UK regulator types on antimicrobial resistance in food

Posted on December 5, 2016 by Douglas Powell

In 1969, the Swann report recommended strict oversight and restrictions on the use of antibiotics used in human medicine as growth promoters in agriculture. That was in the UK, and 37 years later, the UK Food Standards Agency has published a systematic review of the available evidence on antimicrobial resistance (AMR) in food. The review looked at research on the presence of AMR in bacteria in a number of different foods sold at retail.

The research has confirmed the need for extra surveillance of AMR in food at retail level, to support the wider programme of work currently underway across government to help reduce levels of AMR.

The study was produced by the Royal Veterinary College, on behalf of the Food Standards Agency, and looked at the areas where consumers are more likely to be exposed to AMR in bacteria from the food chain. Researchers examined published evidence between 1999 and 2016 for pork and poultry meat, dairy products, seafood and fresh produce sold in shops.

FSA action includes:

Working to encourage the adoption of clear transparent reporting standards that help consumers have access to and understand information about the responsible use of antibiotics in the food chain.

Continued focus on improving the scientific evidence base relating to antimicrobial resistance in the food chain through supporting relevant research and improving surveillance.

Setting up an independent group to advise us on responsible use of antibiotics in agriculture to support the above work.

Background

Antimicrobial resistance (AMR) is a major public health issue worldwide. It is a complex issue driven by a variety of interconnected factors enabling microorganisms to withstand antimicrobial treatments to which they were once susceptible. The overuse and/or misuse of antibiotics has been linked to increasing the emergence and spread of microorganisms which are resistant to them, rendering treatment ineffective and posing a risk to public health.

People can become exposed to AMR bacteria through a number of routes such as human-to-human spread, animals, through the environment and food chain. There is currently uncertainty around the contribution food makes to the problem of AMR and the types of AMR bacteria found in foods on retail sale in the UK. There is a need to consider the literature in this area to gain a better understanding of the potential risk to consumers through contaminated foods and also to identify the key evidence gaps.

Research Approach

The aim of this study was to assess the prevalence of antimicrobial resistant bacteria in retail pork, poultry meat, dairy products, seafood and fresh produce that could pose a risk to UK consumers. For this purpose a systematic review was undertaken following the PRISMA guidelines (Liberati et al., 2009) through which current existing evidence present in scientific databases and grey literature is collected and assessed. A protocol, which describes the methodology used, has been made accessible through the International Prospective Register of Systematic Reviews (PROSPERO). The protocol is available at http://www.york.ac.uk/crd/. Please search PROSPERO using registration number CRD42016033082.

Research questions were developed taking into consideration current evidence for relevant resistant foodborne pathogens and commensal bacteria observed in animals, food and humans in European countries published by the European Food Safety Authority (EFSA) (EFSA, 2015), feedback provided by experts and findings from scoping searches of the literature (i.e. PubMed).

Key recommendations:

There is a need to standardise the selection of antimicrobials for antimicrobial susceptibility testing panels, harmonising criteria for assessment of resistance per bacteria/drug combination for surveillance purposes, using a standardised definition for multidrug resistance (MDR) and the adoption of random sampling and adequate study design for epidemiological studies.

Identification of a core set of relevant antimicrobials when developing and implementing prospective testing for surveillance systems for determination of AMR in the food chain.

Surveillance priorities could be set using a risk-based approach, taking into account the importance of antimicrobials used for treatment in both humans and animals, and continued surveillance of the incidence and emerging resistance (including MDR) in commensal bacteria (Enterococcus spp. and E. coli) should be encouraged.

Data on AMR bacteria from British and imported pork meat in the UK are limited and dated. Further research and surveillance efforts are needed to ascertain AMR levels in both foodborne and commensal bacteria in pork meat in the UK.

There is evidence of increasing levels of resistance to antimicrobials in foodborne bacteria (i.e., Campylobacter spp.) from poultry meat in the UK. Research and surveillance efforts should be continued to monitor AMR trends in both foodborne and commensal bacteria in British and imported chicken and poultry meats in the UK.

There is a lack of information on AMR bacteria in foods of animal origin other than meat at retail level. In recent years, there have been growing numbers of outbreaks associated with milk and dairy products (cheese, butter, yogurt), seafood (fish and shellfish) and fresh produce (fruit, vegetables and salads) at national and international levels but there is scarce, scattered evidence of resistance and MDR occurrence in foodborne and commensal bacteria in these food products and its implications for public health. These gaps should be addressed also using a risk-based approach following evidence of resistance in food items as well as the extent of expected consumer exposure using consumption and import volumes.

