Leverhulme Centre for Integrative Research on
Agriculture and Health (LCIRAH)
Workshop 26th May 2010
Managing zoonotic and food borne diseases
Present:
LIDC: Jeff Waage, Cathy Fletcher
RVC: Jonathan Rushton, Dirk Pfeiffer, Katharina Stärk, Jonathan Elliott, Belen Otero, Alma Yrjo-Koskinen
School of Pharmacy: Russhawn Aldridge
SOAS: Andrew Dorward, Harry West
LSHTM: Marcus Keown-Brown, Sophie Hawkesworth
Birbeck College: Richard Strange
External speakers: Andrew Fearne (Kent Business School); Gael O’Neill (FSA)
Background
Recent reviews of the origins of human diseases indicate that three quarters of emerging diseases come
from animals, which is an increase on historical trends. The reason for the emergence of new diseases
from animals, and the continuing need to manage existing zoonotic and food borne diseases in agricultural
systems and food chains, raise many questions. Are the newly emerging diseases related to: greater contact
between people, wild and domestic animals; changes in how animals are raised and managed or other
reasons? Are the problems faced by food borne diseases caused by increased complexity of food chains?
Are these problems significantly large as to need new methods for surveillance, detection and control? How
can these methods be made cost-effective?
The general theme of zoonotic and food borne diseases will be an important component of the new
Leverhulme Centre for Integrative Research on Agriculture and Health (LCIRAH), which is already exploring,
for instance, the relationship between livestock production and consumption, climate change and health.
This half-day workshop aims to create a basis for developing overarching questions on food-borne and
zoonotic diseases that LCIRAH will address through interdisciplinary and intersectoral research over the
next 5 years.
Presentations:
The following presentations were made and are available as PDFs

Jonathan Rushton, RVC – Managing food borne and zoonotic diseases. What are the researchable
issues?

Dirk Pfeiffer and Katharina Stärk, RVC – what are the zoonotic and food borne risks and how can we
monitor them?
Professor Andrew Fearne, University of Kent – How are food chains changing and what does this
imply for public and private responsibilities on food safety?
Gael O’Neil, Foodborne Diseases Strategy Branch, FSA – Food chain analysis – assessing the risks
and what to about them?
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
Brief summary of the points made
Rushton – historically, zoonotic diseases arise as a result of changes in production systems, which bring a
range of animal disease problems. Outbreaks affecting animal production are dealt with by veterinary
Leverhulme Centre for Integrative Research on
Agriculture and Health (LCIRAH)
Workshop 26th May 2010
services, but more insidious zoonotic diseases with human impact are often not, and take some time for
action (by animal or human health services or both), to be taken. Further, our capacity to anticipate these
problems is limited by a poor understanding of changes and weak monitoring systems.
Pfeiffer/Stärk – in Europe, there is a spectrum of zoonotic diseases dominated by campylobacter and
salmonella. Cost of disease outbreaks is increasing due to trade and the pandemic nature of some recent
zoonotics. Veterinary sciences are well locked into a risk assessment – management- communication
framework. There are three key challenges:
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
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Global food systems, and underlying policy and political factors – anti-microbial issues
Changes in production systems – anti-microbials again, overuse by farmers, esp in China
Urban/peri-urban animal production
Fearne – the food chain comprises farmers and those that provide inputs, linked to processors and
manufacturers and ultimately to retailers. Where change is needed in the food chain, there is process
limited by a major gap:
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

