Food Hygiene

Archive for the ‘Review’ Category

Global burden of human food-borne trematodiasis: a systematic review and meta-analysis

Furst T, Keise, J and Utzinger J. The Lancet Infectious Diseases, 12(3): 210 – 221, March 2012
Published Online: 21 November 2011

Food-borne trematodiases are a group of neglected tropical diseases caused by liver, lung, and intestinal parasitic fluke infections. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD 2010 study) and a WHO initiative, we assessed the global burden of human food-borne trematodiasis, as expressed in disability-adjusted life years (DALYs) for the year 2005.
We systematically searched electronic databases for reports about human food-borne trematodiasis without language restriction, between Jan 1, 1980, and Dec 31, 2008. We used a broad search strategy with a combination of search terms and parasite and disease names. The initial search results were then screened on the basis of title, abstract, and, finally, full text. Relevant quantitative and qualitative data on human prevalence, morbidity, and mortality of food-borne trematodiasis were extracted. On the basis of available information on pathological and clinical appearance, we developed simplified disease models and did meta-analyses on the proportions and odds ratios of specified sequelae and estimated the global burden of human food-borne trematodiasis.
We screened 33 921 articles and identified 181 eligible studies containing quantitative information for inclusion in the meta-analyses. About 56·2 million people were infected with food-borne trematodes in 2005: 7·9 million had severe sequelae and 7158 died, most from cholangiocarcinoma and cerebral infection. Taken together, we estimate that the global burden of food-borne trematodiasis was 665 352 DALYs (lower estimate 479 496 DALYs; upper estimate 859 051 DALYs). Furthermore, knowledge gaps in crucial epidemiological disease parameters and methodological features for estimating the global burden of parasitic diseases that are characterised by highly focal spatial occurrence and scarce and patchy information were highlighted.
Despite making conservative estimates, we found that food-borne trematodiases are an important cluster of neglected diseases.
Swiss National Science Foundation; Institute for Health Metrics and Evaluation.


Written by geraldmoy

March 21, 2012 at 4:57 am

Hygiene: new hopes, new horizons

Curtis V Wolf Schmidt W Stephen Luby S Florez R Touré  O and Biran A (2011) Hygiene: new hopes, new horizons. Lancet Infect Dis; 11: 312–21.

Although promotion of safe hygiene is the single most cost-eff ective means of preventing infectious disease,
investment in hygiene is low both in the health and in the water and sanitation sectors. Evidence shows the benefi t
of improved hygiene, especially for improved handwashing and safe stool disposal. A growing understanding of
what drives hygiene behaviour and creative partnerships are providing fresh approaches to change behaviour.
However, some important gaps in our knowledge exist. For example, almost no trials of the eff ectiveness of
interventions to improve food hygiene in developing countries are available. We also need to fi gure out how best to
make safe hygiene practices matters of daily routine that are sustained by social norms on a mass scale. Full and
active involvement of the health sector in getting safe hygiene to all homes, schools, and institutions will bring
major gains to public health.

Written by geraldmoy

June 13, 2011 at 3:17 pm

The role of food in the epidemiology of cholera

Albert MJ Neira M and Motarjemi Y (1997) The role of food in the epidemiology of cholera. World Health Stat Quarterly; 50(1-2):111-8.


Cholera is an acute dehydrating diarrhoeal disease, traditionally caused by vibrio cholerae O1, and also more recently by V. cholerae O139 (Bengal). Traditionally, water was recognized as the primary vehicle for transmission of cholera, but in the past 30 years, outbreaks of cholera associated with eating contaminated food have demonstrated that food also plays an important role, although in many instances water is the source of contamination of foods. Most commonly associated with cholera is seafood, both molluscan shellfish and crustaceans. Seafood may be contaminated in its natural environment or during preparation. Other food items associated with outbreaks are fruit and vegetables, meat, cooked grains, etc. Vegetables are usually contaminated by contact with sewage in soil and fruits when injected with contaminated water to increase weight and turgor. Food items initially free from V. cholerae organism may become contaminated when mixed with water, or other contaminated food, or through handling by infected persons who have not observed proper hygiene. Refrigeration, freezing, alkaline pH, high concentration of carbohydrate, humidity and absence of competing flora enhance the survival of V. cholerae in food. Survival of V. cholerae is shorter in food with acidic pH. Foodborne cholera can be averted by the hygienic preparation of food and its consumption. However, since the vehicles of transmission vary markedly from place to place, being affected by local customs and practices, selected control and preventive measures that are most important locally must be implemented. To this end, application of the Hazard Analysis and Critical Control Point system to food preparation is essential in order to identify the practices which may present a risk. Restrictions on importation of foods which do not present a risk of being contaminated from areas where cholera is endemic is not warranted.

Written by geraldmoy

June 4, 2011 at 1:57 pm

Food as a vehicle of transmission of cholera

Rabbani GH, Greenough WB 3rd (1999) Food as a vehicle of transmission of cholera. J Diarrhoeal Dis Res;17(1):1-9.


