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The Role of an Food Examiner in the Control and Investigation of Food Poisoning Outbreaks John Waddell Glasgow Scientific Services.

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Presentation on theme: "The Role of an Food Examiner in the Control and Investigation of Food Poisoning Outbreaks John Waddell Glasgow Scientific Services."— Presentation transcript:

1 The Role of an Food Examiner in the Control and Investigation of Food Poisoning Outbreaks John Waddell Glasgow Scientific Services

2 Three main roles SurveillanceEnforcement Outbreak investigation

3 The Queen meeting local dignitaries, June (Aberdeen Journal) L “ Aberdeen in early summer 1964, was in the grip of a typhoid epidemic that was eventually to hospitalise over five hundred people. The Aberdeen outbreak highlighted the continuing potential for serious food poisoning episodes within modern food systems. It was the first such outbreak to attract intense media interest”. The Aberdeen Typhoid Outbreak, 1964 Lesley Diack and David Smith

4 Aberdeen 1964 – Typhoid Outbreak Traced to single 6lb Can of Argentinean Corned Beef Cooled in untreated river water S.typhi thought to have entered can through fault in seam Cross contamination from meat slicer to other products 50 victims a day at height of epidemic which lasted 3 months 500 hospitalised

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6 Wishaw E.Coli 0157 Outbreak Worst recorded case of E.coli 0157 food poisoning 21 fatalities Source traced to apparently clean butcher’s shop Cross contamination between raw and cooked meat Butchers licensing introduced as a consequence

7 What did these outbreaks have in common? Large outbreaks Meat products Pathogenic organisms of faecal origin Causes of outbreaks hypothesised by epidemiologists Inadequate HACCP

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11 The Role of an Food Examiner in the Control and Investigation of Food Poisoning Outbreaks SurveillanceEnforcement Outbreak investigation

12 Food Examiner Food Safety Act 1990 places importance on role of microbiological monitoring process The Food Examiner performs the statutory function of Microbiological Examination of Food This mirrors the Public Analysts responsibility for Chemical Analysis of food Food Safety (Sampling and Qualification) Regulations 1990 sets requirements for qualifications for Food Examiners

13 Food Examiner’s Responsibilities Food Examiner’s Responsibilities Awareness of current legislation Awareness of current methods and standards Method selection and development Staff training Achieve & maintain UKAS accreditation Awareness of emerging techniques Awareness of emerging techniques Awareness of emerging pathogens

14 Surveillance Small local surveys ~ 20 samples Medium sized surveys ~100 samples National surveys 1000s

15 Surveillance 1990-Richmond Committee Recommendations Coordinated food surveillance Targeted food surveillance More emphasis on HACCP National database to be established

16 Surveillance FSA commissioned HPS (April 2000) to deliver UK Food surveillance system Coordination of approach to surveillance FSS system established in 2002 by 4 APA Scottish labs + 4 Scottish NHS IT and laboratory partnership FSS being rolled out across UK

17 Enforcement Statutory Standards specified in Regulations EC Regulations UK Regulations based on EC Directives UK Regulations Non-Statutory Standards Guidelines (e.g. HPA Guidelines for Food Examiners) Industry Codes of Practice

18 Enforcement Range of Food Categories covered by EC Microbiological Criteria Regulations Meat- carcasses, meat preparations, meat products, MRM, minced meat Dairy- milk, cheese, butter, cream, ice cream Shellfish - live and cooked Fresh produce – fresh cut fruit and vegetables, unpasteurised juice and sprouted seeds Miscellaneous - e.g. Infant Foods, RTE foods, Egg Products

19 Surveillance + Enforcement = Prevention? SMA infant formula contaminated with Botulism spores SMA infant formula contaminated with Botulism spores Cadbury’s Chocolate contaminated with Salmonella – Withdrawal of 1 Million bars Cadbury’s lab found to have been using methods which underestimated the risk of Salmonella contamination

20 Current Rates for Food Poisoning Cases in Scotland E.coli 0157 (~200 cases per annum) Salmonella (~800 cases per annum Campylobacter (~5000 cases per annum)

21 What is an Outbreak? Two or more linked cases A greater than expected rate of illness or infection in the community A single case of certain serious, possibly contagious infections suggesting that there will be many more in the community

22 Outbreak Control Team OCT are chaired by a CPHM Format and agenda in accordance with Outbreak Control Plan Purpose is to identify whether there is an outbreak Identify the source Identify the cases Stop the outbreak Learn from the outbreak

23 Outbreak Control Team Members CPHM(s) Infection Control Specialist(s) EHO(s)Clinician(s) Medical Microbiologist(s) + Food Examiner(s) + Water Authorities Other agencies – Police, Public Relations etc

24 Targeted examination Based on clinical symptoms Based on epidemiology Based on availability of sample

25 Standard Microbiological Technique for Detection of Pathogens 1. Pre-enrichment – To boost the numbers of organisms to detectable levels 2. Selective enrichment – To further boost the numbers of the target organism whilst reducing levels of others 3. Selective isolation 4. Purification 5. Confirmation

26 Some pathogens can present new challenges E.coli 0157 – very low infectious dose Technique developed using Immunomagnetic Beads as an aid to isolation

27 Principle of IMS -IMS + low volumes of sample  low sensitivity of detection (e.g. 20 cfu/ml in PBS)

28 Campylobacter Campylobacter – Growth is microaerophilic Requires incubation in modified atmosphere + complex nutritional requirements

29 The Role of an APA Food Examiner in the Control and Investigation of Food Poisoning Outbreaks SUMMARYSurveillanceEnforcment Outbreak Investigation

30 Pathogens that emerged in late 20 th Century Listeria monocytogenes Yersinia enterolytica E.coli 0157 Campylobacter jejuni BSECryptosporidium Helicobacter pylori HIVSARS Avian Flu Clostridium difficile Legionella pneumophila Enterobacter sakazakki MRSA

31 Thank you for listening Any Questions?


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