emerging foodborne pathogens prof. dr. İrfan erol, dvm, ph.d. turkish representative of world vet....
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EMERGING FOODBORNE PATHOGENS Prof. Dr. rfan EROL, DVM, Ph.D. Turkish Representative of World Vet. Assoc. Department of Food Hygiene and Technology School of Veterinary Medicine Ankara University Slide 2 Despite advances in hygiene, consumer knowledge, food treatment and processing, foodborne diseases mediated by pathogenic microorganisms or microbial toxins still represent a significant treat to public health worldwide. Slide 3 Globally, the WHO has estimated that approximately 1.5 billion episodes of diarrhea and more than 3 million deaths occurred in children under 5 years of age, and a significant proportion of these results from consumption of food mainly food of animal origin with microbial pathogens and toxins Slide 4 Emerging & Reemerging Zoonotic Diseases 60 % of the human pathogens are zoonotic 75 % of emerging zoonotic Slide 5 Emerging Foodborne Pathogens Definition: those causing illnesses that have only recently appeared or been recognised in a population or that are well recognised but are rapidly increasing in incidence or geographic range Slide 6 Appeared recently Extended to new vehicles of transmission Started to increase rapidly in incidence or geographic range Been widespread for many years but only recently identified through new or increased knowledge or methods of identification and analysis of the disease agent Emerging Foodborne Diseases Slide 7 Pose a threat to all persons; no matter on age, sex, lifestyle or socio-economic status etc. Feel pain and death Economic impact Emerging Foodborne Diseases Slide 8 Changes in environment (technology, climate, etc) Mass production and globalisation of food supply Economic development International travel and trade Changing character of the population Breakdown in public health Lifestyle changes Microbial adaptation Emerging Foodborne Diseases Major trends Slide 9 Emerging Foodborne Pathogens Bacteria Viruses Parasites Prion Slide 10 Emerging foodborne bacteria Salmonella (multidrug resistant strain) Campylobacter jejuni E. coli O157:H7 Listeria monocytogenes S. aureus MRSA Vibrio vulnificus Yersinia enterocolitica Arcobacter spp. Mycobacterium paratuberculosis Slide 11 Emerging foodborne viruses Hepatit A and E Norovirus (Avian influenza, AI) Slide 12 Emerging foodborne parasites Cryptosporidium parvum Cyclospora cayetanensis Anisakis spp. Slide 13 Foodborne outbreaks 1996 - 2006 Cryptosporidiosis, Leptospirosis, Lyme borreliosis Brucellosis, E. coli 0157, Salmonellosis BSE Reference: WHO Slide 14 Reference: CDC Slide 15 Slide 16 Slide 17 Slide 18 WHO Surveillance Programme for Control of Foodborne Infections and Intoxications in Europe 8th Report 1999-2000 Country Reports: Turkey Slide 19 PathogenEmerging foodborne diseaeses estimated annually Cases No. of No. of Ilnesses Deaths Economic losses from foodborne diseases estimated annualy $ billion Campylobacter spp. 1,963,14110,539991.2 Salmonella non- typhoidal 1,341,87315,6085532.4 E. coli O157:H762,4581,84352.7 E. coli non-O157- STEC 31,22992126.3 L. monocytogenes2,4932,2984992.3 Total3,401,19431,2091,2296.9 Reference: USDAs Economic Research Service & CDC Slide 20 YearCountryFoodSerotype/Phage type No. of cases No. of deaths 1991GermanyOrange creamS.Enteritidis PT41094 1991GermanyPuding (egg)S.Enteritidis8710 1994U.S.AIce creamS.Enteritidis224000- 2003U.S.AChickenS. Typhimurium38- 2005SpainProcessed chicken S. Hadar21381 2006NorwaySalamiS. Kedougou541 2008Ireland&U.KBeef, chickenS. Agona119- Some Important Salmonella Outbreaks in the World Slide 21 Salmonella serotype distribution in Turkey (Erol et al., 2009) S. Agona S. KentuckySpices S. Bredeney Slide 22 Some Important Campylobacter Outbreaks in the World YearCountryFoodNo. of cases 2000U.K & WalesRaw milk333 2001-2002AustraliaChicken601 2005DenmarkChicken salad4 2005ScotlandChicken pate82 2005-2006U.S.AWater32 2007U.S.ACheese (from unpasteurized milk) 67 2007DenmarkWater16 Slide 23 Campylobacter jejuni Quinolone- and fluoroquinolone-resistant Campylobacter jejuni in the United States, 19822001 Slide 24 Campylobacter jejuni Slide 25 Thermophilic Campylobacter spp. in turkey meat (n=270) (Cakmak and Erol, 2009) Thermophilic Camylobacter spp. 123 (45.5%) C. jejuni 109 (40.3 %) C. coli 11 ( 4.0 %) Not typed 3 100 bp 500 bp 735 bp Slide 26 Antibiotic resistance profile of C. jejuni isolates in turkey meat (Cakmak and Erol, 2009) Antibiotics Resistant %Intermediate %Sensitive % Azithromycin104 (95.4)2 (1.8)3 (2.7) Erythromycin103 (94.4)06 (5.5) Gentamicin00109 (100.0) Chloramphenicol03 (2.7)106 (97.2) Nalidixic acid10 (9.1)099 (90.8) Ciprofloxacin19 (17.4)090 (82.5) Tetracycline40 (36.6)2 (1.8)67 (61.4) Slide 27 CountryYearNo