Foodborne illness caused by microorganisms is a large and growing public health problem. Most countries with systems for reporting cases of foodborne illness have documented significant increases over the past few decades in the incidence of diseases caused by microorganisms in food, including pathogens such asSalmonella, Campylobacter jejuni and enterohaemorrhagic Escherichia coli, and parasites such as cryptosporidium, cryptospora, trematodes.
Approximately 1.8 million children in developing countries (excluding China) died from diarrhoeal disease in 1998, caused by microbiological agents, mostly originating from food and water. One person in three in industrialized countries may be affected by foodborne illness each year. In the USA, some 76 million cases of foodborne illness, resulting in 325 000 hospitalizations and 5000 deaths, are estimated to occur each year. There are only limited data on the economic consequences of food contamination and foodborne disease. In studies in the United States of America (USA) in 1995, it was estimated that the annual cost of the 3.3-12 million cases of foodborne illness caused by seven pathogens was US$ 6.5-35 billion. The medical costs and the value of the lives lost during just five foodborne outbreaks in England and Wales in 1996 were estimated at GB£ 300-700 million. The cost of the estimated 11 500 daily cases of food poisoning in Australia was calculated at AU$ 2.6 billion annually. The increased incidence of foodborne disease due to microbiological hazards is the result of a multiplicity of factors, all associated with our fast-changing world. Demographic profiles are being altered, with increasing proportions of people who are more susceptible to microorganisms in food. Changes in farm practices, more extensive food distribution systems and the increasing preference for meat and poultry in developing countries all have the potential to increase the incidence of foodborne illness. Extensive food distribution systems raise the potential for rapid, widespread distribution of contaminated food products. Changes in food production result in new types of food that may harbour less common pathogens. Intensive animal husbandry technologies, introduced to minimize production costs, have led to the emergence of new zoonotic diseases, which affect humans. Safe disposal of manure from large-scale animal and poultry production facilities is a growing food safety problem in much of the world, as manure frequently contains pathogens.
Changes in eating patterns, such as a preference for fresh and minimally processed foods, the increasingly longer interval between processing and consumption of foods and the increasing prevalence of eating food prepared outside the home all contribute to the increased incidences of foodborne illness ascribed to microbiological organisms. The emergence of new pathogens and pathogens not previously associated with food is a major public health concern. E. coli O157:H7 was identified for the first time in 1979 and has subsequently caused illness and deaths (especially among children) owing to its presence in ground beef, unpasteurized apple cider, milk, lettuce, alfalfa and other sprouts, and drinking-water in several countries. Salmonella typhimurium DT104 has developed resistance to five commonly prescribed antibiotics and is a major concern in many countries because of its rapid spread during the 1990s.
These changes in microbiological hazards in foods have been recognized by the World Health Assembly and by the Codex Alimentarius. The 22nd session of the Codex
Alimentarius Commission and the 45th Codex Executive Committee requested FAO and WHO to convene an international expert advisory body similar to the Joint Expert Committee on Food Additives (JECFA) and the Joint Meeting on Pesticide Residues (JMPR) on the microbiological aspects of food safety to address in particular microbiological risk assessment. The results of these risk assessments will provide the scientific basis for measures to reduce illness from microbiological hazards in foods.
Effective management of microbiological hazards is enhanced through the use of tools such as Microbiological Risk Assessment (MRA) and Hazard Analysis and Critical Control Point (HACCP) systems. Sound microbiological risk assessment provides an understanding of the nature of the hazard, and is a tool to set priorities for interventions. HACCP is a tool for process control through the identification of critical control points. The ultimate goal is improvement of public health, and both MRA and HACCP are means to that end.