May 6, 2015 Food Forum for Industry and Government in Southwestern OntarioIngersoll, Ontario

FoodNet Canada – Integrated Surveillance for Food Safety from Farm to Fork

• What is it?» Canada’s National Integrated Enteric Pathogen Surveillance

Program

» Coordinated by Public Health Agency of Canada (PHAC)

» Collaboration with federal, provincial & regional partners

• What we do?» Collect data from sentinel sites to detect trends in human enteric

illness and exposures from food, animal, and water sources

» Determine significant risk factors for enteric illness

» Determine the relative contribution of foods & other sources to illness in Canada (Source attribution)

• Why we do it?» Inform food and water safety policy in Canada

FoodNet Canada

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What is a sentinel site?

British Columbia Sentinel Site - April 2010

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Alberta Sentinel Site - August 2014Ontario Sentinel Site - August 2014

FoodNet Canada – Three Sentinel Sites

FoodNet Canada Structure

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BC AB ON

FoodNet Canada Central

Data integration

and analysis

Data collection

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Dairy, beef, swine, broiler, layer (manure samples)

Farm management questionnaire

Raw surface waterMeat: chicken, beef, pork

Produce: soft berries, fresh cut fruits, leafy greens and herbs (episodic)

Stool samples

Enhanced standardized questionnaires

FoodNet Canada - Design

FoodNet Canada Surveillance: 4 components

• Bacteria• Salmonella spp.

• Campylobacter spp.

• Verotoxigenic E. coli

• Shigella spp.

• Yersinia enterocolitica

• Listeria monocytogenes

• Parasites• Giardia

• Cryptosporidium

• Cyclospora

• Viruses• Norovirus

• Rotavirus

• Speciation• Serotyping• Phagetyping• AMR• PFGE• Genotyping• Ribotyping

Systematic typing of isolates»Harmonised methodology across components

»Enhanced subtyping

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Surveillance : target pathogens

FoodNet Canada

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Built on Public Health Collaboration»Enhanced passive surveillance »Links rich risk factor data & lab data »Standardized Questionnaire »Enhancing Capacity - training »Collaborative projects/research»Inform food and water policy and decision making in Canada

FoodNet Canada

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FNC Retail Surveillance

• Sampling at the grocery store level helps to characterize the risk of exposure at the food handling & consumption levels - can also be used to identify trends at processing (for federally inspected products)

• 3 or 4 randomly selected stores are visited each week

• Samplers are public health inspectors

FNC Agriculture Surveillance

• Collaboration with CIPARS• Commodity inclusion in the farm component is based on

the agricultural profile of the sentinel site region.• Third party sampling to maintain confidentiality• Manure sampling

Sampling in commodities may include the following commodities:

• swine • dairy• beef • broiler chicken • egg layer• turkey

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Agriculture Surveillance in Middlesex- London

Sampling is being conducted in the following commodities:• Swine • Broiler chicken • Egg layer

Sampling is planned for the following commodities:• Dairy

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FNC Water Surveillance

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• Ontario Sentinel Site » 2005-2013: sampling on Grand

River

» Partnership with OMOE

» 3 years of beach sampling

» 2015 – planned sampling on Thames River & well water testing

• Attribution is the partitioning of the human disease burden of one (or more) foodborne infections to specific sources (Pires, 2009)

• Burden : sporadic and/or outbreak cases• Sources : reservoirs and/ or vehicles

• Partitioning : ranking of sources

or number of cases per source

• Modes of transmission: partition cases to

transmission routes to understand impact of interventions

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Slaughter / transformation

Retail Consumption InfectionFarm

FoodNet Canada

Data integration : source attribution

Practical Benefits• Science to Inform Prevention

» Identifies what foods and other sources cause illness in Canada, and regional differences in risk» Positive results from food sampling are shared with food safety partners and support risk

assessments and follow-up» Supports efforts to direct actions based on the greatest risks to public health

• System Performance» Evaluates the effectiveness of food safety programs» Provides the performance evidence demanded by our trade partners.

