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Your health andVotre santé et votresafety… our priority.sécurité… notre priorité. Listeria monocytogenesListeria monocytogenes Hélène Couture, Chief, Evaluation DivisionBureau of Microbial Hazards , Food Directorate , OutlineOutline Background on Listeria monocytogenes •Listeria control in Canada Currentapproach Current New CFIA RTE Meat and Poultry DirectivesUpdated version of the Health Canada policy on L. monocytogenes inRTEfood in Nextsteps Inspection Strategy 2 Listeria monocytogenesListeria monocytogenes Bacterial pathogen that is widely distributed It can be found in soil, vegetation, water, sewage, silage and in the faeces of humans Unlike most bacteria, and sometimes grow on foods being stored Moreover, foods that are contaminated with this bacterium look, smell and taste normal can be killed by proper cooking procedures (e.g., pasteurization) 3 What makesWhat makesListeria monocytogenes unique as a foodborne pathogen?foodborne pathogen? Widely distributed in nature Can grow at 4°C •Very hardy Severe illness is only seen in High case-fatality rate 4 Listeria monocytogenesListeria monocytogenes It is estimated that up to 5% of humans may carry L. monocytogenestheir intestines without ill effects This organism causes a rare, but serious disease called listeriosis, especially among pregnant women, the elderly or individuals with a kdi wea i mmune system• GIsymptomsinnon invasivecases; septicaemia,meningitis,sequelae septicaemia, and death in invasive infections • Listeria ismorelikelytocausedeaththanotherbacteriathatcause • Listeria is food poisoning, i.e., 20 -40 % of foodborne listeriosis infections in high-risk individuals may be fatal 5 Listeria monocytogenesListeria monocytogenes It was not until several large, common-source outbreaks of listeriosis occurred in NorthAmericaandEuropeduringthe North America 1980s that the significance of foods as the recognied First outbreak in Canada , in 1981 was due , to contaminated coleslaw (41 cases, 17 In Canada, there is on average about 100 confirmed cases per year, almost all Listeriosis outbreaksListeriosis outbreaks 7 Listeriosis Outbreaks related to Meat and Poultry ProductsListeriosis Outbreaks related to Meat and Poultry Products 8 Listeriosis Outbreaks related to Meat and Poultry ProductsListeriosis Outbreaks related to Meat and Poultry Products ( International –1980’s and 1990’s ) 1980’s and 1990’s ) ( ) YearLocationInvasive / Number of invasive(deaths)Invasive355(94) Pâté 1990AustraliaInvasive11 (6) Pâté 1992FranceInvasive279 (85) 1993 France Invasive 39(12) Porkrillettes 1993 (pâté-like RTE meat)1998- 1999 U.S.A.Invasive 108 (14) 1999 1999U.S.A.Invasive11 Listeriosis Outbreaks related to Meat and Poultry ProductsListeriosis Outbreaks related to Meat and Poultry Products ( Canadian & International ( Canadian & International ––2000’s 2000’s YearLocationInvasive / Number of invasive(deaths)1999-2000FranceInvasive 10 (3) 1999-2000FranceInvasive32 (10)2000U.S.A.Invasive30 (7) 2000AustraliaNon-2001U.S.A. Non- invasive 16Precooked sliced turkey invasive 2002U.S.A.Invasive54 (8)Sliceable turkey deli meats2008CanadaInvasive57 (22)RTE deli meats 10 Listeriosis Outbreaks related to Dairy ProductsListeriosis Outbreaks related to Dairy Products 11 Listeriosis Outbreaks related to Dairy ProductsListeriosis Outbreaks related to Dairy Products–1980’s and 1990’s)1980’s and 1990’s) YearLocationInvasive / Number of 1983U.S.A.Invasive49 Pasteurized milk () SwitzerlandInvasive122 (31)(Vacherin Mont d’Or)1985U.S.A.Invasive142 le fresh () y DenmarkInvasive26 (6)Blue mould cheese or 1994U.S.A.Invasive45 1995FranceInvasive37 (11)Raw milk soft cheese (Brie de Meaux) Sfth 1997FranceInvasive14 (Pont l’Evêque & Livarot) 1999 FinlandInvasive25 (6) pasteurizedmilk 12 Listeriosis Outbreaks related to Dairy ProductsListeriosis Outbreaks related to Dairy Products–2000’s)2000’s) YearLocationInvasive / Number of 2000-U.S.A.Invasive13 le fresh 2001 2001SwedenNon-invasive� 120 farm farm 2001JapanNon-invasive38Washed-type cheese2001BelgiumInvasive2Frozen ice cream cake 2003U.S.A.Invasive13 (2)Mexican-style