas of innovation between LAs. Provision of generic, managed and co‐ordinated general and targeted food safety education resources in the UK may not only decrease important time and financial costs within LAs, but also increase consumer confidence in the accuracy of information provided and alleviate the risk for potential confusion of information from differing sources.

Biofilm formation in Campylobacter jejuni

The major gastrointestinal pathogen Campylobacter jejuni is shown to exist as three forms of monospecies biofilm in liquid culture. It attaches to a glass surface; forms an unattached aggregate (floc); and forms a pellicle at the liquid-gas interface. The three forms of biofilm resemble each other when examined by scanning electron microscopy. The biofilm mode of growth confers protection against environmental stress, the microaerobic bacteria in flocs surviving up to 24 days at ambient temperature and atmosphere compared to 12 days survival by planktonic bacteria. The wild-type strains C. jejuni 33106, 32799, 33084 and 31485 did not form flocs, and floc formation was reduced in strains mutant in a putative flagellar protein (FliS) and in a phosphate acetyltransferase (Cj0688). All other strains tested, including strains with mutations affecting capsular polysaccharide (kpsM), flagella (maf5), protein glycosylation (pglH) and lipo-oligosaccharide (neuB1) formed flocs. Similarly, all strains tested formed a pellicle and attached to glass except the aflagellate mutant maf5; pellicle formation was reduced in fliS and cj0688 mutants. Different mechanisms, therefore, may control formation of different forms of biofilm. It is proposed that these poorly characterized forms of growth are important for the persistence of C. jejuni in the environment and may in part explain the high incidence of Campylobacter-associated food borne disease.

Consumer perceptions of food safety education sources

PurposeConsumers often use inappropriate food‐handling practices and improving these could help to reduce the incidence of foodborne disease. However the development of an effective food safety education strategy is considered complex and could be improved by having a greater understanding of the consumer. This paper proposes investigating the modes and channels of communication that maybe used in education strategies.Design/methodology/approachA self‐complete postal questionnaire was distributed to a linked demographic quota of adults in South Wales. Responses were entered into a specially constructed food safety database.FindingsResults indicated that the Environmental Health departments and UK Food Standards Agency were perceived to be the most trusted and credible organisations that can provide food safety information. The most believable spokespersons for promotion of food safety advice were determined as Environmental Health officers and the Chief Medical Officer. The most preferred source of food safety information identified were food packaging, followed by advice from a medical doctor.Research limitations/implicationsAlthough only a relatively small sample size, many of the findings have been corroborated by qualitative data from nationwide focus groups. The data have been used as the precursor for a large nationwide study of over 2,000 consumers and this should further validate the data.Originality/valueThe results will be of benefit to a range of organisations currently engaged in food safety education as well as identifying potentially underutilised channels of communication.

The role of irradiation in food safety.

Foodborne disease leads to about 325,000 hospitalizations and 5000 deaths each year in the United States. The irradiation of food could sharply reduce the incidence of foodborne disease, but currently it is rarely performed. This article examines the reasons for the slow growth in the use of food irradiation. Like pasteurization, irradiation is an effective strategy to improve food safety.

Food Safety and Foodborne Disease in the 21st Century

Over the past decade there has been a growing recognition of the involvement of the home in several public health and hygiene issues. Perhaps the best understood of these issues is the role of the home in the transmission and acquisition of foodborne disease. The incidence of foodborne disease is increasing globally. Although foodborne disease data collection systems often miss the mass of home-based outbreaks of sporadic infection, it is now accepted that many cases of foodborne illness occur as a result of improper food handling and preparation by consumers in their own kitchens. Some of the most compelling evidence has come from the international data on Salmonella species and Campylobacter species infections.By its very nature, the home is a multifunctional setting and this directly impacts upon the need for better food safety in the home. In particular, the growing population of elderly and other immnocompromised individuals living at home who are likely to be more vulnerable to the impact of foodborne disease is an important aspect to consider. In addition, some developed nations are currently undergoing a dramatic shift in healthcare delivery, resulting in millions of patients nursed at home. Other aspects of the home that are unique in terms of food safety are the use of the home as a daycare centre for preschool age children, the presence of domestic animals in the home and the use of the domestic kitchen for small-scale commercial catering operations. At the global level, domestic food safety issues for the 21st century include the continued globalization of the food supply, the impact of international travel and tourism, and the impact of foodborne disease on developing nations.A number of countries have launched national campaigns to reduce the burden of foodborne disease, including alerting consumers to the need to practice food safety at home. Home hygiene practice and consumer hygiene products are being refined and targeted to areas of risk, including preventing the onward transmission of foodborne illness via the inanimate environment. It has been said that food safety in the home is the last line of defense against foodborne disease, and it is likely that this will remain true for the global population in the foreseeable future.

