Intro (00:09:22)  

Science on the Menu, a podcast by the European Food Safety Authority.

Ed (00:20:04)

Hello and welcome to another episode of Science on the Menu. Today joining me is Eleonora Sarno from the Biological Monitoring team at EFSA. Welcome to the podcast Eleonora. 

Eleonora (00:33:02)

Hello, hi.

Ed (00:34:03)

Today we're going to be talking about what happens when people get sick from food. 

We're going to be talking about foodborne disease outbreaks, food safety incidents. And, on June the 7th around the world, we celebrate World Food Safety Day and the theme this year is ‘prepare for the unexpected’; the ‘unexpected’ being food safety incidents that can happen. 

So, we're going to be talking about what the EU does to respond and particularly what EFSA does, and that's where you come in. Firstly, Eleonora, can you give us some background? What are the kinds of different types of food safety incident that can occur? And what is a food safety incident?

Eleonora (01:16:16)

Yes, sure. A foodborne outbreak is simply an unexpected and unpleasant event that happens when two or more people can experience the same disease after having ingested the same contaminated food. 

Food can be contaminated by microorganisms that can be viruses, bacteria, but also by chemical compounds. So, whenever this food is eaten by two or more people, this can cause infections and people may experience a different variety of symptoms. These symptoms can be mild to severe symptoms, and they depend on the pathogen and on some other characteristics of the individual. 

This is what a foodborne outbreak is, and this is what we work on at EFSA to evaluate, assess these foodborne outbreaks and to see whether the local events that happen in the countries, at national level, can evolve into bigger events.

This is where we play our role to support the managers through the European Commission and also our colleagues in Stockholm at the European Centre for Disease Prevention and Control (ECDC) to provide scientific assessment and to support, indeed, the managers to take their decisions about the risk.

Ed (02:49:12) 

You talked about some of the reasons there for the food safety and incidents, viruses, etcetera, where along the food chain can this happen?

Eleonora (03:00:11)

This can happen anywhere along the food chain, simply because bacteria or viruses, pathogens in general, can contaminate the food. And when this food is traded across European borders, this food can reach the people and then people can get infections. This can happen at production level, but this can happen also, unfortunately, at consumer level, so we are all responsible for this in this sense. 

Ed (03:35:04) 

When we're cooking at home, how we cook the food could also result in a sickness, possibly.

Eleonora (03:42:22)

Indeed. That's correct. 

Ed (03:45:06)

Can you give us a few examples of possible incidents that could occur? 

Eleonora (03:53:20) 

I can give you an example from many years ago. It was 2011 when there was a big food incident, a big crisis that involved the European Union countries - but not only those countries - and for that the responsible was a bacterium known as E.coli that contaminated some vegetables, some sprouted seeds. And this was an emerging pathogen with unforeseen pathogenicity that caused many infections, very severe infections. It was since 2011 that EFSA has strengthened its collaboration with the countries, with the European Commission and with ECDC in Stockholm to indeed better assess and to be better prepared. 

But this is not the only one. Since then, we have worked on many outbreaks, on many evaluations. We have produced a lot of reports and you know that our reports are known as a rapid outbreak assessments, or also ROA reports. And one of the most recent involved, for example, a target of people known as a ‘vulnerable group’, because the food implicated - some filled chocolate eggs – were intended for children. So that's why this was a vulnerable group, because of the age and because of the health condition.

Ed (05:27:18)

Younger groups tend to be the most vulnerable. I guess also pregnant women. Maybe also some of the elderly as well. You mentioned there some incidents that happened, what are the steps that happen when we recognize some people are getting sick? What are the different steps that immediately start at that point? 

Eleonora (05:53:15) 

Well, the investigations happen at a national level. So, there are the countries - the competent authorities in the countries - that start investigating from the public health sector and from the food safety sector. After that, the competent authorities, whenever they see something unexpected – such as an unusual increase in infections or a particular food type - they immediately notify the other countries in Europe in a platform that is hosted by the European Commission and that is known as Rapid Alert System for Food and Feed - the RASFF platform - and also the EpiPulse post platform hosted by ECDC and the EWRS platforms. These are all warning platforms the countries use to support each other and then to notify about the investigation. When there is a suspicion that the suspected food was traded across Europe, this is when we enter into the game, this is where we intervene, and we try to provide our support.   

Ed (07:06:20) 

Well, that's good point to discuss what EFSA does. We've talked about what a food safety incident is and you mentioned some of the responses. At what point does EFSA start its work and what work do you do? 

Eleonora (07:22:03) 

We start working when there are two or more European countries involved reporting cases of infection. This is when we combine the public health data and the food safety data, and we try to understand whether this event could evolve into a bigger incident. 

We work together with the ECDC, with our colleagues to assess the outbreak and we summarize and collect all the data that the countries have shared - all the information on the food, on the human cases – and we test the hypothesis to see whether the suspected food is really the cause of that outbreak and that involves again all the other countries. So, there must be the multi-country dimension for us to intervene. The rest is managed by the national authorities.

Ed (08:15:09) 

Presumably you're working against the clock here to turn out your report as quickly as possible, how difficult is that? Working under time pressure and also ensuring that you have enough data to come to a conclusion?

Eleonora (08:35:15) 

It's quite challenging to work against the time, but there is a lot of preparatory work that we do before, like the monitoring of all the events at national level. And this is combined with the support that we receive from the countries, the European countries, because they share in advance the data. So, we see the event from the beginning, and we start working on it even before engaging in a production of an assessment. The time is very important because managers need to take their action, need to take their decision on the risk to avoid that further cases of infection happen.

