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

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Presentación del tema: "SIRVETA and National FBD Surveillance in Peru Marisa L. Caipo, Ph.D. Asociacion Peruana de Consumidores y Usuarios (ASPEC) University of Maryland, USA."— Transcripción de la presentación:

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 TypeExpected ResultsRelationship Food-FBD agent PassiveUnspecified indicators for illness None SyndromicUnspecified indicators for illness None Laboratory basedSpecific pathogens (subtypes) Moderate ActiveSpecific pathogens (subtypes), population Moderate IntegratedSpecific pathogens (subtypes), population, reservoirs High 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 Mangos contaminated with Salmonella Newport exported to USA Consequences: 78 human cases 14 hospitalized 2 deaths 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 Animal and Plant Health Human Health Laboratories Food Chain Environmental Health National Policies Laboratories

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 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 – 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 COUNTRYOUTBREAKSSICKDECEASED Argentina Bahamas Barbados 2 70 Bolivia Brasil Chile Colombia Costa rica Cuba Ecuador El Salvador Guatemala Jamaica México Nicaragua Panama Paraguay Perú Rep. Dominicana Trinidad y Tobago Uruguay Venezuela TOTALS 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 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 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 Local Level Interinstitutio nal coordination Integrated surveillance Outbreak analysis Preventive approach Interinstitutio nal coordination Integrated surveillance Outbreak analysis Preventive approach Success stories Municipality of Maldonado, Uruguay. Population 127,257 Tourists +600,000 Municipality of Galvez, Argentina GIS 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 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) Inter-American Network of Food Analysis Laboratories (INFAL)

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 Bolivia Instituto Nacional de Lab. de Salud (INLASA) Lab. de Investigación y Diagnóstico Veterinario (LIDIVET) Colombia Instituto Nacional de Salud Inst. de Vig. de Medicamentos y Alimentos (INVIMA) Instituto Colombiano Agropecuario (ICA) Chile Instituto de Salud Pública de Chile Servicio Agrícola Ganadero 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 Ecuador Instituto Nacional de Higiene 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) 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 Paraguay Laboratorio Central de Salud Pública Ministerio de Agricultura y Ganadería Uruguay Centro Nacional de Salmonella, Inst. de Higiene Min. de Ganadería, Agricultura y Pesca (DILAVE) Venezuela Instituto Nacional de Higiene Rafael Rangel CENTRO REGIONAL: Instituto Nacional de Enfermedades Infecciosas (INEI) - ANLIS Dr.Carlos G. Malbran

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 - 7 countries - Strengthen the surveillance of FBD in Latin America, by the use of biological molecular techniques. - Database for regional isolates –Quality Assurance Program


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