stec know your - european food sure summit · confidential 15 proprietary information of nestlé s....

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Proprietary information of Nestlé S. A., Vevey, Switzerland – This document should not be reproduced or disclosed without prior authorisation

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Proprietary information of Nestlé S. A., Vevey, Switzerland – This document should not be reproduced or disclosed without prior authorisation

STECKnow your enemy!Laurence Blayo,

Nestlé Research Center

«You cannot defeat your enemies until you know who they are»

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Proprietary information of Nestlé S. A., Vevey, Switzerland – This document should not be reproduced or disclosed without prior authorisation2

What is the origin of the name Escherichia coli ?

A: It was first discovered in a fungi called Escherichius C: It was first discovered in a river called Escherich

D: It was first discovered in an insect called EscherichB: The bacteria was discovered by Mister Escherich

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D: It was first discovered in an insect called EscherichB: The bacteria was discovered by Mister Escherich

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B: The bacteria was discovered by Mister Escherich


D: It was first discovered in an insect called Escherich

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Theodor Escherich

1857 - 1911

German-Austrian pediatrician and a

professor at universities in Graz and

Vienna. He discovered the bacterium

Escherichia coli, which was named after

him in 1919, and determined its properties.

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Kiyoshi Shiga

1871 - 1957

Japanese physician and bacteriologist. He

became famous for the discovery of

Shigella dysenteriae, the bacillus causing

dysentery. The bacterium Shigella was

thus named after him, as well as the Shiga

toxin, which is produced by the bacterium.

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.

Few scary figures

1 million illnesses – 128 deathsin 2010 ( WHO Foodborne Disease Burden Epidemiology Reference Group )

265,000 illnesses, 3,600 hospitalizations and 30 deathsEach year in the United States (CDC)

6,378 cases and 10 deathsIn 2016 in the EU (ECDC)

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A complex family

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A complex family

STECVTEC

EHEC

EPECEAEC

O104

O157:H7

O45

O26

O111O121

O145

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A complex family

STECVTEC

EHEC

EPECEAEC

O104

O157:H7

O45

O26

O121

O145

STEC Shiga toxin-producing E. coli =

(VTEC Verocytotoxin-producing E. coli

EHEC Enterohemorrhagic E. coli)

ETEC Enterotoxigenic E. coli

EPEC Enteropathogenic E. coli

EAEC Enteroaggregative E. coli

EIEC Enteroinvasive E. coli

DAEC Diffusely adherent E. coli

Diarrheagenic E. coli

Pathotypes

ww

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O111

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A complex family

STECVTEC

EHEC

EPECEAEC

O104

O157:H7

O45

O26

O121

O145

O26O45O103O111O121O145O157

Serotypes

O111

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A complex family

O26O45O103O111O121O145O157

Serotypes

Due to inadequate analytical methods and

epidemiological and laboratory

surveillance, non-O157 STEC infections

may be under-recognised and under-

reported around the world.

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A complex family

O26O45O103O111O121O145O157

SerotypesThe revision of the ISO/TS 13136:2012 standard “Microbiology of food and animal feed

– Real-time polymerase chain reaction (PCR)-

based method for the detection of Shiga-toxin

producing Escherichia coli and the

determination of O157, O111, O26,

O103 and O145 serogroups”

has been initiated in 2016.

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Pathogenicity

• Not directly related to its serotype

• Based primarily on the presence of

genes for Stx toxin (stx1 and stx2)

and adherence factors (eae

or agg). Pic

ture

: Pro

tein

Dat

a B

ank

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Pathogenicity

Strains with the same serotype may have different virulence profiles and therefore different health significance.

Serotype can be useful in epidemiological investigations, but is not very reliable for risk assessment.

