Salmonellosis in NSW:from controlling outbreaks to a 30% disease reduction strategy

Foodborne Diseases: Changing Epidemiology and Disease Control

1 September 2016

Craig Shadbolt

Manager, Food Incident Response & Complaints

FOOD RETAIL

$45B

PA

Economic contribution of the NSW food sector

TOTAL FOOD INDUSTRY IN

NSW, ACCOUNTS FOR:

24% OF THE GSP

$113B

PA

PRIMARY

PRODUCTION

$12B

PA

FOOD

MANUFACTURING

$25B

PA

FOOD EXPORTS FROM NSW

ACCOUNTING FOR

8% OF THE STATE’S

TOTAL EXPORTS

$5.1B

PA

STORAGE AND

DISTRIBUTION OF FOOD

PRODUCTS

$5B

PA

FOODS

BUSINESSES

15,000

FARM-BASED

BUSINESSES

42,000

RETAIL FOOD

SERVICE BUSINESSES

40,000

FISHING

BUSINESSES

1,400

FOOD-PROCESSING

COMPANIES

2,000

Number of food businesses

PEOPLE EMPLOYED IN

SUPERMARKETS AND

GROCERY STORES

69,000

PEOPLEARE DIRECTLY EMPLOYED IN

THE AGRICULTURE AND

FOOD SECTORS

150,000

PEOPLEEMPLOYED IN CAFES

RESTAURANTS AND

TAKEAWAY FOOD SERVICES

128,000

PEOPLE

Number of people employed in the food industry

Source: KMPG, Estimating the impacts of food regulation in NSW, December 2014

Food regulation in NSW

NSW Department of Primary Industries (Biosecurity & Food Safety)

Setting of food policy, legislation

Only through-chain food safety agency in Australia

Inspections/audits of importers, manufacturers, high risk businesses

– Shellfish, dairy, meat, eggs, hospitals/aged care

– Investigation of foodborne illness/incidents

115 NSW Local Councils

~ 162 Environmental Health Officers involved in NSW food work

Responsible for inspection of retail food businesses

– Cafes, restaurants, takeaway

Annual food interactions

Salmonellosis in NSW

NSW disease trend

Consistently higher

summer peaks

Salmonella numbers

Higher counts in traditionally cooler months

Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Total

2012 320 317 353 241 193 122 151 201 188 269 254 301 2910

2013 409 366 341 345 290 197 187 173 173 316 276 329 3402

2014 504 490 501 404 406 238 209 203 238 286 348 447 4274

2015 602 522 456 361 283 236 206 176 202 276 321 400 4041

2016 690 519 442 393 343 329 345 176 . . . . 3237

Salmonellosis notifications in NSW residents,

by month of disease onset. January 2012 to August 2016

Pork roll outbreak case study• Late afternoon, multiple calls alleging illness after

pork roll consumption

• Local council inspection records obtained

‒Poor history of cleanliness, temperature abuse, hot tap

activated by pair of pliers, pest control issues

• Joint investigation planned with local council

scheduled for next morning

Investigation findings

• Unclean premises

• Unclean equipment

• No sanitising of equipment

• Use of raw eggs

• Uncovered foods in refrigerator

• Evidence of pest activity

• Proprietor’s daughter had Food Safety Supervisor certificate

‒ Studying accounting, rarely at the food business

• Unclean premises and equipment (shelving with rotting food)

• Prohibition order placed on preparation of all foods/ingredients linked to use

of pork rolls

• Business implement full closure until cleaning measures rectified

Test results and outcomes

• 10 different foods positive for Salmonella (raw egg butter, sliced

meats, salad items)

• 14 different swabs positive (cleaning cloth, equipment, chilled

display units, wash up sink, shelves, door handles)

• Prohibition order not lifted on service of pork rolls for 3 weeks

• Doors on chilled display unit had to be replaced due to repeat Salmonella

detections

• Business no longer serving raw egg foods

• Approximately 40 people ill

• Business received ~ $3000 fines, name and shame listing

Salmonella!!

