Foodborne

Disease Strategy

2010-2015

An FSA Programme for the Reduction of Foodborne Disease in the UK

Jacqui McElhiney

Foodborne Disease Strategy

Food Safety Monitoring and Policy Branch

FSA in Scotland

Overview of Presentation

• FDS 2010-2015: Aims and Objectives

• Prioritisation of FDS targets

• FDS Risk Management and Research Programmes

• The Food Hygiene Campaign and complementary

FSA programmes

• Review of key proposals

• Vision for the future

FSA Strategic plan 2010-15

• Reduce foodborne disease using a targeted approach.

Outcome 1: Food produced or sold in the UK is safe to eat

• Improve public awareness and use of messages about (healthy eating and) good food hygiene practice.

Outcome 3: Consumers understand about safe food and healthy eating, and have the information they need to make informed choices

The Foodborne Disease Strategy aims to contribute to delivering

Outcomes 1 and 3 of the Agency’s Strategy for 2010-2015:

A Renewed Foodborne Disease Strategy

Aims and Objectives

• Pathogen specific approach through specific Risk Management

Programmes.

• A refreshed Food Hygiene Campaign to raise awareness of

foodborne disease.

• Work with key stakeholders to develop and implement activities

• Co-ordination with other relevant programmes within the Agency

• Monitoring and horizon scanning to detect and act upon any

resurgence of disease by known pathogens or other emergent

organisms

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Cas

es/y

ear

Total

Campylobacter

Salmonella

E. coli O157

Cl.perfringens

Listeria mono.

Lab-confirmed cases of pathogens monitored by the FSA

UK 2000-2009

Priority for FSA Action How these priorities are being addressed

Campylobacter Highest Greatest burden of foodborne disease due to very high case numbers and severity of disease

Foodborne Disease Strategy – new Campylobacter Risk Management Programme

Listeria monocytogenes HighBurden of disease second to Campylobacter - although infection is rare it is very severe.

Foodborne Disease Strategy – new Listeria Risk Management programme

E. coli O157 HighInfection is rare in comparison to Campylobacter but disease can be severe for affected individuals

FSA Food Hygiene Delivery Programme developed specifically to implement recommendations from the Inquiry into the South Wales E. coli O157 outbreak. Supported by FDS research programme

Salmonella HighAlthough case numbers continue to decrease Salmonella still causes many cases and outbreaks

Implementation of National Control Programmes designed to reduce Salmonella levels in food animal species - led by Defra with FSA support

Norovirus MediumBurden of disease is moderate as it causes a significant number of cases but infection is generally mild.

Foodborne Disease Strategy – new NorovirusResearch Programme to provide improved evidence and understanding as basis for action

Clostridium perfringens LowBurden is low and foodborne disease syndrome is mild

Foodborne Disease Strategy – Food Hygiene Campaign and Programmes designed to assist catering businesses to implement food hygiene legislation (such as Safer Food Better Business and Scores On The Doors)

Campylobacter

Reduction of Campylobacter in chicken is our key priority:

• Attribution studies (MLST) showed 60-80% of cases attributable to

chicken-related exposures

Campylobacter Risk Management Programme:

• Develop a target and work closely with industry and retailers to identify

practical and effective interventions to reduce Campylobacter in chicken-

including lessons learned from other countries

• Reinforce messages to consumers on cooking and cross-contamination

• A strategic research strategy co-funded with BBSRC and Defra

Reducing Campylobacter in Chicken-

Intervention Strategies

Primary Production

• Biosecurity- Personal hygiene, boot changes, vehicle/crate washing fly-

screens

• Assurance Schemes

Processing

• Slaughterhouse Hygiene Tools

• Evisceration-optimise to reduce cross-contamination risks

• Antimicrobial treatments?-used in some countries but not currently

permitted in the EU. Not a ‘silver bullet’

Retail

• Leak-proof packaging

• Modified Atmosphere

Campylobacter-Engaging Consumers

• Improving awareness of Campylobacter-prevalence,

sources and risk factors

• Stronger messaging-particularly on prevention of cross-

contamination in the kitchen

• Assessing the acceptability of proposed interventions for

reducing Campylobacter in chicken-from primary

production through to retail

Listeria monocytogenes

Causes severe illness and death in around a third of cases

• An increase in cases between 2000 and 2009 occurring mainly in

people over the age of 60

• Recent figures suggest an increase in pregnant women in certain ethnic

groups

• Reasons for this increase not clear-need to assess the role of food

handling and storage and impact of susceptibility

Listeria Risk Management Programme:

1. Improving consumer awareness

2. Controlling Listeria in the food production chain

Listeria Risk Management Programme

1. Improving consumer awareness

• Ensure consumers and caterers fully understand the risks from Listeria

and know how to minimise them-especially in relation to vulnerable groups

• Identify methods for delivering messages most effectively to vulnerable

groups (e.g. through healthcare partners, carers, GPs)

Research and surveillance:

• Understanding the risk factors for listeriosis-role of medications and co-

morbidities

• Improve our knowledge of food safety behaviours in the home, particularly

of the over 60s

• Survey of domestic fridge temperatures and storage of chilled foods

2. Industry Interventions

• Identify parts of the food chain where control measures can be most

effective

• Assist food manufacturers, retailers and suppliers in risk assessment and

the implementation of processes and precautions to reduce Listeria in the

food chain.

Research /Surveillance

• Focus surveys to smaller retailers/convenience stores- cooked meats and

sandwiches; slicing machines

• Improve awareness of Listeria management controls in SMEs and develop

decision support tools

Listeria Risk Management Programme

Industry Focused Research in Scotland

• Evidence that low level Listeria contamination in cold smoked fish is

common:

– No bactericidal step

– Product supports the growth of Lmono

– Moist processing environment

– Ability of Lmono to grow at refrigeration temps

• Aware that this sector has difficulty in managing Listeria

– In last year:

• 13 separate L.mono-related food incidents

• 8 of these were smoked fish products (61%)

• Have identified that SMEs need more support

Industry Focused Research in Scotland

Aim:

To develop an aide for smoked fish producers to identify key stages for

control and monitoring of Listeria

Approach:

– Review literature to identify key monitoring and interventions

– Gather information on industry practices

– Gather information on manufacturers’ attitudes in relation to

monitoring Listeria

– Identify difficulties faced by the sector in control and testing

– Gather information on inspection and enforcement regimes

Evidence will inform development of support tools for Listeria

management across all food sectors

E. coli O157Responsible for large and serious foodborne outbreaks:

• Outbreaks in Wishaw (1996) and South Wales (2005) both due to cross-

contamination resulting from poor hygiene practices

• Welsh inquiry made clear recommendations for the FSA to address

Food Hygiene Delivery Programme:

• Improve awareness and control of food safety hazards

• Ensure compliance with legal standards

Research Areas:

• Investigate control measures for reducing the impact of supershedding

• Food safety cultures in FBOs and the enforcement community

Foodborne VirusesNorovirus is the most frequent cause of GI infection in the UK

• Outbreaks often reported in residential institutions, hospitals, cruise ships

• Foodborne outbreaks frequently attributed to consumption of oysters

• Contamination by infected food handlers also believed to play a role

Foodborne Viruses Research Programme

• Requires research to investigate the contribution of different viruses and

food sources to burden of disease

• Work with the shellfish industry to reduce incidents-improved methods for

testing and depuration

Other Pathogens-Monitoring and

Maintenance

Salmonella

• Incidence declining since 2000-National Control Programmes (Defra)

currently in place for eggs, breeders and layers and further

programmes planned for broilers, turkeys and slaughter pigs

• FSA will continue to monitor trends and act accordingly

Clostridium perfringens

• Monitoring of limited use-mild, self-limiting illness, under-reporting a

major issue

• Outbreaks due to poor temperature control and storage of bulk meat

dishes

• Food safety issues being addressed by current FSA initiatives

• Further action to be established through findings of IID2

Refreshing the Food Hygiene

Campaign

General Food Hygiene Activities

• Food Safety Week

• Year round activity

• Review of the 4Cs and messaging

Activity to Support Risk Management Programmes

• Campylobacter

• Listeria monocytogenes

Complementary Programmes

VISION OF THE FUTURE

• In 2015, the number and severity of human cases of foodborne

illness, and their cost to the UK economy, is lower than in 2010.

• In 2015, the prevalence of Campylobacter in UK chicken at retail is

lower than that measured in 2010.

• In 2015, the number of human cases of listeriosis in the UK is lower

than in 2010, particularly among the over 60s

• By 2015 UK consumers better understand how to prepare and store

food safely and more consumers follow best practice as a matter of

course

Thank-you !

Any Questions?