food safety – The Root Cause

Listeria Monocytogenes

Listeria monocytogenes continues to be a serious public health threat, particularly in the food industry, where it has been responsible for numerous deaths and hospitalizations. The World Health Organization (WHO) estimates that globally, foodborne Listeriosis affects around 23,000 people annually. Out of these cases, there are approximately 5,500 deaths each year, giving Listeriosis one of the highest mortality rates among foodborne pathogens at around 20–30%.

There have been multiple large-scale recalls due to Listeria contamination. In one of the most recent cases, Boar’s Head issued a recall of more than 5 million pounds of product. This resulted in 10 deaths and over 50 hospitalizations across the USA. Even more alarming, over 9 million pounds of ready-to-eat meat were recalled this week alone, also linked to Listeria contamination, reflecting the gravity and frequency of the problem.

In recent years, the number of recalls related to Listeria has surged, with many incidents affecting various sectors of the food industry, from fresh produce and dairy to processed and ready-to-eat meats. This has sparked ongoing concerns about whether businesses are effectively controlling Listeria contamination, or whether this pathogen is becoming more resistant to traditional cleaning and control methods.

Listeria’s ability to thrive in harsh conditions—such as cold storage and high-salt environments—and form biofilms on surfaces makes it particularly hard to eliminate. These characteristics contribute to its persistence in food processing facilities and increase the likelihood of contamination. As a result, the food industry must continuously evaluate whether their cleaning practices are sufficient or if Listeria is evolving in ways that render current control methods less effective.

This leads to critical questions about the efficacy of cleaning and sanitation practices and whether certain strains of Listeria may be developing antimicrobial resistance, posing new challenges for food safety management.

What Needs to Be Done to Prevent Future Outbreaks?

We need Stronger Preventive Controls. Food companies, especially those handling high-risk products like deli meats, need to strengthen their Cleaning, Sanitation and Hygiene procedures. Focusing on Deep Cleaning in High-Risk Areas including drains, cold storage units, and food contact surfaces. Listeria often thrives in moist environments like floors and drains, which are frequently overlooked. Ensure all surfaces, equipment, and utensils are cleaned and sanitized frequently, especially those that come into contact with food. Pay special attention to hard-to-reach areas, such as cracks and crevices, where Listeria can hide and form biofilms. Effective Sanitizers are important especially those disinfectants that are proven to be effective against Listeria, such as chlorine-based sanitizers, quaternary ammonium compounds, or peracetic acid. Ensure that concentrations and contact times follow manufacturer guidelines for maximum effectiveness. Enforce strict employee hygiene practices, such as mandatory handwashing, regular changes of protective clothing, and using footbaths or sanitizing mats to prevent contamination from entering the plant.

Enhanced Environmental Monitoring Programs (EMP’s) where Routine Swabbing and Testing are conducted in high-risk areas like food contact surfaces, drains, and equipment. Testing should target Listeria specifically. Additionally, large scale food businesses should be utilizing Advanced detection technologies like Rapid DNA-based testing, which can provide results in 2-24 hours, allowing for faster decision-making.

We need businesses to be Transparent and Issue Timely Recalls. When contamination is detected, companies must act swiftly and transparently. The recall process should be immediate and widespread to ensure consumers are promptly informed and the products are removed from shelves.

We need enhanced Food Safety Culture, food producers need to foster a culture of food safety and responsibility. This includes training employees at all levels on the importance of sanitation, proper equipment handling, and recognizing potential contamination risks.

We need efficient and effective Regulatory Oversight, Government agencies can do better and must ensure regular and unannounced inspections to verify that companies are adhering to HACCP plans, Food Safety Modernization Act (FSMA) regulations, and other safety protocols. Authorities should also make the findings from inspections public to encourage accountability and transparency in the food production industry.

We need Regular Third-Party Audits, outside of government oversight food businesses should have regular third-party audits to provide independent and objective evaluations. Unbiased, Objective Evaluations provide Transparency. An independent audit can identify weaknesses or areas that require improvement without bias, helping the business remain transparent in its food safety operations. This is crucial for maintaining trust with customers, regulators, and stakeholders. Third-party auditors are external, independent organizations with no vested interest in the business, ensuring that their assessments are objective and impartial. They are solely focused on assessing the effectiveness of the food safety controls, particularly when it comes to managing Listeria risks.

The tragic loss of life and the severe illnesses caused by this outbreak are unacceptable, and more must be done to protect consumers. No one should have to fear that the food they purchase will lead to a life-threatening illness. Effective control measures, rigorous testing, and prompt action when contamination is detected are critical in ensuring that foodborne pathogens like Listeria do not reach consumers.

Fresh, Safe, and Local!

