food safety; from farm to fork - a public health perspective
TRANSCRIPT
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4/8/2015© 2010 Laureate International Universities® | Confidential & Proprietary 1
Food Safety; From Farm to Fork -
A public health perspective
4/8/2015© 2010 Laureate International Universities® | Confidential & Proprietary 2
World Health Day
2015 – From farm to plate, make food safe
2014 – Preventing and controlling vector borne diseases
2013 – Control your blood pressure
2012 – Good health adds years
4/8/2015© 2010 Laureate International Universities® | Confidential & Proprietary 3
Meet the Speakers
The U.S. Food Safety Modernization Act: Impact on the Global
Food Supply Chain
Dr. Daniel Okenu, Contributing Professor, Public Health, Walden
University & Food Safety Consultant, H-E-B Grocery Company LP, San
Antonio, USA
Food Safety: A Ugandan Case Study
Constance Shumba, MPH Faculty, University of Roehampton, London
THE U.S. FOOD SAFETY
MODERNIZATION ACT: IMPACT ON
THE GLOBAL FOOD SUPPLY CHAIN
Dr Daniel Okenu, Contributing Professor, Public Health, Walden
University
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5
What is the global burden of foodborne diseases?
In the United States…48 million people get sick of foodborne
disease annually…
…128,000 are hospitalized…
…3,000 people die…
…resulting in an economic burden of $77.7 a year.
Globally 2.2 million people (mostly children) die of Foodborne
and Waterborne Diarrheal disease annually.
Norovirus 58%
Salmonella11%
Clostridium10%
Campylobacter9%
Staphylococcus 3%
Other 9%
What is the biggest cause of foodborne
Disease outbreaks?
How is this common Foodborne Diarrheal
Disease acquired?
Potential sources of Norovirus Outbreaks
Infected food handlers
Infected non-food workers and guests
Bare hands contact with RTE foods
Contamination of food deliveries at source
Improper cleaning and disposal of body fluids
Training gap on sanitizer and disinfectant use
Aerosolized vomitus around food and people
Improper hand washing by food handlers
Contaminated food contact and non-food contact surfaces
Cross contamination from restrooms
Cross contamination from high touch points
What other Foodborne Pathogens are there…
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E.ColiStaphylococcus
aureus Shigella boydii SalmonellaKlebsiella
pneumonae
Gastrointestinal Gastrointestinal Gastrointestinal Gastrointestinal Gastrointestinal; skin infections
Undercooked foods such as beef
Contaminated hands of food handlers
Salads (potato, tuna, shrimp, macaroni, chicken), raw vegetables, milk and dairy products, and poultry
Cutting boards, kitchen utensils
Contaminated hands of food handlers
What is the Food Safety Modernization Act?
Reactive approach
Proactive Science and
Risk-based Prevention
Orientated System
Contaminated foods will
never reach retailers and
consumer
How will FSMA impact the Global Food Supply
Chain?
Other
Mexico Italy
Peru
Colombia
France
Guatemala
China
Ecuador Honduras
Canada
Countries Supplying U,S with Organic
products in 2013
U.S Food Imports Rising Faster than Food
Exports
How will FSMA impact the Global Food Supply
Chain?
How will FSMA impact the Global Food Supply
Chain?
How will FSMA impact the Global Food Supply
Chain?
WHO’s Five Keys to Safer Food
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Keep CleanSeparate raw and
cooked foodCook thoroughly
Keep food at safe temperatures
Use safe water and raw materials
FOOD SAFETY: A UGANDAN CASE
STUDY
Constance Shumba, MPH Faculty, University of Roehampton,
London
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Of 800-900 million liters of milk
produced every year only 10% is pasteurized.
Food Safety in Uganda
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Current population of Uganda 37 million …
Uganda exports...
20% of diet in urban areas is made up of processed foods…
…0.5% in rural areas.
Animal source foods are single most important source of food borne disease.
