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MICROBIOLOGICAL RISK ASSESSMENT SERIES 6
MEETING REPORT |
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WORLD HEALTH ORGANIZATION
FOOD AND AGRICULTURE ORGANIZATION OF THE UNITED NATIONS 2004 |
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Food Quality and Standards Service
Food and Nutrition
Division
Food and Agriculture Organization of the United Nations
Viale
delle Terme di Caracalla
00100 Rome, Italy
Fax: (+39) 06 57054593
E-mail: [email protected]
Web site: http://www.fao.org/es/esn
or
Food Safety Department
World Health Organization
20
Avenue Appia
CH-1211 Geneva 27
Switzerland
Fax: (+41) 22 7914807
E-mail: [email protected]
Web site: http://www.who.int/foodsafety
Cover design:
Food and Agriculture Organization of the United Nations
and
the World Health Organization
Cover picture:
© Dennis Kunkel Microscopy,
Inc.
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The views expressed herein are those of the authors and do not necessarily represent those of the World Health Organization nor of the Food and Agriculture Organization of the United Nations nor of their affiliated organization(s).
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WHO Library Cataloguing-in-Publication Data
FAO/WHO Expert Meeting on Enterobacter sakazakii and
Other Microorganisms in Powdered Infant Formula.
Enterobacter sakazakii
and other microorganisms in powdered infant formula: meeting
report.
(Microbiological Risk Assessment Series No. 6)
1
Enterobacter sakazakii - pathogenicity 2. Enterobacteriaceae -
pathogenicity
3. Infant formula 4. Infant food - microbiology 5. Food
contamination 6. Risk assessment
I. Title II. Series
ISBN 92 4 156262 5 (WHO) (LC/NLM classification: QW
138.5.E5)
ISBN 92 5 105164 X (FAO)
ISSN 1726-5274
All rights reserved. Requests for permission to reproduce or translate the material contained in this publication - whether for sale or for non-commercial distribution - should be addressed to the Chief, Publishing Management Service, Information Division, Food and Agriculture Organization of the United Nations, Viale delle Terme di Caracalla, 00100 Rome, Italy, or by e-mail to [email protected]or to Publications, Marketing and Dissemination, World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland, or by facsimile to +41 22 791 4806, or by email to [email protected].
© FAO/WHO 2004
2. EPIDEMIOLOGYAND PUBLIC HEALTH ASPECTS
2.1.1 Enterobacter sakazakii
2.1.2 Other relevant organisms of concern2.2.1 Identification of products considered
2.2.2 Case definition
3.1 Category “A” organisms - Clear evidence of causality
3.2 Category “B” organisms - Causality plausible, but not yet demonstrated
3.3 Category “C” organisms - Causality less plausible or not yet demonstrated
5.1 Exposure to infant formula/breastfeeding rates
5.2 Developing countries
5.3 Microbialaspects of manufacture and use of powdered infant formula5.3.1 Manufacture
5.3.2 Control of ingredient quality
5.3.3 Processing
5.3.4 Post-processing and packaging
5.3.5 Hazard Analysis Critical Control Point (HACCP) in the manufacture of powdered infant formula
5.3.6 Monitoring
5.3.7 Microbiological specifications
5.3.8 Reconstitution and use
5.3.9 Labelling and preparation
5.3.10 Storage and handling of prepared formula
5.3.11 Education
6.1 Approaches and outputs
6.2 Evaluation of potential risk reduction options for formula-fed infants
7. RISK REDUCTION STRATEGIES FOR FORMULA-FED INFANTS
7.1 Reducing the concentration/prevalence of intrinsic contamination of powdered infant formula by E. sakazakii
7.2 Reducing the level of contamination through heating reconstituted powdered infant formula prior to use
7.3 Minimizing the chance of contamination of reconstituted formula during preparation
7.4 Minimizing the growth of E. sakazakii following reconstitution prior to consumption
8. KEY FINDINGS AND RECOMMENDATIONS
8.1 Key findings
8.2 Recommendations8.2.1 To member countries, NGOs, FAO and WHO
8.2.2 To Codex (e.g. CCFH)
8.2.3 To member countries, FAO, WHO, Codex and NGOs
8.2.4 To FAO, WHO and the scientific community
APPENDIX A LIST OF BACKGROUND PAPERS
APPENDIX B DATA RECEIVED IN RESPONSE TO THE FAO/WHO CALL FOR DATA