Failure to clean and sanitise

NSW Salmonella outbreak data 2014

- Salmonella Typhimurium causative pathogen in 59% of

outbreaks (26/44)

- 50% (13/26) implicated a food vehicle

- raw or partially cooked eggs was the source in 10 outbreaks

Outbreak Contributing factorsMost common factors leading to outbreaks in NSW (historically)

• Use of raw egg foods

– Mayonnaise, aioli, egg butter

– Mousse, fried ice cream, tiramisu

• Failure to clean & sanitise

– Cleaning (removal of visible dirt, grease, food waste)

– Sanitising (destruction of bacteria, viruses by heat of chemicals)

• Lack of skills & knowledge

– Handwashing, temperature control, cross contamination

NSW Food Safety Strategy

Food safety strategy 2015-2021

• Health and safety of NSW consumers is paramount

• By 2021, achieve 30% human salmonellosis reduction, based on 2014 notified

figures

• Salmonella is the most common agent in foodborne disease outbreaks

• 2010 estimates show a 24% increase from 2000

• Reputation of the regulatory system that underpins biosecurity & food safety

are well regarded and vital for market access

‒ 30% growth target for primary production sector

Meeting the targets by 2021• First food regulator in Australia to articulate a target

• Business as usual will not result in improvements

Review of successful international strategies and the NSW approach

• NSW approach on the right track

• Australia has fallen behind other developed countries and trading

partners

‒ Overseas strategies used to drive research (attribution studies)

‒ Develop performance objectives and targets through chain for various

commodities

Challenges for a 30% reduction• Climate

• 2011 report estimated NSW Salmonella rate would rise 4.7% by 2020 and

7.5% by 2030

‒ Based on 0.6ºC rise by 2020 and 0.9ºC, no other interventions

Crude monthly

salmonellosis rate

per 100,000

population and

mean maximum

monthly

temperature in

NSW from 2011 –

2015

Challenges for a 30% reductionMajor outbreaks, external factors

• Outbreaks of unusual severity can skew figures

• 202 people ill from a single bakery in Jan 2016

The Strategy applies to NSW only

• 3 fresh produce outbreaks with interstate origins

• Bagged lettuce, mung bean sprouts, rockmelon

• These issues have impacted significantly on NSW figures

• NSW and FSANZ developing a national approach on Salmonella, and risk

management of fresh produce

Raw egg retail guidelines

Raw egg retail strategy (developed 2014)

- Supplements on-farm risk management programs

•Mandatory document for raw egg use at retail level in 2016-17

•Guidelines for use and length of storage

•Acidification of raw egg foods

•Low heat treatment of dessert products

•http://www.foodauthority.nsw.gov.au/_Documents/retail/raw_egg_guidelin

es.pdf

Food Safety Supervisor

• Mandatory skills and knowledge for one person per premises for the

majority of NSW retail/food service stores (n = 40,000).

• Implemented since 2010, certificates have 5 year shelf life.

• In September 2015, Food Authority introduced changes to provide for

focus on high risk areas.

• These areas were:

Safe egg handling

Cleaning and Sanitation

Education & TrainingIdentifying the Salmonella risk for local council EHOs

•Asking specific questions around raw egg use

•Reviewing menus for high risk items

•Using specific inspection checklist if suspect foods onsite

Education and training workshop for high risk businesses

•Joint projects with local councils to address skills shortage in high risk

businesses (pork roll outlets, fried ice cream)

•Reduction in large Salmonella outbreaks in these types of businesses

Is the strategy working so far?

• Maybe…to a point…very early days…

• Raw egg related outbreaks declined substantially since 2014

‒ 1 Salmonella Typhimurium outbreak linked to raw egg foods in 2016

‒ 4 people affected

Non-Salmonella Typhimurium &

Salmonella Typhimurium human

notifications in NSW (2016 represents

year to date figures). Data supplied by

NSW Health.

Future priorities, 2016-17

• Greater engagement with external agencies and industry

• Development of a Salmonella attribution study

• Consideration of performance targets for food commodities

THANK YOUCIDM and MBI Research Symposium

1 September 2016

Craig Shadbolt; Manager, Food Incident Response & Complaints

Craig.Shadbolt@foodauthority.nsw.gov.au

QUESTIONS?

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