Food Safety in Uganda
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65% of all cases treated by hospitals & clinics are sanitation-
related disease such as Cholera, Hepatitis E & Typhoid
1.3 million Ugandans a year are affected by Intestinal Worms,
non-bloody Diarrhea and Typhoid
80% of child deaths due to diarrhea occur in South Asia and Africa
Food Safety related disease burden in Uganda: Outpatient Diagnoses in Uganda: 1997– 2001
Diagnosis
(All Ages)
Year
1997 1998 1999 2000 2001
Cholera 1,172 17,636 2,614 2,637 632
Diarrheal Dysentery 82,022 70,192 54,852 59,915 77,606
Acute Diarrhea (Not
bloody)
378,457 369,391 38,8570 403,122 504,365
Persistent Diarrhea
(Not bloody)
112,471 116,974 121,633 117,213 114,213
Intestinal worms 733,818 744,917 784,708 778,463 1,235,399
Typhoid & para
typhoid fevers
8,975 7,053 6,336 11,301 12,194
Total 1,316,915 1,326,163 1,358,713 1,372,651 1,944,409
Total OPD 8,132,519 8,833,713 9,806,395 10,502,186 14,527,249
% of Total OPD 16.2 15.0 13.9 13.1 13.4
Source: HMIS District Monthly Reports, MOH
Directorate of Water Development
National Environment Management
Authority
Ministry of Trade and Industry
Ministry of Health Uganda National
Council of Science & Technology
Ministry of Agriculture, Animal Industry & Fisheries
Uganda National Bureau of Standards
Food safety standards & guidelines: a cross-sectoral issue
Food safety gaps contribute to burden of disease
Food Production Processing Storage
Transportation Retailing Handling in homes
Characteristics
• Little support from Public and NGO
• No effective health & safety
regulations
• Traditional processing & retail
practices
• Poor infrastructure
• Many actors
• Pay no tax
Benefits
• Cheap
• Fresh
• Local Breeds
• Taste
• Trust in vendors
• Credit
Informal food markets
4/8/2015© 2010 Laureate International Universities® | Confidential & Proprietary 22 Picture courtesy of Delia Grace and Kristina Roesel Safe Food, Fair Food team Gender aspects of informal
markets. Africa 2013. Ecosante/Ecohealth
Informal food markets
Pigs in Uganda
Evidence from farm sampling carried our among over 1,200
households in 2013 pointed to pig related diseases such as…
African Swine Fever
Brucellosis
Cysticercosis
Diamond Skin Disease
Intestinal Helminths
Salmonellosis
Sarcoptic Manage
Toxoplasmosis
Trichinosis
In the news: Most pork in Kampala is unsafe, say health experts, 6th June 2012
Source: safefoodfairfood.ilri.org
Making food safe
Source: http://safefoodfairfood.ilri.org/2014/04/30/apm2014/
Ugand
a c
on
firms T
yphoid
outb
reak
file
ph
oto
Investig
atio
ns re
main
on
go
ing
to d
ete
rmin
e th
e e
xact s
ou
rce [o
f the illn
ess] b
y
testin
g a
ll so
urc
es o
f wate
r, inclu
din
g w
ate
r bein
g s
old
co
mm
erc
ially
Wo
rld
Bu
lletin
/ N
ew
s D
es
k
Ug
an
da
's H
ea
lth M
inistry
on
Th
urs
da
y c
on
firmed
an
ou
tbre
ak
of T
yp
ho
id in
the E
ast
Afric
an
co
un
try.
"We w
ou
ld lik
e to
info
rm th
e g
en
era
l pu
blic
tha
t the
re is
an
ou
tbre
ak
of T
yp
ho
id in
Ka
mp
ala
a
nd
in s
om
e p
arts o
f the
ne
igh
bo
urin
g W
ak
iso a
nd
Mu
ko
no
distric
ts," Ja
ne
Ru
th A
cen
g,
dire
cto
r-ge
nera
l of h
ea
lth se
rvic
es, to
ld re
po
rters
.
Sh
e sa
id th
e firs
t Ty
ph
oid
infe
ctio
n h
ad
be
en
rep
orte
d o
n F
eb
. 6.
"So
far, tw
o p
eo
ple
are
co
nfirm
ed
to h
av
e d
ied
of th
e d
ise
ase, w
hile
11 m
ore
dea
ths a
re s
till b
ein
g in
vestig
ate
d," A
cen
g sa
id.
Sh
e a
dd
ed
tha
t a to
tal o
f 14
2 p
eo
ple
ha
d so
far b
een
fou
nd
with
sy
mp
tom
s o
f Ty
ph
oid
.