Cholera has been recognized as a killer disease since earliest time. Since 1817, six pandemics have swept over the world, and the seventh one is in progress. The disease is caused by infection of the small intestine by Vibrio cholerae O1 and O139 and is characterized by massive acute diarrhoea, vomiting, and dehydration: death occurs in severe, untreated cases. Cholera is a highly contagious disease, and is transmitted primarily by ingestion of faecally-contaminated water by susceptible persons. Besides water, foods have also been recognized as an important vehicle for transmission of cholera. Foods are likely to be faecally contaminated during preparation, particularly by infected food handlers in an unhygienic environment. The physicochemical characteristics of foods that support survival and growth of V. cholerae O1 and O139 include high-moisture content, neutral or an alkaline pH, low temperature, high-organic content, and absence of other competing bacteria. Seafoods, including fish, shellfish, crabs, oysters and clams, have all been incriminated in cholera outbreaks in many countries, including the United States and Australia. Contaminated rice, millet gruel, and vegetables have also been implicated in several outbreaks. Other foods, including fruits (except sour fruits), poultry, meat, and dairy products, have the potential of transmitting cholera. To reduce the risk of food-borne transmission of cholera, it is recommended that foods should be prepared, served, and eaten in an hygienic environment, free from faecal contamination. Proper cooking, storing, and re-heating of foods before eating, and hand-washing with safe water before eating and after defaecation are important safety measures for preventing food-borne transmission of cholera.

Written by geraldmoy

June 4, 2011 at 1:37 pm

Interventions to improve water quality for preventing diarrhoea: systematic review and meta-analysis.

Clasen TF, Schmidt WP, Rabie T, Roberts I, Cairncross S. Interventions to improve water quality for preventing diarrhoea: systematic review and meta-analysis. British Medical Journal. 2007a;334(7597):782.

Following a systematic review of interventions to improve water quality for preventing diarrheal disease (Clasen et al., 2007a), which compared interventions at the both the source (protected wells, bore holes, and distribution to public standpipes) and in the household (improved water storage, solar disinfection, filtration, and combined flocculation-disinfection), he and coauthors concluded that household-based interventions were nearly twice as effective as source-based measures. Clasen and coworkers subsequently conducted a cost-effectiveness analysis to determine the cost per disability-adjusted life year (DALY, a measure of disease burden) averted for a similar range of source and household interventions (Clasen et al., 2007). The researchers found that upon reaching 50 percent of a country’s population, interventions involving household chlorination and solar disinfection paid for themselves and that all interventions were cost-effective.

Clasen TF, Haller L, Walker D, Bartram J, Cairncross S. Cost-effectiveness of water quality interventions for preventing diarrhoeal disease in developing countries. Journal of Water and Health. 2007;5(4):599–608.

Written by geraldmoy

May 30, 2011 at 12:16 pm

Food fermentation: a safety and nutritional assessment. Joint FAO/WHO Workshop on Assessment of Fermentation as a Household Technology for Improving Food Safety

Y. Motarjemi and M. J. Nout (1996) Food fermentation: a safety and nutritional assessment. Joint FAO/WHO Workshop on Assessment of Fermentation as a Household Technology for Improving Food Safety. Bull World Health Organ; 74(6):553-559.

An assessment of the food-safety and nutritional aspects of lactic acid fermentation for the preparation of weaning food at the household level was carried out during a Joint FAO/WHO Workshop held in Pretoria, South Africa, in December 1995. In particular, lactic acid fermentation was evaluated as a part of food preparation processes involving other operations such as soaking, cooking, and the germination of cereal grains. The use of germinated cereals is of particular interest since they can be used to prepare semi-liquid porridges of high nutrient density. After reviewing the present state of knowledge concerning the antimicrobial effects of the lactic acid in fermented foods, and the nutritional benefits of fermentation and the use of germinated cereals, the Workshop made an inventory of gaps in current knowledge and priorities for further research. High priority areas for research include the following: the effect of lactic acid fermentation on viruses, parasites, certain bacteria, and mycotoxins; certain physiological and nutritional effects of the consumption of fermented foods; the characterization and optimization of fermentation processes and the development of appropriate fermentation starters; and risk mitigation using the Hazard Analysis Critical Control Point system, the health education of food handlers, and efforts to change the consumer perception of fermented foods.

Written by geraldmoy

May 30, 2011 at 11:34 am

Estimating the burden of acute gastroenteritis, foodborne disease, and pathogens commonly transmitted by food: an international review.

Flint JA, Van Duynhoven YT, Angulo FJ, DeLong SM, Braun P, Kirk M, Scallan E, Fitzgerald M, Adak GK,Sockett P, Ellis A, Hall G, Gargouri N, Walke H, Braam P Estimating the burden of acute gastroenteritis, foodborne disease, and pathogens commonly transmitted by food: an international review.

Clin Infect Dis. 2005 Sep 1;41(5):698-704.

The burden of foodborne disease is not well defined in many countries or regions or on a global level. The World Health Organization (WHO), in conjunction with other national public health agencies, is coordinating a number of international activities designed to assist countries in the strengthening of disease surveillance and to determine the burden of acute gastroenteritis. These data can then be used to estimate the following situations: (1) the burden associated with acute gastroenteritis of foodborne origin, (2) the burden caused by specific pathogens commonly transmitted by food, and (3) the burden caused by specific foods or food groups. Many of the scientists collaborating with the WHO on these activities have been involved in quantifying the burden of acute gastroenteritis on a national basis. This article reviews these key national studies and the international efforts that are providing the necessary information and technical resources to derive national, regional, and global burden of disease estimates.

Written by geraldmoy

May 27, 2011 at 9:53 pm