Canadian Food Inspection AgencyCanadian Food Inspection Agency

Denis Allard MD MSc FRCPCDenis Allard MD MSc FRCPCSenior Medical Advisor

Science Branch, CFIA

servingservingPublic HealthPublic Health

Objectives of this PresentationObjectives of this Presentation

1. Familiarise you with the Canadian Food Inspection Agency and some of its activities related to Public Health

2. Highlight some current and emerging challenges

3. Discuss partnership and collaboration with Public Health community

Our OrganisationOur Organisation

CFIA established 1997CFIA established 1997to enhance the effectiveness and efficiency of federal inspection and related services for food safety, and for animal/plant health

Integration inspection activitiesof HC, AAFC, DFO, IC

CFIA REGIONAL OFFICESCFIA REGIONAL OFFICES& LABORATORIES& LABORATORIES

5,500 employees18 regional offices21 laboratories185 field officeson > 400 third party premises

CFIA’s 3 business linesCFIA’s 3 business lines

Safe food & Safe food & consumer protectionconsumer protection

Animal health Animal health

Plant protectionPlant protection

Canada Agricultural Products ActCanadian Food Inspection Agency Act

Consumer Packaging and Labelling ActPenalties Act

Food and Drugs ActFish Inspection Act

Health of Animals ActMeat Inspection Act

Fertilizers ActFeeds Act

Enabling LegislationEnabling Legislation

•CFIA

•Health Canada

•Public Health Agency of Canada

•Fisheries and Oceans

•Agriculture & Agri-Food Canada

•Environment Canada

Federally … Federally … Safe FoodSafe Foodis a shared responsibilityis a shared responsibility

CFIA Food ContinuumCFIA Food Continuum

AgriculturalInputs

Production ProcessingDistribution

Consumption

IMPORTS/EXPORTSIMPORTS/EXPORTS

DOMESTIC

from farm from farm to plate to plate

Food ContinuumFood Continuum

Emergency Response (FIORP)Emergency Response (FIORP) Food Recalls, Food Safety Food Recalls, Food Safety

InvestigationsInvestigations Import and Domestic InspectionImport and Domestic Inspection Nutrition Labeling VerificationNutrition Labeling Verification Monitoring and Surveillance of Food Monitoring and Surveillance of Food

Supply (Testing, HACCP, GMPs, GIPs)Supply (Testing, HACCP, GMPs, GIPs) Contributing to International Contributing to International

Food Safety Standard SettingFood Safety Standard Setting

Food SafetyFood Safety

Food Safety DirectorateFood Safety Directorate

•BFSCP•Food Safety Investigation (prevention/correction)•Fair Labelling Practices

•OFSR•Food Emergency Response/Recall (reactive)•Input in FB Illness investigation (HC/PH)

•HACCP support•FSEP/MPIP/F-QMP/CSSP/OFFSRP

•Food Safety Risk Analysis (input to/from HC)

How the System WorksHow the System Works

Outbreak

Food Source Food Vehicle

Surveillance

Targeted InspectionProduct Recall

Lessons LearnedCorrective Actions

CFIA Food Safety Investigation DataCFIA Food Safety Investigation Data

Data captureData capture• CFIA’s CFIA’s Issues Management SystemIssues Management System (IMS) (IMS)

4,000/yr food safety investigations4,000/yr food safety investigations TriggersTriggers

• complaints, laboratory results, Gov’t depts. complaints, laboratory results, Gov’t depts. referrals, in-plant observations, etc.referrals, in-plant observations, etc.