Data on antimicrobial usage in food-producing animals in the UK are important to explain the occurrence and dynamics of AMR, resistance genes and MDR phenotypes in a defined geographical area. More complete information should therefore be collected on the type of production system from which food samples originate to assess the impact of animal husbandry practices as risk factors for resistance.

There is a need for more studies to quantify the contribution of both domestic and imported foods to AMR occurrence. Information on country of origin for imported products should be collected.

Priorities should be set according to the importance of a food item in terms of exposure of consumers. Consumption data will be essential for assessing the risk of exposure of British consumers.

Finally, further research and surveillance are needed to establish and quantify the risk of transmission of AMR against critically important antimicrobials in organisms from foods of animal and non-animal origin) to humans.

A systematic review of AMR bacteria in pork, poultry, dairy products, seafood and fresh produce at UK retail level

August 2015-October 2016

Food Standards Agency

https://www.food.gov.uk/science/research/foodborneillness/b14programme/b14projlist/fs102127/a-systematic-review-of-amr-in-pork-and-poultry-dairy-products-seafood-and-fresh-produce

Be careful: Pet food – raw, frozen, processed – can be contaminated

Posted on November 30, 2016 by Douglas Powell

My new best friend – Ted, the dog – came from a breeder in Toowoomba, about 90 minutes away, atop Australia’s Great Dividing Ridge.

He weighs less than our cats, but is feisty and loves a walk.

Or a run.

The breeder (we went to the local shelters, but they had dogs that were not deemed appropriate by our townhouse body corporate) so we got the little one rather than make a rush decision to buy an $800K house so we could have a bigger dog.

Besides, this one’s got personality.

The breeder insisted that dogs do better on a raw meat diet.

I just wanted to get the dog, go visit our friends, and go home, so didn’t belabor the point.

But any raw product carries the same risk of Salmonella and E. coli and other things that are not fun to inflict on your dog.

Natures Menu is recalling its ‘Country Hunter 80% Farm Reared Turkey with Wholesome Fruit and Veg’ frozen pet food, because the product contains Salmonella.

The UK Food Standards Agency is issuing this product recall notice because we are responsible for animal feed regulations and their enforcement through local authorities.

Make it mandatory: Voluntary restaurant inspection ratings are silly

Posted on November 28, 2016 by Douglas Powell

According to new research by the UK Food Standards Agency (FSA), only a third (34%) of us regularly check food hygiene ratings before eating in a restaurant or takeaway. With an estimated 4.3 million meals expected to be eaten out over this festive period, FSA is urging people to check a restaurant’s food hygiene rating before booking this Christmas.

The research, released ahead of the expected Christmas spike in restaurant bookings, found that although food hygiene and safety were of concern for 37% of people, only 6% said that they actively consider the food hygiene rating when deciding where to eat. Other priorities included:

quality/type of food (58%)

own experience of the place (32%)

location/convenience (23%)

good service (21%)

price (20%)

appearance (20%)

recommendation (19%)

Mark O’Neill, senior advisor, local authority policy and delivery, Food Standards Agency in Northern Ireland said: ‘We are pleased to see that so many food businesses in Northern Ireland are already compliant with the Food Hygiene Rating Act, which came into operation in October, making it mandatory for food businesses to display their hygiene ratings. This means that around 90% of businesses should now be displaying hygiene information on a green and black sticker somewhere easy to spot outside of their premises. We expect that consumers will be pleased with this development as our recent survey showed that 95% of people in Northern Ireland believe that businesses should have to display their ratings, which now they do.

We are now urging people to look for hygiene ratings and choose restaurants which score three or above this Christmas.

Food fraud: UK unit may get more powers

Posted on November 21, 2016 by Douglas Powell

The UK National Food Crime Unit (NFCU) should be given additional powers and resources to boost its ability to tackle food crime and protect consumers, a review has recommended.

Carried out by officials from the Food Standards Agency (FSA) under the oversight of an independent steering group, the findings are to be considered by the FSA Board at its next meeting on Wednesday 23 November.

The NFCU was set up in 2014 in the wake of the horsemeat incident, when beef was supplemented by cheaper horsemeat in a large-scale fraud across Europe. It was agreed that a review of the NFCU would take place after two years.

This follows implementation of the first phase of the unit’s work which has involved building the intelligence and evidence picture of the risks and the nature of food fraud and food crime in the UK.

The review recommends that the NFCU is made an arms-length body of the FSA, with investigatory powers, providing the agility and freedom to make day-to-day law enforcement decisions. Currently, the unit has no investigatory powers and instead works with partners including local authorities and the police to tackle food crime.

If the FSA Board accepts the review’s recommendation, the next stage is to develop a business case and consult with other government departments on more detailed delivery options. There will also need to be in depth consultation with devolved governments and stakeholders in Wales and Northern Ireland, to ensure that a future NFCU takes into account devolved enforcement arrangements and the need for local political accountability. This further work would be completed by the end of March 2017.