The Importance of Supporting Our Caribbean Farmers and Local Markets

After visiting the market, to purchase some fruits and vegetables I felt the need to show some appreciation to and highlight the importance of our local farmers. Here in Trinidad and Tobago “the market” as we call it is a place where many locals frequent especially on weekends, where you can find the best bargains and the best value for money. You get to visually and physically compare the fresh food products on sale and interact with the sellers of those products. Central market Port Of Spain and Queen’s Park Savannah farmer’s market are the two that I frequent the most. In Trinidad specifically the Farmers’ Market initiative was conceptualized in 2006. The purpose being to provide direct contact with the farmers and consumers and establish an efficient distribution chain for fresh agri-produce. Market places are staples through-out the Caribbean in Jamaica the Charles Gordon Market in Montego Bay, Negril in St.Lucia Castries Market, Kingstown Market in St. Vincent and Cheapside Market in Bridgetown Barbados just to name a few.

When it comes to food safety and security, one of the best things you can do is to purchase produce from local farmers. Not only does this support the local economy, but it also ensures that you are getting fresh, high-quality food that is less likely to be contaminated during transportation. In the Caribbean, where many islands rely heavily on imports for their food supply, purchasing from local farmers is even more important.

Here are some of the benefits of purchasing produce from local farmers in the Caribbean:

Fresher Produce

When you purchase produce from a local farmer, you are getting food that has likely been picked within the last day or two. This means that it is much fresher than produce that has been transported over long distances, which can take days or even weeks. Fresher produce not only tastes better, but it also has higher nutrient levels and is less likely to spoil or become contaminated.

Support for the Local Economy

Purchasing produce from local farmers supports the local economy by keeping money in the community. This can help to create jobs, increase economic activity, and strengthen the overall community. It also ensures that the money you spend on food stays in the local area rather than being sent elsewhere.

Reduced Environmental Impact

Transporting food over long distances requires a lot of energy, which contributes to greenhouse gas emissions and climate change. By purchasing produce from local farmers, you are reducing the distance that your food needs to travel, which in turn reduces its environmental impact.

Greater Food Security

When a community relies heavily on imported food, it becomes vulnerable to disruptions in the global food supply chain. Purchasing produce from local farmers helps to create a more resilient food system, where the community has greater control over its own food supply. This can help to ensure that people have access to fresh, healthy food even in times of crisis.

Improved Food Safety

When you purchase produce from a local farmer, you have a greater degree of transparency about where your food comes from and how it was grown. This can help to reduce the risk of contamination and foodborne illness. Local farmers are also more likely to use sustainable and environmentally friendly farming practices, which can further improve food safety.

In conclusion, purchasing produce from local farmers in the Caribbean is not only beneficial for the local economy, but it also has a positive impact on food safety and security. By supporting local farmers, you can help to create a more resilient and sustainable food system that benefits everyone. So the next time you’re shopping for produce, consider buying from your local farmer’s market or directly from a local farm.

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Oh No No-rovirus

Before the cruise industry and the world were plagued with Coronavirus, there were other warning signs that should have led to more preventative precautions and safety protocols for those on board. Cruises have become a popular form of vacation and relaxation for many persons and families. However, they have the potential of harbouring serious illnesses. While this may be new information for some who have never had this occur, many others may recall experiencing discomfort where either you or someone you knew fell ill from any symptoms of stomach ache, diarrhea or vomiting while on a cruise vacation. Here is what you should know and how you can reduce the likelihood of falling ill.

In recent years there has been an upsurge in the number of norovirus cases on cruise ships. Norovirus is one of the most common causes of acute gastroenteritis in the world, it can be equated to approximately one out of every five cases of acute gastroenteritis. To put that number into perspective norovirus was the causative agent in over 685 million cases. According to the Center for Disease and Control (CDC), norovirus is one of the big 6 of food borne pathogens. The virus affects all age groups and is easily spread from a contaminated person to another. Symptoms include nausea, vomiting abdominal pain, cramps and diarrhea. The transferal of this virus to the human host is generally through the fecal to oral route i.e. person to person, contaminated food handlers, passengers etc. Essentially the main distributors of this virus are those who come in contact with an infected person.

A cruise ship, provides an ideal environment for the spread of the norovirus this includes: a large enclosed space, a large number of people (passengers and employees) from all over the world and cross-contamination through self service food stations. Furthermore, many cruise ships have inadequate facilities to support proper hygiene practices relative to onboard capacity. As a result, food service areas can easily become contaminated by an infected person and become the origin of an outbreak. Norovirus is a public health and an economic concern. The prevalence of norovirus has highlighted the need for revaluation of the standard procedures and practices regarding food safety in these environments.

Th cruise industry needs to foster positive influences of food safety culture onboard. Here are some possible solutions:

Hand washing and sanitizer stations around serving areas as well as increasing the cleaning and sanitation of surfaces to improve hygiene practices among staff and passengers and reduce contamination.

In addition to regular announcements and signage re-enforcing best practices.

Cruise Industry and the Caribbean – Do the Benefits outweigh the risks?