of cases(age) ComplicationsInfection source Japan1996>5499 (students) 12 deathsAlfalfa U.S.A1999321-Beef Canada2000275 deathsWater Sweden200239-Fermented sausage U.S.A2002345 HUSGround beef Netherlands200532-Steak tartare U.S.A20063763 deathsFresh spinach Some important E. coli O157:H7 Outbreaks in the World Slide 28 Slide 29 E. coli O157:H7 isolates found in fecal samples of cattle and sheep at slaughter in Turkey (Erol et al., 2008) SheepCattle (male) Cattle (female)Total Number of samples 21828220775500 Number of positive samples 14117425 Percent (%) 6.423.903.385.335.00 Slide 30 PositiveNegativeTotal stx 1 7411 stx 2 9211 eaeA11- hly11- H711- Toxin profiles of E. coli O157:H7 isolated in Turkey (Erol et al., 2008) Slide 31 Toxin profiles of 11 E. coli O157:H7 isolates within the PFGE groups in cattle in Turkey (Erol et al., 2008) PFGE groupsNToxin profiles A 1stx 2 B 2 C 1stx 1 and stx 2 D 4 2stx 1 1 stx 2 Slide 32 Some Important Listeria outbreaks in the World CountryYearFoodSerotypeNo. of cases No. of deaths U.S.A. 1998Turkey products 4b10818 Finland 1998Butter3a2524 France 2000Pork meat4b3231 U.S.A. 2000Turkey products 1/2a307 U.S.A. 2002Turkey products -5411 U.S.A. 2003Mexican cheese 4b122 Switzerland 2005Soft cheese -112 Norway 2007Cheese-122 Canada 2008Red meat-5320 Slide 33 Slide 34 Contamination level of turkey meat with L. monocytogenes is 17.8 % (32/180) (Ayaz and Erol 2008) Slide 35 L. monocytogenes serotype distribution 44.9 %1/2a 37.2 %4b 9.0 %1/2b 9.0 % 1/2c Slide 36 Antibiotic resistance profiles of L. monocytogenes in turkey meat (n:24) (Ayaz and Erol, 2008) AntibioticsResistant (%)Intermediate (%) Sensitive (%) Ampicillin 18 (75.0)-6 (25.0) Chloramphenicol --24 (100) Erythromycin -9 (37.5)15 (62.5) Gentamicin --24 (100) Penicillin 20 (83.3)-4 (16.7) Streptomycin -8 (33.3)16 (66.7) Tetracycline --24 (100) Vancomycin --24 (100) Slide 37 Slide 38 Occurrence of Cryptosporidium spp. oocysts in Turkey (Kursun and Erol, 2003) Surface water Sewage water treatment at slaughterhouse Ent. Exist. Slaughtered Cattle Sheep Number of samples 2413 60 Number of positive samples 2413 23 4 Percent (%)100 38.3 6.6 Slide 39 Slide 40 Slide 41 Antibiotic resistance Its a global concern of the antibiotic resistance of major foodborne pathogens such as; Salmonella Typhimurium DT 104 Campylobacter spp. Listeria monocytogenes E. coli O157:H7 Staphylococcus aureus (MRSA) Enterococcus (VRE) Slide 42 Lab. Confirmed Cases Reported Positive Isolates Suspectible Cases Unnotified Cases Hospitalised No sample taken No medical intervention Foodborne Infections&Intoxications Known/ Unknown Slide 43 Farm to table; main contamination points Slide 44 Surveillance Risk managementEpidemiological evaluation / Risk assessment Research Slide 45 Control of Foodborne Disease From farm to table approach Implementation of GMP and HACCP Slide 46 Public Health Approach Public health system Surveillance Epidemiology for earlier diagnosis Early response to outbreaks Provide to disease patterns changing Public health lab. support for rapid and accurate diagnosis Rapid communication links Communication to public Education on prevention and/or detection Slide 47 E-mail: [email protected] Slide 48 Factors contributing to the global incidence of foodborne disease Poor sanitary conditions Malnutrition Changing demographics (increasing population of infants, elderly) Inadequate public health infrastructure Inadequate hygienic and technological conditions of food production Inadequate cooking, reheating and storage conditions Increasing tourism and international trade Increasing animal movement and insufficient control of borders Increasing international trade of animal and food Inadequate legislation and official control system Emerging/reemerging foodborne pathogens Acquisition of virulence and antibiotic genes by nonpathogenic bacteria Adaptation and enhanced survival of pathogens in food Inadequate consumer education Slide 49 Trichinellosis outbreak in Turkey Although there is a religious restriction on pork meat consumption, in January 2004 there was a big trichinellosis outbreak occurred by consuming i kfte (raw ground meat ball-traditional food) in Izmir 542 people were affected and samples were found to be contaminated with T. britovi Slide 50 One World One Health (OWOH) The medical and veterinary professions have a common interest in many diseases, primarily zoonotic diseases such as BSE, SARS and, most recently, Avian Influenza (H5N1), have highlighted the need for interprofessional collaboration not just locally and nationally, but on a global scale. Slide 51 One World One Health (OWOH) Improving animal and human health globally through collaboration among all the health sciences, especially between the veterinary and human medical professions to address critical needs.