Lindahl, Johanna F.

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ILRI Food Safety and Zoonoses India and Bihar Johanna Lindahl Bihar Agricultural University, Patna, Bihar, India  9 October 2015 Why food safety and zoonoses? 1. Everyone needs to eat and wants to be healthy  2. Food-borne disease is common, costly and preventable  3. A new disease emerges every 4 months, ¾ are zoonotic   What do we work on? • Which livestock agendas are important in this program? –Safe food –Zoonotic diseases – Emerging infectious diseases – Animal health – Intensification and disease – Climate change and disease – Gender and health – Food safety and nutrition   FSZ program geography – East Africa, West Africa, Southern Africa, South Asia, Southeast Asia – Kenya, Ethiopia, Tanzania, Uganda, Senegal, Zambia, Nigeria, Ghana, Mozambique, Cote d’Ivoire, Rwanda, Malawi – Vietnam, Laos, Thailand, China, Indonesia, Cambodia – India, Bangladesh – Egypt     71% “out-posted” 53% female 33% developing country 25% Asian 1 human nutritionist 1 food technologist 1 biologist 1 animal scientist 1 medical epidemiologist 12 veterinary epidemiologists  81 graduate fellows (54% f)  What we know 1. Most food is sold in informal markets  2. Most health burden is due to biological hazards; chemical hazards and mycotoxins cause concern but there is less evidence for large health burdens  3. Most risky foods are un-boiled dairy products, vegetables  grown in contaminated water or cross-contaminated from  meat, and under-cooked meat  4. GAP for farmers successful at small-scale and for export; large-scale but domestic GAP less successful (Farmer Field Schools)  5. Training and certification of vendors successful at small-scale and some success at scale in Kenya and Assam     FAO statistics 2012 01,000,000,0002,000,000,0000100,000,000200,000,000Production 1000 USD Production MT Change in global and regional demand for food: Livestock and other commodities -50050100150200250300350developed developing SSA SA% change 2005/07 to 2050 cerealsroot/tubermeatdairyModified from Alexandratos and Bruinsma (2012) Steinfeld et al. (2006) Big productivity gaps -largely due to poor animal health Some developing country regions have gaps of up to 430% in milk productivity Agriculture imposes large burdens on human health EmergingFood borneMalnutritionZoonosesMalariaThree million deaths a year are agriculture associated  One quarter of all deaths from infection are agriculture associated Almost all of these occur in developing countries  Zoonoses and FBD kill 2.2 million a year • 2.4 billion people sick  • 2.2 million people dead • more than 1 in 7 animals affected  Zoonoses & FBD cost $84 billion a year • $9 billion in lost productivity • $25 billion in animal mortality  • $50 billion in human health costs Agriculture imposes large burdens on human health Evidence for food safety • 90% of animal products are produced  and consumed in the same country or region • 500 million smallholders produce 80% of food in poor countries.  43% of the workforce are women 13 0102030405060708090100Poor total bacteria Unacceptable totalbacteriaUnacceptablefaecal bacteriaUnaccpetableStaphUnacceptablelisteriaAny unacceptableSupermarketWet marketVillageCompliance : Formal often worse than informal Food-borne diseases • Food-borne diseases are very important • 1.4 million children die every year of diarrhoea • The majority is food and water-associated  • Animal-source food over-represented as a cause   Risks and benefits with dairy Pathogens from the cow and from the milk • Mycobacterium bovis • Brucella spp. • Bacillus anthracis • Salmonella • EHEC  • Streptococcus spp. • Staphylococcus aureus • Clostridium spp. • Listeria spp. Risks and benefits associated with dairy:  What else is in the milk? • Antibiotic residues • Frequently detected • Pesticides • High percentage of milk samples • Mycotoxins (aflatoxins) • Detected in many milk samples, sometimes high levels  Aflatoxins- Food safety outside the ASFs • Acute outbreaks can claim 100s of lives (Kenya outbreak 2004-05, 150 known fatal cases) • 4.5 billion people chronically exposed (estimate by US CDC)  • Cancer • Immunosuppression • Stunting   Farmer Consumer Economic flow Aflatoxin flow Human exposure Feed producer AB1 AB1 AB1-> AM1 AM1 Corn/feed produced at farm Corn/feed purchased Milk produced at farm AB1 AM1 Treatments Feed seller Farmer Veterinary services Milk retailer Agricultural services Consumer Food safety work in India • Focus on the dairy value chain • Agriculture-associated diseases The White Revolution 020,000,00040,000,00060,000,00080,000,000100,000,000120,000,000140,000,000Year19621964196619681970197219741976197819801982198419861988199019921994199619982000200220042006200820102012Milk cowMilk buffaloTotalProject 1: The Assam study • Concerns about milk quality in Assam • Training to promote knowledge and hygiene amongst producers and traders • The objectives was to evaluate the improvements in knowledge 21 2009 2012 2009-2011   Producer Traders Total 2009 405 175 580 2012 161 226 387 Total 566 401 967 Can diseases be transmitted from dung? 22 Believe diseases can be transmitted from dung Producers 