Multidisciplinary and evidence-based method for prioritizing diseases of food-producing animals and zoonoses

To prioritize 100 animal diseases and zoonoses in Europe, we used a multicriteria decision-making procedure based on opinions of experts and evidence-based data. Forty international experts performed intracategory and intercategory weighting of 57 prioritization criteria. Two methods (deterministic with mean of each weight and probabilistic with distribution functions of weights by using Monte Carlo simulation) were used to calculate a score for each disease. Consecutive ranking was established. Few differences were observed between each method. Compared with previous prioritization methods, our procedure is evidence based, includes a range of fields and criteria while considering uncertainty, and will be useful for analyzing diseases that affect public health.

[The new microbiological hazards in food]

This paper describes the new microbiological hazards in food. For protecting human health, nowadays food safety authorities face with many challenges, that years ago were largely unheard. In 2011 verocytotoxigenic Escherichia coli O104:H4 has been isolated in Germany. Strain came from fenugreek sprouts originated from Egypt. It was characterized by unique features such as presence of enteroaggregative Escherichia coli genes (aatA, aggR, aap, aggA, aggC) and resistance to most antibiotics. In Poland only three cases of disease caused by O104:H4 strain have been reported. Another emergence pathogen in Poland is Yersinia enterocolitica 08, biotype 1B. It is the most pathogenic bioserotype recently isolated in the USA only. Food-borne is commonly associated with raw or undercooked pork. The source of Yersinia spp. may be also milk and water. The presence ofbotulinum neurotoxins in food is not new, but still an important issue because of their high toxicity to human. Botulinum neurotoxins are high-molecular thermolabile proteins produced by Clostridium botulinum and some strains of Clostridium butyricum and Clostridium baratii. Based on their antigenic properties, botulin neurotoxins are divided into seven types A-G, however only types A, B, E and F are toxic to humans and some animals. Increasing risk associated with food results from antimicrobial resistance eg. extended spectrum beta-lactamases (ESBLs) producing bacteria, particularly Enterobacteriaceae. Until recently strains ESBL+ were isolated in hospitals, however during last years they have been isolated from healthy humans, animals and food of animal origin. Increasingly common microbiological hazard in food is methicillin-resistant Staphylococcus aureus (MRSA). Although prevalence of this pathogen in food is not high, the thread comes from difficulties of treating of infections caused by MRSA. The occurrence of food-borne in humans may also be associated with presence of viruses in food and water. The carrier of viruses may be equipment in food plant, production line, packaging and man. Most food-borne are caused by noroviruses, rotaviruses, hepatitis A virus and hepatitis E virus. An increased number of food-borne viral outbreaks are recorded in several countries. Reasons for this include the improved diagnostic methods that have enhanced detection of some virus groups, and the increased marketing of fresh and frozen foods that has led to a worldwide availability of high risk food. Viruses may contaminate food either through contamination at source, principally through sewage pollution of the environment, or in association with food

Denmark: botulism in an infant or infant botulism?

A 4.5 months old, previously healthy Danish girl was admitted to a paediatric department after six days of passive behaviour and weak suck. Over the next days she became increasingly weak, developed bilateral ptosis, the muscle stretch reflexes were lost, and mydriasis with slow pupillary responses was noted. Botulism was suspected and confirmed by testing of patient serum in a bioassay. The condition of the patient improved following administration of botulism antiserum. The clinical picture was suggestive of intestinal (infant) botulism. However, botulism acquired from consumption of food with preformed neurotoxin could not be excluded.

Food safety: emerging trends in foodborne illness surveillance and prevention

Between 250 and 350 million Americans are estimated to suffer acute gastroenteritis annually, with 25% to 30% thought to be caused by foodborne illnesses. Most vulnerable to foodborne diseases are elderly people, pregnant women, immune-compromised people, and children. While bacterial causes such as Salmonella are widely recognized and monitored as foodborne infections, other important bacterial causes such as Clostridium perfringens , Bacillus cereus , and Staphylococcus aureus are less well known. While the majority of cases of foodborne diseases are of unknown cause, bacteria and viruses are the most likely causative agents. Caliciviridae (Norwalk-like) virus cases are more difficult to identify, but represent the most common cause of known and probably unknown cases. Fresh produce has to be added to the traditional list of foods requiring careful selection and handling to prevent foodborne disease. To assess the disease burden in the United States, morbidity and mortality surveillance activities are done by several networks and systems with collaboration among federal agencies and health departments. Not all important causes are being equally monitored. Critical behaviors by food processors, food retailers, foodservice personnel, and consumers can reduce the risk of foodborne illness episodes. Dietetics professionals can more readily monitor new developments and update knowledge and practice through online resources.

Food-related illness and death in the United States

To better quantify the impact of foodborne diseases on health in the United States, we compiled and analyzed information from multiple surveillance systems and other sources. We estimate that foodborne diseases cause approximately 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths in the United States each year. Known pathogens account for an estimated 14 million illnesses, 60, 000 hospitalizations, and 1,800 deaths. Three pathogens, Salmonella, Listeria, and Toxoplasma, are responsible for 1,500 deaths each year, more than 75% of those caused by known pathogens, while unknown agents account for the remaining 62 million illnesses, 265,000 hospitalizations, and 3,200 deaths. Overall, foodborne diseases appear to cause more illnesses but fewer deaths than previously estimated.

Food poisoning--fact or fiction? An observation of the current interpretation of the term 'food-poisoning'

The Communicable Disease Report number 84/52 has given a clear indication that Campylobacter infections are now the most significant reported causes of gastrointestinal infection. The figures given indicate approximately 22,000 Campylobacter infections in 1984 as opposed to approximately 14,000 Salmonella infections, with, more importantly, the trend increasing with regard to Campylobacter, and decreasing with regard to Salmonella infections. Campylobacter enteritis would now appear to be a major problem both in terms of human suffering and in its economic effects. It is reported, for example, that at least 80,000 working days may be lost in the United Kingdom per year. The fundamental problem raised by Campylobacter enteritis is whether we need to have a standardized definition of food poisoning accepted in law to allow central government and local authorities to manage in particular the problems related to Campylobacter enteritis. From information available, it appears that local authorities have differing interpretations as to the classification and subsequent management of Campylobacter enteritis. In order to control the identified trend in the increase of Campylobacter infections, the need for a clear and explicit definition is rapidly becoming essential.