Schlundt J, Toyofuku H, Jansen J, Herbst S A
Food Safety Department, World Health Organization, 20, Avenue Appia, CH-1211 Geneva 27, Switzerland.
Rev Sci Tech. 2004 Aug;23(2):513-33. doi: 10.20506/rst.23.2.1506.
Diarrhoeal diseases, almost all of which are caused by food-borne or waterborne microbial pathogens, are leading causes of illness and death in less developed countries, killing an estimated 1.9 million people annually at the global level. Even in developed countries, it is estimated that up to one third of the population are affected by microbiological food-borne diseases each year. The majority of the pathogens causing this significant disease burden are now considered to be zoonotic. The occurrence of some of these zoonotic pathogens seems to have increased significantly over recent years. The factors involved in such increases have not been well studied, but they are generally agreed to include changes in animal production systems and in the food production chain. Both types of changes can cause corresponding changes in patterns of exposure to the pathogens and the susceptibility pattern of the human population. This paper will not attempt a more in-depth analysis of such factors. The authors briefly describe five of the most important emerging food-borne zoonotic pathogens: Salmonella spp., Campylobacter spp., enterohaemorrhagic Escherichia coli, Toxoplasma gondii and Cryptosporidium parvum. The paper does not include a full description of all important emerging food-borne pathogens but instead provides a description of the present situation, as regards these globally more important pathogens. In addition, the authors describe each pathogen according to the new framework of a Food and Agriculture Organization (FAO)/World Health Organization (WHO) microbiological risk assessment, which consists of hazard identification and characterisation, exposure assessment and risk characterisation. Moreover, the authors provide a brief account of attempts at risk mitigation, as well as suggestions for risk management for some of these pathogens, based on thorough international FAO/WHO risk assessments. The authors emphasise the importance of science-based programmes for the continued reduction of pathogens at relevant points of the 'farm-to-fork' food production chain, as this is the only sustainable basis for further reducing risks to human health in the area of preventable food-borne diseases.
腹泻病几乎全部由食源性或水源性微生物病原体引起,是欠发达国家疾病和死亡的主要原因,全球每年估计有190万人死亡。即使在发达国家,据估计每年也有多达三分之一的人口受到食源性微生物疾病的影响。造成这一重大疾病负担的大多数病原体现在被认为是人畜共患病原体。近年来,其中一些人畜共患病原体的出现似乎显著增加。导致这种增加的因素尚未得到充分研究,但人们普遍认为包括动物生产系统和食品生产链的变化。这两种变化都可能导致病原体接触模式和人群易感性模式的相应变化。本文不会尝试对这些因素进行更深入的分析。作者简要描述了五种最重要的新出现的食源性人畜共患病原体:沙门氏菌属、弯曲杆菌属、肠出血性大肠杆菌、弓形虫和微小隐孢子虫。本文没有全面描述所有重要的新出现的食源性病原体,而是介绍了这些全球更重要病原体的现状。此外,作者根据联合国粮食及农业组织(粮农组织)/世界卫生组织(世卫组织)微生物风险评估的新框架描述了每种病原体,该框架包括危害识别与特征描述、暴露评估和风险特征描述。此外,作者基于粮农组织/世卫组织全面的国际风险评估,简要介绍了降低风险的尝试以及针对其中一些病原体的风险管理建议。作者强调了基于科学的计划对于在“农场到餐桌”食品生产链的相关环节持续减少病原体的重要性,因为这是在可预防的食源性疾病领域进一步降低对人类健康风险的唯一可持续基础。