Experts have urged caution in interpreting the decline in the number of foodborne illnesses in the UK and Ireland during the coronavirus outbreak as an actual reduction in infection.
Public Health England (PHE) said it was still not possible to know the impact of the COVID-19 pandemic on testing gastrointestinal pathogens and reporting the results to the agency.
Data on laboratory reports of gastrointestinal infections in England and Wales reported to PHE from the end of February to the end of March show that Campylobacter dropped from 930 in February to 394 in March. Salmonella declined from 93 reports to 67 and noroviruses from 204 to 38, respectively.
More icebergs under water
Professor Alan Reilly, from the Food and Health Institute at University College Dublin, used the example of the iceberg to explain the current situation in reports of foodborne infections.
“We talk about the tip of the iceberg when it comes to foodborne diseases, I think there may be more icebergs under water now than above during this pandemic. Individuals, lighter cases will not be reported. “That’s the problem, but the more serious ones still need to be caught,” he said Food Safety News.
“We need to look back at a period longer than three months when we have more data to analyze and assess. It was just hard to say what was happening. The study will be conducted at the end of the year because people are evaluating surveillance monitoring data for 2020 and will be compared with other years, the same way we see deaths and increased deaths. “
Other PHE data show reports of food poisoning in England and Wales to be in 1,700 from the beginning of 2020 to May. That compared with 2,674 and 3,071 in the same period in 2019 and 2018, respectively.
When asked if there were fewer people who experienced food poisoning or decreased reporting, Public Analyst Dr. Duncan Campbell, said that maybe a little of both.
“There will be less food prepared outside the home consumed, of course there is no all-you-can-eat buffet or mass catering events. It is likely that those who offer delivery have streamlined their menus, so that there will be less food stored. People wash their hands more. People who think they are food poisoning are far less likely to report it or seek medical help. “
An expert, who did not want to be named, said Food Safety News that there are several factors to consider:
“With the restaurant closed, the chance for food poisoning is reduced, and I don’t expect food delivered to the house to be on a scale like ‘eating in’ when we can do it. In addition, statistics depend on GP notifications with or without fecal samples. GP does most of the consultations via telephone or video link and there seems to be a general reluctance to attend. So, food poisoning in every household will not be reported for various reasons. “
PHE suspended some services
In April, the World Health Organization and the Food and Agriculture Organization issued guidelines for the authorities responsible for the national food safety control system.
The document includes food fraud, testing and analysis in laboratories and a national food safety inspection program.
“Minimum capacity in microbiological and chemical safety needs to be maintained to support food inspection in high-risk businesses, to handle consumer complaints and food incidents, and for the investigation and management of foodborne disease outbreaks. Public health disease surveillance systems may have a reduced capacity to identify cases of foodborne illness in humans, but it is very important to maintain national minimum capacity, ”according to the guidelines.
“Some monitoring and supervision programs that are routinely carried out by the authorities can be temporarily suspended during this pandemic without jeopardizing food safety, consumer health, or international trade. Temporarily suspending low risk control activities will enable the authorities to continue to maintain the health and safety of their staff while refocusing efforts in higher risk areas and towards activities that are critical for food safety. “
In the PHE gastrointestinal bacterial reference unit, identification and typing of pathogens including Bacillus, Clostridium perfringens, Campylobacter, Vibrio and Yersinia have been temporarily suspended, but can be restarted if there is an outbreak.
Ongoing services are detection of E. coli (STEC) producing Shiga toxin from fecal specimens and isolates using PCR, detection of Clostridium botulinum and botulinum toxin from food, stool samples, serum and tissue, and confirmation of identity and typing of Salmonella, Shigella, STEC and Listeria using sequencing of the entire genome.
The expert said refocusing with a number of deferred typing and identification services might be good resource management:
“It must be risk based, with lower risks that do not directly impact food safety postponed for the sake of testing, monitoring and tracking COVID-19. Does this mean we can skip the plague – only time will tell but it is very important that food security is maintained especially in the situation of the new supply chain. “
A decline in the record of foodborne diseases also occurred in Ireland. Based on data from the Health Protection Monitoring Center (HPSC), from the beginning of the year to the beginning of May, the Campylobacter report fell from 921 in the same period in 2019 to 592 this year. There was also a smaller decrease in Salmonella and E. coli infections.
Reilly, former chief executive of the Irish Food Safety Authority, said mitigation factors played a role in that number.
“It is not surprising that the reduced number of cases of foodborne illness reported as public health specialists who will usually track and investigate cases and outbreaks focus their efforts and primary attention on COVID-19,” he said.
“There are other mitigating factors because restaurants, pubs and cafes are closed and people don’t eat out so there is a reduction in exposure to food-borne dangers. People do not report to general practitioners or their doctors and they live far from A&E in the hospital for fear of being infected by SARS-CoV-2. Let’s hope that one of the positive results of this pandemic is that people will pay more attention to hand washing and personal hygiene.
“The FAO and WHO reports highlight the problems that food safety authorities will face in connection with routine law enforcement issues. The real challenge for them is not to distract from what is their true priority. When it comes to foodborne diseases, food safety authorities need to focus on outbreaks or complaints and identify case groups.
“If it’s serious, you will need food inspectors to come in and investigate whatever food is involved, where it comes from and trace back all the food involved that causes the disease and immediately expel them from the market. For larger outbreaks, the food safety authority must maintain the capacity to deal with it. “
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