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SIRVETA and National FBD Surveillance in Peru

SIRVETA and National FBD Surveillance in Peru

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SIRVETA and National FBD Surveillance in Peru

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  1. SIRVETA and National FBD Surveillance in Peru Marisa L. Caipo, Ph.D. Asociacion Peruana de Consumidores y Usuarios (ASPEC) University of Maryland, USA Universidad San Ignacio de Loyola, Lima, Peru

  2. Major developments that have a significant effect on food safety • Changes in the nature and concentration of hazards in food • Changes in the controls used to ensure that food is safe to eat • A shift of the primary responsibility for food safety to industry • Changes in consumer habits. Mackenzie et al, 2004

  3. Epidemiologic surveillance of Fooodborne illness Needs: • Modes of transmission and risk of foodborne disease • Focus on policies and strategies for prevention and control • Identify priorities for interventions, particularly at the local level • Evaluate the impact of food safety intervention programs

  4. Types of Surveillance Lopez, 2005

  5. Integrated surveillance approach to the Food Chain Mangos for export from Brazil Contaminated hot water is used as treatment against Mediterranean fruit fly Consequences: 78 human cases 14 hospitalized 2 deaths Mangos contaminated with Salmonella Newport exported to USA PAHO, Lopez, 2005

  6. FBD Outbreaks / Detection Traditional Scenario • Locally detected • MD • Community • Epidemiologist • Based on syndromic surveillance and good relationships New Scenario • Detected by the lab • Rare Serotypes • Subtypes (phagetyping PFGE) • AMR • Based on lab surveillance and communication between lab and epidemiology PAHO, Lopez, 2005

  7. Integrated surveillance Human Health Environmental Health Animal and Plant Health Food Chain Laboratories Laboratories National Policies

  8. FBI Surveillance in Latin America • Low coverage in general and in particular for FBI • Low sensibility in detection and investigation of outbreaks • Problems with data analysis and information management

  9. INFORMATION SYSTEM FOR EPIDEMIOLOGICAL SURVEILLANCE OF FOODBORNE DISEASES – SIRVETA 1995 – 2002 6930 reports of FBI outbreaks from 22 countries in the region. Food items most commonly associated with the reported outbreaks were fish (22%), water (20%) and red meats (14%).

  10. COUNTRY OUTBREAKS SICK DECEASED Argentina 155 3520 5 Bahamas 89 10688 0 Barbados 2 7 0 Bolivia 5 1244 2 Brasil 645 18945 5 Chile 342 4101 2 Colombia 9 383 0 Costa rica 54 146 0 Cuba 3996 159272 59 Ecuador 54 2670 23 El Salvador 26 7984 4 Guatemala 21 291 7 Jamaica 3 99 0 México 633 19493 107 Nicaragua 129 1152 0 Panama 73 1131 2 Paraguay 89 1277 0 Perú 112 5285 89 Rep. Dominicana 85 1833 0 Trinidad y Tobago 54 567 1 Uruguay 120 3322 1 Venezuela 234 5787 11 TOTALS 6930 249197 318 Chemical Contaminants, Plant toxins

  11. New and improved Sirveta Lopez, 2005

  12. PERU • Population 26.7 M • Surface Area 1.3 M sq km • Population per sq km 20.5 • Life expectancy 69.8 years • GNI per capita $2020 USD • GDP 56.5 billion USD Source: World Development Indicators, 2004 • Most common causes of FBD • Salmonella spp • Staphylococcus aureus • Enteric viruses • Source: • Ministerio de Salud, 2004

  13. PERU Illnesses subject to Epidemiological Surveillance Immunopreventable (Hep B, MMR, Yellow fever, etc) Zoonoses Human rabies, anthrax, plague Vector-transmitted (dengue, malaria) Other transmissible (cholera) Mandatory weekly notification Acute Diarrheal diseases (EDAs) Other illnesses (Chagas, bartonellosis, etc.) Occurences of importance for public health Outbreaks Epizooties Natural disasters

  14. PERU

  15. Adequate surveillance requires • Political decision and implementation techniques • Integrate FBD within the National Surveillance Programs • Coordinated participation with the lab • Continuous training • Appropriate Resources

  16. Adequate Surveillance • Capability for detection of outbreaks and cases • Capability to identify agent • Identify place in the food chain where contamination occured • Identify associated risk factors • Define risk scenarios

  17. Interinstitutional coordination • Integrated surveillance • Outbreak analysis • Preventive approach Local Level Success stories • Municipality of Maldonado, Uruguay. Population 127,257 Tourists +600,000 • Municipality of Galvez, Argentina GIS Food Analysis Lab Training for Food Handlers Technicians Hygiene Inspectors Primary School Ed

  18. General level • Networking to improve national capacities in surveillance and laboratory confirmation • Training • Standardization • Quality assurance • Scientific support

  19. The Inter-American Network of Food Analysis Laboratories - INFAL 54 laboratories from 28 countries Achieve equivalence in methods and quality management systems for food analysis laboratories Regarding FBD surveillance, INFAL is promotes the integration of the official laboratories dealing with analysis of foodstuffs into programs of food safety and epidemiological surveillance. Inter-American Network of Food Analysis Laboratories (INFAL) http://www.panalimentos.org/rilaa/ingles/index.asp

  20. WHO-GLOBAL SALM SURV All countries of the Region General objective Strengthen the capability of the participating countries in the surveillance and response systems and to contribute to the global effort of containment of antimicrobial resistance of foodborne pathogens.

  21. WHO - Global Salm-Surv www.panalimentos.org.salmsurv • Colombia • Instituto Nacional de Salud • Inst. de Vig. de Medicamentos y Alimentos (INVIMA) • Instituto Colombiano Agropecuario (ICA) • Venezuela • Instituto Nacional de Higiene “Rafael Rangel” • Brasil • Inst.Oswaldo Cruz - Centro de Referencia Nac. de Cólera y Entero infecciones Bacterianas (FIOCRUZ – RJ) • Ministerio da Agricultura e do Abastecimiento • Secretaria de Defensa Animal • Departamento de Defensa animal • Ecuador • Instituto Nacional de Higiene • Perú • Inst. Nac. de Salud – Centro Nac. Lab. Salud Publica.- • Div de Bacteriología – Lab Entero patógenos • Inst. Nac. de Salud -Centro Nac. de Alimentación y Nutrición • Paraguay • Laboratorio Central de Salud Pública • Ministerio de Agricultura y Ganadería • Bolivia • Instituto Nacional de Lab. de Salud (INLASA) • Lab. de Investigación y Diagnóstico Veterinario (LIDIVET) • Uruguay • Centro Nacional de Salmonella, Inst. de Higiene • Min. de Ganadería, Agricultura y Pesca (DILAVE) • Chile • Instituto de Salud Pública de Chile • Servicio Agrícola Ganadero CENTRO REGIONAL: Instituto Nacional de Enfermedades Infecciosas (INEI) - ANLIS “Dr.Carlos G. Malbran” • Argentina • Inst. Nac. de Enfermedades Infecciosas (INEI) - ANLIS “Dr. Carlos G. Malbran” • Inst. Nac. de Producción de Biológicos (INPB)- ANLIS “Dr. C G. Malbran” • Instituto Nacional de Alimentos (INAL) • Servicio Nac. de Sanidad Animal (SENASA)

  22. - 7 countries • - Strengthen the surveillance of FBD in Latin America, by the use of biological molecular techniques. • - Database for regional isolates • Quality Assurance Program http://www.panalimentos.org/pulsenet