EMERGING FOODBORNE PATHOGENS

1. EMERGING FOODBORNE PATHOGENS Prof.Dr. İrfan EROL, DVM, Ph.D. Turkish Representative of World Vet. Assoc. Department of Food Hygiene and TechnologySchool of Veterinary MedicineAnkara University

2. Despite advances in hygiene, consumer knowledge, food treatment and processing, foodborne diseases mediated by pathogenic microorganisms or microbial toxins still represent a significant treatto public health worldwide.

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

4. Emerging & Reemerging Zoonotic Diseases • 60 % of the human pathogens are zoonotic • 75 % of emerging zoonotic

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

6. Emerging Foodborne Diseases • 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

7. Emerging Foodborne Diseases • Pose a threat to all persons; no matter on age, sex, lifestyle or socio-economic status etc. • Feel pain and death • Economic impact

8. Emerging Foodborne DiseasesMajor trends • 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

9. Emerging Foodborne Pathogens • Bacteria • Viruses • Parasites • Prion

10. Salmonella (multidrug resistant strain) Campylobacter jejuni E. coli O157:H7 Listeria monocytogenes S. aureus MRSA Vibrio vulnificus Yersinia enterocolitica Arcobacter spp. Mycobacterium paratuberculosis Emerging foodborne bacteria

11. Emerging foodborne viruses • Hepatit A and E • Norovirus • (Avian influenza, AI)

12. Emerging foodborne parasites • Cryptosporidium parvum • Cyclospora cayetanensis • Anisakis spp.

13. Foodborne outbreaks 1996 - 2006  ● ▼  ●  ●  ● ● ●  ● ● ▼  ● ● ● ●  ● ●  ●   ● ● ● ● ● ● ● ● ● ▼ ● ▼ ● ● ● ● ● ● ▼ ● ● ▼Cryptosporidiosis, Leptospirosis, Lyme borreliosis ●Brucellosis, E. coli 0157, Salmonellosis  BSE Reference: WHO

14. Reference: CDC

18. WHO Surveillance Programme for Control of Foodborne Infections and Intoxications in Europe 8th Report 1999-2000 Country Reports: Turkey

19. Reference: USDA’s Economic Research Service & CDC

20. Some Important Salmonella Outbreaks in the World

21. Salmonella serotype distribution in Turkey(Erol et al., 2009) • S. Agona • S. Kentucky Spices • S. Bredeney

22. Some Important Campylobacter Outbreaks in the World

23. Campylobacter jejuni Quinolone- and fluoroquinolone-resistant Campylobacter jejuni in the United States, 1982–2001

24. Campylobacter jejuni

25. 100 bp 500 bp 735 bp 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

26. Antibiotic resistance profile of C. jejuni isolates in turkey meat (Cakmak and Erol, 2009)

27. Some important E. coli O157:H7 Outbreaks in the World

29. E. coli O157:H7 isolates found in fecal samples of cattle and sheep at slaughter in Turkey (Erol et al., 2008)

30. Toxin profiles of E. coli O157:H7 isolated in Turkey(Erol et al., 2008)

31. Toxin profiles of 11 E. coli O157:H7 isolates within the PFGE groups in cattle in Turkey (Erol et al., 2008)

32. Some Important Listeria outbreaks in the World

34. Contamination level of turkey meat with L. monocytogenes is 17.8 % (32/180) (Ayaz and Erol 2008)

35. L. monocytogenes serotype distribution • 44.9 % 1/2a • 37.2 % 4b • 9.0 % 1/2b • 9.0 % 1/2c

36. Antibiotic resistance profiles of L. monocytogenes in turkey meat (n:24) (Ayaz and Erol, 2008)

38. Occurrence of Cryptosporidium spp. oocysts in Turkey(Kursun and Erol, 2003)

41. Antibiotic resistance • It’s a global concern of the antibiotic resistance of major foodborne pathogens such as; Salmonella TyphimuriumDT 104 Campylobacter spp. Listeria monocytogenes E. coli O157:H7 Staphylococcus aureus (MRSA) Enterococcus (VRE)

42. Foodborne Infections&Intoxications Known/ Unknown Reported Positive Isolates Lab. Confirmed Cases Suspectible Cases Hospitalised No sample taken Unnotified Cases No medical intervention

43. Farm to table; main contamination points

44. Surveillance Risk management Epidemiological evaluation / Risk assessment Research

45. Control of Foodborne Disease • From farm to table approach • Implementation of GMP and HACCP

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

47. THANK YOU E-mail: erol@veterinary.ankara.edu.tr

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

49. Trichinellosisoutbreak in Turkey • Although there is a religious restriction on pork meat consumption, in January 2004 there was a big trichinellosis outbreak occurred by consuming çiğ köfte (raw ground meat ball-traditional food) in Izmir • 542 people were affected and samples were found to be contaminated with T. britovi

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.