How has public perception of food safety and health risks changed a year after the pandemic and vaccines roll out?

The recent coronavirus pandemic (COVID-19) has caused unprecedented turmoil and spurred fears that have profoundly changed the public's social and health behaviours, including the perception of food safety risks. One year after the pandemic and the global vaccination campaign, the public perception of food safety and the changes in their hygiene behaviour, health risks concerns, and trust were studied in Jordan, Lebanon, and Tunisia using a cross-sectional online survey. The results of 538 subjects showed a rise in the frequency of hygiene practices, notably in handwashing. Sixty-four percent of the participants were vaccinated, a proportion made up mainly of the Jordanians and Lebanese. For 66% and 64% of the two population groups, respectively, there were no longer trust concerns about COVID-19 health risks following vaccination, whereas the worries about getting COVID-19 persisted for others. Only 47% of participants trusted eating food prepared by vaccinated food handlers. A great majority of the Tunisians (81%) showed varying degrees of concern about COVID-19 transmission from food and the lowest vaccination rate (33%). The current study demonstrated that the impact of vaccination policy positively affects public perception of food-related risks during the pandemic. On the other hand, 33% of the surveyed Jordanians and Tunisians lost trust in the health authorities' management of the pandemic, and 45% of the Lebanese still don't trust them. Communication strategies on health and food safety with the public still represent a challenge for these and probably other countries in the Middle East and North Africa (MENA). Strategies for building and maintaining public trust are crucial to curb persistent fear of food, hence, avoiding potential stigmatization affecting the food economy by promoting health awareness and positive changes in food safety perceptions for safer practices.

An on-line survey of the behavioral changes in Lebanon, Jordan and Tunisia during the COVID-19 pandemic related to food shopping, food handling, and hygienic practices.

The impact of the novel coronavirus pandemic (COVID-19) has spanned across the various aspects of life globally. Understanding public reactions is vital for effective risk communication and outbreak control and prevention. The Arab world has diverse cultural, economic, and social structures, so public choices and decisions also vary. To investigate the changes in behavior related to food shopping and handling, precautions measures, and hygiene practices of the public during the pandemic, a web-based survey tool was developed and conducted on 1074 subjects in three Arab countries, Lebanon, Jordan, and Tunisia, using a snowball sampling technique. The results showed a significant reduction in RTE consumption during the pandemic, as shown in the 19.2% and 12.2% rise in the proportion of respondents not ordering hot and cold RTE food delivery, respectively. Compared to pre-COVID-19 times, a substantial increase in behaviors related to hygiene and disinfection practices (22.0%-32.2%) was observed with a lesser increase (11.2%) in handwashing practices before food preparation. Moreover, public concerns about contracting COVID-19 from food led to almost doubling the number of Tunisians using cleaning agents for washing fresh fruits and vegetables (e.g., soaps, non-food grade chlorine bleach) besides a 16% and 26.1% increase in use among the Jordanian and Lebanese, respectively. However, a third of the respondents did not follow instructions on labels for the use of chemical products. In conclusion, this study identified culture-specific shortfalls in handwashing and unsafe food handling practices during COVID-19 in the Arab countries and sheds light on the paramount role of coordinated efforts between the local health authorities and the food safety and public health stakeholders in risk communication. To reduce health risks, there need to be rigorous educational campaigns and targeted messages that reach out to the general audience on hand hygiene, the health effects of haphazard use of unsafe chemical compounds on food, and recommendations on following label instructions.

The public perception of food and non-food related risks of infection and trust in the risk communication during COVID-19 crisis: A study on selected countries from the Arab region.