Implementation of various compliance / Implementation of various compliance / enforcement options at CFIA’s disposalenforcement options at CFIA’s disposal

Proposed Foodborne OutbreakProposed Foodborne OutbreakInvestigation Report Template (CFIA)Investigation Report Template (CFIA)

Cause Effect

Food RecallsFood Recalls Class 1Class 1

• serious health consequences or deathserious health consequences or death

Class 2Class 2• temporary health consequencestemporary health consequences

Class 3Class 3• unlikely health consequencesunlikely health consequences

((** in all cases, food products violate one or more Acts enforced by CFIA) in all cases, food products violate one or more Acts enforced by CFIA)

Food RecallsFood Recallsby Type (mean of 2000-03)

0 20 40 60 80 100

Class 1Imports

Class 1Domestic

All Classes

%

Other

Extraneous

Chemical

Allergen

Micro

Average yearly food recalls – Class 1 206Average yearly food recalls – All classes 408

Food RecallsFood Recallsby Class (2003-04)

020406080

100120140160180200

Class I Class II Class III

Food RecallsFood Recallsby Trigger (2003-04)

0

5

10

15

20

25

30

35

CFIA Client Consumer External

Perc

en

tag

e

Food RecallsFood Recallsby Type (2003-04)

0

20

40

60

80

100

120

12

4

21

2

1910

10

12

8

4 3

Egg

Gluten

Milk

Other

PeanutSesame Seeds

Soy

Sulphites

Tree Nut

Hazelnut Wheat

April 29, 2004

Allergens RecallsAllergens Recallsby Foodstuff (2003-04)

TOTAL: 105

April 29, 2004

Microbiological Incidents & Microbiological Incidents & Recalls Recalls (2003-04)

6

1

4

3

3

6

2

3

3

14

7

3

6

1

2

3

2

6

2

1

3

5

7

3

0 5 10 15

Container Integrity - Low Acid

Undetermined

Quality Molds

Salmonella

S. aureus

Pseudomonas aeruginosa

Pathogenic - Other

Listeria

E. coli 0157:H7

E. coli

C. botulinum

Other

Total Incidents: 41

Total Recalls: 55

April 29, 2004

Chemical Incidents & RecallsChemical Incidents & Recalls

(2003-04)

9

11

19

11

14

26

6

7

10

18

10

11

24

6

0 5 10 15 20 25 30

Additives

Drug Residues

Heavy Metals

Other

Residues

Toxin

Trace Elements

Incidents: 86

Recalls: 96

Public WarningsPublic Warnings

Issued for most Class I recalls May be issued for other classes Reserved for those situations deemed

to be of higher risk to consumers• examples: undeclared allergens, botulism

risk, Salmonella, E.coli 0157, pieces of glass in baby food

* * Web-site posting and e-mail distribution list

Consumer Education and Consumer Education and Public Awareness ProgramsPublic Awareness Programs

• control and eradication of- traditional zoonotic diseases (TB, brucella, rabies)- new and emerging diseases (WNV; AI … SARS?)

• therapeutant residue mitigating/monitoring (A-M, H, …)

• policy/management of- animal health issues (within federal mandate)- recycling of agricultural byproducts through feed and fertilizers into the food chain- environmental concerns (disposal, …)

- Animal Health -- Animal Health -Public Health related activitiesPublic Health related activities

- - Animal Animal HealthHealth - -Prevention of Foreign Animal DiseasesPrevention of Foreign Animal Diseases

SurveillanceSurveillance• passivepassive (producers, priv.vets, F/P labs, vet. colleges, PH)(producers, priv.vets, F/P labs, vet. colleges, PH)

• activeactive (sentinel systems, pro-active testing)(sentinel systems, pro-active testing)

Reporting of Notifiable Animal DiseasesReporting of Notifiable Animal Diseases• International (OIE, PROMED AHEAD)International (OIE, PROMED AHEAD)• Domestic (Domestic (Health of Animals ActHealth of Animals Act))

Risk Analysis Risk Analysis (importation)(importation) Import ControlsImport Controls On-Farm BiosecurityOn-Farm Biosecurity(& traceability)(& traceability)

* * Can. Health of Animals NetworkCan. Health of Animals Network http://www.cahnet.org/ http://www.cahnet.org/

1. African horse sickness2. African swine fever 3. Anaplasmosis4. Anthrax 5. Bluetongue6. BSE 7. Bovine Tb (M. bovis) 8. Brucellosis9. Chronic Wasting Disease 10. Contagious bovine pl-pneumonia11. Contagious equine metritis12. Cysticercosis 13. Equine Infectious Anemia 14. Equine piroplasmosis15. Foot and Mouth Disease16. Fowl typhoid (S gallinarum)

