Transcript FOOD SAFETY: FOODBORNE PATHOGENS

EMERGING FOODBORNE
PATHOGENS
Prof. Dr. İrfan EROL, DVM, Ph.D.
Turkish Representative of World Vet. Assoc.
Department of Food Hygiene and Technology
School of Veterinary Medicine
Ankara University
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Despite advances in hygiene, consumer
knowledge, food treatment and processing,
foodborne diseases mediated by pathogenic
microorganisms or microbial toxins still
represent a significant treat to public health
worldwide.
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Globally, the WHO has
estimated that
approximately 1.5 billion
episodes of diarrhea and
more than 3 million deaths
occurred in children under
5 years of age, and a
significant proportion of
these results from
consumption of food
mainly food of animal
origin with microbial
pathogens and toxins
Emerging & Reemerging Zoonotic
Diseases
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60 % of the human pathogens are zoonotic
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75 % of emerging zoonotic
Emerging Foodborne Pathogens
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Definition:
those causing illnesses that have only
recently appeared or been recognised in a
population or that are well recognised but are
rapidly increasing in incidence or geographic
range
Emerging Foodborne Diseases
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Appeared recently
Extended to new vehicles of transmission
Started to increase rapidly in incidence or
geographic range
Been widespread for many years but only
recently identified through new or increased
knowledge or methods of identification and
analysis of the disease agent
Emerging Foodborne Diseases
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Pose a threat to all persons; no matter on
age, sex, lifestyle or socio-economic status
etc.
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Feel pain and death
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Economic impact
Emerging Foodborne Diseases
Major trends
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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
Emerging Foodborne Pathogens
Bacteria
 Viruses
 Parasites
 Prion
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Emerging foodborne bacteria
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Salmonella (multidrug resistant strain)
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Campylobacter jejuni
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E. coli O157:H7
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Listeria monocytogenes
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S. aureus MRSA
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Vibrio vulnificus
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Yersinia enterocolitica
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Arcobacter spp.
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Mycobacterium paratuberculosis
Emerging foodborne viruses
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Hepatit A and E
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Norovirus
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(Avian influenza, AI)
Emerging foodborne parasites
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Cryptosporidium parvum
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Cyclospora cayetanensis
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Anisakis spp.
Foodborne outbreaks 1996 - 2006
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▼ Cryptosporidiosis, Leptospirosis, Lyme borreliosis
Reference: WHO
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Brucellosis, E. coli 0157, Salmonellosis
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BSE
Reference: CDC
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WHO Surveillance Programme for Control of Foodborne Infections and Intoxications in
Europe 8th Report 1999-2000 Country Reports: Turkey
Pathogen
Emerging foodborne diseaeses
estimated annually
Cases
No. of
Ilnesses
No. of
Deaths
Economic
losses from
foodborne
diseases
estimated
annualy
$ billion
Campylobacter
spp.
1,963,141
10,539
99
1.2
Salmonella nontyphoidal
1,341,873
15,608
553
2.4
E. coli O157:H7
62,458
1,843
52
.7
E. coli non-O157STEC
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: USDA’s Economic Research Service & CDC
Some Important Salmonella Outbreaks in the World
Year
Country
Food
Serotype/Phage
type
No. of
cases
No. of
deaths
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
-
Salmonella serotype distribution in Turkey
(Erol et al., 2009)
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S. Agona
S. Kentucky
S. Bredeney
Spices
Some Important Campylobacter Outbreaks in the World
Year
Country
Food
No. of
cases
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 (from
unpasteurized milk)
67
2007
Denmark
Water
16
Campylobacter jejuni
Quinolone- and fluoroquinolone-resistant Campylobacter jejuni in the United
States, 1982–2001
Campylobacter jejuni
Thermophilic Campylobacter spp. in turkey meat (n=270)
(Cakmak and Erol, 2009)
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Thermophilic Camylobacter spp. 123 (45.5%)
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C. jejuni 109 (40.3 %)
C. coli
11 ( 4.0 %)
Not typed 3
100 bp
500 bp
735 bp
Antibiotic resistance profile of C. 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)
Some important E. coli O157:H7 Outbreaks in the World
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
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Fermented
sausage
U.S.A
2002
34
5 HUS
Ground beef
Netherlands 2005
32
-
Steak tartare
U.S.A
376
3 deaths
Fresh
spinach
2006
E. coli O157:H7 isolates found in fecal samples of cattle and
sheep at slaughter in Turkey (Erol et al., 2008)
Number
of
samples
Number
of
positive
samples
Percent
(%)
Sheep
Cattle
Cattle
(male)
Cattle
(female)
Total
218
282
207
75
500
14
11
7
4
25
6.42
3.90
3.38
5.33
5.00
Positive
Negative
Total
stx1
7
4
11
stx2
9
2
11
eaeA
11
-
11
hly
11
-
11
H7
11
-
11
Toxin profiles of E. coli O157:H7 isolated in Turkey (Erol et al., 2008)
Toxin profiles of 11 E. coli O157: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
stx1 and stx2
4
stx1 and stx2
2
stx1
1
stx2
D
Some Important Listeria outbreaks in the World
Country
Year
Food
Serotype
4b
No. of
cases
108
No. of
deaths
18
U.S.A.
