2. Trends of Foodborne Diseases at Dubai 2006 – 2010 Dr. Fatma Al Attar M.D,ABFM,MRCGP Head of Preventive Services Section

3. Contents Introduction Definitions Situation in Dubai Aims Methods Trends over 5 years Conclusions and recommendations

4. Introduction Foodborne diseases (FBDs) is a significant public health problem with major economic and social effects. Cases of FBDs occur daily in all countries, from the most to the least developed. Unsafe food causes many acute and life-long diseases, ranging from diarrhoeal diseases to various forms of cancer.

5. WHO estimates that foodborne and waterborne diarrhoeal diseases taken together kill about 1.9 million people annually, 1.6 million of them children under (5) years of age. (WHO 2004). As well as the significance of FBDs in terms of morbidity and mortality, these illnesses have enormous implications for  primary industry  food manufacturing  retail industry and for trade.

6. Definition of Forborne Diseases  WHO FBDs are the result of ingestion of foodstuffs contaminated with microorganisms or chemicals. The contamination of food may occur at any stage in the process from food production to consumption (“farm to fork”) and can result from environmental contamination, including pollution of water, soil or air.

7.  CDC FBDs are caused by consuming contaminated foods or beverages. Many different diseases causing microbes, or pathogens, can contaminate foods, so there are many different foodborne infections. In addition, poisonous chemicals, or other harmful substances can cause FBDs if they are present in food.

8. More than 250 different FBDs have been described. Most of these diseases are infections, caused by a variety of bacteria, viruses, and parasites. NO one syndrome for FBDs. However, the microbe or toxin enters the body through the gastrointestinal tract, and often causes the first symptoms; nausea, vomiting, abdominal cramps and diarrhea are common symptoms in many FBDs.

9. Infections can spread through contaminated food, drinking water, swimming water, and from toddler to toddler at a day care center. Measures to control / reduce other cases from occurring could range from removing contaminated food from stores, chlorinating a swimming pool, or closing a child day care center.

10. Food Services Situation in Dubai

11. Although it is currently impossible to assess the cost and extent of foodborne diseases in UAE, (FBDs) still constitute public health problem. Surveillance and epidemiology are important in understanding and controlling food borne pathogens and their patterns of transmission.

12. Obstacles and barriers Ununified case definition Most cases are not reported, the true dimension of the problem is unknown. Methods and mechanism of reporting are not adequate in addition to feedback.

13. Most reported foodborne diseases are sporadic rather than associated with well-defined outbreaks. This may be more frequently due to non-hygienic food handling practices

14. Aim of the Presentation To provide briefing of trends of foodborne diseases in Dubai according to current data from 2006 to 2010.

15. Methods Secondary data collected from SAM system Data validated with annual reports Statistical SPSS version 13 and MS Excel 2007 was used for data analysis

16. Figure (1) :Percentage of Patients With Foodborne Diseases by Age Group

17. Population pyramids of U.A.E 2000

18. Figure (2) :Percentage of Patients With Foodborne Diseases by Gender

19. Foodborne Diseases through the Five Years Studied Period

21. Figure (6): Relative rates of laboratory-confirmed infections with Campylobacter, STEC1 O157, Listeria, Salmonella, and Vibrio compared with 1996–1998 rates, by year- Foodborne Active Surveillance Network, United States, 1996–2009

26. Conclusion Although the trends of foodborne diseases showed a clear drop in the last (5) years due to effective preventive measures, still there is possibility of increasing, this is explained by…  Accurate and adequate data is not always available.  Unified reporting system based on policy and guideline is not always available. Accordingly we recommend the following

27. Recommendations 1.Develop best practice guidelines for surveillance, investigation and control of foodborne diseases. 2.Establishment of a national laboratory network to identify gaps in laboratory diagnosis / investigation of foodborne disease, including specimen collection, submission, and make recommendations for improved detection.

28. 3.Updating the notification list to include the emerging and re emerging pathogens. 4.Develop and implement a National Foodborne Disease Outbreak Surveillance System.

29. 5.Plan and conduct of appropriate research to support these plans. 6.Uniform food safety legislation and standards at the national level.

30. 7.Increase public and industry awareness on foodborne diseases Food contamination can occur at any stage from farm to table. Everyone on the food delivery chain must employ measures to keep food safe. Farmer, processor, vendor and consumer education is just as vital to prevent disease outbreaks. Educating school children on safe food handling behaviors is key to preventing foodborne diseases today and in the future.

31. Preventing animal infections at the farm level can reduce foodborne diseases. Collaboration with concerned sectors (Ministry of; agriculture, education, water and environment, etc…. 5 Keys to Food Safety Keep Clean Separate raw food from Ready-to-eat Cook food thoroughly Keep food at safe temperature Use safe water and raw materials

32. In addition to ongoing Training in Quality Assurance across all food sectors.

33. References: Second formal meeting of the Foodborne Disease Burden Epidemiology Reference Group (FERG). 2008. Available online at http://www.who.int.foodsafety/foodborne_disease/FERG2_report.pdf http://www.who.int.foodsafety/foodborne_disease/FERG2_report.pdf The Environment: where’s the risk, and where are children safe? 2008. Available online at http://www.who.int/mediacentre/news/release/2004/pr43/en/http://www.who.int/mediacentre/news/release/2004/pr43/en/ 2011 Foodborne Disease Outbreak Case Definition. 2010. Available online at www.cdc.gov/ncphi/diss/nndss/casedef/foodbornecurrent.htm www.cdc.gov/ncphi/diss/nndss/casedef/foodbornecurrent.htm Unpublished literatures: Annual reports

34. Thank U