17. H P Avian influenza18. Classical swine fever19. Lumpy skin disease 20. Newcastle Disease 21. Peste des petits ruminants 22. Pseudorabies23. Pullorum disease (S. pullorum) 24. Rabies 25. Rift valley fever26. Rinderpest27. Scrapie 28. Sheep and goat pox 29. Swine vesicular disease 30. Trichinellosis 31. Venezuelan equine encephalitis 32. Vesicular stomatitis

Surveillance - Reportable DiseasesSurveillance - Reportable Diseases

Schedule II - Health of Animals ActSchedule II - Health of Animals Act

Emerging Zoonotic DiseasesEmerging Zoonotic Diseases(non-foodborne)(non-foodborne)

Viral Haemorrhagic FeversViral Haemorrhagic Fevers (1960s (1960s )) Lyme Disease (Lyme Disease (~~1975)1975) AIDS/HIV (1978)AIDS/HIV (1978) Hanta (1993)Hanta (1993) Hendra (1994)Hendra (1994) TSEs (1996)TSEs (1996) Nipah (1999)Nipah (1999) West Nile (1937/1950s/1999)West Nile (1937/1950s/1999) Avian Influenza (1997/2004)Avian Influenza (1997/2004) Monkeypox (1970 …2003)Monkeypox (1970 …2003) SARS/CSARS/Coronavirus oronavirus (2003)(2003) Bio-terrorism (Anthrax …)Bio-terrorism (Anthrax …)

Role of AnimalsRole of Animals(Livestock, Pets, Wildlife)(Livestock, Pets, Wildlife)

Reservoirs Amplifier Host Link Host Incidental Host Shedder Sentinel

Avian Influenza OutbreakAvian Influenza OutbreakBC Coast – 2004

Animal Epidemiology UnitAnimal Epidemiology Unit

Monitor changes in infectious/toxic agentsMonitor changes in infectious/toxic agents Define a problem/Detect outbreaksDefine a problem/Detect outbreaks Estimate magnitude of the problemEstimate magnitude of the problem Determine geographic distribution of illnessDetermine geographic distribution of illness Generate hypothesesGenerate hypotheses Stimulate researchStimulate research Describe the natural history of a diseaseDescribe the natural history of a disease Evaluate effectiveness of control measuresEvaluate effectiveness of control measures Detect effect of changes in practicesDetect effect of changes in practices Facilitate planning/risk-based priority-settingFacilitate planning/risk-based priority-setting

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

May

Production Type # of FarmsBroiler Breeder

Turkey HatchingBroilers

Leghorn BreederSquab

Table EggLayers

Layers/PulletsAsian Meat Birds

Turkey

Peking DuckTurkeys/LayersDuck & Geese

Turkey Layers/Pullets

13

42

11

2

9

1

1

62

13

1

Laboratory Confirmation

Backyard Flocks 11

Abbotsford

PortCoquitlam

Surrey

Commercial - Matrix Positive Backyard

HPAI 2004

Total

12

Commercial - Isolation Positive

Surveillance Activities

AI Control Area – Hot SpotsAI Control Area – Hot Spots

Routes of virus transmission? Tools Tools

veterinary visit & questionnaireveterinary visit & questionnaire follow-up on movements of risk products (eggs, …)follow-up on movements of risk products (eggs, …)

Transmission routes investigated …Transmission routes investigated … waterborne (ground and surface water)waterborne (ground and surface water) feedfeed hatcherieshatcheries wild birdswild birds CFIA crewsCFIA crews litterlitter aerosol dispersionaerosol dispersion service providers (owners, workers, equipment …)service providers (owners, workers, equipment …)

Avian Influenza in BCAvian Influenza in BC Epidemiologic InvestigationEpidemiologic Investigation

• Destruction (‘stamping-out’)

