Prioritisation of food-borne parasites in Europe, 2016.

Background and aimsPriority setting is a challenging task for public health professionals. To support health professionals with this and in following a recommendation from the Food and Agriculture Organization of the United Nations (FAO) and World Health Organization (WHO), 35 European parasitologists attended a workshop from 8-12 February 2016 to rank food-borne parasites (FBP) in terms of their importance for Europe and regions within Europe. Methods: Countries were divided into European regions according to those used by the European Society of Clinical Microbiology and Infectious Diseases. We used the same multicriteria decision analysis approach as the FAO/WHO, for comparison of results, and a modified version, for better regional representation. Twenty-five FBP were scored in subgroups, using predefined decision rules. Results: At the European level, Echinococcus multilocularis ranked first, followed by Toxoplasma gondii and Trichinella spiralis. At the regional level, E. multilocularis ranked highest in Northern and Eastern Europe, E. granulosus in South-Western and South-Eastern Europe, and T. gondii in Western Europe. Anisakidae, ranking 17th globally, appeared in each European region's top 10. In contrast, Taenia solium, ranked highest globally but 10th for Europe. Conclusions: FBP of importance in Europe differ from those of importance globally, requiring targeted surveillance systems, intervention measures, and preparedness planning that differ across the world and across Europe.

Discovering foodborne illness in online restaurant reviews.

Objective: We developed a system for the discovery of foodborne illness mentioned in online Yelp restaurant reviews using text classification. The system is used by the New York City Department of Health and Mental Hygiene (DOHMH) to monitor Yelp for foodborne illness complaints. Materials and Methods: We built classifiers for 2 tasks: (1) determining if a review indicated a person experiencing foodborne illness and (2) determining if a review indicated multiple people experiencing foodborne illness. We first developed a prototype classifier in 2012 for both tasks using a small labeled dataset. Over years of system deployment, DOHMH epidemiologists labeled 13 526 reviews selected by this classifier. We used these biased data and a sample of complementary reviews in a principled bias-adjusted training scheme to develop significantly improved classifiers. Finally, we performed an error analysis of the best resulting classifiers. Results: We found that logistic regression trained with bias-adjusted augmented data performed best for both classification tasks, with F1-scores of 87% and 66% for tasks 1 and 2, respectively. Discussion: Our error analysis revealed that the inability of our models to account for long phrases caused the most errors. Our bias-adjusted training scheme illustrates how to improve a classification system iteratively by exploiting available biased labeled data. Conclusions: Our system has been instrumental in the identification of 10 outbreaks and 8523 complaints of foodborne illness associated with New York City restaurants since July 2012. Our evaluation has identified strong classifiers for both tasks, whose deployment will allow DOHMH epidemiologists to more effectively monitor Yelp for foodborne illness investigations.

Ingestão de corpo estranho de chumbo por cão da raça daschund - Relato de caso / Ingestion of lead object by a daschund dog - Case report / Ingestión de cuerpo extraño de plomo por perro de la raza daschund - Relato de caso

O presente trabalho relata a ingestão de corpo estranho de chumbo por um cão da raça Daschund, fêmea, atendido em uma clínica particular no município de Pitanga-PR visualizado pelo proprietário há aproximadamente 20 dias. A paciente apresentava vomito há 48 horas, mas apresentava-se hidratada e demais parâmetros dentro da normalidade. O diagnóstico foi confirmado com radiografia simples e o protocolo terapêutico instituído foi o cirúrgico. Apesar do tempo de exposição ao objeto púmblico, a paciente não apresentava alterações clinicas de intoxicação pelo metal. Após 10 dias da gastrotomia, a paciente recebeu alta e permaneceu sem sinais de intoxicação pelo chumbo até o momento.(AU)

This study reports the ingestion of a lead object by a female Daschund dog attended in a private clinic in the city of Pitanga ­ PR witnessed by the owner 20 days before. The patient presented vomit for 48 hours but it was hydrated, with other parameters within normality. The diagnosis was confirmed with an X-ray and surgery was the therapeutic treatment of choice. In spite of the time of exposure to the lead object, the patient did not present clinical signs of intoxication by the metal. Ten days after the gastrostomy, the patient was discharged and did not present further signs of intoxication.(AU)

El presente trabajo relata la ingestión de un cuerpo extraño de plomo por un perro de la raza Daschund, hembra, atendido en una clínica particular en el municipio de Pitanga-PR visualizado por el propietario hacía aproximadamente 20 días. La paciente presentaba vomito hacía 48 horas, pero se presentaba hidratada y demás parámetros dentro de la normalidad. El diagnóstico se ha confirmado con radiografía simple y el protocolo terapéutico instituido fue el quirúrgico. A pesar del tiempo de exposición al objeto plúmbeo, la paciente no presentaba alteraciones clínicas de intoxicación por el metal. Después de 10 días de la gastrostomía, la paciente recibió alta y permaneció sin signos de intoxicación por el plomo hasta el momento.(AU)

Categorizing food-related illness: Have we got it right?

Since the 1950s food safety hazards have been categorized simply as (micro) biological, chemical or physical hazards with no clear differentiation between those that cause acute and chronic harm. Indeed international risk assessment methods, including hazard analysis critical control point (HACCP) use these criteria. However, the spectrum of food related illness continues to grow now encompassing food allergy and intolerance, obesity, type 2 diabetes, stroke, heart disease, cancer as well as food poisoning, foodborne illness and food contamination. Therefore over a half-century later is this the time to redefine the spectrum of what constitutes food related illness? This paper considers whether such "redefinition" of food related intoxicating and infectious agents would provide more targeted policy instruments and lead to better risk assessment and thus mitigation of such risk within the food supply chain.

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]. / Nowe zagrozenia mikrobiologiczne w zywnosci.