• Example: FNC detected reduced levels of E. coli O157 in ground beef correlated with a decrease in human cases of E. coli O157

• Stakeholder Engagement» Provides practical information to federal, provincial and territorial food and water safety partners » Provides industry with information that can support better industry-led approaches to improve

upstream prevention efforts

FoodNet Canada - Roles

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CIPARS: Active and Passive Surveillance Components

Farm Surveillance - Methods

• Sentinel farm based system

• Field work: Flock/herd veterinarians» Confidentiality and biosecurity» Compensation for producers and vets

• Flock/herd selection and recruitment» Inclusion and exclusion criteria

• Composite fecal samples» E. coli, Salmonella (Campylobacter)» AMR testing: Sensititre® System

– NARMS panel of antimicrobials

• Questionnaires» Antimicrobial use data» Flock/herd demographics, animal inventory and health data

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30130

330 (12)*

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304

Nationally: 129 flocks

15 Vets

Implementation flocks allocation per province(Target of 30 flocks in each FoodNet Canada sentinel site)

AB Ag Lab, Edmonton AB

PHAC-LFZ Lab, Guelph ON

PHAC-LFZ Lab, St. Hyacinth QC

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*Additional flocks sampled within London-Middlesex FoodNet Canada Sentinel Site

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Broiler Poultry: Distribution of sentinel flocks & vets

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Hatchery Stage Broiler BarnAT PLACEMENT

Characterization of : 1)Vertically-transmitted E. coli and Salmonella spp2)Carry-over 3) AMR emergence associated with subcutaneous & in-ovo drug uses

- Reflects barn-level AMR associated with total antimicrobial exposure and barn characteristics;- Proximal to consumer

Subcutin-ovo

Broiler Barn PRE-HARVEST

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AGE TO MARKET

Feed & Water AMU

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Placement Pre-harvest

Sampling points

Stage (Days)

Antimicrobial Use

Significance

Broiler Poultry: Surveillance Methods

268

155

123

277

286

Nationally: 108 Herds29 Vets

•At implementation, herds were allocated per province proportional to the number of Grower/Finisher Units in each province

• AF Lab

• PDS Lab

• PHAC-LFZ Lab

• PHAC-LFZ Lab

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G-F Swine: Distribution of sentinel herds & vets

WINTER SUMMER FALL

Herd dataPig #sAM useHealth

Composite fecal samples from CTM* pens collected & submitted by the herd veterinarian

CTM* Questionnaire:• Herd/site demographic data • Number of pigs, mortalities, marketed• Antimicrobial use data• Animal Health data

* CTM = Close-To-Market, pigs > 80 Kgs (175 Lbs)

Sampling Seasons

Herd dataPig #sAM usePig Health

• One sampling/data collection visit per herd per year

• Veterinarians distribute sampling of herds over the calendar year

G-F Swine: Sample & Data Collection - Refined

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Human ComponentON Site 2013

o438 Cases Reportedo 57% endemico 25% travel-relatedo 15% LTFo 2% outbreak-related

oTop 3 endemic diseases reported:o Campylobacteriosiso Salmonellosiso Giardiasis

FNC Data Highlights

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Endemic Cases

Yearly distribution of pathogen contamination on retail meat in the ON site, 2006 to 2013

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Note: Dashed lines indicate a laboratory or sampling method change. Chicken breast samples with skin were tested in 2006 and 2007. Starting in 2008, skinless chicken breast samples were tested. Testing for Campylobacter and Salmonella on ground beef samples was discontinued in 2011. Testing for VTEC on chicken breast samples was discontinued in 2011.

FNC Data Highlights

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FNC Data Highlights

Retail Component - Targeted Surveillance, Ontario, 2013

Pathogen Detection on Retail Meat

Ground Chicken Frozen Chicken Nuggets

2012† 2013 2012† 2013

percent positive (number positive/number tested)

Campylobacter 20% (29/142) 17% (17/102) 0% (0/29)a .

Salmonella 66% (95/144) 54% (55/102)* 41% (59/144) 39% (40/102)

Listeria monocytogenes 35% (51/144) 31% (32/102) 20% (29/144) 17% (17/102)

Retail Component - Targeted Surveillance, Ontario, 2013

Bagged Leafy Greens

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FNC Data Highlights

Pathogen Detection on Leafy Greensa

ON Site BC Site

2010† 2013 2010† 2013

percent positive (number positive/number tested)

Cryptosporidium 0% (0/372) 3.8% (11/293)*** 0% (0/202) 2.4% (7/294)c**

Giardia 3.0% (11/372) 8.5% (25/296)*** 2.0% (4/202) 5.4% (16/295)*

Cyclospora 0% (0/372) 0.34% (1/296) 0% (0/202) 0.34% (1/295)