Globalization of the food supply–food safety implications: Special regional requirements: future concerns

The existence of regional differences in the prevalence of various food-borne pathogens in the food chain should be recognised and taken into account in the risk management process in international trade of foods. For the sake of human health protection and to minimise the incidence of food-borne disease it is important to acknowledge that acceptable risk levels for food-borne hazards will vary according to the regional microbiological conditions. This principle should be acknowledged by the relevant international bodies, such as the WTO and the Codex Alimentarius, and should be reflected in the elaboration of relevant international documents, such as risk management procedures in general and more specifically sampling plans and criteria. An acceptance of regional requirements may represent an incitement for the food industry to produce food products with a documented low prevalence of pathogens. Ultimately, this will benefit the consumers in all the countries by reducing the incidence of food-borne disease.

The use of epidemiological data in the control of foodborne viruses.

The Codex Committee on Food Hygiene has recommended the adoption of Hazard Analysis and Critical Control Point (HACCP) as the basis for food safety control. To provide an objective basis for the construction of HACCP systems, epidemiological data are required. The data should be accurate, up-to-date, and identify emerging pathogens, such as viruses. The number of laboratory reports of small, round-structured viruses in England and Wales has increased from 400 cases in 1990 to 2387 in 1996. Although a food vehicle is not essential for the spread of viral particles, food my be the primary unidentified vehicle. The Advisory Committee on the Microbiological Safety of Foods recommends the use of the Kaplan Criteria, which can give strong circumstantial evidence that an outbreak is attributable to small, round-structured viruses. The application of these criteria would give a more accurate reflection of the involvement of viruses in the incidence of foodborne disease. This review considers the use of epidemiological data to support HACCP and risk-assessment systems. It discusses the implications of focusing on traditional pathogens, for example Salmonella spp., as opposed to emerging pathogens, for the design of control systems. Recommendations are made for improving the system of data collection.

Management and environmental risk factors for Salmonella enteritidis contamination of eggs

SUMMARY Objective To analyze data for 60 poultry flocks voluntarily enrolled in the Pennsylvania Salmonella enteritidis Pilot Project and determine management and environmental risk factors associated with production of S enteritidis-contaminated eggs. Sample Population 60 flocks for which at least 1 environmental sample (manure or egg-handling equipment) was positive for S enteritidis. Procedure Samples of manure, egg-handling equipment, and mice were submitted for bacterial culture of S enteritidis. When S enteritidis was isolated from environmental samples, 1,000 eggs were collected from the flock every 2 weeks for 8 weeks and submitted for bacterial culture. Results 18 flocks were found to have produced contaminated eggs. Estimated overall prevalence of contaminated eggs was 2.64/10,000 eggs produced, but flock-specific prevalence ranged from 0 to 62.5/10,000 eggs. Flocks with high levels of manure contamination were 10 times as likely to produce contaminated eggs as were flocks with low levels. However, 5 flocks with low levels of manure contamination produced contaminated eggs. Conclusions Evaluation of the level of manure contamination could be used to help identify flocks at risk of producing S enteritidis-contaminated eggs. Clinical Relevance Flocks with high levels of S enteritidis-contaminated manure appeared to pose the greatest public health threat, and on-farm programs to reduce the prevalence of egg contamination should be developed for farms with high levels of manure contamination. Efforts to reduce the overall number of on-farm pathogens should decrease the incidence of foodborne disease in humans. (Am J Vet Res 1998;59:824–829)

Application of HACCP Principles in the Meat Industry: A United Kingdom Perspective

