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Bài giảng An toàn thực phẩm - Lê Hoàng Ninh

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Nội dung text: Bài giảng An toàn thực phẩm - Lê Hoàng Ninh

  1. AN TOÀN THỰC PHẨM GS TS BS LÊ HOÀNG NINH Biên soạn theo tài liệu của CDC, FDA Hoa kỳ,center for food security and public health
  2. Nội dung ▪ Organisms ▪ History ▪ Epidemiology ▪ Transmission ▪ Foodborne illness ▪ Prevention and Control Center for Food Security and Public Health Iowa State University 2004
  3. Vi sinh vật ▪ Estimated 250 foodborne pathogens ▪ Foodborne illness 2 or more cases of a similar illness resulting from ingestion of a common food Bacteria most common cause Also viruses, parasites, natural and manufactured chemicals, and toxins from organisms Center for Food Security and Public Health Iowa State University 2004
  4. ▪ Foodborne disease outbreaks, cases and deaths ▪ 1993-1997 ▪ Salmonella had the highest number Center for Food Security and Public Health Iowa State University 2004
  5. LỊCH SỮ
  6. History ▪ Early 1900’s Contaminated food, milk and water caused many foodborne illnesses ▪ Sanitary revolution Sewage and water treatment Hand-washing, sanitation Pasteurization of milk- 1908 Refrigeration in homes- 1913 Center for Food Security and Public Health Iowa State University 2004
  7. History ▪ Animals identified as a source of foodborne pathogens Improved animal care and feeding Improved carcass processing ▪ Surveillance and research ▪ Outbreak investigations ▪ Laws and policies regarding food handling Center for Food Security and Public Health Iowa State University 2004
  8. EPIDEMIOLOGY
  9. Dịch tễ ▪ Foodborne diseases each year in US Affects 1 in 4 Americans 76 million illnesses 325,000 hospitalizations 5,000 deaths  1,500 of those deaths caused by Salmonella, Listeria, and Toxoplasma Center for Food Security and Public Health Iowa State University 2004
  10. Epidemiology ▪ Many unrecognized or unreported Mild disease undetected Same pathogens in water and person to person Emerging pathogens unidentifiable ▪ Greatest risk Elderly Children Immunocompromised Center for Food Security and Public Health Iowa State University 2004
  11. Giám sát / luật lệ ▪ Surveillance CDC  FoodNet and PulseNet ▪ Regulation FDA  Domestic and imported food USDA FSIS  Meat, eggs, poultry National Marine Fisheries Service Center for Food Security and Public Health Iowa State University 2004
  12. Surveillance ▪ FoodNet: Active surveillance Established 1996 CDC, USDA, FDA, select state health departments Nine sites in U.S. monitor 13% of U.S. population  California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New York, Oregon, Tennessee Center for Food Security and Public Health Iowa State University 2004
  13. Surveillance ▪ PulseNet: Identify cause Molecular fingerprinting 45 state public health labs certified ▪ Passive surveillance: Survey methods Hospital discharges Outpatient treatment facilities ▪ FoodBorne Disease Outbreak Surveillance System All states submit outbreak data Center for Food Security and Public Health Iowa State University 2004
  14. Chi phí ▪ Economic Research Service - USDA Cost of top 5 foodborne pathogens $6.9 billion annually  Medical cost  Productivity losses (missed work)  Value estimate of premature death Center for Food Security and Public Health Iowa State University 2004
  15. Center for Food Security and Public Health Iowa State University 2004
  16. LÂY TRUYỀN
  17. Transmission ▪ Oral route ▪ Contamination varies Organism, reservoir, handling/processing, cross- contamination ▪ Human reservoir Norwalk-like virus, Campylobacter, Shigella ▪ Animal reservoir Campylobacter, Salmonella, E. coli 0157:H7, Listeria, and Toxoplasma Center for Food Security and Public Health Iowa State University 2004
  18. Transmission ▪ Contamination can occur at several points along the food chain On the farm or in the field At the slaughter plant During processing At the point of sale In the home Center for Food Security and Public Health Iowa State University 2004
  19. Produce Processing Center for Food Security and Public Health Iowa State University 2004
