ilri food safety and zoonoses: india and bihar
TRANSCRIPT
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ILRI Food Safety and ZoonosesIndia and Bihar
Johanna Lindahl
Bihar Agricultural University, Patna, Bihar, India 9 October 2015
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Why food safety and zoonoses?
1. Everyone needs to eat and wants to be healthy
2. Food-borne disease is common, costly and preventable
3. A new disease emerges every 4 months, ¾ are zoonotic
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What do we work on?
• Which livestock agendas are important in this program?
–Safe food–Zoonotic diseases– Emerging infectious diseases– Animal health– Intensification and disease– Climate change and disease– Gender and health– Food safety and nutrition
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FSZ program geography
– East Africa, West Africa, Southern Africa, South Asia, Southeast Asia
– Kenya, Ethiopia, Tanzania, Uganda, Senegal, Zambia, Nigeria, Ghana, Mozambique, Cote d’Ivoire, Rwanda, Malawi
– Vietnam, Laos, Thailand, China, Indonesia, Cambodia– India, Bangladesh– Egypt
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71% “out-posted”53% female33% developing country25% Asian
1 human nutritionist1 food technologist1 biologist1 animal scientist1 medical epidemiologist12 veterinary epidemiologists
81 graduate fellows (54% f)
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What we know
1.Most food is sold in informal markets
2. Most health burden is due to biological hazards; chemical hazards and mycotoxins cause concern but there is less evidence for large health burdens
3.Most risky foods are un-boiled dairy products, vegetables grown in contaminated water or cross-contaminated from meat, and under-cooked meat
4. GAP for farmers successful at small-scale and for export; large-scale but domestic GAP less successful (Farmer Field Schools)
5. Training and certification of vendors successful at small-scale and some success at scale in Kenya and Assam
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FAO statistics 2012
Milk, w
hole fresh co
w
Rice, p
addy
Meat indigenous, c
attle
Meat indigenous, p
ig
Meat indigenous, c
hicken
Wheat
Soyb
eans
Sugar c
ane
Eggs, hen, in
shell
Maize
Potatoes
Milk, w
hole fresh buffalo
0
100,000,000
200,000,000
0
1,000,000,000
2,000,000,000Production 1000 USD Production MT
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Change in global and regional demand for food: Livestock and other commodities
developed developing SSA SA-50
0
50
100
150
200
250
300
350
cerealsroot/tubermeatdairy
% ch
ange
200
5/07
to 2
050
Modified from Alexandratos and Bruinsma (2012)
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Steinfeld et al. (2006)
Big productivity gaps-largely due to poor animal health
Some developing country regions have gaps of up to 430% in milk productivity
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Agriculture imposes large burdens on human health
EmergingFood borneMalnutritionZoonosesMalaria
Three million deaths a year are agriculture associated One quarter of all deaths from infection are agriculture associatedAlmost all of these occur in developing countries
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Zoonoses and FBD kill 2.2 million a year• 2.4 billion people sick • 2.2 million people dead• more than 1 in 7 animals affected
Zoonoses & FBD cost $84 billion a year• $9 billion in lost productivity• $25 billion in animal mortality • $50 billion in human health costs
Agriculture imposes large burdens on human health
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Evidence for food safety
• 90% of animal products are produced and consumed in the same country or region
• 500 million smallholders produce 80% of food in poor countries. 43% of the workforce are women
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130
10
20
30
40
50
60
70
80
90
100
Poor total bacteria Unacceptable totalbacteria
Unacceptablefaecal bacteria
UnaccpetableStaph
Unacceptablelisteria
Any unacceptable
SupermarketWet marketVillage
Compliance : Formal often worse than informal
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Food-borne diseases
• Food-borne diseases are very important• 1.4 million children die every year of diarrhoea• The majority is food and water-associated • Animal-source food over-represented as a cause
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Risks and benefits with dairy
Pathogens from the cow and from the milk
• Mycobacterium bovis• Brucella spp.• Bacillus anthracis• Salmonella• EHEC
• Streptococcus spp.• Staphylococcus
aureus• Clostridium spp.• Listeria spp.
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Risks and benefits associated with dairy: What else is in the milk?
• Antibiotic residues
• Frequently detected
• Pesticides
• High percentage of milk samples
• Mycotoxins (aflatoxins)
• Detected in many milk samples, sometimes high levels
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Aflatoxins- Food safety outside the ASFs
• Acute outbreaks can claim 100s of lives (Kenya outbreak 2004-05, 150 known fatal cases)
• 4.5 billion people chronically exposed (estimate by US CDC)
• Cancer• Immunosuppression• Stunting
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Farmer Consumer
Economic flow
Aflatoxin flow
Human exposure
Feed producer
AB1
AB1AB1-> AM1
AM1
Corn/feed produced at farm
Corn/feed purchased
Milk produced at farm
AB1 AM1
Treatments
Feed seller Farmer
Veterinary services
Milk retailer
Agricultural services
Consumer
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Food safety work in India
• Focus on the dairy value chain
• Agriculture-associated diseases
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The White Revolution
Year1962
19641966
19681970
19721974
19761978
19801982
19841986
19881990
19921994
19961998
20002002
20042006
20082010
20120
20,000,000
40,000,000
60,000,000
80,000,000
100,000,000
120,000,000
140,000,000
Milk cowMilk buffaloTotal
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Project 1: The Assam study
• Concerns about milk quality in Assam• Training to promote knowledge and hygiene
amongst producers and traders• The objectives was to evaluate the
improvements in knowledge
21
2009
2012
2009-2011 Producer Traders Total
2009 405 175 580
2012 161 226 387
Total 566 401 967
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Can diseases be transmitted from dung?
