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| Agenda Item 5.2 | Conference Room Document 85 English only |
FAO/WHO SECOND GLOBAL FORUM FOR FOOD SAFETY REGULATORS
Bangkok, Thailand, 12-14 October 2004
(Paper prepared by M.C. Tirado, WHO Regional Office for Europe
and K. Schmidt, Federal Institute for Risk Assessment, Germany)
The WHO Food Surveillance Programme for the Control of Foodborne Infections and Intoxications in Europe (after this the Programme) was launched almost 25 years ago as a consequence of the international awareness of the socio-economic impact of the increase of foodborne diseases in the Region.
The Programme is coordinated by the FAO/ WHO Collaborating Centre for Research and Training in Food Hygiene in and Zoonoses at the Federal Institute for Risk Assessment in Berlin. The WHO Food Safety Programme of the Regional Office for Europe is responsible for the overall supervison of the Programme.
Main objective of the Programme is to provide support for the development of appropriate measures for the prevention and control of foodborne diseases in the region. Specific objectives include:
The Programme has grown continuously since 1980 and currently has 51 participating countries from the WHO European Region. The WHO European Region comprises 850 million people in diverse climatic, structural and socio-economic conditions and includes countries from Portugal to the Pacific Coast of Russian Federation. Currently half of these countries belong to the European Union and most of the other half are New Independent States, have newly established economies and some of them have been declared by the United Nations as being below the poverty level.
The Programme has had a major role in the standardization of data collection across Europe and improved reporting. Currently the Programme has a solid network of National Contacts which have been reporting official national data for hazard identification and for the analysis of trends in the European Region during the last 25 years.
New priorities of the Programme include the collection of quantitative and qualitative data from epidemiologically investigated outbreaks for it use in microbiological risk assessment and the network of national contacts will be expanded to include experts in the field of food microbiology. The Programme is promoting its activities in coordination with European and international networks in order to share information and avoid duplication of work.
The Programme is not mandatory and is based on surveillance activities at a national level. Each participating country has designated a national contact point, generally based at the Ministry of Health, at the National Public Health Institutes, or Epidemiological Centers which provides official surveillance data to the Programme.
A standardized reporting form is sent to each national contact point for the collection of data on statutory notification, laboratory-report surveillance data, investigated outbreaks and other relevant information.
The WHO Food Surveillance Programme compiles national data into reports, which are distributed to all interested institutions and are available at the web1. In addition, the Programme publishes quarterly newsletters in English and in Russian, which are in the web and are sent to more than 1500 institutions worldwide.
The official data and information collected from the participating countries include:
The Programme focuses mainly on the reports of epidemiologically investigated outbreaks and it also receives information from laboratory reports, special surveys and epidemiological bulletins.
A major contribution of the Programme has been the standardization of data collection including the introduction of harmonized definitions and standardized codes, which are used by many of the participating countries. Also, the programme has developed a EPI-INFO based questionnaire for the report of an incident which is available in several languages. All this has lead to an improved reporting and to an increased awareness of the burden of foodborne disease in the WHO European Region
Despite this it is still difficult to make comparisons among participating countries in the WHO European Region. Each country collects the information according to their national surveillance and reporting systems. National surveillance systems vary considerably within the Region due to the differences in the degree of development of the countries and the infrastructure and resources dedicated to surveillance at the national level. In addition diagnostic and reference laboratory methods and national reporting systems vary among countries, making difficult data comparability. This situation is being improved by building the capacity of laboratory based surveillance in the Region.
The WHO Food Safety Programme in Europe is collaborating with the WHO Global Salmonella Surveillance (GSS) network in building the capacity of surveillance and food contamination monitoring in the European Region.
The WHO GSS aims to enhance the capacity of national and regional reference laboratories to conduct Salmonella serotyping and antimicrobial susceptibility testing through international training courses and an External Quality Assurance System. The WHO GSS also provides training on epidemiological methods for surveillance of foodborne diseases. Currently the WHO GSS is involved in Salmonella and Campylobacter surveillance and it is considering the inclusion of other important foodborne pathogens such as E. coli and possibly gastrointestinal virus.