  20. IMPORTANT ORGANISMS
  21. Important Organisms ▪ Norwalk-like viruses ▪ Campylobacter ▪ Salmonella ▪ E. coli O157:H7 ▪ Clostridium botulinum ▪ Shigella spp ▪ Toxoplasma ▪ Emerging organisms Center for Food Security and Public Health Iowa State University 2004
  22. Pathogen No. of Cases Salmonella 6,017 Campylobacter 5,215 Shigella 3,021 Cryptosporidium 480 E. coli 0157 443 Yersinia 161 Listeria 138 Vibrio 110 Cyclospora 15 Total in 2003 15,600 Center for Food Security and Public Health Iowa State University 2004
  23. MMWR Center for Food Security and Public Health Iowa State University 2004
  24. MMWR Center for Food Security and Public Health Iowa State University 2004
  25. Center for Food Security and Public Health Iowa State University 2004
  26. Norwalk-like Viruses ▪ Norovirus; Caliciviridae family Most common foodborne agent 23 million cases annually ▪ Sources Person-to-person  Shed in human feces, vomitus  Outbreaks in daycares, nursing homes, cruise ships Contaminated shellfish Center for Food Security and Public Health Iowa State University 2004
  27. Norwalk-like Viruses ▪ Small infectious dose ▪ Signs 12-48 hours post-exposure Nausea, vomiting, diarrhea, abdominal cramps Headache, low-grade fever Duration: 2 days ▪ Food handlers should not return to work for 3 days after symptoms subside Center for Food Security and Public Health Iowa State University 2004
  28. Campylobacter jejuni ▪ Leading cause of bacterial diarrhea ▪ 2.4 million people each year Children under 5 years old Young adults (ages 15-29) ▪ Very few deaths ▪ Can lead to Guillain-Barré Syndrome Leading cause of acute paralysis Develops 2-4 weeks after Campylobacter infection (after diarrheal signs disappear) Center for Food Security and Public Health Iowa State University 2004
  29. Campylobacteriosis ▪ Sources Raw or undercooked poultry Non-chlorinated water Raw milk Infected animal or human feces  Poultry, cattle, puppies, kittens, pet birds ▪ Clinical signs Diarrhea, abdominal cramps, fever, nausea Duration: 2-5 days Center for Food Security and Public Health Iowa State University 2004
  30. Salmonellosis ▪ Gram negative bacteria ▪ Many serotypes can cause disease ▪ S. enteritidis and typhimurium  41% of all human cases  Most common species in U.S. ▪ 1.4 million cases annually 580 deaths Center for Food Security and Public Health Iowa State University 2004
  31. Salmonellosis ▪ Sources Raw poultry and eggs Raw milk Raw beef Unwashed fruit, alfalfa sprouts Reptile pets: Snakes, turtles, lizards ▪ Signs Onset: 12-72 hours Diarrhea, fever, cramps Duration: 4-7 days Center for Food Security and Public Health Iowa State University 2004
  32. Salmonellosis. Reported cases per 100,000 population, by year – U.S., 1972-2002 30 25 20 15 Rate Most common serotypes: S. typhimurium, 10 S. enteriditis, S. Newport 5 0 1972 1977 1982 1987 1992 1997 2002 Year MMWR Center for Food Security and Public Health Iowa State University 2004
  33. E. coli O157:H7 ▪ Enterohemorrhagic Escherichia coli (EHEC) Surface proteins; toxin ▪ Sources Undercooked or raw hamburger; salami Alfalfa sprouts; lettuce Unpasteurized milk, apple juice or cider Well water Animals: Cattle, other mammals Center for Food Security and Public Health Iowa State University 2004
  34. E. coli O157:H7 ▪ Signs Watery or bloody diarrhea, nausea, cramps Onset: 2-5 days Duration: 5-10 days ▪ Sequela Hemolytic Uremic Syndrome (HUS)  Acute kidney failure in children  Life threatening Center for Food Security and Public Health Iowa State University 2004
  35. MMWR Center for Food Security and Public Health Iowa State University 2004
  36. Botulism ▪ Clostridium botulinum Neurotoxin leads to flaccid paralysis Infants at greatest risk Annually: 10-30 outbreaks; ~110 cases ▪ Sources: Home-canned foods, honey ▪ Signs Double vision, drooping eyelids, difficulty speaking and swallowing Onset: 18-36 hours Center for Food Security and Public Health Iowa State University 2004
  37. 110 100 90 80 70 60 50 40 30 Reported Cases Reported 20 10 0 1982 1987 1992 1997 2002 Year MMWR Center for Food Security and Public Health Iowa State University 2004