I don’t see color, it doesn’t matter: UK hamburger edition

Posted on August 26, 2016 by Douglas Powell

Don’t burger up your bank holiday.

Get it? Don’t bugger it up? Burger it up?

Those bureaucrats at UK’s Food Standards Agency are really yukking it up, focused on stupid jokes rather than evidence-based communications.

FSA has long been in its own undersirable class when talking about food safety risks, and class is so very important to the Brits.

FSA is great is talking at people rather than talking with people (a huge difference, like educating versus providing information).

FSA’s idea of risk communication is to commission a meaningless survey – people lie, especially about food and drink – which found that despite 71% of people stating that they are concerned about food poisoning, over a third (36%) of Brits would eat a burger that isn’t fully cooked through. More than one in 10 said that they actually prefer burgers cooked this way. When cooking them at home 81% of those admit to undercooking them. So we at the FSA are encouraging all those who are getting their barbecues out this weekend to ensure they cook their burgers all the way through – until steaming hot throughout, there’s no pink meat in the middle and the juices run clear.

Those scientifically meanginless terms – steaming hot, no pink – have featured prominently in FSA foodsafetytalk for years, with steaming hot replacing piping hot.

Lead FSA policy thingy said something that is not worth repeating because it ignores the risks associated with needle-tenderized steaks.

And we’ve been over this so many times before.

The BBC repeated the advice verbatium in its latest version of PR blowjobs rather than something resembling journalism.

Use a thermometer and stick it in.

And now this.

Campy overestimates: FSA accused of undermining meat industry

Posted on August 24, 2016 by Douglas Powell

Alex Black of FG Insight reports the UK Association of Independent Meat Suppliers (AIMS) has claimed the Food Standards Agency (FSA) ’appears to continue to undermine the meat processing sector’ with misleading campylobacter figures.

An article in The Meat Trades Journal quoted figures published on the Food Standards Agency website stated campylobacter was believed to cause 100 deaths a year.

However, AIMS pointed out the figure was an extract from a FSA funded paper which said ’We could not estimate deaths attributable to foodborne illness, due to the lack of reliable data sources on pathogen-specific mortality rates’.

AIMS head of policy, Norman Bagley, said: “Selectively quoting from its own commissioned report on its own website has once again undermined the excellent work and progress the industry has made on combating campylobacter.

“Stating that campylobacter causes 100 deaths a year is just not based on science and leads to continuing scary, misleading stories being carried in both the trade and consumer media, which once again, undermines our sector.

“This is far from helpful and needs to stop.”

A FSA spokesman said: “We explain on our website that the campylobacter deaths figure is a previous estimate, and that we are continuing to analyse the full impact that campylobacter has.

“We are determining which updated figures to use in the future.”

Brits want Campy reduced in chickens; testing to be resumed

Posted on August 22, 2016 by Douglas Powell

The UK Food Standards Agency reports that two thirds (66%) of consumers think the industry should continue to reduce campylobacter beyond the agreed current target of less than 10% of chickens at the most highly contaminated level. Retailers should also be telling customers what proportion of chickens are at this highest level of contamination, according to 75% of those questioned.

The research has been released to coincide with the resumption this month of our campylobacter survey, part of our on-going efforts to reduce the high levels of food poisoning caused by the bug. Testing was suspended in April so we could update the way the survey was carried out to ensure results continued to be robust.

Steve Wearne, Director of Policy at the FSA, said, “Publishing surveillance data on campylobacter has prompted action from retailers and processors and we are now seeing progress. Our campaign has also raised awareness of campylobacter amongst the public and it is good to see from our research that it is customers, and not just the FSA, demanding action and information from retailers. We have always said that consumer power will ultimately push industry action.

“Many retailers and processors should be commended for the action they have taken so far. The majority signed up to the pledge to ensure that campylobacter in chicken ceases to be a significant public health issue, and continued action will be needed to deliver this.”

The FSA’s research shows that 76% of people questioned want retailers to be more proactive in telling them what actions they are taking to reduce the campylobacter levels on the raw chicken they sell. More than half of people (53%) said that they would start buying chicken from another retailer if their usual shop was found to sell more than the industry average ‘high risk’ chicken.

Don’t let the accent influence: British egg industry explains why runny eggs are now safe to eat

Posted on July 27, 2016 by Douglas Powell

I’m a guy sitting on my couch in Brisbane who’s no preacher just provides information. But I can imagine the various ways this video will be used in the next Salmonella-linked-to-eggs outbreak in the UK.

Mark Williams, chief executive of the British egg industry council, told Radio 4’s Today programme they are “absolutely delighted” that the Advisory Committee on the Microbiological Safety of Food had made the recommendation to the Food Standard Agency (FSA), which will now consult on the recommendation.