Many cruises are marketed towards Caribbean destinations and the Caribbean experience. The negative impact that food-borne diseases like norovirus could have on our socioeconomic development cannot be ignored. It is crucial that cruise ships and the cruise industry be closely monitored and regulated through-out the Caribbean. The strain an outbreak could place on our healthcare systems, as well as the harm to tourism and trade industries, would be too much for a small country to tolerate.

National enforcement of regulations by the World Health Organization (WHO) have proved to be essential and effective public health protection methods. More specifically cruise ships once entering a port must provide a Maritime Declaration of Health (MDH), this is a requirement of International Health Regulations (IHR).

Over the past three years there have been incidents recorded at ports of entry in Jamaica, Barbados and St. Lucia, fortunately, serious public health risks were avoided as passengers were quarantined and not allowed to disembark these vessels. Caribbean countries must be mindful and careful that passengers infected or affected by the virus do not infect the local populous resulting in a widespread disease outbreak. Small island states may not have the resources to contain and control and outbreak of that potential.

Some checks and balances are necessary to prevent the occurrence of an outbreak. Ports of entry have to be monitored there has to be some communication between vessels entering the country, carrying passengers who have been contaminated. Prechecks will have to be adopted whereby local and regional health agencies examine the ships and passengers for illnesses and make a resolute decision based on ensuring the health and safety of the population. Reducing or limiting the cruise ship aspect of tourism could lead to economic difficulty as these garner a large amount of foreign exchange.

Preventative measures present & are they effective

The IHR requires the use of the Maritime Declaration of Health (MDH) for reporting and information sharing. The MDH should be submitted each and every time a vessel arrives in a port of call, not only when there is an illness/death on board; however, it is up to each country as to whether to enforce this, since submission of an MDH is only required under the IHR when an illness/death has occurred on board the vessel.

CARPHA is the regional public health agency for the Caribbean and the lead authority for regional surveillance and response. It has three main roles with respect to surveillance of and response to public health issues occurring among visitors to the Caribbean arriving on passenger ships in the Caribbean: Surveillance Collect, analyse, and disseminate information on illnesses/outbreaks on ships coming to the Caribbean; Inform and evaluate various national and regional programs; Notify member countries and relevant agencies of illnesses/outbreaks on ships coming to the Caribbean; Train public health authorities and other competent authorities in the surveillance/detection, investigation, and reporting of travel-related illnesses and outbreaks. CARPHA has developed this protocol and guidelines to facilitate disease surveillance on cruise ships visiting the region.

The present methods have proven to be effective, however additional risk management principles would be necessary to circumvent the possibility of a norovirus outbreak. Robust monitoring and regular health status updates are important, protection of our ports of entry and will be the first line of defense against an outbreak. Governments must work with the cruise industry to ensure proper food safety techniques are utilized. Attention must be paid to the food handling workers and food service stations. Additionally, the surveillance methods introduced by CARPHA to benefit CARICOM member states should be employed. In this regard CARPHA has developed the Caribbean Vessel Surveillance System (CVSS) for rapid information flow and coordinated multi-sectoral response for public heath events occurring among visitors from passenger ships. This also involved in the establishment of protocols to facilitate the standardized submission of the Maritime Declaration of Health from ships to competent national authorities.

At the moment the world is in crisis, the cruise industry and many global economies are experiencing many challenges, my only hope is that we adapt and accept the changes necessary for the future.

References

Caribbean Public Health Agency. 2019. PASSENGER SHIP SURVEILLANCE. Accessed 04 19, 2019. http://carpha.org/What-We-Do/Tourism-and-Health-Programme/Surveillance-and-Response-System.

Center for Disease Control and Prevention . 2019. Outbreak Updates for International Cruise Ships. 04. Accessed 04 20, 2019. https://www.cdc.gov/nceh/vsp/surv/gilist.htm.

Center for Disease Control and Prvention. 2018. Common Setting for Norovirus Outbreak. Accessed 04 17, 2019. https://www.cdc.gov/norovirus/trends-outbreaks/outbreaks.html.

—. 2013. General Information about Norovirus. Accessed 04 19, 2019. https://www.cdc.gov/HAI/organisms/norovirus.html.

Cruise Lines International Association. 2019. Nororvirus on Cruise Ships. Accessed 04 18, 2019. https://cruising.org/about-the-industry/policy-priorities/public-health-and-medical/nororvirus-on-cruise-ships.

2019. Norovirus outbreak on Royal Caribbean cruise ship sickens 475 passengers. 01. Accessed 04 19, 2019. https://abcnews.go.com/US/270-cruise-ship-passengers-sickened-norovirus-royal-caribbean/story?id=60291868.

Orlando Sentinel. n.d. Oasis of the Seas’ norovirus outbreak among worst in a decade. But are cruises getting cleaner? Accessed 04 19, 2019. https://www.orlandosentinel.com/travel/florida-cruise-guide/os-bz-cruise-norovirus-outbreaks-20190116-story.html.