Canadian Food Inspection Agency serving Public Health Denis Allard MD MSc FRCPC Senior Medical Advisor Science Branch, CFIA Objectives of this Presentation 1. Familiarise you with the Canadian Food Inspection Agency and some of its activities related to Public Health 2. Highlight some current and emerging challenges 3. Discuss partnership and collaboration with Public Health community Our Organisation CFIA established 1997 to enhance the effectiveness and efficiency of federal inspection and related services for food safety, and for animal/plant health Integration inspection activities of HC, AAFC, DFO, IC CFIA REGIONAL OFFICES & LABORATORIES 5,500 employees 18 regional offices 21 laboratories 185 field offices on > 400 third party premises CFIA’s 3 business lines Safe food & consumer protection Animal health Plant protection Enabling Legislation Canada Agricultural Products Act Canadian Food Inspection Agency Act Consumer Packaging and Labelling Act Penalties Act Food and Drugs Act Fish Inspection Act Health of Animals Act Meat Inspection Act Fertilizers Act Feeds Act Federally … Safe Food is a shared responsibility •CFIA •Health Canada •Public Health Agency of Canada •Fisheries and Oceans •Agriculture & Agri-Food Canada •Environment Canada CFIA Food Continuum IMPORTS/EXPORTS Agricultural Inputs Production Processing DOMESTIC from farm to plate Distribution Consumption Food Continuum Food Safety Emergency Response (FIORP) Food Recalls, Food Safety Investigations Import and Domestic Inspection Nutrition Labeling Verification Monitoring and Surveillance of Food Supply (Testing, HACCP, GMPs, GIPs) Contributing to International Food Safety Standard Setting Food Safety Directorate •BFSCP •Food Safety Investigation (prevention/correction) •Fair Labelling Practices •OFSR •Food Emergency Response/Recall (reactive) •Input in FB Illness investigation (HC/PH) •HACCP support •FSEP/MPIP/F-QMP/CSSP/OFFSRP •Food Safety Risk Analysis (input to/from HC) How the System Works Surveillance Food Source Targeted Inspection Product Recall Outbreak Food Vehicle Lessons Learned Corrective Actions CFIA Food Safety Investigation Data Data capture • CFIA’s Issues Management System (IMS) 4,000/yr food safety investigations Triggers • complaints, laboratory results, Gov’t depts. referrals, in-plant observations, etc. Implementation of various compliance / enforcement options at CFIA’s disposal Proposed Foodborne Outbreak Investigation Report Template (CFIA) Cause Effect Food Recalls Class 1 • serious health consequences or death Class 2 • temporary health consequences Class 3 • unlikely health consequences (* in all cases, food products violate one or more Acts enforced by CFIA) Food Recalls by Type (mean of 2000-03) All Classes Other Extraneous Chemical Allergen Micro Class 1 Domestic Class 1 Imports 0 20 40 60 80 100 % Average yearly food recalls – Class 1 206 Average yearly food recalls – All classes 408 Food Recalls by Class (2003-04) 200 180 160 140 120 100 80 60 40 20 0 Class I Class II Class III Food Recalls by Trigger (2003-04) 35 Percentage 30 25 20 15 10 5 0 CFIA Client Consumer External Food Recalls by Type (2003-04) 120 100 80 60 40 20 th er s O s an eo u Ex tr ic al Ch em M ic ro Al le rg en 0 Allergens Recalls by Foodstuff (2003-04) 4 8 Hazelnut 3 12 Wheat Egg Tree Nut 4 Gluten 12 Sulphites 21 Milk 10 Soy 2 10 Sesame Seeds 19 Peanut Other TOTAL: 105 April 29, 2004 Microbiological Incidents & Recalls (2003-04) 3 Undetermined Total Incidents: 41 3 7 Quality Molds 5 Salmonella 55 14 3 S. aureus 3 1 Pseudomonas aeruginosa 3 2 Pathogenic - Other 2 6 Listeria 6 2 E. coli 0157:H7 3 3 E. coli 3 2 C. botulinum 4 1 Other 1 6 Container Integrity - Low Acid 6 0 April 29, 2004 Total Recalls: 7 5 10 15 Chemical Incidents & Recalls (2003-04) 6 6 Trace Elements 24 Toxin 26 11 Residues 14 10 Other 11 Incidents: 86 Recalls: 96 18 Heavy Metals 19 10 Drug Residues 11 7 Additives 9 0 April 29, 2004 5 10 15 20 25 30 Public Warnings Issued for most Class I recalls May be issued for other classes Reserved for those situations deemed to be of higher risk to consumers • examples: undeclared allergens, botulism risk, Salmonella, E.coli 0157, pieces of glass in baby food * Web-site posting and e-mail distribution list Consumer Education and Public Awareness Programs - Animal Health - Public Health