1998
Turkey
products
Finland
1998
Butter
3a
25
24
France
2000
Pork meat 4b
32
31
U.S.A.
2000
Turkey
products
1/2a
30
7
U.S.A.
2002
Turkey
products
-
54
11
U.S.A.
2003
Mexican
cheese
4b
12
2
Switzerland
2005
Soft
cheese
-
11
2
Norway
2007
Cheese
-
12
2
Canada
2008
Red meat -
53
20
Contamination level of turkey meat with
L. monocytogenes is 17.8 % (32/180)
(Ayaz and Erol 2008)
L. monocytogenes serotype
distribution
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44.9 %
37.2 %
9.0 %
9.0 %
1/2a
4b
1/2b
1/2c
Antibiotic resistance profiles of L. monocytogenes in
turkey meat (n:24) (Ayaz and Erol, 2008)
Antibiotics
Resistant (%)
Intermediate
(%)
Sensitive (%)
Ampicillin
18 (75.0)
-
6 (25.0)
Chloramphenicol
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24 (100)
Erythromycin
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9 (37.5)
15 (62.5)
Gentamicin
-
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24 (100)
Penicillin
20 (83.3)
-
4 (16.7)
Streptomycin
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8 (33.3)
16 (66.7)
Tetracycline
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24 (100)
Vancomycin
-
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24 (100)
Number of Brucella cases in Turkey, 1999-2003
(Ministry of Health)
20.000
16.000
12.000
8.000
4.000
0
1999
2000
2001
2002
2003
Occurrence of Cryptosporidium spp. oocysts in Turkey
(Kursun and Erol, 2003)
Sewage water
treatment at
slaughterhouse
Surface water
Ent.
Number of
samples
Number of
positive
samples
Percent
(%)
Exist.
Slaughtered
Cattle
Sheep
24
13
13
60
60
24
13
13
23
4
100
100
100
38.3
6.6
Antibiotic resistance
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It’s a global concern of the antibiotic
resistance of major foodborne pathogens
such as;
Salmonella Typhimurium DT 104
Campylobacter spp.
Listeria monocytogenes
E. coli O157:H7
Staphylococcus aureus (MRSA)
Enterococcus (VRE)
Lab.
Confirmed
Cases
Foodborne Infections&Intoxications
Known/ Unknown
Suspectible Cases
Reported
Positive
Isolates
Hospitalised
No sample taken
Unnotified Cases
No medical
intervention
Farm to table; main contamination points
Surveillance
Risk management
Epidemiological
evaluation /
Risk assessment
Research
Control of Foodborne Disease
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From farm to table approach
Implementation of GMP and HACCP
Public Health Approach
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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
E-mail:
[email protected]
Factors contributing to the global incidence of foodborne
disease
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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
Trichinellosis
outbreak in Turkey
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Although there is a religious restriction on pork meat
consumption, in January 2004 there was a big
trichinellosis outbreak occurred by consuming çiğ
köfte (raw ground meat ball-traditional food) in Izmir
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542 people were affected and samples were found
to be contaminated with T. britovi
One World One Health (OWOH)
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The medical and veterinary professions have
a common interest in many diseases,
primarily zoonotic diseases such as BSE,
SARS and, most recently, Avian Influenza
(H5N1), have highlighted the need for
interprofessional collaboration not just locally
and nationally, but on a global scale.
One World One Health (OWOH)
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Improving animal and human health globally
through collaboration among all the health
sciences, especially between the veterinary
and human medical professions to address
critical needs.