• CO2, electrocution, others

• ensure ‘humane’ culling

Some Disease Control StrategiesUsed in Animal Disease Outbreak

• Disposal

•landfill, incineration, composting, rendering

•easier to arrange once emergency powers invoked

• Cleaning & Disinfection ◦ manure, structure

• Movement control /Quarantine

Human Health ProtectionHuman Health Protection

OSH considerationsOSH considerations Health screening Health screening (suitability)(suitability) Information/TrainingInformation/Training Protective clothing Protective clothing Personal HygienePersonal Hygiene Health surveillance / reporting / ff-upHealth surveillance / reporting / ff-up Prophylactic meds / vaccinationProphylactic meds / vaccination

PH considerationsPH considerations Exposure / bio-security issuesExposure / bio-security issues Health surveillance / CD controlHealth surveillance / CD control

Need for Need for increasing collaborationincreasing collaboration

betweenbetweenCFIACFIA and its partners and its partners

• global distribution (food, livestock, pets, feed, seeds)• intensive farming /new technologies• changes in consumption and eating patterns• consumer expectations/practices• effects of global warming (insect vectors; ecology)• speed and scope of international travel• increasing susceptibility of large segments of the population (e.g. compromised immunity; allergies)• public demand for transparency and involvement

Increasing Challenges for CFIAIncreasing Challenges for CFIA

Emergence of Foodborne PathogensEmergence of Foodborne Pathogens

19001900• Botulism toxinBotulism toxin• BrucellaBrucella• Vibrio choleraVibrio cholera• Hepatitis AHepatitis A• Staph toxin Staph toxin • M. tuberculosisM. tuberculosis• S. typhoidS. typhoid

1970s 1970s • Campylobacter jejuniCampylobacter jejuni• Salmonella Enteritidis Salmonella Enteritidis • Shiga-toxigenic E. coliShiga-toxigenic E. coli• Listeria monocytogenesListeria monocytogenes• Clostridium botulinum (Clostridium botulinum (infantinfant))• Vibrio parahemolytici/vulnificusVibrio parahemolytici/vulnificus• Yersinia enterocoliticaYersinia enterocolitica• Giardia lambliaGiardia lamblia• Toxoplasma gondiiToxoplasma gondii• Cryptosporidium parvumCryptosporidium parvum• Cyclospora cayetanensisCyclospora cayetanensis• Hepatitis EHepatitis E• NorovirusesNoroviruses• BSE prionBSE prion• ……

Increasing food vehicles: ground beef, poultry, shellfish, veggies (sprouts, salads), fruits (cantaloup, berries, juice), dairy (ice cream), imports (halva, chocolates), irrigation water

Factors in EmergenceFactors in Emergenceof Zoonosesof Zoonoses

AgentAgent• Microbial adaptation & changeMicrobial adaptation & change

HostHost (human)(human)• DemographicsDemographics• Susceptibility to infection, FamineSusceptibility to infection, Famine• Behaviour (hygiene, outdoors, Behaviour (hygiene, outdoors,

pets, …)pets, …) EnvironmentEnvironment

• PhysicalPhysical climate and weatherclimate and weather changing eco-systems (vectors)changing eco-systems (vectors) land use /encroachmentland use /encroachment

• Socio-economicSocio-economic economic developmenteconomic development intensive farming/husbandryintensive farming/husbandry international travel & tradeinternational travel & trade breakdown in PH measuresbreakdown in PH measures poverty & social inequalitypoverty & social inequality war and bioterrorismwar and bioterrorism

• PoliticalPolitical lack of willlack of will disruption in leadershipdisruption in leadership

Our world Our world changed changed foreverforever

onon September 11, 2001September 11, 2001

Threat of bio-terrorismThreat of bio-terrorism

When new foodborne disease identifiedWhen new foodborne disease identified What is the nature of the disease?What is the nature of the disease? What is the nature of the pathogen?What is the nature of the pathogen? Simple ways to easily identify the pathogenSimple ways to easily identify the pathogen and diagnose the and diagnose the

disease?disease? What is the incidence of the infection?What is the incidence of the infection? How can the disease be treated?How can the disease be treated? Which foods transmit the infection?Which foods transmit the infection? How pathogen gets into the food, and how well it persists How pathogen gets into the food, and how well it persists

there?there? Is there an animal reservoir?Is there an animal reservoir? How do the animals themselves become infected?How do the animals themselves become infected? How can the disease be prevented?How can the disease be prevented? Does the prevention strategy work?Does the prevention strategy work?