Acco
rdin
g to
the H
ea
lth M
inistry
, 20
to 3
0 m
ore
peo
ple
ha
ve
co
mp
lain
ed
of T
yp
ho
id-lik
e
sy
mp
tom
s, in
clu
din
g fe
ve
r, ab
do
min
al p
ain
an
d c
ou
gh
.
"Inv
estig
atio
ns h
av
e re
ve
ale
d th
at p
eo
ple
are
be
ing
infe
cte
d b
y s
om
eth
ing
the
y a
re e
atin
g o
r d
rink
ing
at th
eir w
ork
pla
ces," A
cen
g sa
id.
"Inv
estig
atio
ns re
ma
in o
ng
oin
g to
dete
rmin
e th
e e
xa
ct s
ou
rce [o
f the
illne
ss] b
y te
stin
g a
ll so
urc
es o
f wa
ter, in
clu
din
g w
ate
r be
ing
sold
co
mm
erc
ially
," she
ad
ded
.
Ty
ph
oid
is a c
om
mo
n b
acte
rial d
isea
se u
sua
lly tra
nsm
itted
by
the in
ge
stio
n o
f foo
d o
r wa
ter
co
nta
min
ate
d w
ith fe
ces.
"It is im
po
rtan
t tha
t peo
ple
are
trea
ted
ea
rly to
av
oid
the p
ossib
le s
pre
ad
of th
e d
isea
se,"
Acen
g sa
id.
Sh
e la
men
ted
, ho
we
ve
r, tha
t Ug
an
da
cu
rren
tly la
ck
ed
Ty
ph
oid
va
ccin
es, g
oin
g o
n to
ca
ll for
the u
se o
f an
tibio
tics to
trea
t the
dise
ase.
http
://ww
w.w
orld
bu
lletin
.net/n
ew
s/15
53
51/u
gan
da-c
on
firms-ty
ph
oid
-ou
tbre
ak
19
Feb
ruary
20
15
Uganda confirms Typhoid outbreak
file photo
Investigations remain ongoing to determine the exact source [of the illness] by testing all sources of water, including water being sold commercially
World Bulletin / News Desk Uganda's Health Ministry on Thursday confirmed an outbreak of Typhoid in the East African country.
"We would like to inform the general public that there is an outbreak of Typhoid in Kampala and in some parts of the neighbouring Wakiso and Mukono districts," Jane Ruth Aceng, director-general of health services, told reporters.
She said the first Typhoid infection had been reported on Feb. 6.
"So far, two people are confirmed to have died of the disease, while 11 more deaths are still being investigated," Aceng said.
She added that a total of 142 people had so far been found with symptoms of Typhoid.
According to the Health Ministry, 20 to 30 more people have complained of Typhoid-like symptoms, including fever, abdominal pain and cough.
"Investigations have revealed that people are being infected by something they are eating or drinking at their workplaces," Aceng said.
"Investigations remain ongoing to determine the exact source [of the illness] by testing all sources of water, including water being sold commercially," she added.
Typhoid is a common bacterial disease usually transmitted by the ingestion of food or water contaminated with feces.
"It is important that people are treated early to avoid the possible spread of the disease," Aceng said.
She lamented, however, that Uganda currently lacked Typhoid vaccines, going on to call for the use of antibiotics to treat the disease.
http://www.worldbulletin.net/news/155351/uganda-confirms-typhoid-outbreak
19 February 2015
In the news: Uganda confirms Typhoid outbreak
4/8/2015© 2010 Laureate International Universities® | Confidential & Proprietary 27
What is the role of public health practitioners in
food safety?
Advocate for legislation on
food
Advocate for strict
controls
Increase awareness on effects
of unhygienic food to human
health & national socio-
economic status
Enhance public
participation through
dialogue
Don’t forget...
WHO’s Five Keys to Safer Food
4/8/2015© 2010 Laureate International Universities® | Confidential & Proprietary 28
Keep CleanSeparate raw and
cooked foodCook thoroughly
Keep food at safe temperatures
Use safe water and raw materials
Thank you.
4/8/2015© 2010 Laureate International Universities® | Confidential & Proprietary 29