A world perspective on Cronobacter research and surveillanceciversen.tripod.com/benembarek.pdf ·...
Transcript of A world perspective on Cronobacter research and surveillanceciversen.tripod.com/benembarek.pdf ·...
A world perspective on Cronobacter A world perspective on Cronobacter
research and surveillanceresearch and surveillance
1st International Conference on Cronobacter
January 22-23rd 2009
Dublin, Ireland
Peter Karim Ben Embarek
World Health Organization (WHO),
Geneva, Switzerland
Department of Food Safety, Zoonoses & Foodborne Diseases
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Cronobacter: Assessing and managing risks
� Data for Assessments activities
� Data for management activities
� Surveillance.
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NoveltyNovelty productsproducts
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Cronobacter : sudden international concern
2003 Alert from certain countries to the problem.
2004 Scientific assessment of E.sakazakii and other pathogens in PIF.
2004 Codex initiate revision of the Code of Practice for infant formula
2005 World Health Assembly Resolution
2006 FAO/WHO Risk Assessment on E.sakazakii in PIF.
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Cronobacter : International concern (2)
2007 WHO/FAO guidelines on safe preparation, handling & storage of PIF
2007 Codex finalize code of practice, sampling plans and micro criteria.
2007 FAO/WHO web based user friendly risk management tool.
2008 Codex adopt revised Code of Practice and Micro Criteria
2008 FAO/WHO Expert meeting on Cronobacter in follow up formula
2008 Codex develop micro criteria for follow up formula.
2009 1st International scientific conference on Cronobacter, Dublin.
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What was different?What was different?
� Urgency – High mortality in infants
– World Health Assembly requested rapid action
– Risk managers defined needs
– PIF meeting existing standards implicated in cases of illness
� Very specific product
� Product in international trade –
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20032003--2009 Major discoveries2009 Major discoveries
� Detection methods– Development of wide range of methods (traditional and molecular-
based)
� Sources of Cronobacter spp.– PIF linked (milk powder and ingredients issues)
– Environment,…
� Taxonomy – 2008 name change E. sakazakii to Cronobacter spp.– Evolving situation– Cronobacter new genus with several new spp.
� Prevalence and control measures during production– Role of wet environment for the maintenance and spread of in plant
contamination– Role of dry cleaning in reducing prevalence
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Surveillance Surveillance --20092009
� Approx 120 recorded cases of E.sakazakii
(Cronobacter spp.) infections and
colonisations in infants and young children
from some 19 countries.
� Other age groups also affected (e.g. elderly)
� Embryonic and emerging information from
developing countries
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Key factors for successful future research & Key factors for successful future research &
surveillancesurveillance
� Probably first time we have had a risk
assessment identifying data gaps to guide
research.
� Committed industry organizations and
consumer organizations supporting data
collection.
� Critical mass of research groups.
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Research and surveillance needsResearch and surveillance needs
� Data from other parts of the world.
– Some presented here but more needed
– Prevalence data
– Incidence of disease
� Surveillance systems
– No active surveillance systems anywhere in the world
– Need for lab-based systems
– Raising awareness of public health workers
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Research and surveillance needs (2)Research and surveillance needs (2)
� Epidemiology.
– Different patterns of disease (severity)
– Differences between age groups
– Incidence/under-reporting
– Exposure of young children (6 month >)
– Role/impact of immunodeficiency in infants and young children (malnutrition, underweight, Vitamin deficiencies, co-infection, HIV/AIDS,…)
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Research and surveillance needs (3)Research and surveillance needs (3)
� Developments of standardized and affordable
methods for surveillance and monitoring
� Dissemination of recent R&D outcomes
– Taxonomy
– Ecology
– At risk groups
– Epidemiology
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CommunicationCommunication
- For at-risk groups
- Interventions available for risk reduction
- Translation into national guidance
- New languages for wider dissemination
- Validation of current guidance for FUF
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Cronobacter : International concern (2)
2009 1st International scientific conference on Cronobacter, Dublin.
2009 UCD-Center for Food Safety : WHO
Collaborating Center for E.sakazakii
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Internet :
http://www.who.int/foodsafety
http://www.fao.org/ag/agn
� E. sakazakii tool www.mramodels.org
E.mail:
For further information :For further information :