salmonellosis in nsw
TRANSCRIPT
Salmonellosis in NSW:from controlling outbreaks to a 30% disease reduction strategy
Foodborne Diseases: Changing Epidemiology and Disease Control
1 September 2016
Craig Shadbolt
Manager, Food Incident Response & Complaints
FOOD RETAIL
$45B
PA
Economic contribution of the NSW food sector
TOTAL FOOD INDUSTRY IN
NSW, ACCOUNTS FOR:
24% OF THE GSP
$113B
PA
PRIMARY
PRODUCTION
$12B
PA
FOOD
MANUFACTURING
$25B
PA
FOOD EXPORTS FROM NSW
ACCOUNTING FOR
8% OF THE STATE’S
TOTAL EXPORTS
$5.1B
PA
STORAGE AND
DISTRIBUTION OF FOOD
PRODUCTS
$5B
PA
FOODS
BUSINESSES
15,000
FARM-BASED
BUSINESSES
42,000
RETAIL FOOD
SERVICE BUSINESSES
40,000
FISHING
BUSINESSES
1,400
FOOD-PROCESSING
COMPANIES
2,000
Number of food businesses
PEOPLE EMPLOYED IN
SUPERMARKETS AND
GROCERY STORES
69,000
PEOPLEARE DIRECTLY EMPLOYED IN
THE AGRICULTURE AND
FOOD SECTORS
150,000
PEOPLEEMPLOYED IN CAFES
RESTAURANTS AND
TAKEAWAY FOOD SERVICES
128,000
PEOPLE
Number of people employed in the food industry
Source: KMPG, Estimating the impacts of food regulation in NSW, December 2014
Food regulation in NSW
NSW Department of Primary Industries (Biosecurity & Food Safety)
Setting of food policy, legislation
Only through-chain food safety agency in Australia
Inspections/audits of importers, manufacturers, high risk businesses
– Shellfish, dairy, meat, eggs, hospitals/aged care
– Investigation of foodborne illness/incidents
115 NSW Local Councils
~ 162 Environmental Health Officers involved in NSW food work
Responsible for inspection of retail food businesses
– Cafes, restaurants, takeaway
Annual food interactions
Salmonellosis in NSW
NSW disease trend
Consistently higher
summer peaks
Salmonella numbers
Higher counts in traditionally cooler months
Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Total
2012 320 317 353 241 193 122 151 201 188 269 254 301 2910
2013 409 366 341 345 290 197 187 173 173 316 276 329 3402
2014 504 490 501 404 406 238 209 203 238 286 348 447 4274
2015 602 522 456 361 283 236 206 176 202 276 321 400 4041
2016 690 519 442 393 343 329 345 176 . . . . 3237
Salmonellosis notifications in NSW residents,
by month of disease onset. January 2012 to August 2016
Pork roll outbreak case study• Late afternoon, multiple calls alleging illness after
pork roll consumption
• Local council inspection records obtained
‒Poor history of cleanliness, temperature abuse, hot tap
activated by pair of pliers, pest control issues
• Joint investigation planned with local council
scheduled for next morning
Investigation findings
• Unclean premises
• Unclean equipment
• No sanitising of equipment
• Use of raw eggs
• Uncovered foods in refrigerator
• Evidence of pest activity
• Proprietor’s daughter had Food Safety Supervisor certificate
‒ Studying accounting, rarely at the food business
• Unclean premises and equipment (shelving with rotting food)
• Prohibition order placed on preparation of all foods/ingredients linked to use
of pork rolls
• Business implement full closure until cleaning measures rectified
Test results and outcomes
• 10 different foods positive for Salmonella (raw egg butter, sliced
meats, salad items)
• 14 different swabs positive (cleaning cloth, equipment, chilled
display units, wash up sink, shelves, door handles)
• Prohibition order not lifted on service of pork rolls for 3 weeks
• Doors on chilled display unit had to be replaced due to repeat Salmonella
detections
• Business no longer serving raw egg foods
• Approximately 40 people ill
• Business received ~ $3000 fines, name and shame listing
Salmonella!!