22
Believe diseases can be transmitted from dung
Producers
2009 2.7% (11/404)
2012 37.2% (60/161)***
Trained (2012) 69.8% (37/53)***
Untrained (2012) 21.3% (23/108)
Traders
2009 1.1% (2/175)
2012 47.1% (106/225)***
Trained (2012) 63.9% (78/122)***
Untrained (2012) 27.2% (28/103)
Comparison between 2009 and 2012 surveyComparison between trained and untrained 2012Comparison between 2009 and untrained 2012
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Can diseases be transmitted by milk?
23
Believe diseases can be transmitted from milk
Producers
2009 13.0% (52/401)
2012 35.4% (57/161)***
Trained (2012) 64.2% (34/53)***
Untrained (2012) 21.3% (23/108)
Traders
2009 9.1% (16/175)
2012 41.5% (93/224)***
Trained (2012) 64.8% (79/122)***
Untrained (2012) 13.7% (14/102)
Comparison between 2009 and 2012 surveyComparison between trained and untrained 2012Comparison between 2009 and untrained 2012
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Which diseases can be transmitted?
Tuberculosis
Food poisoning/ gastrointestinal disease
General disease symptoms (fever, cough, cold) Worms
Producers
2009 3.5% (14/405) 18.3% (74/405) 0.3% (1/405) 4.7% (19/405)
2012 8.7% (14/161)** 36.0% (58/161)*** 11.2% (18/161)*** 9.3% (15/161)*
Trained (2012) 18.9% (10/53)*** 64,2% (34/53) *** 20.8% (11/53)** 9.4% (5/53)
Untrained (2012) 3.7% (4/108) 22.2% (24/108) 6.5% (7/108)*** 9.3% (10/108)
Traders
2009 4.0% (7/175) 9.7% (17/175) 0% (0/175) 2.9% (5/175)
2012 13.7% (31/226)*** 42.9% (97/226)*** 11.5% (26/226)*** 4.0% (9/226)
Trained (2012) 23.8% (29/122)*** 61.5% (75/122)*** 20.5% (25/122)*** 6.6% (8/122)*
Untrained (2012) 1.9% (2/104) 21.2% (22/104)** 1.0% (1/104) 1.0% (1/104)
24
Comparison between 2009 and 2012 surveyComparison between trained and untrained 2012Comparison between 2009 and untrained 2012
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What do you use most often to wash your hands?
• Traders• Untrained: 74% answered soap• Trained: 92% answered soap (p<0.001)
• Producers• Untrained: 53% answered soap• Trained: 92% answered soap (p<0.001)
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Some specks of dirt in the milk are not harmful
• Traders• Untrained: 37.5% agree• Trained: 28% agree
• Producers• Untrained: 58% agree• Trained: 77% agree (p=0.046)
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You can tell if milk is safe to drink
• Traders• Untrained: 96% agree• Trained: 89% agree
• Producers• Untrained: 96% agree• Trained: 77% agree (p<0.001)
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Improving production – not always rocket science
• Follow up in 2014• Trained farmers reported less diseases and
higher milk production (p<0.001)
• No difference in Brucella prevalence
Average milk production in liters per cow and day 2 years ago/before ILRI training
Average milk production in liters per cow and day now
Trained farmers 7.0 (range 2.5-10) 7.8 (range 3-15)
Untrained farmers 7.3 (range 2.5-14) 6.8 (range 2.5-14)
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Project 2: Peri-urban milk production
• Can we affect the incidence of bovine tuberculosis?• Can we affect the prevalence of antibiotic residues?
• Evaluate the risks• Identify risk practices• Pilot interventions
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Risk mitigation at the human-livestock interface
• It is possible to change people’s perceptions and
habits but difficult to assess the effect
• Farmers at high risk for zoonoses
• Milk is a risk product
• Assess the risks, mitigate the risks, increase the profits
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Mycobacterium bovis
• Tuberculosis can be caused by 2 types of bacteria: Mycobacterium tuberculosis and Mycobacterium bovis
• Chronic disease in both humans and animals
• Fatal
• Difficult to treat
• Best method is to stop the spread
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Antibiotic residues
• Unregulated antibiotic
• Risk for antibiotic residues in the milk: there is no
testing and no control
• The problem: residues or resistance
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Study design
1. Estimate the burden
• Estimate the prevalence of Mycobacterium bovis, Brucella abortus, Coxiella burnetii, Listeria monocytogenes infection among livestock in smallholder dairy farms in peri-urban areas
• Describe and quantify antibiotic use and associated levels of milk production, including testing of pooled milk samples for antibiotic residues
2. Design an intervention and pilot it!
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Study sites
Image Source: http://www.coachingindians.com/i/india_political.jpg
Bangalore
Ludhiana
GuwahatiUdaipur
Bhubaneshwar
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Project 3: Animal health in Bihar
• Bihar is one of the poorest and least developed states
• Common farm size: 1-3 dairy cows or buffaloes• 3-5 litres of milk• Little is known about the limitations to the dairy
production
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Scoping study about the animal health problems
• Collecting morbidity and mortality data
• Including mastitis and antibiotic resistance• Production and cost estimates• Serology for selected diseases
• Brucellosis, leptospirosis, Q fever, haemorrhagic septicaemia
• Special focus on brucellosis
• Evaluation of rapid tests• Molecular testing
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Finding the best bet interventions
Identify the limitations Risk factors
Identify what is feasible Pilot Evaluate sustainability and long-term effects
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Other potentially upcoming projects
• Pig production in Meghalaya
• Small ruminants value chain
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