fresh 2005SwitzerlandInvasive10 (3) (Tomme)2007U.S.A.Invasive5 (3) 13 Listeriosis Outbreaks related to Dairy ProductsListeriosis Outbreaks related to Dairy Products Lti Ii/ Nbf er o f cases (deaths) F oo 2001ManitobaInvasive7Flat whipping cream 2002 British Invasive 47 Cheesemadefrom 2002 British 2002QuebecInvasive17Soft and semi-hard raw milkcheese milk 2002British Non-invasive86Cheese made from (Tiny Tomme) 2008QuebecInvasive38(2) Listeriosis Outbreaks related to Fish and Seafood ProductsListeriosis Outbreaks related to Fish and Seafood Products 15 Listeriosis Outbreaks related to Fish and Seafood ProductsListeriosis Outbreaks related to Fish and Seafood Products YearLocationInvasive / Number of invasive(deaths)1989U.S.A.Non- NZlddd 1991TasmaniaNon- an pro d uce 1992New Invasive4(2) Zealand SwedenInvasive6 (1)“Gravad” rainbow trout or cold-smoked rainbow 1996CanadaInvasive2Imitation crab meatUnknownFinlandNon- Listeriosis Outbreaks related to Fruit and Vegetable Listeriosis Outbreaks related to Fruit and Vegetable Listeriosis Outbreaks related to Fruit and Vegetable Listeriosis Outbreaks related to Fruit and Vegetable YearLocationInvasive / Number of 1981CanadaInvasive41(17)Cole slaw mix1997ItalyNon-Corn and tuna salad AustraliaInvasive6(5)Commercially prepared 18 Listeriosis Outbreaks related to Other Food ProductsListeriosis Outbreaks related to Other Food Products 19 Listeriosis Outbreaks related to Other Food ProductsListeriosis Outbreaks related to Other Food Products YearLocationInvasive / Number of 1993ItalyNon-2003UKInvasive5 Prepacked sandwiches 2009Australia?8 20 How does How does Listeriaget into Foods? •The environment ( 1.3-7.3% ) ( ) Ruminant farms (5.9-33%) •Raw foods Food processing environments (to �.1 ;退 30%) •Ready-to-eat foods (0.17-4.7%) 21 Barriers and Challenges to the Control of Barriers and Challenges to the Control of The microorganism is commonly found in the environment, including fdiditibtitilitdithh f oo process i ng, t r u on, re t a env i ronmen s, an d i e Lmonocytogenes iseverywhereitcaneasilyenter L everywhere processing plants via raw foods, humans, equipment, vehicles, shoes, Once inside a processing plant, L. monocytogenescan establish itself and persist for long periods of time It can grow in many foods during refrigerated storage 22 Roles of Government and IndustryRoles of Government and Industry Government: Setsfoodsafetystandardsandobjectives standards Ensures that the industry is meeting its food safety responsibilities Develop and implement GMP’s and HACCP principles to produce safe Develop sampling protocols and use microbiological testing to y of control measures for Listeria Current BMH Guidance on Current BMH Guidance on Listeria Bureau of Microbial Hazards (BMH) develops policies, guidelines and standards, conducts laboratory research and risk assessments, Pli Litit id t tfd and provides science-based information to the Canadian public related to the microbiological safety of foods cy on Li s t a monocy t ogenes n rea d y- f The purpose of this policy is to provide guidance regarding the inspection and compliance action of ready-to-eat (RTE) foods with respect to their potentialtosupportgrowthoftheorganism (htt//h /f potential growth an/legislation/pol/policy_listeria_monocytogenes_politique_toc-eng.php) covers ALL read y -to-eat foods sold in Canada pyy It’s Your Health document on c.ca/hl-vs/i p h p gpp Bureau of Microbial HazardsBMH Bureau des dangers microbiens Canada’s General Approach toCanada’s General Approach toListeria Focus is on environmental control, especially in post-processing areas areas Includes a combination of industry controls, environmental and Eitlttiidtitthffiiflt’ • E ronmen l t ng s use d t o mon it or e e ffi c i ency o f a p l an When environmental testing indicates persistence of thltitthittiiiddtb th e p l an env i ronmen th e san it a on program i s cons id ere t The inspection strategy then shifts to heightened environmental dd dtttiditiittidlii an en d -pro t ng, an d i n t ve san it a on an d c ng undertaken to correct the problem 25 Changes to the Canadian PolicyChanges to the Canadian Policy • CFIA