The coronavirus pandemic caused a state of panic worldwide. Mixed messages were given about its risk and how to contain it, when trust in authorities and reliable scientific information are essential to reduce unnecessary scares and inappropriate risk perceptions. We know little about public concerns and opinions in health authorities in the Arab world. Thus, an attempt was made to generate such information through a web-based survey. A total of 1074 subjects from Lebanon, Jordan, and Tunisia were recruited to explore their perception of food and non-food risks of infection and the influence of the source of information, trust, and attitudes towards the local authorities' communication of risk. Seventy percent of the respondents were concerned that COVID-19 may be transmitted through food. The perception of risk from touching contaminated surfaces and food packaging and being exposed to infected people during food shopping was even higher. For only less than half of the respondents, the information from local authorities was considered trustworthy and the associated risk communication and response to false rumors were timely, effective, and clear. But the satisfaction level among the Jordanians was remarkably stronger than for the Lebanese and Tunisian respondents. The demographic factors, trust in information, and attitudes towards authorities' performance in risk communication did not influence risk perceptions. Respondents' knowledge was limited based on their chief sources of information, such as social media, local news media broadcasts, and announcements by the World Health Organization. Our conclusion is that unnecessary fear increases among the public when risks that impact heath are unknown. More research in the Arab region is needed to understand the determinants of risk perceptions considering psychological factors on the risk to health. Unfortunately, it is difficult to restrict or contain misleading information from various forms of social media. We recommend that for reducing fear and building confidence with the public for appropriate action during the pandemic, local authorities should enhance the quality and level of details of the information that they share during such crises.

Prevention and Control of Foodborne Diseases in Middle-East North African Countries: Review of National Control Systems.

Foodborne diseases continue to be a global public health problem with an estimated 600 million people falling ill annually. In return, international standards are becoming stricter which poses challenges to food trade. In light of the increasing burden of foodborne diseases, many countries in the Middle East and North Africa (MENA) region have upgraded their food laws and undertaken changes to the organizational structure of their regulatory institutions to maintain or expand international export activities, tighten control on local and imported products, and protect consumers' health. However, until this date, the published information on the regional health burdens of foodborne diseases is very limited and it is not clear whether the recent changes will serve towards science-based and effective preventive functions and the adoption of the risk management approach. In this review, we summarize the recent food safety issues and the national food control systems of selected countries in the region although we were challenged with the scarcity of information. To this end, we examined the national food safety systems in the context of the five essential elements of the FAO/WHO Guidelines for Strengthening National Food Control Systems. These five elements-food law and regulations; food control management; inspection services; laboratory services; food monitoring; and epidemiological data, information, education, communication, and training-constitute the building blocks of a national food control system, but could also serve as tools to assess the effectiveness of the systems.

A Review on the Rising Prevalence of International Standards: Threats or Opportunities for the Agri-Food Produce Sector in Developing Countries, with a Focus on Examples from the MENA Region.

Food safety standards are a necessity to protect consumers' health in today's growing global food trade. A number of studies have suggested safety standards can interrupt trade, bringing financial and technical burdens on small as well as large agri-food producers in developing countries. Other examples have shown that economical extension, key intermediaries, and funded initiatives have substantially enhanced the capacities of growers in some countries of the Middle East and North Africa (MENA) region to meet the food safety and quality requirements, and improve their access to international markets. These endeavors often compensate for the weak regulatory framework, but do not offer a sustainable solution. There is a big gap in the food safety level and control systems between countries in the MENA region and those in the developed nations. This certainly has implications for the safety of fresh produce and agricultural practices, which hinders any progress in their international food trade. To overcome the barriers of legal and private standards, food safety should be a national priority for sustainable agricultural development in the MENA countries. Local governments have a primary role in adopting the vision for developing and facilitating the implementation of their national Good Agricultural Practices (GAP) standards that are consistent with the international requirements and adapted to local policies and environment. Together, the public and private sector's support are instrumental to deliver the skills and infrastructure needed for leveraging the safety and quality level of the agri-food chain.

The Impact of Climate Change on Raw and Untreated Wastewater Use for Agriculture, Especially in Arid Regions: A Review.

