Foodborne Illness in Scotland Dr Jane Horne 24 June 2015
Food Standards Scotland • Public sector food body for Scotland • Independent of industry and the Scottish Government - accountable to the public in Scotland through the Scottish Parliament. • Our primary concern is consumer protection – making sure that food is safe to eat, ensuring consumers know what they are eating and improving nutrition.
Foodborne Disease Strategy 2010-2015 Estimated annual burden of foodborne disease in Scotland: • 43,000 cases • 5,800 GP presentations • 500 hospitalisations FDS 2010-2015 aims to reduce the burden of foodborne disease by: • Working with industry to control risks in the foodchain • Working with the relevant sectors to ensure that the food they prepare and serve is safe • Raising consumer awareness of the risks and how to protect themselves
Foodborne Disease in Scotland 7000 Number of reported cases 6000 5000 4000 Campylobacter Norovirus 3000 Salmonella E. coli O157 2000 Listeria 1000 0 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Year
Over 60’s and foodborne disease • Over 60’s are particularly susceptible to foodborne disease and are at a greater risk of more severe illness. • 916 care homes for older people in Scotland, with 33,636 Care Home residents aged over 65.
Campylobacter - The Scottish Picture • Scotland: comprehensive baseline on attribution of Campylobacter infection – world leading research • Clear evidence linking high proportion of human Campylobacter infection in Scotland to a chicken source • Under 5’s more likely to be linked to a ruminant source
Campylobacter risks in the kitchen Exposure via: • Eating undercooked chicken and chicken livers • Cross-contamination to Ready to Eat foods
Contamination in the kitchen Percentage (%) of surfaces contaminated with Campylobacter after the production of various chicken meals within catering establishments (n=50) Sink Hot tap Deep fat fryer handle Chef’s Chopping Cold tap board cloth Work Refrigerator Bin lid surfaces handle Draining board Tongs Knife
Retail Packaging • Clearer labelling on fresh poultry – ‘Do not wash’ • Leak proof packaging • Roast in the bag chickens Customer communication • Customer magazines, websites, in-store Retail survey • 73% chickens positive for Campylobacter with 19% in most heavily contaminated band. • Number of retailers have published action plans to tackle Campylobacter along the food chain.
Consumers / Caterers
E. coli O157 in the UK
E. coli O157 in Scotland, age band and sex
E. coli O157 and Meat Outbreaks • Wishaw, Scotland (1996) – 279 confirmed cases, 17 died • South Wales (2005) - 118 confirmed cases, 1 died
E. coli O157 and Fresh produce May - July 2011, large outbreak of E. coli O104 in Europe linked to fenugreek seeds December 2010 - July 2011, 250 cases of E. coli O157 reported across Great Britain, associated with soil contaminated root vegetables Both outbreaks associated with fresh produce
Controlling E. coli O157 in the foodchain Key aims: • Improve awareness and control of food safety hazards by food businesses, food law enforcers and consumers • Ensure that compliance with legal standards is maintained Focus on control of cross-contamination: • Separation of work areas, surfaces and equipment for raw and ready-to-eat food • The importance of handwashing using a proper technique • The use of disinfectants and sanitisers which meet officially recognised standards and as instructed by the manufacturer
Scottish Government VTEC Action Group Framework Colonised animals Colonised animals Direct Direct Environment Environment Food Food Water Water Contaminated animal faeces Contaminated animal faeces Environment Environment Treated Water Treated Water Untreated water Untreated water Untreated Food Untreated Food Treated Food Treated Food Human case Human case Direct Direct Environment Environment Food Food Water Water Contaminated human faeces Contaminated human faeces
Proposals for recommended action 1. Controlling VTEC risks in the production of fruit and vegetables in Scotland: • Promoting best practice throughout the industry • Ensure the use of organic wastes in agriculture is subject to on-going review • Ensuring compliance with hygiene requirements in all areas of production -including businesses supplying directly to the consumer 2. Effective implementation of the FSA’s cross -contamination guidance across all relevant food businesses in Scotland: • Training for LAs and food businesses • Prioritising the guidance in inspection programmes • Audit and monitoring
Proposals for recommended action (2) 3. Effective risk communication • Review point of sale information for consumers in relation to unpasteurised cheeses • Ensure consumers are aware of the risks and how to avoid them (safe cooking and avoidance of cross-contamination) 4. Research and food surveillance • Improve our understanding of the contribution of food (compared to water and environmental exposure) to VTEC infection in Scotland • Evidence for the risks associated with vegetables • Targeted surveillance to identify the risks in the food chain and assess compliance with cross-contamination control
Listeria • Listeria widely distributed in the environment, is adaptable and persistent. • Listeriosis is rare but is the number one cause of death due to foodborne disease in the UK. • Most cases are hospitalised and approximately a third die. • Prolonged incubation (up to 90 days)
High-risk population groups Listeriosis generally affects those with reduced immunity: – Pregnant women and their unborn babies – Newborns – Weakened immunity – Patients with specific underlying medical conditions and/or undergoing certain drug treatments – Elderly (People aged over 60 years)
Higher Risk Foods • Higher risk foods are generally: – Ready-to-eat – Able to support the growth of the bacterium – Chilled, i.e. refrigerated – Sold with a long shelf life
Consumer behaviours / actions PRIORITY FOCUS: Cancer patients
Industry compliance / enforcement PRIORITY FOCUS: SMEs producing high-risk chilled RTE foods
Procurement / provision of food to the vulnerable PRIORITY FOCUS: Hospitals
Norovirus in Scotland , age band and sex
Norovirus Role of food unclear but: • Shellfish and fresh produce can be contaminated during production and processing • Contaminated food handlers pose the biggest risk in catering • Effective personal hygiene is the most effective means of control • Important for staff to adhere to fitness to work policies
Cooksafe • CookSafe helps catering businesses in Scotland understand and implement HACCP-based systems. • e-CookSafe has been developed as an additional support to the hard copy manual and as a learning tool. • Learn - Food Safety Refresher • Develop – Building your own CookSafe system • Resources – Templates for you to use.
FSA Guidance for Care Homes • Produced to help caterers and staff working in small residential care homes prepare and cook safer food for their residents. • Covers specific food safety issues found in care homes: • extra care: protecting food • gift food • mini-kitchens
Questions • How is food safety taken into account when you are planning menus? • What are your biggest concerns with regard to food hygiene in the Care Home environment? • What could FSS do to help you? Is there a need to improve guidance and/or training?
Thank-you Any Questions or Comments? Jane.Horne@fss.scot
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