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Pathogenicity

The estimated infectious dose of STEC is very low

10–100 cells

Incubation period:

1-10 days

Humans can be asymptomatic carriers of STEC

2.5% of healthy individuals

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Pathogenicity

Infections have been associated with a wide range of symptoms:

Mild intestinal discomfortHemorrhagic colitis (HC)Hemolytic uremic syndrome (HUS)End-stage renal disease (ESRD)Death

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Pathogenicity

High genome plasticity

Novel arrangements of virulence features Novel sero-pathogroups

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53 deaths

850 cases of hemolytic-uremic syndrome

4321 cases of acute gastroenteritis

were attributed to this

new clone of EAEC/EHEC

Summer 2011

Europe is facing the largest

outbreak of hemolytic-uremic

syndrome (HUS) ever reported

in the world, caused by a Shiga

toxin–producing strain of

Escherichia coli

O104:H4

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“Birth of a serial killer”: E. coli O104

“The events […] show how rapidly - literally over a weekend - an infectious agent can develop into a

major health threat for a whole country” Reinhard Burger, of the Robert Koch Institute

Improving Food Safety Through a One Health Approach: Workshop Summary (2012)

53 deaths

850 cases of hemolytic-uremic syndrome

4321 cases of acute gastroenteritis

were attributed to this

new clone of EAEC/EHECDramatic example of genetic exchange between bacterial cells

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ECOLOGY

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2009: USA STEC O157: First reported STEC outbreak associated with

consuming ready-to-bake commercial prepackaged cookie dough

Before 2009: Flour was not used to be a “usual suspect” as an outbreak

vehicle.

2015-2016: USA STEC O121/O26

2016-2017: Canada STEC O121

Flour and doughs &

STEC,

2009, 2016, 2017

Picture: www.oalgroup.com

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ECOLOGY

Flour and doughs &

STEC,

2009, 2016, 2017

Hazelnuts & STEC

O157, 2011

SoyNut Butter &

STEC O157:H7, 2017Rice cake & STEC

O157, 2011

Walnuts &

STEC O157, 2011

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OTHER CHARACTERISTICS

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Temperature

Optimum growth

temperatures: 35-40°C

Range: 7-46°C

Resist freezing

Survives well for long

periods at refrigerated

temperatures

pH

Optimum growth pH:

6.0-7.0

Range: 4.0-9.0

Survives in high acid

products

aw

Optimum growth aw:

0.995

Minimum: 0.95

Survives fermentation

and drying process e.g.

used in the manufacture

of dry fermented meat

Ref.: International Commission on Microbiological Specifications for Foods. 1996. Intestinally pathogenic Escherichia coli. In: Microorganisms in Foods 5. Microbiological Specifications of Food Pathogens, pp. 126–140.

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Heat-resistance

Heat-sensitivity of STEC is

similar to that of generic

Escherichia coli and below

that of Salmonella

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OTHER CHARACTERISTICSTemperature

(°C)

Meat (fresh, minced,

fermented or dried)Thermal treatment 72 1 sec

Food and Agriculture Organization. 2007. Meat

processing technology for small to medium-scale

producers. Heat treatment of meat products.

http://www.fao.org/docrep/010/ai407e/AI407E08.htm

Raw milk or products

from raw milk (e.g.

cheese)

Pasteurization of

Milk72 15 sec

Food and Drug Administration. 2009. Grade “A”

Pasteurized Milk Ordinance, page 82.

http://www.fda.gov/downloads/Food/GuidanceRegu

lation/UCM209789.pdf

FruitsCantaloupe

(blanching) 76 3 min

Annous, B.A., Burke, A., Sites, J.E. 2004. Surface

pasteurization of whole fresh cantaloupe inoculated

with Salmonella Poona or Escherichia coli . J. Food

Prot. 67(9): 1876–1885

Fruit Juices (≤ pH 4) 71 6.0 sec

77 1.3 sec

Vegetables (spinach) 60 5 min 50 sec

70 5 sec

80 ≤ 1 sec

Dry air roasting ≥130 ≥ 5 min

Oil Roasting 127 ≥ 2.0 min

Blanching 85 2 min 30 sec

Blanching

Monu, E.A., Valladares, M., D'Souza, D.H.,

Davidson, P.M. 2015. Determination of the thermal

inactivation kinetics of Listeria monocytogenes ,

Salmonella enterica , and Escherichia coli O157:H7

and non-O157 in buffer and a spinach homogenate.

