Risk assessment of foodborne pathogens in the meat production chain 57th ICoMST Congress, 7-12 August 2011, Ghent, Belgium

Winy Messens On behalf of the Unit on Biological Hazards

Outline

EFSA and microbial risk assessment (MRA)

BIOHAZ Panel and Activities Example of Scientific Opinion: Campylobacter in broiler meat: control options and performance objectives and/or targets

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Outline

EFSA and microbial risk assessment (MRA)

BIOHAZ Panel and Activities Example of Scientific Opinion: Campylobacter in broiler meat: control options and performance objectives and/or targets

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EFSA • Keystone of European Union (EU) risk assessment (RA) regarding food and feed safety • EFSA provides independent scientific advice and clear communication on existing and emerging risks • Supports the European Commission, European Parliament and EU Member States in taking effective and timely risk management decisions • Remit covers food and feed safety, nutrition, animal health and welfare, plant protection and plant health

• In close collaboration with national authorities and in open consultation with its stakeholders 4

EFSA’s organisational structure

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Why risk assessment? • To estimate numbers of cases attributable to a food source • To evaluate how public health goals can be met • To demonstrate/evaluate the equivalence of different control measures • To compare the effectiveness of potential control measures • In situations where a series of options are available to control risks • To investigate the likelihood of different potential scenarios 6

Risk analysis in the EU

Risk assessment

Risk management

Risk communication

European 7 legislation

DATA

RESOURCES

Quantitative MRA

Comparative or risk ranking MRA

Specific product and process Microbiological Risk profile

DECISION MAKING UTILITY

Types of MRA

Qualitative MRA 8

Outline

EFSA and microbial risk assessment (MRA)

BIOHAZ Panel and Activities Example of Scientific Opinion: Campylobacter in broiler meat: control options and performance objectives and/or targets

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BIOHAZ Panel The Panel on Biological Hazards (BIOHAZ) deals with questions on biological hazards relating to Food Safety and Food-borne Diseases, including:

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Food-borne Zoonoses;

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Food Hygiene;

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Microbiology;

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Transmissible Spongiform Encephalopathies (TSE); Independent scientific experts

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BIOHAZ Panel + ad hoc Working Groups

Associated Waste Management.

EFSA staff BIOHAZ unit: Scientific and administrative secretariat

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Work activities of BIOHAZ Panel • Provision of Scientific Opinions  General questions: Providing guidance and advice in response to questions  Investing in food safety science: Development, promotion and application of new and harmonized scientific approaches and methodologies for (quantitative) RA

• Evaluation of Products (or Processes):  Animal By-Products: Assessing effectiveness of new disposal methods  TSE Tests: Assessing if the performance of the tests meet requirements  Decontamination treatments: Assessing the efficacy to remove microbial contamination

• Data Collection  Networking: Collaboration with national authorities/bodies on microbiological risk assessment and TSEs  Procurement: Usually data collection or development of RA models

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From the “question” to the “answer” European Commission European Parliament

Question?

Member States EFSA (“self mandate”)

Opinion

Consumers Media Industry Professionals

Risk Assessment

Risk Communication Risk Management

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From the “question” to the “answer”

SCIENTIFIC Panel

Opinion adopted

Mandate

Working Group

Draft Opinion

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Outcome of the opinions • Publication on EFSA website

• Communicated to originator of question (EC, MS, Parliament), provides support for changes of legislation • In the published opinion o Background and explanation of the Terms of Reference (ToR) o Assessment (detailed report of the Panel) o Conclusions o Set of recommendations:  Reduce data gaps and scientific uncertainty  Communicated to Risk Manager  Communicated to DG Research of the EC (DG RTD)  Usually advice for future research topics

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Outline

EFSA and microbial risk assessment (MRA)

BIOHAZ Panel and Activities Example of Scientific Opinion: Campylobacter in broiler meat: control options and performance objectives and/or targets

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Background • Campylobacteriosis is the most frequently reported zoonosis in the EU

• EU harmonised baseline survey on the prevalence and AMR of Campylobacter in broiler flocks and carcasses (2008) • Legal basis to consider targets and microbiological criteria  EC requested EFSA advice (June 2008) 16

Terms of reference • EFSA was requested to: – Assess the extent to which meat derived from broilers contributes to human campylobacteriosis at EU level. The importance may be expressed as a percentage of the total number of human campylobacteriosis cases. – Identify and rank the possible control options within the broiler meat production chain, taking into account the expected efficiency in reducing human campylobacteriosis […] – Propose potential performance objectives and/or targets at different stages of the food chain in order to obtain e.g. 50% and 90% reductions of the prevalence of human campylobacteriosis in the EU caused by broiler meat consumption or crosscontamination […]

ToR 1 ADOPTED Dec 09 PUBLISHED Jan 2010

ToRs 2a and 2b ADOPTED March2011 PUBLISHED April 2011

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ToR 1: Source attribution

Conclusion • Handling, preparation and consumption of broiler meat may account for 20% 20-30% to 30% of human cases of campylobacteriosis, while 50 - 80% 50% to 80% may be other attributed to the chicken sources reservoir as a whole. • Data for source attribution in EU are limited and there are indications that the epidemiology of human campylobacteriosis differs between regions. Hence, these conclusions must be interpreted with care.

