Food Safety; From Farm to Fork - A Public Health Perspective

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4/8/2015© 2010 Laureate International Universities® | Confidential & Proprietary 1

Food Safety; From Farm to Fork -

A public health perspective


World Health Day

2015 – From farm to plate, make food safe

2014 – Preventing and controlling vector borne diseases

2013 – Control your blood pressure

2012 – Good health adds years


Meet the Speakers

The U.S. Food Safety Modernization Act: Impact on the Global

Food Supply Chain

Dr. Daniel Okenu, Contributing Professor, Public Health, Walden

University & Food Safety Consultant, H-E-B Grocery Company LP, San

Antonio, USA

Food Safety: A Ugandan Case Study

Constance Shumba, MPH Faculty, University of Roehampton, London

THE U.S. FOOD SAFETY

MODERNIZATION ACT: IMPACT ON

THE GLOBAL FOOD SUPPLY CHAIN

Dr Daniel Okenu, Contributing Professor, Public Health, Walden

University


5

What is the global burden of foodborne diseases?

In the United States…48 million people get sick of foodborne

disease annually…

…128,000 are hospitalized…

…3,000 people die…

…resulting in an economic burden of $77.7 a year.

Globally 2.2 million people (mostly children) die of Foodborne

and Waterborne Diarrheal disease annually.

Norovirus 58%

Salmonella11%

Clostridium10%

Campylobacter9%

Staphylococcus 3%

Other 9%

What is the biggest cause of foodborne

Disease outbreaks?

How is this common Foodborne Diarrheal

Disease acquired?

Potential sources of Norovirus Outbreaks

Infected food handlers

Infected non-food workers and guests

Bare hands contact with RTE foods

Contamination of food deliveries at source

Improper cleaning and disposal of body fluids

Training gap on sanitizer and disinfectant use

Aerosolized vomitus around food and people

Improper hand washing by food handlers

Contaminated food contact and non-food contact surfaces

Cross contamination from restrooms

Cross contamination from high touch points

What other Foodborne Pathogens are there…


E.ColiStaphylococcus

aureus Shigella boydii SalmonellaKlebsiella

pneumonae

Gastrointestinal Gastrointestinal Gastrointestinal Gastrointestinal Gastrointestinal; skin infections

Undercooked foods such as beef

Contaminated hands of food handlers

Salads (potato, tuna, shrimp, macaroni, chicken), raw vegetables, milk and dairy products, and poultry

Cutting boards, kitchen utensils

Contaminated hands of food handlers

What is the Food Safety Modernization Act?

Reactive approach

Proactive Science and

Risk-based Prevention

Orientated System

Contaminated foods will

never reach retailers and

consumer

How will FSMA impact the Global Food Supply

Chain?

Other

Mexico Italy

Peru

Colombia

France

Guatemala

China

Ecuador Honduras

Canada

Countries Supplying U,S with Organic

products in 2013

U.S Food Imports Rising Faster than Food

Exports


Chain?


Chain?


Chain?

WHO’s Five Keys to Safer Food


Keep CleanSeparate raw and

cooked foodCook thoroughly

Keep food at safe temperatures

Use safe water and raw materials

FOOD SAFETY: A UGANDAN CASE

STUDY

Constance Shumba, MPH Faculty, University of Roehampton,

London


Of 800-900 million liters of milk

produced every year only 10% is pasteurized.

Food Safety in Uganda


Current population of Uganda 37 million …

Uganda exports...

20% of diet in urban areas is made up of processed foods…

…0.5% in rural areas.

Animal source foods are single most important source of food borne disease.

Food Safety in Uganda


65% of all cases treated by hospitals & clinics are sanitation-

related disease such as Cholera, Hepatitis E & Typhoid

1.3 million Ugandans a year are affected by Intestinal Worms,

non-bloody Diarrhea and Typhoid

80% of child deaths due to diarrhea occur in South Asia and Africa

Food Safety related disease burden in Uganda: Outpatient Diagnoses in Uganda: 1997– 2001

Diagnosis

(All Ages)

Year

1997 1998 1999 2000 2001

Cholera 1,172 17,636 2,614 2,637 632

Diarrheal Dysentery 82,022 70,192 54,852 59,915 77,606

Acute Diarrhea (Not

bloody)

378,457 369,391 38,8570 403,122 504,365

Persistent Diarrhea

(Not bloody)

