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Wednesday, 4 January 2012

Food safety in 2011 – Did your favourite bug make the least wanted list?

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On December 21st, one of the public health holiday “presents” was the release of Canada’s food safety report CFIA food safety page with links.  Later on that very day, the US food safety report was also released and is accessible at US food safety report .  Coincidence?  The probability of two annual reports being released on the same day is roughly 0.002.  The probability that two independent national level reports on the same subject are released on the same day within the year that they were actually supposed to be released is even closer to zero.  We should be reassured that our governments continue to have close relations and work collaboratively on many joint public health issues. 
The major difference between the two reports, is the US report is in relatively plain language and easier to read.  The Canadian report talks about what has been done since the Listeria outbreak of 2008.  The US report speaks to what has been accomplished since adoption of the Food Safety Modernization Act early in 2011 and clearly states the steps going forward. Both are worth reading and provide a crash course in the food safety issues and a real impetus to drive down disease rates further like some Scandinavian countries have already accomplished through aggressive methods of ensuring food reaching the kitchen is not contaminated.
According to CFIA 1 in 3 Canadians is expected to suffer a bout of foodborne illness every year, that converts to some 11 Million episodes each year in Canada.  Using the US estimates would suggest the rate of illness is about half south of the border.   Actually it is unlikely that the rates are substantially different but the methods to calculate them are.   What’s a few Million illnesses between neighbours anyway.  Conservatively about 12000 will require hospitalization and there will be some 300 deaths that are likely attributable to foodborne illness.
The good news, is most enteric infection rates continue to trend downward.  See the embedded graph of Campylobacter (red), Salmonella (green) and Verotoxic E. Coli. (blue) rates in Canada from 89-04   

The bad news and the constant reminder of why renewed vigilence is required is on the front pages of newspapers.   In a continuing education module (which is not openly accessible) was a review of a few of the top foodborne outbreaks for 2011. They are a sobering reminder of the burden. 
·         In June the deadliest modern history foodborne outbreak killed at least 46, caused haemolytic uremic syndrome in 782 and infected nearly 4000 people associated with fenugreek sprouts – the contaminated seeds of two epicentres of the outbreak were traced back to Egypt. The causative agent was a Shiga-toxin producing E. Coli 0104:H4.
·         In August, 106 infections for Salmonella Agona associated with papayas from Mexico
·         On the tails of the 23 Canadians who died in 2008, a cantaloupe associated Listeria outbreak killed 30 Americans through the fall.
·         In November, some 136 infections and one death were associated with multidrug resistant S. Heidelberg in ground turkey resulting in 16 Million kilos being recalled.
If you haven’t noticed, an increasing proportion of foodborne outbreaks appear to be associated with fresh fruits and vegetables.   Ground meats (including processed meat slices) remain a major cause and are usually associated with cross contamination in the meat processing plant. 
A nice quick review of the top 10 bugs can be found on the CFIA website Top 10 foodborne illness bugs
A few quick tips for personal protection:
·         Clean your fresh fruits and vegetables
·         Keep cold foods cold, and hot foods hot – probably applies to fresh fruits now too.
·         Don’t cross contaminate surfaces in the kitchen.  
·         Use a food thermometer to makes sure foods are cooked
Did you know that during pregnancy, for persons over 60, and those with weakened immune systems should avoid processed meats and unpasteurized mild products (eg. Some soft cheeses)?   While the warning is posted in many places, it is not advise that is getting to those at risk.  

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