related activities • control and eradication of - traditional zoonotic diseases (TB, brucella, rabies) - new and emerging diseases (WNV; AI … SARS?) • therapeutant residue mitigating/monitoring • policy/management of (A-M, H, …) - animal health issues (within federal mandate) - recycling of agricultural byproducts through feed and fertilizers into the food chain - environmental concerns (disposal, …) - Animal Health Prevention of Foreign Animal Diseases Surveillance • passive (producers, priv.vets, F/P labs, vet. colleges, PH) • active (sentinel systems, pro-active testing) Reporting of Notifiable Animal Diseases • International (OIE, PROMED AHEAD) • Domestic (Health of Animals Act) Risk Analysis (importation) Import Controls On-Farm Biosecurity(& traceability) * Can. Health of Animals Network http://www.cahnet.org/ Surveillance - Reportable Diseases Schedule II - Health of Animals Act 1. African horse sickness 2. African swine fever 3. Anaplasmosis 4. Anthrax 5. Bluetongue 6. BSE 7. Bovine Tb (M. bovis) 8. Brucellosis 9. Chronic Wasting Disease 10. Contagious bovine pl-pneumonia 11. Contagious equine metritis 12. Cysticercosis 13. Equine Infectious Anemia 14. Equine piroplasmosis 15. Foot and Mouth Disease 16. Fowl typhoid (S gallinarum) 17. H P Avian influenza 18. Classical swine fever 19. Lumpy skin disease 20. Newcastle Disease 21. Peste des petits ruminants 22. Pseudorabies 23. Pullorum disease (S. pullorum) 24. Rabies 25. Rift valley fever 26. Rinderpest 27. Scrapie 28. Sheep and goat pox 29. Swine vesicular disease 30. Trichinellosis 31. Venezuelan equine encephalitis 32. Vesicular stomatitis Emerging Zoonotic Diseases (non-foodborne) Viral Haemorrhagic Fevers (1960s ) Lyme Disease (~1975) AIDS/HIV (1978) Hanta (1993) Hendra (1994) TSEs (1996) Nipah (1999) West Nile (1937/1950s/1999) Avian Influenza (1997/2004) Monkeypox (1970 …2003) SARS/Coronavirus (2003) Bio-terrorism (Anthrax …) Role of Animals (Livestock, Pets, Wildlife) Reservoirs Amplifier Host Link Host Incidental Host Shedder Sentinel Avian Influenza Outbreak BC Coast – 2004 Animal Epidemiology Unit Monitor changes in infectious/toxic agents Define a problem/Detect outbreaks Estimate magnitude of the problem Determine geographic distribution of illness Generate hypotheses Stimulate research Describe the natural history of a disease Evaluate effectiveness of control measures Detect effect of changes in practices Facilitate planning/risk-based prioritysetting May Laboratory Confirmation 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Production Type # of Farms Broiler Breeder 13 Turkey Hatching 1 Broilers 9 Leghorn Breeder 1 Squab 1 Table Egg 1 Layers 2 Layers/Pullets 6 Asian Meat Birds 2 Turkey 1 Turkey Layers/Pullets 1 Peking Duck 3 Turkeys/Layers 1 Duck & Geese 2 Total Backyard Flocks HPAI 2004 Port Coquitlam Surrey 42 11 Abbotsford Commercial - Matrix Positive Commercial - Isolation Positive Backyard Surveillance Activities AI Control Area – Hot Spots Avian Influenza in BC Epidemiologic Investigation Routes of virus transmission? Tools veterinary visit & questionnaire follow-up on movements of risk products (eggs, …) Transmission routes investigated … waterborne (ground and surface water) feed hatcheries wild birds CFIA crews litter aerosol dispersion service providers (owners, workers, equipment …) Some Disease Control Strategies Used in Animal Disease Outbreak • Destruction (‘stamping-out’) • CO2, electrocution, others • ensure ‘humane’ culling • Movement control /Quarantine • Disposal •landfill, incineration, composting, rendering •easier to arrange once emergency powers invoked • Cleaning & Disinfection ◦ manure, structure Human Health Protection OSH considerations Health screening (suitability) Information/Training Protective clothing Personal Hygiene Health surveillance / reporting / ff-up Prophylactic meds / vaccination PH considerations Exposure / bio-security issues Health surveillance / CD control Need for increasing collaboration between CFIA and its partners Increasing Challenges for CFIA • • • • • • • global distribution (food, livestock, pets, feed, seeds) intensive farming /new technologies changes in consumption and eating patterns consumer expectations/practices effects of global warming (insect vectors; ecology) speed and scope of international travel increasing