  38. Shigellosis ▪ Bacillary dysentery Most cases Shigella sonnei 90,000 cases every year in U.S. ▪ Sources: Human fecal contamination of food, beverages, vegetables, water ▪ Signs: Watery or bloody diarrhea, nausea, vomiting, cramps, fever Onset: 2 days Duration: 5-7 days Center for Food Security and Public Health Iowa State University 2004
  39. 15 10 Rate 5 0 1972 1977 1982 1987 1992 1997 2002 Year MMWR Center for Food Security and Public Health Iowa State University 2004
  40. Toxoplasmosis ▪ Toxoplasma gondii- intracellular protozoan 112,500 cases annually Pregnant women/immunocompromised at greatest risk ▪ Sources Infected cats, soil, undercooked meat ▪ Signs Fever, headache, swollen lymph nodes Center for Food Security and Public Health Iowa State University 2004
  41. Emerging Pathogens ▪ Cyclospora (Protozoan) 1996, imported raspberries ▪ Listeria monocytogenes Sources  Ready-to-eat meats, soft cheeses Signs  Human abortions and stillbirths  Septicemia in young or low-immune Center for Food Security and Public Health Iowa State University 2004
  42. Center for Food Security and Public Health Iowa State University 2004
  43. PREVENTION AND CONTROL
  44. HACCP ▪ Hazard Analysis Critical Control Point ▪ To monitor and control production processes ▪ Identify food safety hazards and critical control points  Production, processing and marketing  Establish limits  Monitor ▪ Applied to meat, poultry, and eggs Center for Food Security and Public Health Iowa State University 2004
  45. On Farm Strategies ▪ Testing and removal for Salmonella Serologic, fecal culture, hide culture ▪ Vaccinating Many serotypes Varying effectiveness ▪ Minimize rodents, wild birds ▪ Isolation of new animals Center for Food Security and Public Health Iowa State University 2004
  46. At the Slaughter Plant ▪ FSIS target organisms Salmonella and E. coli ▪ Control points Removal of internal organs Minimize contact between carcasses Proper movement through facilities Chilling Cooking processes (time, temperature) Center for Food Security and Public Health Iowa State University 2004
  47. Irradiation ▪ Used since 1986 for Trichina control in pork ▪ Gamma rays Poultry in 1990/1992 Meat in 1997/1999 Reduction of bacterial pathogens ▪ Kills living cells of organisms Damaged and cannot survive Center for Food Security and Public Health Iowa State University 2004
  48. Irradiation ▪ Identified with radura ▪ Does not affect taste quality ▪ Nutrients remain the same ▪ Handle foods appropriately afterwards Does not sterilize Contamination can still occur Center for Food Security and Public Health Iowa State University 2004
  49. USDA Recall Classification Health hazard situation; reasonable probability that the use of the product Class I will cause serious, adverse health consequences or death. Health hazard situation; remote probability of adverse health Class II consequences from the use of the product. Use of the product will not cause Class III adverse health consequences. Center for Food Security and Public Health Iowa State University 2004
  50. In the Home ▪ Drink pasteurized milk and juices ▪ Wash hands carefully and frequently After using the bathroom Changing infant’s diapers Cleaning up animal feces ▪ Wash hands before preparing food Center for Food Security and Public Health Iowa State University 2004
  51. Tại nhà ▪ Wash raw fruits and vegetables before eating ▪ After contact with raw meat or poultry Wash hands, utensils and kitchen surfaces Hot soapy water ▪ Defrost meats in the refrigerator Center for Food Security and Public Health Iowa State University 2004
  52. In the Home ▪ Cook beef/beef products thoroughly Internal temperature of 160oF ▪ Cook poultry and eggs thoroughly Internal temperature of 170-180oF ▪ Eat cooked food promptly ▪ Refrigerate leftovers within 2 hours after cooking ▪ Store in shallow containers Center for Food Security and Public Health Iowa State University 2004
  53. Additional Resources ▪ Centers for Disease Control and Prevention ▪ U.S. Department of Agriculture n.html Center for Food Security and Public Health Iowa State University 2004