Failure to clean and sanitise
NSW Salmonella outbreak data 2014
- Salmonella Typhimurium causative pathogen in 59% of
outbreaks (26/44)
- 50% (13/26) implicated a food vehicle
- raw or partially cooked eggs was the source in 10 outbreaks
Outbreak Contributing factorsMost common factors leading to outbreaks in NSW (historically)
• Use of raw egg foods
– Mayonnaise, aioli, egg butter
– Mousse, fried ice cream, tiramisu
• Failure to clean & sanitise
– Cleaning (removal of visible dirt, grease, food waste)
– Sanitising (destruction of bacteria, viruses by heat of chemicals)
• Lack of skills & knowledge
– Handwashing, temperature control, cross contamination
NSW Food Safety Strategy
Food safety strategy 2015-2021
• Health and safety of NSW consumers is paramount
• By 2021, achieve 30% human salmonellosis reduction, based on 2014 notified
figures
• Salmonella is the most common agent in foodborne disease outbreaks
• 2010 estimates show a 24% increase from 2000
• Reputation of the regulatory system that underpins biosecurity & food safety
are well regarded and vital for market access
‒ 30% growth target for primary production sector
Meeting the targets by 2021• First food regulator in Australia to articulate a target
• Business as usual will not result in improvements
Review of successful international strategies and the NSW approach
• NSW approach on the right track
• Australia has fallen behind other developed countries and trading
partners
‒ Overseas strategies used to drive research (attribution studies)
‒ Develop performance objectives and targets through chain for various
commodities
Challenges for a 30% reduction• Climate
• 2011 report estimated NSW Salmonella rate would rise 4.7% by 2020 and
7.5% by 2030
‒ Based on 0.6ºC rise by 2020 and 0.9ºC, no other interventions
Crude monthly
salmonellosis rate
per 100,000
population and
mean maximum
monthly
temperature in
NSW from 2011 –
2015
Challenges for a 30% reductionMajor outbreaks, external factors
• Outbreaks of unusual severity can skew figures
• 202 people ill from a single bakery in Jan 2016
The Strategy applies to NSW only
• 3 fresh produce outbreaks with interstate origins
• Bagged lettuce, mung bean sprouts, rockmelon
• These issues have impacted significantly on NSW figures
• NSW and FSANZ developing a national approach on Salmonella, and risk
management of fresh produce
Raw egg retail guidelines
Raw egg retail strategy (developed 2014)
- Supplements on-farm risk management programs
•Mandatory document for raw egg use at retail level in 2016-17
•Guidelines for use and length of storage
•Acidification of raw egg foods
•Low heat treatment of dessert products
•http://www.foodauthority.nsw.gov.au/_Documents/retail/raw_egg_guidelin
es.pdf
Food Safety Supervisor
• Mandatory skills and knowledge for one person per premises for the
majority of NSW retail/food service stores (n = 40,000).
• Implemented since 2010, certificates have 5 year shelf life.
• In September 2015, Food Authority introduced changes to provide for
focus on high risk areas.
• These areas were:
Safe egg handling
Cleaning and Sanitation
Education & TrainingIdentifying the Salmonella risk for local council EHOs
•Asking specific questions around raw egg use
•Reviewing menus for high risk items
•Using specific inspection checklist if suspect foods onsite
Education and training workshop for high risk businesses
•Joint projects with local councils to address skills shortage in high risk
businesses (pork roll outlets, fried ice cream)
•Reduction in large Salmonella outbreaks in these types of businesses
Is the strategy working so far?
• Maybe…to a point…very early days…
• Raw egg related outbreaks declined substantially since 2014
‒ 1 Salmonella Typhimurium outbreak linked to raw egg foods in 2016
‒ 4 people affected
Non-Salmonella Typhimurium &
Salmonella Typhimurium human
notifications in NSW (2016 represents
year to date figures). Data supplied by
NSW Health.
Future priorities, 2016-17
• Greater engagement with external agencies and industry
• Development of a Salmonella attribution study
• Consideration of performance targets for food commodities
THANK YOUCIDM and MBI Research Symposium
1 September 2016
Craig Shadbolt; Manager, Food Incident Response & Complaints
QUESTIONS?
foodauthority.nsw.gov.au nswfoodauthority nswfoodauth