susceptibility of large segments of the population (e.g. compromised immunity; allergies) • public demand for transparency and involvement Emergence of Foodborne Pathogens 1900 • Botulism toxin • Brucella • Vibrio cholera • Hepatitis A • Staph toxin • M. tuberculosis • S. typhoid 1970s • • • • • • • • • • • • • • • Campylobacter jejuni Salmonella Enteritidis Shiga-toxigenic E. coli Listeria monocytogenes Clostridium botulinum (infant) Vibrio parahemolytici/vulnificus Yersinia enterocolitica Giardia lamblia Toxoplasma gondii Cryptosporidium parvum Cyclospora cayetanensis Hepatitis E Noroviruses BSE prion … Increasing food vehicles: ground beef, poultry, shellfish, veggies (sprouts, salads), fruits (cantaloup, berries, juice), dairy (ice cream), imports (halva, chocolates), irrigation water Agent Factors in Emergence of Zoonoses • Microbial adaptation & change • Socio-economic Host (human) economic development intensive farming/husbandry • Demographics • Susceptibility to infection, Famine international travel & trade breakdown in PH measures • Behaviour (hygiene, outdoors, poverty & social inequality pets, …) Environment • Physical war and bioterrorism • Political climate and weather changing eco-systems (vectors) land use /encroachment lack of will disruption in leadership Threat of bio-terrorism Our world changed forever on September 11, 2001 When new foodborne disease identified What is the nature of the disease? What is the nature of the pathogen? Simple ways to easily identify the pathogen and diagnose the disease? What is the incidence of the infection? How can the disease be treated? Which foods transmit the infection? How pathogen gets into the food, and how well it persists there? Is there an animal reservoir? How do the animals themselves become infected? How can the disease be prevented? Does the prevention strategy work? Tauxe R., Emerging Foodborne Diseases: An Evolving PH Challenge, CDC 1997 Guidelines for Research on Zoonoses Identify the source of infection, to determine whether it is from wildlife, domestic or peridomestic animals, or from multiple sources; Establish the mode of transmission, to determine whether it is by direct contact, vectorborne, environmental contamination, or a combination of modes; Identify potential host species and the natural reservoirs of the zoonotic pathogen, possibly with molecular and/or epidemiological methods; Conduct preliminary surveys of target species and follow-up, when indicated, with long-term ecological and epidemiological studies of identified reservoir species in the wild and/or in an experimental setting where appropriate. from Report on WHO/FAO/OIE consultation May 2004 Scientific Collaboration Ecology Economics Entomology Epidemiology Biostatistics Environmental Health Occupational Medicine Pathology (human & animal) Behavioural Science (human & animal) Clinical Medicine (Human and Vet.) Public Health practice (Human and Vet.) Regulatory, Wildlife, & Agricultural Sciences CFIA Partnerships • Other federal depts (HC/PHAC, AAFC, DFO, EC) • Provincial gov’ts (Health, Agric., Fish., NR, Env) • Int’nal Orgs (WHO, FAO, OIE), and other countries • Food industry (production and processing) • Food retail and food service sectors • Trade associations • Med/Vet practitioners and professional ass’ns • Academia • School system • Mass media • Consumer associations and consumers * Counter-terrorism aspects (RCMP, CSIS, PSEP) Opportunities for Collaboration between CFIA and PH Community on Foodborne Illness and Zoonosis Data exchange/integration Expertise exchange Enforcement Industry education/training OSH considerations Public information Joint training (e.g. epi) Research (e.g. strains, spread) Human/Animal Interface CFIA’s Senior Medical Advisor * Areas of involvement … Food safety, foodborne infections, zoonoses Strategies to address Risk communication/perception Standards, regulations, legislation, agreements The Plague Doctor * Liaison with • Health Canada (esp.FD) and PH Agency of Canada • Provincial/Regional Public Health officials • Health professionals (PH and clinical) • other national and international bodies (US, EU, WHO) • Consumer groups * Advice/Assistance in • Canada-wide surveillance systems • Inter-departmental/jurisdiction information exchange • Issues/Risk management Questions/Comments?