Climate change is one of the major challenges of our time that pose unprecedented stress to the environment and threats to human health. The global impacts of climate change are vast, spanning from extreme weather events to changes in patterns and distribution of infectious diseases. Lack of rainfall associated with higher temperatures has a direct influence on agricultural production. This is compounded by a growing population forecasted to expand further with increasing needs for food and water. All this has led to the increasing use of wastewater worldwide. In this review, we more specifically discuss the use of untreated wastewater in agriculture in the Middle East and North Africa (MENA) countries, the most arid region in the world. This presents challenges for agriculture with respect to water availability and increasing wastewater use in agri-food chain. This in turn exerts pressures on the safety of food raised from such irrigated crops. Current practices in the MENA region indicate that ineffective water resource management, lack of water quality policies, and slow-paced wastewater management strategies continue to contribute to a decline in water resources and an increased unplanned use of black and graywater in agriculture. Radical actions are needed in the region to improve water and wastewater management to adapt to these impacts. In this regard, the 2006 WHO guidelines for the use of wastewater contain recommendations for the most effective solutions. They provide a step-by-step guide for series of appropriate health protection measures for microbial reduction targets of 6 log units for viral, bacterial, and protozoan pathogens, but these need to be combined with new varieties of crops that are drought and pest resistant. More research into economic local treatment procedures for wastewater in the region is warranted.

Prevalence of antimicrobial-resistant Escherichia coli from raw vegetables in Lebanon.

INTRODUCTION: Fresh produce has been implicated in a number of documented outbreaks of foodborne illness caused by bacteria, viruses, and parasites. Shiga toxin-producing Escherichia coli (STEC) have been detected on vegetables, raising concerns about the prevalence of E. coli contamination in produce, which can take place at various points from farm to fork. This study aimed to detect the presence of STEC and multidrug-resistant (MDR) E. coli on fresh vegetables and water from different sources along the fresh produce supply chain in Lebanon. METHODOLOGY: E. coli isolates (n = 60) were group serotyped using trivalent antisera (trivalent 1 [O111+O55+O26], trivalent 2 [O86+O119+O127], trivalent 3 [O125; O126; O128], and trivalent 4 [O114+O124+O142]) and tested for stx1 and stx2 genes by polymerase chain reaction (PCR) assay. Resistance to antimicrobial agents was determined using the disk diffusion method. RESULTS: The virulence genes stx1 and stx2 were not detected in any of the isolates. However, 60% of the isolates were MDR and predominantly observed in trivalent 2 (32%). It is postulated that the inadequate post-harvest washing contributed to transmission of antimicrobial-resistant E. coli at wholesale and retail levels. Fresh vegetables harbor MDR E. coli and their consumption poses risks of increasing the reservoir of antimicrobial resistance in the intestines of the Lebanese population. CONCLUSIONS: Greater emphasis should be placed on vigilant sanitation measures at the consumption level, and effective national risk mitigation strategies are crucial to minimize fecal contamination in the early stages of production, particularly in the post-harvest washing processes.

The transfer rate of Salmonella Typhimurium from contaminated parsley to other consecutively chopped batches via cutting boards under different food handling scenarios.

In many Mediterranean and Middle Eastern countries, leafy green parsley is typically eaten raw and prepared by fine chopping several batches. This study aimed to quantify the transfer rate of S. Typhimurium (Tr) across all chopped batches in scenarios that resemble normally occurring operations in restaurants and home kitchens. Fresh parsley leaves were inoculated at concentrations of 6 and 3logCFU/g and chopped on a polyethylene cutting board (CB). Uninoculated parsleys were sequentially chopped in individual batches on the same cutting surface, 1) instantly (CB Instant), 2) after washing in water and holding at 30°C 24h (CBWW), 3) after washing in soapy water, sponge scrubbing and holding at 30°C 24h (CB SW). Using the high inoculum levels, the mean Tr was 0.012±0.04, 0.014±0.02 and 0.010±0.008, via CB Instant, WW and SW, respectively. Comparatively, the Tr mean values were significantly higher with the low inoculum levels, 0.60±0.65 and 0.64±0.46, via CB Instant and CB WW respectively, and transmissions of S. Typhimurium significantly decreased across consecutively chopped batches on both washed CBs (P<0.05). These results demonstrated continuous transfer of Salmonella cells, from contaminated parsley to cutting boards and subsequently re-contaminating up to 6 batches of parsley chopped consecutively on the same surface. A greater cross-contamination rate was recorded during the initial phases of chopping and remained at 24h at 30°C. Vigilant cleaning and sanitation procedures on cutting surfaces should be a fundamental requirement after use with fresh produce, particularly if there is a likelihood of insufficient food safety measures at harvest and post-harvest stages.