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Terms of reference • EFSA was requested to: – Assess the extent to which meat derived from broilers contributes to human campylobacteriosis at EU level. The importance may be expressed as a percentage of the total number of human campylobacteriosis cases. – Identify and rank the possible control options within the broiler meat production chain, taking into account the expected efficiency in reducing human campylobacteriosis […] – Propose potential performance objectives and/or targets at different stages of the food chain in order to obtain e.g. 50% and 90% reductions of the prevalence of human campylobacteriosis in the EU caused by broiler meat consumption or crosscontamination […]

ToR 1 ADOPTED Dec 09 PUBLISHED Jan 2010

ToRs 2a and 2b ADOPTED March2011 PUBLISHED April 2011

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ToR 2 a: Identify and rank possible control options

Approach

• Description of risk factors and interventions – based on literature review and EU baseline survey report

• Estimation of effect of control options on human campylobacteriosis – based on quantitative model

• Description of advantages and disadvantages of potential interventions – based on expert opinion

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ToR 2 a: Identify and rank possible control options

Estimation effect of control options • Quantitative model developed by contractor (CAMO)* + some modifications of DR model • Data sources: Source

Data

Baseline survey (2008)

Between-flock prevalence (BFP) Carcass concentration Numbers of broilers slaughtered

Community Summary Report (2008)

Human incidence data

Expert opinion/Questionnaire

Control options implemented in a country

• Applicable to any EU Member State (MS), but intervention analysis run for four countries • Output: relative reduction of human campylobacteriosis cases attributable to broiler meat Full report available at http://www.efsa.europa.eu/en/supporting/doc/132e.pdf

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ToR 2 a: Identify and rank possible control options

Example: BFP broiler batches in EU (2008) 71% (range 2-100%)

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ToR 2 a: Identify and rank possible control options

Selection of interventions • Selection was based on published literature: – Experimental study: reduction microbial load and/or prevalence – Epidemiological study: risk factor analysis

• • • • •

PRIMARY PRODUCTION Hygiene/biosecurity Fly screens Discontinued thinning Reduction of slaughter age Reducing on-farm colonization

• Expert opinion:

AT SLAUGHTER • Scheduled slaughter POST SLAUGHTER • Chemical carcass decontamination • Physical carcass decontamination RETAIL PREPARATION HANDLING broiler meat

– Advantages and disadvantages of interventions

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ToR 2 a: Identify and rank possible control options

Quantitative model (CAMO) • Built to reflect the situation in the broiler meat chain for all individual EU MSs • Implemented in Microsoft Excel with contractor’s add-in ModelRisk 3.0 • The effect of control options on microbial load and/or prevalence was implemented in the model and the relative change in the predicted human health burden (attributable to broiler meat!) was estimated • For evaluation of control options aimed at reducing Campylobacter concentrations, the model was modified by the WG QMRA Input (data) Output Model

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ToR 2 a: Identify and rank possible control options

Overview CAMO model

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ToR 2 a: Identify and rank possible control options

Limitations • Local (slaughterhouse) situation and practices not taken into account

• Unclear correlation between caecal samples, skin samples and end product samples • Diagnostic sensitivities of both tests varied significantly between Member States • Campylobacter strains and variants were assumed to have identical properties • Many data gaps

• Model was run for four countries only

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ToR 2 a: Identify and rank possible control options

General conclusions • ~ 9 million campylobacteriosis cases per year in the EU27 • Estimated disease burden is 0.35 million DALYs per year and total annual costs are 2.4 billion € • The public health benefits of controlling Campylobacter in primary broiler production are expected to be greater than control later in the chain as bacteria may also spread from farms to humans by other pathways than broiler meat

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ToR 2 a: Identify and rank possible control options

Conclusions Based on results of QMRA based on four countries: • 100% risk reduction by ↓ carcass conc by > 6 log10 units  by irradiation/cooking

• > 90% risk reduction by ↓ carcass conc by > 2 log10 units  by freezing for 2-3 weeks or by ↓ the conc in intestines at slaughter by > 3 log10 units

• 50-90% risk reduction by ↓ carcass conc by 1-2 log10 units  by freezing for 2-3 days, hot water or chemical carcass decontamination with lactic acid, acidified sodium chlorite or trisodium phosphate 28

ToR 2 a: Identify and rank possible control options

Conclusions cont’d Based on results of QMRA based on four countries: • ~ 60% risk reduction by applying fly screens to all indoor flocks (based on data from one MS) • < 50% risk reduction by modifications of primary production,

– restriction of slaughter age to a max 28 days (only indoor flocks) – discontinued thinning • The risk reduction associated with interventions in primary production is expected to vary considerably between MSs 29

ToR 2 a: Identify and rank possible control options

Example slaughter age

• Reducing max. age of indoor broiler flocks to – 42 days: limited effect (< 5% risk reduction) – 35 days: 0.6%-18% risk reduction – 28 days: 21%-43% risk reduction

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ToR 2 a: Identify and rank possible control options