Mead, G, c.: Application of HACCP Principles in the Meat 1ndustry: a United Kingdom Perspective, Acta vet. Brno 1997.66: 117-125. Because of the rising incidence of microbial foodborne disease in the UK. particular attention is being given to the application of HACCP principles in all sectors of the food industry, including meat production. The basic requirements of HACCP systems for the red meat and poultry industries are well known. but not yet uniformly applied in UK abattoirs. To monitor progress in hygiene control, the Hygiene Assessment System (HAS) has been developed for abattoirs and meat cutting plants and the basis for the system is described. In a study of beef abattoirs. there was a significant negative correlation between mean HAS scores for each premises and mean total viable counts from carcasses sampled prior to chilling. In poultry plants. cross-contamination of carcasses via processing equipment is a continuing problem. Measures to reduce such contamination have been studied with the aid of a readily identifiable marker organism. which can be introduced and followed at any stage in the process. When similar control measures were used in an attempt to reduce contamination of carcasses with naturally occurring campylobacters, a small but significant reduction in count was observed. Further possible benefits of using more hygienic processing equipment and a terminal decontamination treatment for carcasses are discussed. The use of HACCP systems in the producion of ready-to-eat meat and poultry products is considered essential for optimum pathogen control. It is not yet possible, however, to exclude Listeria fIIollocytogenes. which occurs in various niches in the processing environment. Thus. low levels of Listeria are to be expected in a proportion of ready-to-eat products and are not regarded in the UK as hazardous to consumers. Foodbome iIIness,food safety. public health Over the last decade, foodborne illness has continued to rise in the UK and new causative agents have emerged, particularly thermophilic campylobacters, Salmonella enteritidis PT4 and Listeria monocytogenes. Between 1985 and 1994, the number ofnotified cases in England and Wales for all agents rose from approximately 12,000 to 49,000 per annum. By the late 1980s, the problem had received considerable publicity and consumer concern was widespread. The British Government responded to the situation by establishing an advisory body, the Committee on the Microbiological Safety of Food. The remit of the Committee included a thorough investigation of the relationship between foodborne disease and existing practices in food production, processing and handling and the development of effective control measures. An important outcome of the exercise was the realisation that a more systematic approach was needed for the identification and control of microbial hazards in the food industry, as provided by the Hazard Analysis Critical Control Point (HACCP) system (Report 1990, 1991). It was recognised that the HACCP approach directs attention to the key factors in controlling food safety, defines both safety parameters and the action to be taken when safe limits are exceeded and provides documentary evidence of regular process monitoring. How has this modern view of food-safety control affected the UK Meat Industry? Firstly, it has highlighted the inadequacies of the traditional system of post mortem meat inspection, which focuses on visible lesions and carcass defects, but largely fails to address the public

Food safety: Review and Implications for Dietitians and Dietetic Technicians

Section 103 (d) of the Americans with Disabilities Act directs the secretary of health and human services to identify, publish, and annually review a list of pathogens transmitted via food contaminated by infected food handlers. The secretary is also directed to publish means by which diseases on the list are transmitted. The intent of the list is to protect disabled food handlers when they become ill and to provide managers with information for determining when to remove or reassign disabled food handlers who have infectious or communicable diseases to jobs that do not involve handling food. Pathogens often transmitted via food contaminated by infected food handlers are Salmonella lyphi, Shigella species, Staphylococcus aureus, Streptococcus pyogenes, hepatitis A virus, and the Norwalk and Norwalk-like viruses. This article discusses section 103 (d) and for each of the six pathogens describes characteristics and growth requirements, types of foods involved in outbreaks, factors that contribute to foodborne outbreaks, and prevention and control measures. Human beings are the only reservoir of Sal typhi. The source of Shigella species is the intestinal tract of human beings and other primates. Human beings are the common reservoir of Staph aureus and Strep pyogenes. Staph aureus is frequently found in the nose and on the skin of healthy people, whereas Strep pyogenes is carried in the throat of infected or asymptomatic carriers. Foodborne viruses of public health concern originate in the human intestine. Foods that favor the multiplication of Sal typhi are often foods that require no cooking. Many outbreaks of foodborne disease attributed to Shigella species and viruses have been associated with salads. Moist, high-protein, and salty foods that have been cooked are most often involved in outbreaks of staphylococcal foodborne illness. Foods usually implicated in Strep pyogenes outbreaks are predominately composed of milk, eggs, or meat. Dietitians and dietetic technicians can use three approaches to reduce the incidence of foodborne disease attributed to food handlers: conducting training and education programs, implementing a Hazard Analysis and Critical Control Points system, and supporting certification of foodservice managers. J Am Diet Assoc. 1996; 96:163–168,171.

