MANILA — Foodborne outbreaks are becoming more challenging to tackle, and food safety authorities and experts that gathered in Abu Dhabi this week see issues such as e-commerce and food fraud as contributing to the problem.
Increasingly, fresh produce such as fruits and vegetables, and ready-to-eat food are being linked to foodborne outbreaks, Peter Karim Ben Embarek, manager of the International Food Safety Authorities Network or INFOSAN Network Secretariat, and a food safety expert at the World Health Organization, told Devex via phone. This is reflective of the complexity of food production and food distribution systems today, as well as people’s changing consumption habits, Embarek said.
“it's very easy to tamper with food, to change labels or to fake labels. It's easy to change the ingredients in your food.”— Peter Karim Ben Embarek, manager, INFOSAN Network Secretariat
“We're in a much better position with the food sector that we can trade food so much. And the success of that is that we have a globalized food supply. The downside of that is that we have then also a globalized problem with food … Contaminated food is spreading disease globally,” Embarek said from the second global INFOSAN meeting, held from Dec. 9-11.
In today’s distribution chains, an ingredient produced in one place is likely to be used in several different products via different channels. If that ingredient is contaminated, then it can be transported through different production lines, making detection and control of a potential outbreak more challenging.
The growing role of e-commerce is also making food tracing more difficult. Embarek said one of the things discussed at this week’s meeting was the growing trend of food fraud.
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“Unfortunately it's very easy to tamper with food, to change labels or to fake labels. It's easy to change the ingredients in your food. It's easy to fake the food in many ways. But also with the content, [for example] substituting cheap meat dishes, or an expensive one for a cheaper one,” he said.
“So the way we tamper food is also easy, in a way, and criminals have discovered that. Well, it's nothing new, but they have increasingly seen that there is a lot of money to be made in the food business and they take advantage of that,” he added.
The introduction of artificial intelligence and robotics in the food production systems could be a game-changer — or an additional challenge.
“We need to ensure that these future machines have some understanding of food hygiene and food safety. So we don't have in the future to train robots in food hygiene for example. That would be a little bit stupid,” Embarek said.
In 2015, WHO published the first global estimates of foodborne diseases, which revealed that 1 in 10 persons globally get sick from foodborne diseases every year. That’s about 600 million annually. Foodborne diseases also kill about 420,000 people every year, including children according to WHO estimates. Embarek said WHO plans to work on an update of that report in 2020.
“These are estimates based on only 31 different foodborne diseases out of about 200 foodborne diseases. So the true picture is probably much bigger than that,” he said.
This shows the seriousness of the issue for public health, but also economically, Embarek said. A World Bank study in 2018 estimated total productivity loss associated with foodborne diseases in low and middle-income countries at $95 billion per year. Add to that, the annual cost of treating foodborne diseases is $15 billion, according to the bank’s estimates.
“Unfortunately [this is] an issue that is not given enough attention, that is not addressed seriously in many places, and in clear need of more investments and more coordinated effort,” Embarek said.
Asked what role can the aid sector play in helping ensure food safety worldwide, Embarek said donors should integrate food safety into their development plans, while NGOs can help educate consumers in the process of preparing and handling food.
The private sector needs to take the issue more seriously too, given their involvement with food production and distribution.
“Frankly speaking, some in the private sector should not produce food because they sometimes do not understand the seriousness of what they are doing. It's much more serious and sensitive thing to do to produce safe food than to produce a t-shirt or a table or something else. Because if you make a mistake producing food, you can kill people,” he said.
These different entities already have some involvement in addressing food safety issues, but Embarek said there is a need for more integrated forums where these different actors can talk to each other, combine and coordinate their efforts, and better understand each other’s roles and responsibilities.
Recent foodborne outbreaks
The most recent foodborne outbreaks are linked to the bacteria Listeria monocytogenes, which causes listeriosis, a deadly disease that has a fatality rate of 20-30%, according to the U.S. Food and Drug Administration. Pregnant women, newborn babies, the elderly, and people with immunocompromised health status are particularly susceptible to the disease.
In 2017, the world’s biggest listeriosis outbreak was reported in South Africa. The culprit: ready-to-eat meat products traced to a food-production facility by Enterprise Foods, a subsidiary of Tiger Brands, the country’s most established company. The outbreak affected over 1,000 people and led to the deaths of more than 200.
“Apart from being the world's largest, it was also the first major outbreak of listeriosis we saw in developing countries,” Embarek said.
This was soon followed by a listeriosis outbreak in Europe in 2018, which was traced back to frozen vegetables produced in a factory in Hungary whose food products are distributed to over 100 countries globally. About 47 people reportedly fell ill from the outbreak, which was found to be ongoing since 2015.
The latest listeriosis outbreak was reported in Spain last August 2019. Over 200 people fell sick, and three died. It was the largest listeriosis outbreak in the country, traced to a chilled roasted pork product by Magrudis Company Limited. The outbreak rapidly spread within days, Embarek said, who noted that the number of tourists in Spain when the outbreak was reported was additionally concerning.
New technologies such as whole genome sequencing have proven helpful in all three outbreaks, said the food safety expert.
“By having the DNA fingerprints of different bacteria, we can much faster and much quicker than before link the bacteria we found in a contaminated food with the same bacteria we find in a patient. And thereby we can make the link between that patient and what was consumed, and then we can be sure that these people got sick from this particular food and not something else,” Embarek said.
“We can also link patients across different countries who have consumed the same food that was traded internationally,” he added.