Meat and Poultr y Health Canada Policy 26 -CFIA’s Directives for RTE meat/poultry registered establishmentsCFIA’s Directives for RTE meat/poultry registered establishments- The CFIA is implementing major enhanced controls Under the new requirements, federally registered establishments must implement food contact surface testing for In addition, the CFIA will increase the frequency of its own environmental Liti bitdittidtiitffdll Li s t b y i n t ng new t es ng an d repor ti ng requ i remen f d registered establishments,e.g., positive test results from all FCS must now Federallyregisteredestablishmentsmustperformtrendanalysisontheir Federally http://www.inspection.gc.ca/english/fssa/meavia/man/direct/2009/direct1e.shtml CFIA’s Directives for RTE meat/poultry registered establishmentsCFIA’s Directives for RTE meat/poultry registered establishments IRequirement for federally registered Establishments will be required to maintain an environmental sampling plan for testing food contact surfaces Testing recommended for non-food contact surfaces Follow-up action to establishment’s environmental testsPositive results must be brought to the attention of the regulatory authority–Follow-up action is required Lm result from FCS = evalsanitations; possible recall if product distributed II Regulatory environmental testingby CFIA II Regulatory CFIA will do Lm sampling of FCS (under CFIA environmental sampling plan) and will test 6 times/year/establishment 28 Testing Frequency for the Mandated Testing Frequency for the Mandated EstablishmentCategory FoodContactSurface Lower risk Establishment Testing Alternative 12/year/line Post-lethality treatment and an antimicrobial agent or • At lthlitttthii�1llthlit 4/year/line pos t - l e a ac hi ev ng a � 1 l a (currently under discussion)An antimicrobial agent or process resulting in no more than a 2-log increase of Sanitation only1 to 4/month/lineand type of products (non-deli & non-hot-dogs versus deli & hot-dogs) Higher risk 29 -CFIA’s Directives for RTE meat/poultry registered establishmentsCFIA’s Directives for RTE meat/poultry registered establishments- IRequirement for federally registered All establishmentswillbe required tomaintainariskbasedsamplingplanfortestingpost - a lethality exposed RTE meats and poultry products (previously only US export eligible). AltControl measuresFrequencies of end- product testing 1 Antimicrobialagentorprocessandpost - lethalitytreatmentafterthe 1/year 1 Antimicrobial - treatment primary lethality process 1/year Post-lethality treatment after the primary lethality process3/year 2B Antimicrobialagentorprocess 6/year Positive result will trigger the Hold and Test procedure 2B Antimicrobial Sanitation only1/month All positive results must be immediately transmitted to the regulatory authorityII Regulatory CFIA will do Lm sampling of end-products and will test 6 times/year/establishment 30 -CFIA’s Directives for RTE meat/poultry registered establishmentsCFIA’s Directives for RTE meat/poultry registered establishments- Imported products An equivalency determination process will be initiated with the New Directive ; inspection will Industry Best Practices (IBP) • CFIAillihil • CFIA w rev i ew t h e env i ronmenta component developed by industry for non-food contact If found acceptable, some parts of the IBP could become mandatory for federally- 31 Impact of Proposed Changes to Health Canada PolicyImpact of Proposed Changes to Health Canada Policy 32 Health Canada’s Health Canada’s HC is currently reviewing its 2004 policy on “Listeria monocytogenesReady-to-Eat (RTE) Foods”: Appliesto all RTEfoods(ie dairyproducefishandseafoodmeats ); Applies RTE . e , applies to both federally registered and non-registered sectorsAny changes made and subsequent consultations that are done, will need to address all commodity sectors CategoriesAction Level for LmGMP Nature of Linked to outbreaks and or rated k” in HH S/US DA e n t Detected in 50gn/a g sS/USassesset All other RTE supporting growth of Lm (shelf life �10 days)Detected in 25gn/aRTE foods supporting growth with 100 cfu/ gAdequate 10 days and all RTE foods not 100 cfu/ gInadequate/� 