Tauxe R., Tauxe R., Emerging Foodborne Diseases: An Evolving PH ChallengeEmerging Foodborne Diseases: An Evolving PH Challenge, CDC 1997, CDC 1997

Guidelines for Guidelines for Research on ZoonosesResearch on Zoonoses

Identify the source of infection, to determine whether it is from wildlife, domestic or peri-domestic animals, or from multiple sources;

Establish the mode of transmission, to determine whether it is by direct contact, vectorborne, environmental contamination, or a combination of modes;

Identify potential host species and the natural reservoirs of the zoonotic pathogen, possibly with molecular and/or epidemiological methods;

Conduct preliminary surveys of target species and follow-up, when indicated, with long-term ecological and epidemiological studies of identified reservoir species in the wild and/or in an experimental setting where appropriate.

from Report on WHO/FAO/OIE consultation May 2004

Scientific CollaborationScientific Collaboration EcologyEcology EconomicsEconomics EntomologyEntomology EpidemiologyEpidemiology BiostatisticsBiostatistics Environmental HealthEnvironmental Health Occupational MedicineOccupational Medicine Pathology (human & animal)Pathology (human & animal) Behavioural Science (human & animal)Behavioural Science (human & animal) Clinical Medicine (Human and Vet.)Clinical Medicine (Human and Vet.) Public Health practice (Human and Vet.)Public Health practice (Human and Vet.) Regulatory, Wildlife, & Agricultural SciencesRegulatory, Wildlife, & Agricultural Sciences

CFIA PartnershipsCFIA Partnerships

• Other federal depts (HC/PHAC, AAFC, DFO, EC)• Provincial gov’ts (Health, Agric., Fish., NR, Env)• Int’nal Orgs (WHO, FAO, OIE), and other countries• Food industry (production and processing)• Food retail and food service sectors• Trade associations• Med/Vet practitioners and professional ass’ns• Academia• School system• Mass media• Consumer associations and consumers* Counter-terrorism aspects (RCMP, CSIS, PSEP)

Opportunities for CollaborationOpportunities for Collaborationbetween CFIA and PH Communitybetween CFIA and PH Community

on on Foodborne IllnessFoodborne Illness and and ZoonosisZoonosis

Data exchange/integration Expertise exchange Enforcement Industry education/training OSH considerations Public information Joint training (e.g. epi) Research (e.g. strains, spread) Human/Animal Interface

CFIA’s Senior Medical AdvisorCFIA’s Senior Medical Advisor

* Advice/Assistance in* Advice/Assistance in• Canada-wide surveillance systems Canada-wide surveillance systems • Inter-departmental/jurisdiction information exchangeInter-departmental/jurisdiction information exchange• Issues/Risk managementIssues/Risk management

* Liaison with * Liaison with • Health Canada (esp.FD) and PH Agency of CanadaHealth Canada (esp.FD) and PH Agency of Canada• Provincial/Regional Public Health officialsProvincial/Regional Public Health officials• Health professionals (PH and clinical)Health professionals (PH and clinical)• other national and international bodies (US, EU, WHO)other national and international bodies (US, EU, WHO)• Consumer groupsConsumer groups

* Areas of involvement … * Areas of involvement … Food safetyFood safety, , foodborne infectionsfoodborne infections, , zoonoseszoonoses Strategies to address Risk communication/perceptionStrategies to address Risk communication/perception Standards, regulations, legislation, agreementsStandards, regulations, legislation, agreements

The Plague Doctor

Questions/Comments?Questions/Comments?