J. Food Prot. 78(8): 1467-1471

Raw nuts and seeds Nestlé report

ReferenceRaw Materials known to

be associated with STEC

Control Measures for a 5 log reduction of STEC

Control Step Holding time

Pasteurization

Food and Drug Administration. 2004. Guidance for

Industry: Juice HACCP Hazards and Controls

Guidance First Edition; Final Guidance.

http://www.fda.gov/Food/GuidanceRegulation/Guida

nceDocumentsRegulatoryInformation/Juice/ucm072

557.htm#v

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MITIGATION

STRATEGIES

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Farm to Fork approach

Picture: pixabay.com

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Farm to Fork approach

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GAP GHP GMP HACCP

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GAP GHP GMP HACCP

GAP

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GAP GHP GMP HACCP

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GAP GHP GMP HACCP

FDA’s observations:

GMP

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GAP GHP GMP HACCP

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GAP GHP GMP HACCP

[…]

HACCP

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GAP GHP GMP HACCP

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GAP GHP GMP HACCP

UPSTREAM SUPPLY CHAIN

If STEC is considered as a significant hazard in a raw material used

without any killing step:

• Validated control measure at the vendor’s (selection and audits)

• Ask vendors to perform regular checks on their suppliers (e.g.

growers) for their proper implementation of GAP and GHP

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GAP GHP GMP HACCP

UPSTREAM SUPPLY CHAIN

If STEC is considered as a significant hazard in a raw material used

without any killing step:

• Validated control at the vendor’s (selection and audits)

• Ask vendors to perform regular checks on their suppliers (e.g.

growers) for their proper implementation of GAP and GHP

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GAP GHP GMP HACCP

IN-HOUSE CONTROL MEASURES

• Testing useless (prevalence of STEC in most raw materials is

<1%).

• Validated control measures

• Good Manufacturing Practices and hygiene prerequisite

programs, including facility design, zoning, cleaning, hygienic

design and practices in place

• When no control measures at the vendor’s or in-house identified,

RM replaced with an alternative that either does not pose a risk

or has a validated control measure.

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GAP GHP GMP HACCP

DOWNSTREAM SUPPLY CHAIN

• Careful positioning of a product as RTE or NRTE also

considering consumer perception and use/ reasonable misuse of

a RTE or NRTE product.

• Communication to the consumer, through different channels e.g.

written cooking instructions, written or displayed serving

instructions/recipes, advertisements so that the consumer

understands that some or all of the ingredients may not have had

a microbial kill step applied

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Codex Committee on Food Hygiene (CCFH)

Requested FAO and WHO to develop a report on the following aspects of STEC:

• Global burden of disease attribution based on outbreak data,

• Hazard identification and characterization of STEC, including information on genetic profiles and

virulence factors; and

• Current monitoring and assurance programs including the status of the currently available

methodology (commercially available and validated for regulatory purposes) for monitoring of STEC in

food as a basis for management and control.

United States of America and Uruguay will prepare a discussion paper on future work on STEC for

consideration at 50th session of CCFH in November 2018.

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• STEC kills every year

Remember the faces behind the figures

• Challenges with the detection methods

ISO under revision

• Pathogenicity is not linked to serotypes

Remember toxin and virulence genes

• High plasticity of STEC genome leading to new seropathotypes

Remember the serial killer O104

• STEC is a significant hazard in many more raw materials than

minced meat and raw milk

Remember low moisture foods e.g. flour and nuts

• Combined approach of GAP, GHP, GMP and HACCP at all

stages along the food chain

Don’t underestimate the misuse by the consumer

• Global regulatory landscape evolving

Codex new work item on STEC

• Theodor and Kiyoshi !

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THANK YOU FOR YOUR ATTENTION

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Daniel Elmer Salmon

Salmonella

Joseph Lister

Listeria monocytogenes

Edwin Klebs

Klebsiella

Alexandre Yersin

Yersinia

David Bruce

Brucella

Herald Rae Cox

Coxiella

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