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Raise awareness
Increase knowledge
Change attitudes
Change behaviour
Academics and surveys get as far as changing attitude but rarely go on to change in behaviour, and analysis
of Tesco Clubcard data suggests that behaviour does not change even if attitudes do (from surveys) –
contested by LSHTM. Five-a-day, for instance, is a failure claimed as a success.
To effect behavioural change, there is a need for an enabling environment and methods.
Do not regard food chains as uniform and, despite the global spread of supermarkets, do not think there is
a global trend towards sameness. Even supermarket chains struggle to be different, in the absence of
product branding, they develop unique store branding with particular relelvant to food quality and safety.
But they don’t do much research as yet – research is done by those who own brands (e.g. Nestle, Unilever).
Change will occur in the food chain with better strategic alignment, value chain visibility, collaborative
relationships, and consumer insights.
O’Neil – FSA has done a study of the major diseases causing food safety problems in UK and where they are
arising. They are by far CAM and SALMONELLA. CAM dominates and 70% of cases appear to originate from
chicken, about 70% of chicken meat going into the food chain is contaminated and about 70% of fresh
chicken purchased and taken home is contaminated, although most human infection probably comes from
environmental contamination after handling chicken and not from under-cooking.
Main points discussed:
1. Anti-microbial resistance. Basically, we monitor chemicals in the food chain well, including
antibiotics, but we do not monitor microbes well, in part a technical issue and in part policy related.
This means that we can regulate levels of antibiotics, but we do not regulate the movement of
antibiotic resistance. The pathway for the spread of resistance from agriculture to human health is
broad and growing, particularly in countries like China, where rapid growth of intensive production
has led to excessive use of (often poor quality) antibiotics in an unregulated environment, with
Leverhulme Centre for Integrative Research on
Agriculture and Health (LCIRAH)
Workshop 26th May 2010
rapid national and international movement of the outputs of this. A disaster waiting to happen,
while all attention is focused on not so comical environments for resistance development. Is this
agri-health problem of potentially greater health consequence than new infectious zoonotic
diseases? While we look for the next SARS, a needle in a haystack, are we neglecting the elephant
in the room?
Subsequent discussion with Dorward – this problem has all the hallmarks of major global
environmental conflicts over “public bads” and “private goods” (e.g. climate change) - short term
private interest to overuse antimicrobials completely opposed to long term public interest to
protect medicines.
2. Food safety – so what? From an LCIRAH point of view, campylobacter and salmonella may be
northern phenomena of limited health consequence, even there. Engaging the health sector in
agricultural issues works where the health sector actually has to make an intervention to stop or
prevent the problem. This arises in three ways –
 infectious diseases that spread between people (which campylobacter and salmonella
don’t very well)
 contaminants that accumulate (pesticides, mycotoxins) and have long term health effects
(e.g. cancer or organ breakdown) – do microbes have more than an acute, short term
effect?
 Disruption of health systems by agricultural medicines (antimicrobial resistance)
This does not apply to salmonella or campylobacter. Further, in developing countries, the
impression at the meeting is that children quickly develop a degree of immunity to such food borne
diseases, so it is not really a problem in adult live. But then again, how dangerous is it to children –
you could say the same about malaria and that is still a major neglected disease. The result of the
WHO study on burden of food borne diseases will be important.
Asia provides a very interesting comparison of national strategies on food safety – Singapore is
enormously protected by government interests (benefiting from a lack of producers and therefore
able to reject suppliers with impunity), whereas Hong Kong and China are much less able to
regulate – you could study campylobacter between these countries with some clear hypotheses
about food safety drivers.
The related issue is that international regulations may be driven by Northern experience of food
borne diseases whose epidemiology in the north is different than their epidemiology in the south –
hence an opportunity for policy misalignment.
3. Role of the private sector – Fearne gave a convincing argument that tomorrows food quality and
safety will be a matter of public-private co-regulation. What is the relationship between supermarketization (bearing in mind we must not generalize!) and health – does it:
 Make food more safe or just change the disease and toxic threats
 Make food less nutritious by selling cheaper food, or make healthier food more available.
 Does food safety conflict with food quality in a supermarket context – e.g. moving to
protected processed brands for safety reasons which are less nutritious
Leverhulme Centre for Integrative Research on
Agriculture and Health (LCIRAH)
Workshop 26th May 2010
We must not forget the restaurants (e.g. MacDonalds) – many people eat out and get disease and poor
nutrition, food safety is not just about what you buy (it may be less about that than where you eat).
Andrew Dorward’s comments
The discussion towards the end on the threat of resistance to anti-microbials was very serious - I did not
realise quite how much is at stake. There are very difficult issues here of short term private incentives to
behave in ways that carry huge long term global risks. It reminds me very much of the global public bads of
ghg emissions, bio-diversity loss, water depletion, etc and comes back to major questions about
behavioural change, though in a different context from the discussion of behavioural change earlier in the
workshop.
The tensions between allowing low level exposure with high disease incidence etc but some building up of
resistance versus virtual elimination of exposure but consequent loss of resistance and hence vulnerability
to epidemic etc is also an important question - one that plays out differently for different disease risks in
different country contexts (an issue that Jeff was raising this morning).
And that is the third issue - how different the problems, risks, diseases etc are in different countries, but we
are all tied together by trade and transport routes –
and that brings us back to the questions about short term private goods versus long term global public risks
/ bads ......
Rich Smith email
I had mentioned AMR I think to Jeff recently - I have been involved in it off and on over last 15 years! Big
issues of agri use vs human use and could be very interesting focal point for many of the stream activities,
so perhaps stick on agenda to discuss at some point?
Harry West’s email
I too found the workshop very interesting and very useful. As LCIRAH moves forward on this front, among
the things we may wish to think about include:
The political-economic dynamics that both produce great concentration of production in livestock
industries and dampen public debate/discussion/awareness of the hazards of zoonotic disease/foodborne
pathogens. (I am reminded here of Marion Nestle's accounts of the beef industry in the US doing all they
can, whenever they can, to lessen their responsibility for supplying "clean meat" and to increase the
consumer's responsibility for "safe practices" in the kitchen, as the balance between the two is anything
but a given. I am also reminded of Erik Millstone's discussions of how science does not merely inform or
provide data for risk assessment and subsequently risk management, but is in fact shaped by the political
dimensions of these purportedly "down-stream" processes.)
The psychological dimensions of risk, including how perceptions may be shaped by certainty v. uncertainty;
familiarity v. unfamiliarity; a sense of control v. a sense of no control, etc. These of course mean that, for
example, the horror of CJD far outweighs concern about listeria, despite the numbers telling us it should be
otherwise, and that while this clouds "reality," it becomes a tangible force that can be ignored only at great
political peril, etc.
Themes not discussed:

There was little or no discussion on zoonoses
Leverhulme Centre for Integrative Research on
Agriculture and Health (LCIRAH)
Workshop 26th May 2010

There was little discussion of the human health aspects in terms of organizational and institutional
responses, or lack of them, to food-borne and zoonotic diseases
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The need to balance food security with food safety – do models exist to help decision makers look
at the pay-offs?
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Attitudes and beliefs on risk
Emerging themes:
The following are suggestions:

General areas
o
o
o
o
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Co-regulation – public and private cooperation

Are lessons to be learnt from developed country experience that could be
examined in developing countries context where public regulation and
enforcement tend to be weak
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What are the impacts of private standards (regulations) on consumers and
producers in developing countries
How good are our methods to identify and prioritization interventions and regulation?
Some examples:

Supermarkets may be quite good at enforcing standards to limit disease risks, there
may be bigger problems in the catering and home preparation parts of the food
chain

Good mechanisms exist for residue monitoring which may be out of proportion to
the risk and leave inadequate funding for other activities.
How to translate available technical knowledge of limiting/managing food borne and
zoonotic risk into recommendations that are adopted
 The need to be able to identify the people involved (they are not homogenous)
 To be able to understand their constraints, abilities, knowledge and understanding
 To be able to create positive enabling environments to stimulate true behavioral
change
Comparative analysis across regions to assess the impact of food-borne disease burdens
and the drivers of change
 Political economy
 Religious rituals in the handling and slaughter of animals, handling of livestock
products
Specific disease areas
o
Campylobacter

impact of the disease in different regions/countries

current responses to the disease adequate in a changing environment of meat
supply
Leverhulme Centre for Integrative Research on
Agriculture and Health (LCIRAH)
Workshop 26th May 2010

o
Brucellosis (not discussed yesterday)
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Can lessons be learnt from developed countries and made available for developing
country settings where intensive poultry raising is becoming more common.
Institutional setting of control options
Other areas discussed
o
Anti-mircobials
o
Aflatoxins