Many countries in the WHO European Region are members of the WHO GSS network. Eighteen countries from Central, Eastern and South Eastern countries have completed a series of three level WHO GSS courses in the new established official Regional training Center in Poland. A second level course of the WHO GSS will be organized for ten Russian speaking countries by the WHO Collaborating Center at the Institute Pasteur in Saint Petersburg this year.
The WHO Food Safety Programme in Europe is providing additional technical assistance to address specific public health needs of some countries in the WHO European Region. An important sub-regional project is the Public Health Initiative on Food Safety for the Central Asian Republics in collaboration with partners including FAO, the Centers of Disease Control, several European Universities, Laboratories and local partners such as the Kazakhstan School of Public Health.
In this context the WHO Food Safety Programme in Europe has been providing training on microbiological and chemical food contamination monitoring and on Surveillance of foodborne diseases and outbreak investigation in the Central Asian Republics. This initiative has been followed up at the national level in some countries to further support the prevention of foodborne diseases such as Brucellosis and Botulism.
Additionally the WHO Food Safety Programme in Europe is promoting among the Commonwealth Independent States the concept of updating the Sanitary Epidemiological Stations system into an intersectorial clinical, microbiological and veterinary network of laboratories for the prevention of food risks.
The FAO/WHO Pan European Conference on Food Safety and Quality in 2002 recommended to improve the reporting of foodborne diseases at the national level as well as to the WHO Surveillance Programme for Control of Foodborne Infections and Intoxications in Europe and to strengthen national capabilities to perform microbiological risk assessments.
The experts who prepare risk assessments, the expert consultations that review the assessments as well as the Codex Committee on Food Hygiene all have identified gaps in data and current knowledge and have stressed the strong need for additional information, especially from surveillance.
The last meeting of the Advisory Committee of the WHO Surveillance Programme for Control of foodborne diseases in Europe in 2002 identified priorities of work which include:
In line with this the questionnaire for reporting foodborne incidents to the WHO Surveillance
Programme for Control of Foodborne Diseases in Europe is being revised to consider the inclusion of quantitative and qualitative information that could be used for risk assessment.
For this purpose, an expanded network of counterparts on food microbiology should be established to support the Programme including experts on food microbiology, food technology and microbiological risk assessment.
Currently there is an ongoing collaboration between the WHO Surveillance Programme for Control of Foodborne Diseases and the EFSA group for zoonosis in the process of the development of templates for data reporting and particularly in view of the future requirements for reporting on the foodborne outbreak by the zoonosis directive, so that compatible forms for the report of foodborne outbreaks are used across the European Region. It is necessary to maintain this collaborative effort in order to generate compatible formats for the reporting of data that eventually will be used for risk assessment.
The WHO Food Surveillance Programme for the Control of Foodborne Infections and Intoxications in Europe has a solid network of official contacts in 51 countries which have been providing information for the identification of priorities in the prevention and control of foodborne diseases and for the analysis trends during the last 25 years.
The Programme has had a major role in the standardization of data collection and in improved reporting in the WHO European Region. Improved quality and comparability of data is being achieved by building the laboratory based surveillance capacity in the European Region in collaboration with the WHO Global Salmonella Surveillance network and by providing additional support to countries with specific needs.
Future priorities of the Programme include the provision of information and data from epidemiologically investigated outbreaks to be used for microbiological risk assessment. For this purpose the network of national contacts will be expanded to include food microbiologists.
The Programme is promoting its activities in coordination with European institutions and scientific bodies particularly the European Commission and the EFSA in order to share networks, experience and resources to optimize efforts to reach common goals.
1 http://www.euro.who.int/eprise/main/WHO/Progs/FOS/Surveillance/20020903_3