112,471 116,974 121,633 117,213 114,213

Intestinal worms 733,818 744,917 784,708 778,463 1,235,399

Typhoid & para

typhoid fevers

8,975 7,053 6,336 11,301 12,194

Total 1,316,915 1,326,163 1,358,713 1,372,651 1,944,409

Total OPD 8,132,519 8,833,713 9,806,395 10,502,186 14,527,249

% of Total OPD 16.2 15.0 13.9 13.1 13.4

Source: HMIS District Monthly Reports, MOH

Directorate of Water Development

National Environment Management

Authority

Ministry of Trade and Industry

Ministry of Health Uganda National

Council of Science & Technology

Ministry of Agriculture, Animal Industry & Fisheries

Uganda National Bureau of Standards

Food safety standards & guidelines: a cross-sectoral issue

Food safety gaps contribute to burden of disease

Food Production Processing Storage

Transportation Retailing Handling in homes

Characteristics

• Little support from Public and NGO

• No effective health & safety

regulations

• Traditional processing & retail

practices

• Poor infrastructure

• Many actors

• Pay no tax

Benefits

• Cheap

• Fresh

• Local Breeds

• Taste

• Trust in vendors

• Credit

Informal food markets

4/8/2015© 2010 Laureate International Universities® | Confidential & Proprietary 22 Picture courtesy of Delia Grace and Kristina Roesel Safe Food, Fair Food team Gender aspects of informal

markets. Africa 2013. Ecosante/Ecohealth

Informal food markets

Pigs in Uganda

Evidence from farm sampling carried our among over 1,200

households in 2013 pointed to pig related diseases such as…

African Swine Fever

Brucellosis

Cysticercosis

Diamond Skin Disease

Intestinal Helminths

Salmonellosis

Sarcoptic Manage

Toxoplasmosis

Trichinosis

In the news: Most pork in Kampala is unsafe, say health experts, 6th June 2012

Source: safefoodfairfood.ilri.org

Making food safe

Source: http://safefoodfairfood.ilri.org/2014/04/30/apm2014/

http://safefoodfairfood.files.wordpress.com/2014/06/sfff-apm-2014-blog.jpg

http://safefoodfairfood.files.wordpress.com/2014/06/sfff-apm-2014-blog.jpg

http://safefoodfairfood.ilri.org/2014/04/30/apm2014/

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Investigations remain ongoing to determine the exact source [of the illness] by testing all sources of water, including water being sold commercially

World Bulletin / News Desk Uganda's Health Ministry on Thursday confirmed an outbreak of Typhoid in the East African country.

"We would like to inform the general public that there is an outbreak of Typhoid in Kampala and in some parts of the neighbouring Wakiso and Mukono districts," Jane Ruth Aceng, director-general of health services, told reporters.

She said the first Typhoid infection had been reported on Feb. 6.

"So far, two people are confirmed to have died of the disease, while 11 more deaths are still being investigated," Aceng said.

She added that a total of 142 people had so far been found with symptoms of Typhoid.

According to the Health Ministry, 20 to 30 more people have complained of Typhoid-like symptoms, including fever, abdominal pain and cough.

"Investigations have revealed that people are being infected by something they are eating or drinking at their workplaces," Aceng said.

"Investigations remain ongoing to determine the exact source [of the illness] by testing all sources of water, including water being sold commercially," she added.

Typhoid is a common bacterial disease usually transmitted by the ingestion of food or water contaminated with feces.

"It is important that people are treated early to avoid the possible spread of the disease," Aceng said.

She lamented, however, that Uganda currently lacked Typhoid vaccines, going on to call for the use of antibiotics to treat the disease.

http://www.worldbulletin.net/news/155351/uganda-confirms-typhoid-outbreak

19 February 2015

In the news: Uganda confirms Typhoid outbreak


What is the role of public health practitioners in

food safety?

Advocate for legislation on

food

Advocate for strict

controls

Increase awareness on effects

of unhygienic food to human

health & national socio-

economic status

Enhance public

participation through

dialogue

Don’t forget...

WHO’s Five Keys to Safer Food


Keep CleanSeparate raw and

cooked foodCook thoroughly

Keep food at safe temperatures

Use safe water and raw materials

Thank you.


Health & Medicine

Food Safety; From Farm to Fork - A Public Health Perspective