Dáil Éireann debate -
Wednesday, 9 Feb 2000

Vol. 514 No. 1

Adjournment Debate. - Food Poisoning.

Dr. Upton

Figures published today in one of our newspapers indicate a high incidence of food poisoning despite the recent sustained efforts by the Food Safety Authority to highlight the risk of food-borne illness at all points in the food chain, from production to consumer. The consequences of food-borne illness range from mild symptoms, including symptoms such as diarrhoea and vomiting which, although debilitating, are not life-threatening in most cases, to severe cases where the infected person may actually die. The very young and the elderly are particularly at risk and other vulnerable groups, such as the immunocompromised and pregnant women, may be at greater risk than the rest of the population.

Statistics on cases or outbreaks of food poisoning will never be complete, accurate or up to date but the responsibility for collection and collation of the data currently rests with the Department of Health and Children. Many types of food poisoning, however, are not even notifiable. Incredible as it might seem, e.coli 0157:H7 is not yet notifiable in this country. This particular micro-organism was first associated with food poisoning in 1982. Its symptoms are well defined. Among other symptoms, it may cause severe kidney damage. There was a huge outbreak in Scotland just over two years ago when 20 people died. Many other outbreaks have been recorded throughout the world. A very small infective dose will cause illness and we know that here in Ireland at least one child, sadly, died from an infection with this bacteria a few years ago. We also know that it has been isolated from an increasing number of patients in Irish hospitals in the past few years, though these cases were not necessarily traced to a food source. Clearly its incidence is on the increase. It is life-threatening. We have a number of dedicated funded research programmes in our universities and research institutes, so the awareness level is high yet it is not notifiable. It is totally unacceptable that this particular food-borne illness is not notifiable.

Another food poisoning bacterium that we know is very common is campylobacter. In the United Kingdom and the United States, it is the single most common cause of food-borne illness, well ahead of salmonella, and yet campylobacter is not notifiable here either. The incidence of food related illness from campylobacter has been widely documented since the late 1970s. It has to be admitted that the symptoms are not nearly as serious as those caused by e.coli 0157 but, nevertheless, they are very unpleasant and debilitating for the unfortunate victim. It seems that Ireland is lagging behind in a big way in relation to notification procedures. The cost of this lethargy is borne by the unfortunate consumer who falls victim to the illness and, in both the cases I have just mentioned, they do not even become a statistic.

In addition to the fact that a number of food-borne illnesses are not notified, there are many pitfalls in the notification system as it exists at present. In the first instance, the patient must go along to his or her general practitioner, and many people who experience mild symptoms of food poisoning never even get to the reporting stage. According to the infectious diseases legislation of 1981, the requirements for notification currently remain with doctors, environmental health officers and directors of community care. Reporting from laboratory confirmed infections is voluntary at present, and while any data is useful, what is currently available is far from complete and it is widely recognised that a high level of under-reporting exists, particularly for mild ill ness. Incidentally, this is true for other countries as well as Ireland; it is not peculiar to Ireland. A co-ordination of the various sources of data collection through one recognised agency and with a standardised questionnaire would do much to simplify the system and, at the same time, improve the level of awareness of the real incidence of food-borne illness.

In addition to the cost in terms of illness that I have outlined, and the attendant human suffering, there are many other costs also associated with food-borne illness. These include medical expenses, loss in productivity and the possible recall of a product from the market. That would include the subsequent financial cost and the cost of the damage done to the perception of our quality and safe food industry.

The recent figures for food-borne illness and the associated costs suggest that the Minister needs to provide additional resources as a matter of urgency, especially in data collection, the inspectorate and the laboratory area. The Food Safety Authority has been very proactive in attempting to raise the level of awareness in relation to food poisoning. It seems, however, that much greater resources need to be concentrated in this whole area if we are to have confidence in it.

Every Deputy, without exception, who spoke on the national beef assurance scheme referred to food safety as a matter of priority.

