WHO -CODEX COMMITTEE ON FOOD HYGIENE – DRAFT GUIDANCE FOR THE MANAGEMENT OF BIOLOGICAL FOODBORNE OUTBREAKS

FAO

INTRODUCTION
1.Foodborne illnesses encompass a wide spectrum of illnesses and are an important public health problem. They are the result of ingestion of foodstuffs contaminated with biological hazards (biological foodborne illness) or chemicals (chemical foodborne illness). The contamination of food may occur at any stage in the process from primary production through to consumption and can result from the presence of zoonotic agents in animal production or from handlers, environmental contamination, via equipment, water, soil or air.
2.Biological foodborne illness usually takes the form of gastrointestinal symptoms; however, such illnesses can also have neurological, gynecological, immunological and other symptoms. The symptoms can be mild with recovery within days or have severe consequences for the individuals due to long-term sequelae with serious health effects or even death.
3.Biological foodborne outbreaks can have significant socio-economic costs, which may be exacerbated in populations comprised of vulnerable groups, related to hospitalization and medical treatment, lost productivity and effects on tourism. For food businesses, the consequences can be lost markets, loss of consumer confidence, litigation and company closures. Such foodborne outbreaks can cause impediments to domestic production and international trade. Globalization of the food supply has led to the rapid and widespread international distribution of foods, further increasing opportunities for pathogens being inadvertently introduced into many geographical areas.
4.Codex Alimentarius has issued several guidelines for food businesses and competent authorities on hygienic practices to ensure food safety. Those guidelines focus on prevention, monitoring and corrective actions in case of deviations along the production processes. Despite efforts to ensure a high level of hygiene, foodborne outbreaks still occur.
5.In order to handle biological foodborne outbreaks efficiently, local and national multiagency networks of preparedness should be in place. To facilitate a common understanding and a consistent approach to these situations such networks should use comparable methods and interpretations to the extent possible, as well as transparent exchange of information. Cooperation through international networks is essential and should be a feature of any national network.
6.Communication and data sharing between and among networks, food business operators and internationally is fundamental for the management of foodborne outbreaks. Existing procedures on confidentiality should be used or, if not present, procedures should be developed.
7.The principles for risk analysis including risk assessment, risk management and risk communication, as described in the Codex Working Principles for Risk Analysis for Food Safety for Application by Governments(CXG 62-2007) should form the framework/basis for the establishment of a system for preparedness and management of foodborne outbreaks. The risk management measures chosen will vary according to the situation and the regulatory framework of the competent authorities.
8.Within the available analytical methods, molecular methods often best contribute to the detection of clusters of human cases and allow them to be linked to the food source when used in conjunction with epidemiological analysis. They also help to better identify batches/lots of food involved and the root cause; hence reducing the exposure of humans to hazards. In particular, the use of specific genetic methods (e.g. Pulsed-Field Gel Electrophoresis (PFGE), Whole Genome Sequencing (WGS) and Multilocus Sequence Typing (MLST)) can result in improved detection of outbreaks, including detection of associated or linked cases, when the country has the adequate resources to perform it. The increase in the use of these methods will likely lead to the detection of more outbreaks and the need for enhanced preparedness.
9.The decision to categorize an outbreak as an incident, an emergency or crisis is at the discretion of the competent authorities which should be consistent at the local and national level. The following factors may be used by the competent authorities to categorize the outbreak and to develop and adapt response plans.
The number of cases, the geographic spread of the outbreak, and whether the outbreak is ongoing,. The disease severity and its consequences, including the number of deaths and treatment options available.
The population affected, e.g. more vulnerable groups.
The pathogenicity (virulence / infectivity) of the microorganism.
The source of contamination and the history of the establishment and business.
The distribution pattern, whether the contaminated food is still available for sale or consumption, the volumes of the food and national and international trade implications.
Consumer perception (e.g. referring to an outbreak as a “crisis”) can affect the consumer confidence in a product or food category clearly not belonging to the consignment implicated.
The need to remove or reduce risk to consumers through public health action such as product recall risk communication including media alerts.
Likely exposure and consumption patterns
Whether or not the outbreak was intentional (e.g. the consequence of fraud or bioterrorism).
Whether the hazard is known or unknown.
The capacity of the country to quickly react and limit the extent of the outbreak

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