Conclusions cont’d Directly available interventions (from technical point of view)

• Primary production: – Restriction of slaughter age – Discontinuing thinning

• Reducing carcass concentration: – Freezing – Hot water carcass decontamination – Chemical decontamination 31

Terms of reference • EFSA was requested to: – Assess the extent to which meat derived from broilers contributes to human campylobacteriosis at EU level. The importance may be expressed as a percentage of the total number of human campylobacteriosis cases. – Identify and rank the possible control options within the broiler meat production chain, taking into account the expected efficiency in reducing human campylobacteriosis […] – Propose potential performance objectives and/or targets at different stages of the food chain in order to obtain e.g. 50% and 90% reductions of the prevalence of human campylobacteriosis in the EU caused by broiler meat consumption or crosscontamination […]

ToR 1 ADOPTED Dec 09 PUBLISHED Jan 2010

ToRs 2a and 2b ADOPTED March2011 PUBLISHED April 2011

ToR 2b: Propose potential performance objectives and/or targets

Approach • Targets – Specific model (CamPrev) – Expected risk reduction if BFP reached a target of 50%, 25%, 10%, 5%, 1%, or 0%

• Microbiological criteria – Specific model (CAMC) – EU baseline survey data – The percentage of batches not complying with the criterion (BNMC) is calculated to evaluate the public health impact of a MC 33

ToR 2b: Propose potential performance objectives and/or targets

Results targets

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ToR 2b: Propose potential performance objectives and/or targets

Conclusions targets • Achieving a target of 25% or 5% between-flock prevalence is estimated to result in 50% and 90% risk reduction at the EU level, respectively. • Higher risk reduction if current BFP is higher

• The realistic time period needed to obtain reductions will differ between countries. • It is not realistic to consider targets for flocks with outdoor access. 35

ToR 2b: Propose potential performance objectives and/or targets

Approach Microbiological Criteria (CAMC Model) • Data and assumptions: – Data from Baseline survey (2008) represent the prevalence and level of contamination of all batches produced in a country – Samples are the same as those used in the EU Baseline survey (2008) – Sensitivity and specificity of the test = 100% – MC applicable to every individual batch placed on the market

• Application of MC – m = limit to microbiological counts (CFU/g skin sample) – n = number of samples tested – c = maximum number of samples with counts > m

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ToR 2b: Propose potential performance objectives and/or targets

CAMC Model Batch not complying with MC: diverted away from fresh market chain

Country MC

Batch

Doseresponse model

Minimum relative residual risk (MRRA; in %)

Risk with batches that meet MC

Current risk (all batches)

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ToR 2b: Propose potential performance objectives and/or targets

Scenario evaluation Microbiological Criteria Example: scenario with m=1000, n=5, c=1

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ToR 2b: Propose potential performance objectives and/or targets

Scenario evaluation Microbiological Criteria MSs

EU mean

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ToR 2b: Propose potential performance objectives and/or targets

Conclusions Microbiological Criteria • A public health risk reduction > 50% or > 90% at the EU level could be achieved if all batches that are sold as fresh meat would comply with MC with a critical limit of 1000 or 500 cfu/gram of neck and breast skin, resp. • If applied, a total of 15% and 45%, of all batches tested in the EU baseline survey of 2008, would not comply with these criteria. • The impact could be very different between MSs.

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General conclusions WHAT’S NEXT???

EFSA’s role ends here… …it’s now up to the “risk manager”: EC and MSs evaluate the possible actions based on: – Scientific considerations – Cost-benefit analysis – Political considerations

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Other examples of QMRA in EFSA BIOHAZ • Quantitative estimation of the public health impact of setting a new target for the reduction of Salmonella in laying hens (2010) • Quantitative Microbiological Risk Assessment of Salmonella in slaughter and breeder pigs (2010) • Link between Salmonella criteria at different stages of the poultry production chain (2010) • Quantitative estimation of the public health impact of setting a new target for the reduction of Salmonella in broilers (2011)

• Scientific Opinions available on EFSA website www.efsa.europa.eu 42

Thanks to • EFSA ad hoc Working Group members “Campylobacter in broiler meat”: – Paolo Calistri, Pierre Colin, Janet Corry, Arie Havelaar (Chair), Merete Hofshagen, Günter Klein, Maarten Nauta, Diane Newell, Hanne Rosenquist, Moez Sanaa, John Sofos, Mieke Uyttendaele, Jaap Wagenaar

• EFSA BIOHAZ Panel • External consultant QMRA model • BIOHAZ unit colleagues: – Michaela Hempen, Pablo Romero Barrios, Pietro Stella

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Useful information • EFSA website: www.efsa.europa.eu • EFSA Opinion “Campylobacter in broiler meat”: – Opinion 1: www.efsa.europa.eu/en/efsajournal/pub/1437.htm – Opinion 2: www.efsa.europa.eu/en/efsajournal/pub/2105.htm – Report QMRA Campylobacter: www.efsa.europa.eu/en/supporting/pub/132e.htm

• Questions on this presentation: [email protected] - [email protected]

• Questions on EFSA activities: www.efsa.europa.eu/askefsa

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