Ed (09:16:20) 

Essentially, you're on alert at any time, whether you get a request to start producing one of these reports. 

I was interested in getting an international perspective on this, what happens at international level when there's a food safety incident or a food safety crisis. And so for this, I reached out and spoke to Peter Hoejskov, who works at the World Health Organization, he works in their Regional Office for Europe as a Technical Officer working on food safety and zoonotic diseases. I asked Peter what happens at international level when there's a food safety incident, and this is what he said:

Peter (09:54:18)

When there is a food safety incident, civil actions take place at the international level - if the event, of course, involves more than one country. 

First of all, it's about investigation and risk assessment. Investigation is about identifying the origin (or region) of the incident, and risk assessment is about assessing the risk for further spread and also about the severity of the incident. Other action that takes place are about coordination and communication between sectors, between stakeholders and countries. 

For incidents that involve more than one country, this also requires coordination and communication across countries and between the food safety authorities. WHO and FAO manage the International Food Safety Authorities Network - we also call it InFoSAN - and that serves as a platform for rapidly sharing information about food safety incidents between countries and countries can upload information about how they are responding, what actions they have taken, share good practices that can then be used by other countries. And then, of course, communication is also about keeping consumers informed of what they need to do in case they have consumed a product that has been implicated in a food safety incident. Or if they have purchased it, how can they return it to the producer, to the place where they purchased it? Or if they are feeling any symptoms, what should they do in terms of seeking medical support? 

Ed (11:28:11) 

He discussed the cooperation at international level, which is something that obviously we do also at European level as well. How is technology evolving or developing to make this process quicker? 

Eleonora (11:45:13)  

Technology is proceeding very fast and is a really big help for the investigators, not only at national level but also at European level and globally. 

The new technologies are known as new sequences technologies: these are technologies that are based on the analysis of the whole genetic makeup of the microorganism. Thanks to these technologies, new clusters of infection are quickly identified, promptly identified, and also it became easier to test the hypothesis of the suspected food, meaning that whenever the same microorganism was detected in the case, in the individual, the person who got the infection and the food that was consumed, then this is the real confirmation of the food involved. So, these technologies are of extreme help for the investigators in terms of speed and also precision for the confirmation of the outbreak itself. 

Ed (12:59:08)  

Talking more about preparation, do you also run crisis preparedness exercises in case of different events, to be ready? 

Eleonora (13:08:22)  

Yes, we do exercises, we do internal crisis exercises. We also do external crises exercises together with the colleagues from the other European agencies that are in anyway involved and this could be, for example not only ECDC, but also the European Medical Agency or ECHA, which is the agency dealing with the chemical compounds and so on. We meet now and then, and we simulate some crisis so that everyone knows what to do in case a crisis arrives. 

Ed (13:49:15)  

Let's talk now a bit about the consumer perspective. Fortunately, these kinds of food safety incidences are rare, let's say, but they do happen - as you've said - there are various reasons. 

I’m a consumer and something happens: how can you reassure me that the system will react in a way that I'm not at risk? Or to a product that might be out there? What are the kinds of steps taken at national level or a European level that protect me as a consumer?

Eleonora (14:22:20)  

There are many actions that are done. In Europe, we have a strong food safety system, even though it cannot be excluded that outbreaks and food incidents happen, because we work in a globalized world, because food is traded, because contamination can happen at all levels of the food chain; but whenever this happens, then immediately something that is called ‘control measures’ and ‘corrective measures’ are implemented by the investigators.

These are, for example, the withdrawal from the shelf of the contaminated food or the recalls from the consumers, there are many consumers notices that are displayed at the supermarkets. So, everyone in this sense has a role. Consumers are immediately informed by the investigators and also by us, as an assessing agency, and they can decide autonomously what is the best for them: not to consume, not to buy or give back the contaminated food that was recalled and so on. So, everyone is in indeed responsible for food safety. Everyone has a role. Consumers can be reassured that the European Union as a very good and strong food safety system. 

Ed (15:45:13) 

Maybe I'll also mention that we have a campaign at EFSA going on - the Safe2Eat campaign, which is also providing information to consumers about food safety and what they can do. 

You said everyone has a role. Well, we also have a role as consumers, I guess, in the kitchen; how we prepare the food, but also how we store food. Can you talk more about that? What are the kinds of risks that are involved right at the end of the process when we're actually making our food? 

Eleonora (16:15:02)   

That's true.

I'm also a consumer and I know that there are some basic hygiene rules to be respected even in the kitchen, like: do not contaminate the cooked food, do not put this cooked food in contact with raw food or wash your hands, wash the surfaces where we are going to prepare our food, keep the food at the refrigeration temperature, and do not leave the food too long at room temperature and so on. These are basic rules that we can all follow to protect our health.

Ed (16:57:07)   

I think that's a good place there to finish for the listeners. Thanks very much for joining us today, Eleonora.

Eleonora (17:05:07)    

Thanks a lot to you.    

Ed (17:06:11)   

And thanks very much to our listeners. 

As always, you can find previous episodes of the podcast on our website. Please check out our social media channels where you can find teasers, more information, and hope to join you again soon for another episode of Science on the Menu.

But that's all for now. Thank you and goodbye.