“If it’s got the British lion mark on it’s the safest in the world,” he says.

UK says raw eggs ‘safe for pregnant women’

Posted on July 26, 2016 by Douglas Powell

That didn’t take long.

Six months after a UK Food Standards Agency working group suggested that raw or lightly cooked – runny – eggs were safe for all as long as they were produced under the Lion code or equivalent standards, the report was adopted by FSA so the BBC headline was, “Raw eggs ‘safe for pregnant women.”

This in a country that still recommends cooking meat until it is piping or steaming hot, with temperature and thermometers as an afterthought because, it may be too complicated for consumers.

The risk of Salmonella from UK eggs produced to Lion code or equivalent standards should be considered “very low”, the Advisory Committee on the Microbiological Safety of Food said.

It said this meant eggs could be served raw or lightly cooked to “vulnerable” groups like the elderly and the young.

The Food Standards Agency (FSA) has begun a consultation on the issue.

The committee’s report said there had been a “major reduction in the microbiological risk from salmonella in UK hen shell eggs” since a report it produced in 2001,

Its recommendation to classify certain eggs as “very low” risk only applies to UK hens’ eggs produced under Lion code or equivalent standards.

It also warns that safety guidelines including proper storage and eating eggs within best before dates must be followed.

The FSA said it had launched an eight-week consultation in response to the report.

“The consultation is inviting views on the recommended changes to the FSA’s advice from a range of stakeholders, including food and hospitality industries, consumer and enforcement bodies, and health care practitioners,” it said.

It currently advises members of vulnerable groups against eating “raw eggs, eggs with runny yolks or any food that is uncooked or only lightly cooked and contains raw eggs” due to the risk of food poisoning.

Professor John Coia, Chair of the ACMSF Expert Ad Hoc group on eggs said, ‘The committee has found that there has been a major reduction in the risk from Salmonella in UK hens’ eggs since 2001. This is especially the case for eggs produced under the Lion Code, or equivalent schemes. It also recommended that these eggs could be served raw or lightly cooked to both those in good health and those in more vulnerable groups.’

Following Committee approval and a UK wide consultation of the report, the FSA has agreed to examine its advice taking into account the Committee’s conclusions and recommendations.

Report for UK FSA says pre-packaged sandwiches should not be served in hospitals

Posted on July 17, 2016 by Douglas Powell

Stephan Adams of the Daily Mail writes that a new report commissioned by the UK Food Standards Agency concludes pre-packed sandwiches have been responsible for ‘almost all’ hospital outbreaks of listeria since 2003.

The bug kills around 50 people a year in England, according to official figures, with most deaths thought to be due to food being prepared and stored incorrectly.

Food safety company STS, which advises hospitals and care homes, believes patients may also be dying from eating infected sandwiches at these institutions.

Fiona Sinclair, director of food safety at STS, said: ‘Hospitals and care homes feed the most vulnerable people in society. The last thing these people need is to get something else on top of their illness.’

Pre-packed sandwiches often contain protein-rich fillings such as meat, paté, cheese, prawns and egg, on which listeria can thrive. Days can elapse between preparation and consumption, giving listeria time to multiply, and experts say too few people understand that sandwiches must be kept very cold – below 5C – to stop the bug growing.

The report, written by Ms Sinclair and colleagues, says: ‘Research into previous [listeria] outbreaks in hospitals found that almost all were linked to consumption of pre-packed sandwiches.’

These cases ‘were thought to have been caused by low-level contamination during manufacture in the factory, followed by a breakdown in the control of the cold chain in the hospitals’. During recent inspections, Ms Sinclair found sandwiches were being kept in fridges that were not cold enough, staff were serving packs past their use-by date, and sandwiches were being left on trolleys for lengthy periods before being handed to patients.

The firm’s report, commissioned by the Food Standards Agency, has prompted the FSA to revise its guidance to hospitals and care homes on minimising the risk of listeria.

Measures include cutting maximum fridge temperatures from 8C to 5C.

Welcoming the new rules, STS said: ‘The thought that a loved one should lose their life from eating a sandwich in hospital is ridiculous.’

Ms Sinclair said the research, undertaken with Surrey University, identified nine hospital listeria outbreaks across the UK since 2003. Each case affected between two and seven patients. Ms Sinclair said it was unclear from the data they had seen if anyone died from listeria infection during these outbreaks.

The fact that the bug kills up to 30 per cent of people in ‘vulnerable groups’ – such as pregnant women and the elderly – suggests that some did.

Hugh Pennington, emeritus professor of bacteriology at Aberdeen University, said: ‘If somebody is at death’s door, they could be finished off by a sandwich.

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