2009 2.7% (11/404) 2012 37.2% (60/161)*** Trained (2012) 69.8% (37/53)*** Untrained (2012) 21.3% (23/108) Traders 2009 1.1% (2/175) 2012 47.1% (106/225)*** Trained (2012) 63.9% (78/122)*** Untrained (2012) 27.2% (28/103) Comparison between 2009 and 2012 survey Comparison between trained and untrained 2012 Comparison between 2009 and untrained 2012 Can diseases be transmitted by milk?  23 Believe diseases can be transmitted from milk Producers 2009 13.0% (52/401) 2012 35.4% (57/161)*** Trained (2012) 64.2% (34/53)*** Untrained (2012) 21.3% (23/108) Traders 2009 9.1% (16/175) 2012 41.5% (93/224)*** Trained (2012) 64.8% (79/122)*** Untrained (2012) 13.7% (14/102) Comparison between 2009 and 2012 survey Comparison between trained and untrained 2012 Comparison between 2009 and untrained 2012 Which diseases can be transmitted? Tuberculosis Food poisoning/ gastrointestinal disease General disease symptoms (fever, cough, cold) Worms Producers 2009 3.5% (14/405) 18.3% (74/405) 0.3% (1/405) 4.7% (19/405) 2012 8.7% (14/161)** 36.0% (58/161)*** 11.2% (18/161)*** 9.3% (15/161)* Trained (2012) 18.9% (10/53)*** 64,2% (34/53) *** 20.8% (11/53)** 9.4% (5/53) Untrained (2012) 3.7% (4/108) 22.2% (24/108) 6.5% (7/108)*** 9.3% (10/108) Traders 2009 4.0% (7/175) 9.7% (17/175) 0% (0/175) 2.9% (5/175) 2012 13.7% (31/226)*** 42.9% (97/226)*** 11.5% (26/226)*** 4.0% (9/226) Trained (2012) 23.8% (29/122)*** 61.5% (75/122)*** 20.5% (25/122)*** 6.6% (8/122)* Untrained (2012) 1.9% (2/104) 21.2% (22/104)** 1.0% (1/104) 1.0% (1/104) 24 Comparison between 2009 and 2012 survey Comparison between trained and untrained 2012 Comparison between 2009 and untrained 2012 What do you use most often to wash your hands? • Traders • Untrained: 74% answered soap • Trained: 92% answered soap (p<0.001) • Producers • Untrained: 53% answered soap • Trained: 92% answered soap (p<0.001)  Some specks of dirt in the milk are not harmful • Traders • Untrained: 37.5% agree • Trained: 28% agree • Producers • Untrained: 58% agree • Trained: 77% agree (p=0.046)  You can tell if milk is safe to drink • Traders • Untrained: 96% agree • Trained: 89% agree • Producers • Untrained: 96% agree • Trained: 77% agree (p<0.001)  Improving production – not always rocket science • Follow up in 2014 • Trained farmers reported less diseases and higher milk production (p<0.001)     • No difference in Brucella prevalence    Average milk production in liters per cow and day 2 years ago/before ILRI training Average milk production in liters per cow and day now Trained farmers 7.0 (range 2.5-10) 7.8 (range 3-15) Untrained farmers 7.3 (range 2.5-14) 6.8 (range 2.5-14) Project 2: Peri-urban milk production • Can we affect the incidence of bovine tuberculosis? • Can we affect the prevalence of antibiotic residues?  • Evaluate the risks • Identify risk practices • Pilot interventions     Risk mitigation at the human-livestock interface • It is possible to change people’s perceptions and habits but difficult to assess the effect • Farmers at high risk for zoonoses • Milk is a risk product • Assess the risks, mitigate the risks, increase the profits    Mycobacterium bovis • Tuberculosis can be caused by 2 types of bacteria: Mycobacterium tuberculosis and Mycobacterium bovis • Chronic disease in both humans and animals • Fatal • Difficult to treat • Best method is to stop the spread  Antibiotic residues • Unregulated antibiotic  • Risk for antibiotic residues in the milk: there is no testing and no control • The problem: residues or resistance Study design 1. Estimate the burden  • Estimate the prevalence of Mycobacterium bovis, Brucella abortus,  Coxiella burnetii, Listeria monocytogenes  infection among livestock in smallholder dairy farms in peri-urban areas   • Describe and quantify antibiotic use and associated levels of milk production, including testing of pooled milk samples for antibiotic residues  2. Design an intervention and pilot it!  Study sites Image Source: http://www.coachingindians.com/i/india_political.jpg Bangalore Ludhiana  Guwahati  Udaipur  Bhubaneshwar  Project 3: Animal health in Bihar • Bihar is one of the poorest and least developed states • Common farm size: 1-3 dairy cows or buffaloes • 3-5 litres of milk • Little is known about the limitations to the dairy production  Scoping study about the animal health problems • Collecting morbidity and mortality data • Including mastitis and antibiotic resistance • Production and cost estimates • Serology for selected diseases • Brucellosis, leptospirosis, Q fever, haemorrhagic septicaemia • Special focus on brucellosis • Evaluation of rapid tests • Molecular testing Finding the best bet interventions   Identify the limitations  Risk factors  Identify what is feasible  Pilot  Evaluate sustainability and long-term effects  Other potentially upcoming projects • Pig production in Meghalaya • Small ruminants value chain  The presentation has a Creative Commons license. 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ILRI food safety and zoonoses: India and Bihar

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ILRI food safety and zoonoses: India and Bihar

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