100 cfu/ gn/a 33 Update of the policy on Update of the policy on L. monocytogenes in RTE foods foods ----Version 2009/10Version 2009/10 Goal: Enhance the ability to detect L. monocytogenes Updating information in the policy to reflect the latest scientific Reviewing our Operational and Sampling guidelines for in the environment and in end-product, as well as the text pyg Likely developing new end-product compliance criteria to align with the International Codex standard 34 Update of the policy on Update of the policy on L. monocytogenes in RTE foods foods ----Version 2009/10Version 2009/10 Under consideration: CategoriesAction Level for LmGMP Nature of RTE foods in which growth of Lm can occur Detected in 125g (5x25g) n/aHealth Risk 1 occur (5 x RTE foods in which growth of Lm 100 cfu/ gAdequate� 100 cfu/ g Detected in 25g(5 x 5g) Growth of Lm can occur in a RTE food if there is greater than an average of 0.5 log CFU/g increase in Lm levels for at least the expected shelf-life, under reasonable foreseeable conditions of distribution, storage and use 35 --Version 2009/10Version 2009/10 Encouraging companies to use post-processing lethality treatment and/or growth inhibitors Incorporating ingredients that inhibit the growth of diacetate)Processes that inhibits growth during shelf life, (e.g., low moisture, high acidity, Processes that can inactivate (e.g., cooking, steam heat or hot water) Encourage companies to do trend analysis of data Encouragingfocusonoutreachtoincreaseawarenessoftherisk of foodborne listeriosis, and to provide guidance to institutions where vulnerable people may be exposed 36 Impact of All Proposed Changes Impact of All Proposed Changes ––2009/10 Taken together, changes to the directiveswill: directives in the food processing environmential persistent contamination of the p lant environment p Provide increased ability to identify and mitigate against Lm contamination Theseactionswillprovideearlywarningandpermitappropriate provide appropriate interventions to protect consumersIn addition, outreach by Health Canada will enhance awareness of the stepsthatthoseatgreatestriskcantaketoavoidexposuretoLm inthe steps first place 37 RiskRisk--ranking of RTE dairy productsranking of RTE dairy products High Unpasteurized soft and semi-soft cheeses Pasteurized mould ripened cheeses Pasteurized soft and semi-soft fresh cheeses Pasteurized soft and semi-soft ripened cheeses . monocyto g Whey and el of Risk growth of L Washed rind cheesesFermented dair y p Unpasteurized firm and hard cheeses High salt cheese varieties Le Pasteurized firm cheeses s upport the yp Ice cream and Milk p owders Pasteurized hard cheeses Ability to s Low Processed cheeses 38 --DRAFT -- RiskRisk--ranking of RTE fish and seafood productsranking of RTE fish and seafood products Higher Risk •Lightly preserved fish products Semi-preserved fish Mildly heat processed fish products and crustaceans •Heat-processed fish• Dried,dry saltedandsmoke - dried fish• Frozenfishandcrustaceans Ability to support the growth of Adapted from Rocourt et al., Next StepsNext Steps Industry and stakeholders consultations with all affected sectors We will review how inspection activities are performed for RTE NumberofplantsbeinginspectedandtheirbreakdownbyRTEproduct RTE Current status (done by regulatory authority or processing plant)Environmental (FCS and/or NFCS) and end-product testing (%) What actions do companies/regulatory authorities take after a Frequencyoftesting(Areyouadoptingarisk basedapproach?) a Next StepsNext Steps(cont’d) For other sectors, are there perceived advantages/disadvantages and what is the potential applicability of the CFIA new RTE Registered Meat and PoultryDirectivesforRTEproducts Poultry RTE products Frequency of testing by the operator and regulatory authority – Form an Industry Best Practices Group for NFCS testing, etc.Risk-based approach for industry testing Are there any “alternatives” at the research stage that could be applicable? 41 42 Bureau of Microbial HazardsBMH Bureau des dangers microbiens Canadian listeriosis outbreaksCanadian listeriosis outbreaks 1981199620012002 (4) & 20082008 43