Minister of State at the Department of Health and Children (Dr. Moffatt)

I thank Deputy Upton for raising this matter on the Adjournment. Under the provisions of the Infectious Diseases Regulations, 1981, a number of categories of food poisoning are statutorily notifiable by medical practitioners to the health boards. The health boards in turn make weekly returns of infectious disease notifications to my Department. The figure of 2,233 cases referred to by Deputy Upton does not accord with the provisional figure of 2,140 cases for 1999 notified to date by the Eastern Health Board to my Department. We are in contact with the board with a view to finalising the 1999 figures.

In 1998, 2,678 cases were reported in the Eastern Health Board area. However, there is no room for complacency. We are aware that the reported figures are really only the tip of the iceberg and that the actual figures are likely to be somewhat greater. The diseases that can cause severe illness – for example, salmonellosis – are most likely to be notified by clinicians, but people who suffer from food poisoning, where the symptoms are clinically mild – for example, small round structured viruses – may not seek medical care. It is estimated, therefore, that there is a high incidence of under-reporting, the extent of which varies from year to year.

Both globally and in Ireland there has been a trend towards an increase in the reporting of cases of food poisoning. The reasons for increased reporting are many, and I would like to outline some of those. First, with improved food-borne disease surveillance being carried out by the health boards, in co-operation with the National Disease Surveillance Centre and the Food Safety Authority, the figures are likely to increase in coming years rather than decrease. This is a trend not only for Ireland but is the case for many other countries.

Second, we have seen over the past few years an increase in the reporting of food-borne illness because of increased consumer awareness. Consumers are now more aware of food-borne disease because of the educational consumer focused campaigns carried out by public health departments of the health boards, the food unit and the health promotion unit of my Department, and by the newly established Food Safety Authority of Ireland.

Third, we have seen an enormous increase in the market for convenience foods associated with a change in lifestyle of Irish consumers. More and more people are eating out, which has resulted in the rapid expansion of fast food outlets. Some staff working in this area are untrained and inexperienced in food hygiene practices. It is imperative that employees know the causes of food poisoning and what they must do to prevent it. The responsibility for good food hygiene practices rests firmly on the owners of these food businesses.

The Food Safety Authority of Ireland, which has been in existence on a non-statutory basis since 1997, was formally established by the Government in January 1999. This honours the commitment contained in the Government's An Action Programme for the Millennium that an independent, science based statutory agency with responsibility for food safety be set up. In July last year the Food Safety Authority took over responsibility for the enforcement of all food safety legislation which, prior to that date, had been the responsibility of a range of State agencies. The primary function of the Food Safety Authority is to ensure that food produced or marketed in Ireland meets the highest standards of food safety and hygiene. The authority also has a statutory function to foster at all stages of food production, from primary production through to final use by the consumer, the establishment and maintenance of high standards of food hygiene and safety.

The Food Safety Authority is not solely concerned with the compliance of food safety legislation and it places great emphasis on the creation of a culture of food safety in Ireland. In this regard, we must be conscious that the responsibility for food safety lies at all levels, producer, retailer and consumer. While it is not possible to completely prevent food poisoning, the work of the Food Safety Authority of Ireland should help to minimise outbreaks in the future by developing a food safety culture. Already the Food Safety Authority has provided a guide for takeaway premises because of the relatively high risk associated with ready to go meals.

Another major initiative relates to the use of eggs in the catering sector. Eggs have been associated with outbreaks of salmonella food poisoning.

The Food Safety Authority has collaborated with the egg association and An Bord Bia in developing a quality assurance scheme that incorporates strict disease control and monitoring measures in flocks.

The Food Safety Authority has also had major initiatives focused on the control and prevention of e.coli 0157 in the food chain. This has involved working closely with the food sector in developing codes of best practice for reducing contamination of meat products during processing and the safety labelling of minced beef products with consumer instructions for preparation and cooking of these foods. I also note the reduction in the reported incidence of e.coli 0157 infection from 76 cases in 1998 to 51 cases in 1999.

I am aware that e.coli is not at present a notifiable disease under the Infectious Diseases Regulations, 1981, although an informal reporting mechanism is in place. However, the current list of notifiable diseases under these regulations is being reviewed by the scientific advisory committee of the National Disease Surveillance Centre as part of a process of review of the regulations. I will ensure that campylobacter is included among the diseases.

I thank the Deputy for raising this important issue on the Adjournment.