FAO/WHO to consider potential future activities to address this issue

Background: Enterohaemorrhagic Escherichia coli (EHEC) was first identified as a human pathogen in 1982 when strains of a previously uncommon serotype, O157:H7, were implicated in two outbreaks of haemorrhagic colitis in the United States. Since then, outbreaks of EHEC O157:H7 infection have occurred and continue to occur throughout many regions of the world, as have outbreaks of infections from non-O157 serotypes of E. coli, including O26:H11, O111:H8, O103:H2, O113:H21, and O104:H21.

Human response from EHEC ingestion ranges from asymptomatic infection to death, with the incubation period ranging from one to eight days. Illness typically begins with abdominal cramps and non-bloody diarrhoea that can progress to bloody diarrhoea within two to three days. Infection with EHEC may lead to further complications, most notably haemolytic uremic syndrome (HUS), the most common cause of acute renal failure in young children.

EHEC have been isolated from various domestic animals and wildlife, including sheep, swine, goats, and deer. Cattle, however, are considered the main reservoir of EHEC. Accordingly, data based on outbreaks and sporadic infections indicate consumption of beef, including ground beef and processed beef products, is the most important source of foodborne EHEC infection.

The Codex Committee on Food Hygiene is considering addressing the need for risk-based control of EHEC. A risk profile has been prepared as the basis for further work in this area. The Committee has expressed the need for scientific advice on this issue in order to move forward.

New work: Taking into consideration the ongoing public health problem of EHEC in their Member Countries, the impact of this pathogen on meat trade and the suggestion from Codex to undertake a risk assessment on this issue, FAO and WHO consider that this issue is in need of urgent attention both at national and at international level to develop appropriate management interventions. Therefore, as part of the JEMRA activities FAO and WHO are taking steps to initiate work on this issue.

It has been noted that a number of risk assessments have already been undertaken on this issue and that there is experience in some countries on the risk management of this issue. Therefore before embarking on any international risk assessment initiative FAO and WHO together with the Food Safety Authority of Ireland will implement an inception meeting in Dublin, Ireland on 4- 8 September to review the existing risk assessments and related information and their use in risk management of EHEC in meat in meat products with the objective of developing a roadmap for future FAO/WHO activities in this area.

To this end the objectives of the meeting are:

•  Review the existing risk assessments on EHEC in terms of a) fulfilling their scope and providing the basis for scientifically based risk management actions and b) their potential application (in whole or on a modular basis) to the development of a risk assessment at international level.

•  Consider the risk management actions, if any, taken to date that were based on risk assessment and identify the strengths and weakness of the risk assessments from a risk management perspective, in particular identifying when and why the risk assessments did not meet the risk managers needs.

•  Identify the key issues currently faced by risk managers in terms of addressing the problems associated with EHEC in meat and meat products

•  Considering the output of the above objectives and the existing data on EHEC in meat and meat products provide guidance to FAO and WHO on the specific areas to be addressed in any future work on this issue.

The background papers, report of this meeting and the direction of FAO/WHO future work on this issue, including possible calls for experts and data, will be posted here as they become available.