Foods and microbiological risks
It is increasingly recognized that between 1 and 5 '6 of episodes of acute gastro-enteritis lead to serious, and often chronic, sequelae including rheumatoid conditions, nutritional and malabsorption problems, and other illnesses such as atherosclerosis, and Guillain-Barre syndrome following infection by Campylobacter spp.
Abstract
Illness caused by the consumption of food contaminated with infectious and toxigenic micro-organisms is a major cause of suffering and a very significant cause of death throughout the world (Allen & Kaferstein, 1983). In Africa, Asia (excluding China) and Latin America, it has been estimated that annually there are more than 1000 million cases of gastro-enteritis amongst children under the age of five and up to 5 million deaths, and most are cau\ed by the consumption of contaminated food (Kaferstein & Sims, 1987); in some countries, e.g. Mexico and Thailand, half of the children aged between 0-4 years suffer from Campylobacter enteritis alone. In Europe, morbidity from foodborne illness is second only to respiratory diseases and recent estimates of illness would indicate that in many European countries there are at least 50 000 cases of acute gastro-enteritis per million population per year with a figure of 300000 recently suggested for the Netherlands (Guiguet e t al., 1992; Notermans & van der Giessen, 1993). Estimates for the USA are even higher and one recent estimate suggests that up to 350000 persons per million population per year suffer acute ga4tro-enteritis and the majority of this is probably associated with contaminated food (Archer & Kvenberg, 1985). Whilst death rates from foodborne illness are considerably lower in developed than in developing countries, it is increasingly recognized that between 1 and 5 '6 of episodes of acute gastro-enteritis lead to serious, and often chronic, sequelae including rheumatoid conditions (such as ankylosing spondylitis and Reiter's syndrome), nutritional and malabsorption problems, ha e m o 1 y t i cu raemi c s y n d r o me (caused by ve r o t oxinp r oducing strains of Escherichia coli, and particularly serotype 0 1 57 : H7), and other illnesses such as atherosclerosis, and Guillain-Barre syndrome following infection by Campylobacter spp. (Archer, 1984,1987 ; Archer & Young, 1988; NACMCF, 1993; Smith e t al., 1993). The cost of foodborne illness in economic terms is enormous. Thus a figure of 8.4 billion dollars per annum has been estimated for the USA by Todd (1989).