A Preliminary Risk Assessment of Yersinia Enterocolitica in the Food Chain: Some Aspects Related to Human Health in Norway

T. Nesbakken, G. Kapperud, J. Lassen, B. Lunestad, E. Rimstad, L. Robertson, E. Skjerve, Y. Wasteson, H. Kruse
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Abstract

This preliminary risk assessment is a result of self-tasking by the Panel on Biological Hazards, Norwegian Scientific Committee for Food Safety. The suggestion was offered to the Norwegian Food Safety Authority (Mattilsynet), which responded and requested a risk profile, or a preliminary risk assessment, to evaluate whether a full risk assessment would be needed at a later date. Yersinia enterocolitica is one of a few zoonotic bacteria that have a stable reservoir within the domestic animal population in Norway. This bacterial species has been isolated from human patients with acute enteritis, who sometimes exhibit symptoms resembling appendicitis. Y. enterocolitica has attracted considerable attention due to its ability to cause serious post-infectious complications. Serious clinical consequences occur relatively often with Y. enterocolitica as a relatively high frequency of people in Norway possess the tissue type HLA-B27. A severe sequela linked to this tissue type is reactive arthritis. The cold climate in Norway may enhance growth of Y. enterocolitica. Although the predominant cause of yersiniosis in Norway is Y. enterocolitica O:3, and the pig is considered the main source of infection, the relative contribution of pork consumption compared with other risk factors, for example drinking untreated water, is unknown. In Norway, a decline in human cases of yersiniosis has been recorded since the beginning of the 1990s. This decline has been attributed to implementation of improved slaughtering methods, including enclosure of the anus into a plastic bag after rectum-loosening. In Norway, most fattening pigs are slaughtered at the age of 150 to 180 days. By this age the tonsils may be an even more significant source of human pathogenic Y. enterocolitica than intestinal contents, since the occurrence in the intestinal tract and faeces is reduced at the time of slaughter. Accordingly, hygienic handling of the head and the plucks during slaughter and dressing is very important to avoid contamination of the carcass. The most efficient way to limit the spread from tongue and tonsils is probably decapitation early on in the carcass dressing procedure. In such a procedure, the head, including tongue and tonsils, should be removed on a separate line. Also, avoidance of incision of the sub-maxillary lymph nodes might reduce the spread, Epidemiological data suggest that it is possible to reduce the herd prevalence of Y. enterocolitica O:3 by minimising contact between infected and noninfected herds. Further, attempts to reduce the prevalence at the top levels of the breeding pyramids may be beneficial for the industry as a whole. The meat industry might be able to categorise herds using serological methods, and use these results in its strategy to reduce the risks for consumers. However, such a strategy has to be evaluated in a cost benefit context. The apparently low prevalence of pathogenic Y. enterocolitica in food may be due to lack of suitable selective methods. The culturing methods, which are used routinely in microbiological laboratories, are insufficiently sensitive. There is a need for a standardised DNA-based technique, with improved sensitivity, for the detection of Y. enterocolitica in clinical, food and environmental samples.
食物链中小肠结肠炎耶尔森菌的初步风险评估:挪威与人类健康有关的一些方面
这一初步风险评估是挪威食品安全科学委员会生物危害小组自行完成任务的结果。该建议被提交给挪威食品安全局(Mattilsynet),该机构回应并要求提供风险概况或初步风险评估,以评估是否需要在晚些时候进行全面风险评估。小肠结肠炎耶尔森菌是挪威家畜种群中具有稳定宿主的几种人畜共患细菌之一。这种细菌已从人类急性肠炎患者中分离出来,这些患者有时表现出类似阑尾炎的症状。小肠结肠炎因其能够引起严重的感染后并发症而引起了相当大的关注。严重的临床后果发生相对频繁的小肠结肠炎,因为挪威人具有相对高频率的组织型HLA-B27。与这种组织类型相关的严重后遗症是反应性关节炎。挪威寒冷的气候可能促进小肠结肠炎菌的生长。虽然挪威耶尔森菌病的主要病因是小肠结肠炎耶尔森菌O:3,并且猪被认为是主要的感染源,但与其他危险因素(例如饮用未经处理的水)相比,猪肉消费的相对贡献尚不清楚。在挪威,自1990年代初以来,人类感染耶尔森菌病的病例有所减少。这种下降归因于实施改进的屠宰方法,包括在直肠松动后将肛门装入塑料袋。在挪威,大多数育肥猪在150至180天的时候被屠宰。到这个年龄,扁桃体可能是比肠道内容物更重要的人类致病性小肠结肠炎耶氏菌来源,因为在屠宰时肠道和粪便中的发生率减少了。因此,在屠宰和包扎期间,对头和拔毛的卫生处理对于避免对胴体的污染非常重要。限制从舌头和扁桃体传播的最有效方法可能是在胴体修整过程的早期将其斩首。在这种手术中,头部,包括舌头和扁桃体,应该在一条单独的线上切除。此外,避免切开上颌下淋巴结可能会减少传播。流行病学数据表明,通过尽量减少感染和未感染畜群之间的接触,有可能降低O:3型小肠结肠炎耶氏菌的畜群患病率。此外,试图降低养殖金字塔顶层的流行率可能对整个行业有益。肉类行业也许能够使用血清学方法对畜群进行分类,并将这些结果用于降低消费者风险的策略中。然而,这种策略必须在成本效益的背景下进行评估。致病性小肠结肠炎耶氏菌在食品中的流行率明显较低,可能是由于缺乏合适的筛选方法。微生物实验室常规使用的培养方法灵敏度不够。需要一种标准化的、灵敏度更高的基于dna的技术来检测临床、食品和环境样本中的小肠结肠炎耶氏菌。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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