Norovirus 0.54% (2/372) 0.68% (2/296) 0.50% (1/202) 0.68% (2/294)

Rotavirus 0% (0/372) 0% (0/296) 0% (0/202) 0.34% (1/294)

Listeria monocytogenes 2.4% (9/372) 1.0% (3/296) 0% (0/202) 0.34% (1/294)

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Agriculture Component - Individual Manure Samples

FNC Data Highlights

Broiler chicken: Placement and pre-harvest recovery rates, 2013

Broiler Poultry: CIPARS results, 2013

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RECOVERY RESULTS

Higher percentages of recovery at preharvest

CIPARS Component/

Animal species

Chicken -placement British Columbia 2013 72% 43/60 28% 17/60

Alberta 2013 89% 31/35 29% 29/35

Ontario 2013 85% 64/75 17% 13/75

Québec 2013 82% 53/65 17% 11/65

National 2013 81% 191/235 22% 51/235

Chicken -preharvest British Columbia 2013 98% 94/96 71% 68/96 28% 27/96

Alberta 2013 100% 60/60 40% 24/60 25% 15/60

Ontario 2013 100% 120/120 54% 65/120 17% 20/120

Québec 2013 99% 111/112 64% 72/112 17% 19/112

National 2013 99% 385/388 59% 229/388 20% 81/388

Province / region YearPercentage (%) of isolates recovered and number of isolates recovered / number of samples submitted

Escherichia coli Salmonella Campylobacter Enterococcus

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• Surveillance initiative supported by:» PHAC Food Safety Action Plan

» Ontario Ministry of Agriculture and Food (OMAF)

• Ranking exposures and identifying knowledge gaps (Evers et al. 2008) » QMRA based

» Ontario

» 19 exposure routes: • foodborne (beef, pork, chicken, seafood/fish, vegetables, firm and soft fruits, raw

milk),• waterborne (drinking water, recreational water), and• contact with animals (dog/cat, petting zoos, & living on or visiting chicken, pig, beef,

or dairy farms).

Campylobacter Comparative Exposure Assessment

FoodNet Canada: Successes

Possible routes of exposure considered in FoodNet study

Raw chicken, beef, pork, fish, shellfish

• Prepared chicken, beef, pork Produce (fruit and vegetables)• Raw milk (scoping review and meta-analysis)

• Water Treated drinking water» Untreated well water (scoping review) Recreational water (accidental ingestion during swim)

• Animal contact » Pets (scoping review and meta-analysis)» Petting zoos (scoping review and meta-analysis) Farms

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Campylobacter Comparative Exposure Assessment

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Campylobacter Comparative Exposure Assessment

Identifying Issues: Retail Frozen Chicken Nuggets/Strips and Salmonella Enteritidis

EstablishmentProportion positive

SalmonellaProportion positive

S. Enteritidis

Identified establishment

41.7% 25.0%

All other establishments

19.2% 3.4%

Total 28.3% 12.1

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FoodNet Canada: Successes

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Percent of Ground Beef positive for VTEC

Decline in Human illness and VTEC in Ground Beef with Increased Interventions by Industry

Preliminary results

FoodNet Canada: Successes

FoodNet Canada: Successes

FoodNet Canada Data and Research:

Enables the PHAC to determine the proportion of human illness stemming from various sources

Informs data and knowledge gaps in Canada

Informs the Canadian F/P/T Government/Industry

Informs Provincial, Territorial and National outbreak investigations and response

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Informing national/provincial/territorial outbreak investigations and response

Salmonella Enteritidis subtypes in exposures

Salmonella Thompson WGS

Evaluating VTEC in swine manure and ground pork

Identifying parasites on produce as an emerging issue for risk profile/policy development

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FoodNet Canada: Successes

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• Enhanced and integrated surveillance: a priority for Health and Agriculture»Exploring expansion to full FNC design: 5 sites

• AMR also a priority»Continued collaboration with CIPARS

• Full operation in BC, AB & ON sites

• Bolster KT & Science to Policy

• Focus on utilizing source attribution methodologies that are based on molecular typing

• Inform food and water policy and decision making in Canada

Moving into 2015

FoodNet Canada

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FNC & CIPARS rely on collaboration with public health at all levels of government, provincial agriculture and environment, industry

and other stakeholders

Thank you!Q&A and Discussion

FoodNet Canada