Limits In Assessing Microbiological Food Safety

Scientific information pertaining to the incidence of foodborne disease and the sources of pathogenic microorganisms is often limited in relation to the knowledge needed to make informed microbiological food safety decisions. Inherent limitations in the current epidemiological reporting system constrain its usefulness for ascertaining the true incidence of foodborne disease. Additionally, current detection methods are insufficient to make real-time decisions on the microbiological safety of products. An integrated approach that combines enhanced epidemiological data, improved detection methods, detailed knowledge of the behavior of pathogens in food systems, and development of techniques for making quantitative risk assessments is essential for the development of a comprehensive, cost-effective strategy for assuring microbiologically safe foods.

Will irradiation enhance or reduce food safety?

The results of over 30 years of research on the toxicological, microbiological and nutritional quality of irradiated foods have led the World Health Organization to recommend food irradiation as a technique for preserving and improving the safety of food. The alarming increase in the incidence of food-borne disease in many parts of the world has strengthened arguments in favour of using this technique. Practical experience in countries where food irradiation has been used for 10–20 years has not confirmed any of the fears expressed by opponents of the process. Nevertheless strong political opposition has blocked the practical application of food irradiation in many countries and has hampered it in others.

Data Needs to Address Economic Issues in Food Safety

Invisible hazards and imperfect information held by producers, consumers, and regulators continue to make food a volatile issue that can disrupt markets and cause substantial losses to suppliers of agricultural inputs, farmers, marketers, and consumers. New and improved data are needed to assess risks, consumer demand, and costs of alternative private and public control strategies. Food data were identified as a high priority by several groups. The 1989 Survey of Agricultural and Rural Social Scientists ranked very important data collection and dissemination efforts and gave develop measures of food safety a rank of seventh and inventory of pesticide and herbicide applications a rank of ninth (Hushak, Chern, and Tweeten). A report of the planning and budget subcommittee of the Experiment Station Committee on Organization and Policy (ESCOP), Research Agenda for the 1990s: A Strategic Plan for the State Agricultural Experiment Stations, rated ensuring the and stability of consumer foods as its first priority. The National Research Initiative Competitive Grants Program in the U.S. Department of Agriculture (USDA) added food to its list of program areas for funding in 1990, largely because of ESCOP's rating. President Bush proposed a major food initiative in 1989 with a large data collection component, and Congress appropriated funds in 1990. Better data are needed on the incidence, severity, and economic dimensions of foodborne disease from microbial (bacteria, parasites, fungi, and viruses), chemical (insecticides, herbicides, fertilizers, animal drugs, environmental contaminants, food additives), and natural constituents (including biotechnology) in food.' No data source exists with definitive estimates of the number of illnesses caused by foodborne sources or the distribution of disease severities (OMB). The estimates in the literature suggest that microbial sources are causing from 6.5 to 33 million cases of foodborne disease annually and 9,000 deaths (Bennett et al., Garthright, Archer, and Kvenberg). Chemical sources of foodborne disease risk are less well characterized. A worst case EPA estimate suggests 6,000 cases of cancer annually (EPA 1987), while others have reckoned the risk to be much smaller (EPA 1990, Ames and Gold, Archibald and Winter). Economists can contribute to the food discussion by identifying data needed for economic analysis, estimating the social welfare costs of foodborne illness, and estimating benefits and costs of alternative control programs.

Incidence of Foodborne Diseases in The Netherlands: Annual Summary 1982 and an Overview from 1979 to 1982

Data on the incidence of foodborne disease in 1982 are presented. A total of 319 incidents affecting 1376 ill persons was analyzed. In 86 incidents (553 cases), the etiology was established. Microorganisms appeared to be the main causative agents: Bacillus cereus was responsible for 17 of these incidents (53 cases), Salmonella for 15 (83 cases), Campylobacter jejuni and Staphylococcus aureus for 11 (220 and 51 cases, respectively). Clostridium perfringens for 10 (96) and Yersinia enterocolitica for 1 (3). In 2 outbreaks (7 cases), several bacterial agents were detected without being able to discover which one had caused the symptoms. In 7 episodes (13 cases), illness resulted from ingestion of food contaminated with scombrotoxin. In one incident (4 cases), food had been contaminated with an excess of nutmeg and in 9 (20 cases) with monosodium glutamate. Two episodes (3 cases) were attributed to spoiled food. Cases of foodborne disease recorded by the Chief Medical Inspectorate, but not analyzed due to a lack of epidemiological information, included infections from Salmonella (6795), C. jejuni (1728) and Y. enterocolitica (274). Meat and meat products (24 incidents), fish and shellfish (25), snacks (21) and Dutch meals (23), but especially Chinese foods (132) were associated with incidents most frequently. About 70% of the incidents involved places where food is prepared for immediate consumption. Examples of outbreaks are presented.

