Reporting of Outbreaks of Foodborne Illness under the International Health Regulations
During the past 20 years, the global food trade has increased and, with it, the potential for the spread of foodborne illnesses caused by imported foods. The World Health Organization in 2007 implemented new International Health Regulations which help guide reporting of foodborne outbreaks. In this podcast, CDC's Dr. Scott McNabb discusses a study in the September 2008 issue of the journal Emerging Infectious Diseases which analyzed foodborne outbreaks in Australia in the early part of this decade and assessed how many would have been reported under the current health regulations. Created: 8/27/2008 by Emerging Infectious Diseases.
Date Released: 8/27/2008. Series Name: Emerging Infectious Diseases.
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[Ted Pestorius] Hello. I'm Ted Pestorius, sitting today with Dr. Scott McNabb, the Associate Director for Science in CDC’s National Center for Public Health Informatics. Today, we’re talking about a study that appears in the September 2008 issue of the CDC's journal, Emerging Infectious Diseases. The study is about reporting foodborne disease outbreaks and how it’s changed since the adoption in mid-2007 of the new International Health Regulations. So, Scott, this study talks about the changing landscape of foodborne outbreaks because of imported foods. Can you start by explaining about that landscape?
[Scott McNabb] Surely, Ted. Over the past 20 years, the global food trade has increased and, with it, the potential for the spread of foodborne illnesses caused by imported foods. As you can imagine, when you have imported foods, it can be difficult to track the source of outbreaks and prevent them from happening.
[Ted Pestorius] That does sound like a challenging situation. So what’s being done to try to control these outbreaks?
[Scott McNabb] Well, one of the first things is to get a better handle on how many outbreaks are occurring and what’s causing them. To help us, the World Health Organization in 2007 implemented a new set of rules called the International Health Regulations, or IHR for short. These regulations lay out a way to help governments worldwide determine what kinds of outbreaks need to be reported to federal health authorities in each country and to WHO. The World Health Organization, along with the United Nations’ Food and Agricultural Organization, also established the Information Food Safety Authorities Network, or INFOSAN, to try to improve the exchange of information about foodborne outbreaks worldwide.
[Ted Pestorius] This study appears in the September issue of Emerging Infectious Diseases and it was done in Australia and looked at foodborne outbreaks, but particularly those caused by food that had been imported from elsewhere? Is that correct?
[Scott McNabb] Yes. You’re right, Ted. The authors reported more than 750 foodborne outbreaks in Australia between 2001 and 2007, and this study looked at the 14 outbreaks which were linked to internationally distributed foods. These outbreaks made more than 500 people sick in Australia. The outbreaks ranged from just a handful of cases to up to 230 in one outbreak that was caused by eating contaminated oysters.
[Ted Pestorius] So, did the researchers determine that there was anything unusual about these outbreaks?
[Scott McNabb] Yes. In fact, 4 of the 14 outbreaks caused by imported foods were what the health regulations classify as “unusual or unexpected” because they were caused by germs that hadn’t previously been seen in Australia. It’s important to note that these diseases were common in the country that exported the foods, just not in Australia. In five of the outbreaks, the foods had been exported to other countries, as well, and there were multinational recalls to help protect consumers.
[Ted Pestorius] So, clearly there’s a risk of foodborne outbreaks spreading farther because food can now be sent all around the world into so many different countries. How have communications between importing and exporting countries changed and has it had an impact?
[Scott McNabb] Before the inception of INFOSAN in 2004, health experts in the importing country relied on diplomatic channels to try to communicate with the exporting country, but they often weren’t very successful. Since 2004, INFOSAN has made it possible to quickly assess whether the implicated food item has been exported to other countries and whether there are any outbreaks caused by the same food item in the exporting country.
[Ted Pestorius] That’s good to hear. Now that the health regulations are in effect, what kind of changes will people have to make?
[Scott McNabb] Well, had the International Health Regulations been in effect during the period of the outbreaks studied here, half of the outbreaks would have been reported to WHO. This underscores the importance of countries using the new health regulations to quickly report outbreaks that involve imported or exported foods so that we can try to prevent the spread of diseases worldwide. It also may be important for health officials to consider notifying or reporting events involving contaminated foods that haven’t caused human illness. Outbreaks that aren’t international but are serious or unusual may also need to be reported. By keeping better track of outbreaks around the world and working with other countries to minimize risks caused by foodborne illnesses, we hope to more effectively protect the public’s health.
[Ted Pestorius] So thanks, Scott, for taking the time to talk to us today about this paper. Again, with us today has been Dr. Scott McNabb, Associate Director for Science in CDC’s National Center for Public Health Informatics. He was talking about a study in the September 2008 issue of CDC's journal, Emerging Infectious Diseases. You can see the whole article online at www.cdc.gov/eid. Again, that’s www.cdc.gov/eid. And if you’d like to comment on this podcast, please send us an email at eideditor, that’s one word, at cdc.gov; again firstname.lastname@example.org. I’m Ted Pestorius and thank you for listening.
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