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

Animal production food safety: priority pathogens for standard setting by the World Organisation for Animal Health.

In this short study, expert opinion and a literature review were used to identify the pathogens that should be prioritised by the World Organisation for Animal Health (OIE) for the development of future standards for animal production food safety. Prioritisation was based on a pathogen's impact on human health and amenability to control using on-farm measures. As the OIE mandate includes alleviation of global poverty, the study focused on developing countries and those with 'in-transition' economies. The regions considered were Eastern Europe, Asia, the Middle East, Africa and South America. Salmonella (from species other than poultry) and pathogenic Escherichia coli were considered to be top priorities. Brucella spp., Echinococcus granulosus and Staphylococcus aureus were also mentioned by experts. As Salmonella, and to a lesser extent pathogenic E. coli, can be controlled by on-farm measures, these pathogens should be considered for prioritisation in future standard setting. On-farm control measures for Brucella spp. will be addressed in 2010-2011 in a review of the OLE Terrestrial Animal/Health Code chapter on brucellosis. In Africa, E. granulosus, the causative agent of hydatidosis, was estimated to have the greatest impact of all pathogens that could potentially be transmitted by food (i.e. via contamination). It was also listed for the Middle East and thought to be of importance by both South American experts consulted. Taenia saginata was thought to be of importance in South America and Africa and by one expert in the Middle East.

Molecular characterization of temporally and geographically matched Streptococcus agalactiae strains isolated from food products and bloodstream infections.

In a defined geographic area, during a 3-month period, 914 food products were screened for Streptococcus agalactiae, and S. agalactiae strains isolated from bloodstream infections (BSI) in nonpregnant adults were collected. Eleven S. agalactiae strains were isolated from 1.2% of food products, with high rates in pastries (7.0%) and seafood products (11.8%). These findings indicate that S. agalactiae is a food product contaminant. Seven S. agalactiae BSI were observed in nonpregnant adults representing an incidence of 0.015/100 admissions. The distribution of strains in serotypes did not differ according to origin of the strains; food products and clinical strains were of serotypes Ia (22%), Ib (11%), II (5%), III (22%), IV (5%), and V (33%). The strains isolated from seafoods were of serotypes Ia and Ib. The distribution of strains in Sequence Types differed according to their origin; food strains were equally distributed between the major clonal complex (CC), CC1 (27%), CC9 (18%), CC17 (18%), and CC23 (27%), whereas a high proportion of BSI strains belonged to CC1 (57%). DNA macrorestriction using SmaI revealed diversity; nine different patterns were found for the 11 food strains and seven for the 7 BSI strains. One pattern was similar for two food strains and one BSI strain. On account of the molecular characteristics previously described for S. agalactiae strains of human carriage and fish and mice infections, the serotype characteristics of seafood strains suggest contamination by aquatic S. agalactiae, whereas the molecular characteristics of strains from pastries suggest human contamination, but may also originate from rodents. Indeed, serotype V CC1 strains, found in food and responsible for a high percentage of BSI in nonpregnant adults, belong to a known clone spreading worldwide, and have also been described in mice.

Evidence-based semiquantitative methodology for prioritization of foodborne zoonoses.

OBJECTIVES: To prioritize an extended list of food- and water-borne zoonoses to allow food safety authorities to focus on the most relevant hazards in the food chain. METHODS: An evidence-based semiquantitative methodology was developed. Scores were given by 35 scientific experts in the field of animal and public health, food, and clinical microbiology and epidemiology to 51 zoonotic agents according to five criteria related to public health (severity and occurrence in humans), animal health (severity of disease coupled with economic consequences and occurrence in animals), and food (occurrence in food). The scoring procedure was standardized and evidence-based as experts were provided, for each zoonotic agent, a same set of up-to-date help information data related to the five criteria. Independently, the relative importance of the five criteria was weighted by seven food chain risk managers. The zoonotic agents were ranked based on overall weighted scores and were grouped in four statistically different levels of importance. RESULTS: The following foodborne zoonotic pathogens were classified as "most important": Salmonella spp., Campylobacter spp., Listeria monocytogenes, and verocytotoxigenic Escherichia coli. A second group of "significant importance" included Toxoplasma gondii, the agent of bovine spongiform encephalopathy, Clostridium botulinum, Staphylococcus aureus, Cryptosporidium parvum, Mycobacterium bovis, Echinococcus granulosus, Streptococcus spp., Echinococcus multilocularis, Yersinia enterocolitica, Mycobacterium avium, Fasciola hepatica, Giardia intestinalis, and Rotavirus. CONCLUSIONS: This methodology allowed to rank 51 zoonotic agents with objectivity and taking account of a combined input from risk assessors and risk managers. APPLICATIONS: These results support food safety policy makers to establish the multiannual monitoring program of foodborne zoonoses. They also enable to identify knowledge gaps on specific zoonotic agents and to formulate key research questions. Principally, this method of prioritization is of general interest as it can be applied for any other ranking exercise and in any country.

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.

Inmigración y necesidades de asistencia psiquiátrica en población infanto-juvenil / No disponible

No disponible

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.

Manual para instructores de inspectores de alimentos

Detalla sobre la protección de alimentos y los servicios de inspección. Condiciones a reunir la materia prima de los alimentos, su proceso e industrialización para obtener alimentos de calidad para el consumo humano. Normas de inspección y requisitos para formar inspectores bromatológicos y tipos de inspeccion a realizar. Requisitos para la industrialización y rotulación de alimentos y para los establecimientos de proceso y expendio de los mismos. Sistemas de análisis de riesgo y determinación de los puntos críticos del control de alimentos. Clasificación de las enfermedades alimentarias y las bacterias que las producen. Legislación sobre alimentos en Argentina

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.