Incidence of Foodborne Disease in the Netherlands: Annual Summary - 1981

Data on the incidence of foodborne disease in 1981 are presented. A total of 415 incidents affecting 3618 ill persons was analyzed. In 122 incidents (1683 cases) the etiology was established: micro-organisms appeared to be the main causative agents. Clostridium perfringens was responsible for 18 of these incidents (106 cases), Staphylococcus aureus for 17 (67), Salmonella for 16 (1114), including the outbreak during the European Summit Conference at Maastricht (700 cases), Bacillus cereus for 15 (135) and Campylobacter jejuni for 13 (142). Two episodes were probably caused by Clostridium botulinum (2 cases) and ECHO-viruses (48). In 7 episodes (11 cases) illness resulted from ingestion of food contaminated with scombrotoxin, in 6 episodes (13) with saxitoxin (shellfish poison). In 16 incidents (32 cases) foods had been contaminated with chemical substances. Cases of foodborne disease recorded by the Chief Medical Inspectorate included infections from Salmonella (7496), C. jejuni (1496) and Yersinia enterocolitica (262). However, these could not be analyzed further due to a lack of epidemiological information. Meat and meat products (49 incidents), fish and shellfish (42), Dutch meals (42) and Chinese foods (128) were associated with outbreaks most frequently. About 60% of the incidents involved places where food is prepared for immediate consumption. Examples of outbreaks are presented.

Incidence of Foodborne Disease in the Netherlands: Annual Summary - 1980

Data on the incidence of foodborne disease in 1980 are presented. A total of 272 incidents affecting 1298 ill persons were analysed. In 64 incidents (337 cases), the etiology was established; micro-organisms appeared to be the main causative agents. Salmonella was responsible for 15 of these incidents (55 cases), Staphylococcus aureus for 6 (106), Clostridium perfringens for 8 (57), Bacillus cereus for 17 (88) and Campylobacter jejuni for 4 (9). Three episodes (4 cases) were caused by Yersinia enterocolitica, Escherichia coli and Vibrio sp. In 11 episodes (18 cases) illness resulted from ingestion of food contaminated with chemical substances. Cases of foodborne disease recorded by the Chief Medical Inspectorate included infections from Salmonella (6347) C. jejuni (531) and Y. enterocolitica (264). However, these could not be analysed further due to a lack of epidemiological information. About 60% of the outbreaks were associated with only two food items: meat and meat products (15%) and Chinese foods (44%). Mishandling of food in foodservice establishments resulted in about two-thirds of the incidents. It is supposed that there is an “over-reporting” of incidents involving Chinese foods from take-away restaurants, compared to episodes involving other foods from other locations, especially from private households. The role of viruses in outbreaks of foodborne gastroenteritis with an incubation period of more than 24 h is discussed.

Incidence of Foodborne Disease in The Netherlands: Annual Summary 1979

Data on the incidence of foodborne disease in 1979 are presented. A total of 163 incidents affecting 604 ill persons were analyzed. In 42 incidents, the etiology was established; microorganisms appeared to be the main causative agents. Salmonella was responsible for 8 of these incidents (20 cases), Staphylococcus aureus for 7 (28), Clostridium perfringens for 11 (24) and Bacillus cereus for 6 (29). In 9 incidents (15 cases), illness resulted from ingestion of chemicals. About 60% of the episodes were associated with only two food items-meat and meat products (30%) and Chinese food (28%). Mishandling of food in foodservice establishments resulted in about one third of the incidents, and mishandling at home in another quarter. Cases of foodborne disease recorded by the Ministry of Public Health included infections from Salmonella (6174), Yersinia enterocolitica (116) and Campylobacter (202). However, these could not be analyzed further due to a lack of epidemiological information.