Food Safety Issues in

South East Asia

IUMS outreach programme on Food Safety Bali, June 22-24, 2011
Indonesian Society of Microbiology, the International Commission on Food Mycology
(ICFM) and the International Committee on Food Microbiology and Hygiene (ICFHM)

Ratih Dewanti-Hariyadi

Department of Food Science and Technology

SEAFAST Center
Bogor Agricultural University, Bogor, Indonesia

Outlines
• Food Safety Definition
• SEA Countries
• Issues with Foodborne Diseases Data in SEA
• Food Safety Microbiology Status in:
- Brunei, Singapore
- Indonesia, Malaysia, The Philippines,
Thailand
- Cambodia, Lao PDR, Myanmar,Vietnam
• Common Pathogens, Foods and Conditions

Ratih Dewanti-Hariyadi/2011

Bogor Agricultural University

Food Safety

A condition and or effort such that foods do not
contain biological, chemical or physical
hazards at levels that can cause adverse
effects on human’s health

Ratih Dewanti-Hariyadi/2011

Bogor Agricultural University

SEA countries No Country 1 2 3 4 5 6 7 8 9 10 Singapore Brunei Malaysia Thailand Indonesia Philippines Vietnam Laos Cambodia Myanmar GDP per capita* (USD) 43.451 *2010 Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .638 0.117 31.805 0.174 984 814 702 HDI* 0.744 0.497 0.423 4.239 8.007 1.600 0.572 0.992 3.015 2.654 0.494 0.846 0.

Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .

2004) 1.000 death due to typhoid fever US 1988-1992 : 90% of outbreaks due to bacterial pathogens (Bean et al.16 million cases of typhoid fever 216.Foodborne Diseases World wide (WHO..1 billions cases of foodborne diarrhea 52.7-124 million cases of foodborne salmonellosis 2.8-3. 1997) 2000+ Noroviruses accounted for 50% of outbreaks Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .

may not always represent to the true picture . mostly from stool isolates. not equal to those foodborne • Reports on food intoxications/poisoning due to bacterial toxin is fewer • Other food safety problems also occur : chemical agents or `biotoxins.information scarce and patchy .increase in number due to increased awareness • Data on microbial illnesses are available.Issues with Foodborne Disease Data in SEA • Lack of a coherent and consistent surveillance programs in countries . abuse of chemicals/adulteration Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .

e.g. best health services Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University . 72 confirmed and 1999 outbreak involving 29 suspect cases happened in school • Sporadic outbreaks.Brunei • Cholera was no longer reported since 1982 (WHO report. no pathogen identified (2000) • High GDP.1999) • Largest cholera outbreak in 1965 . outbreak due to rice-chicken. 24 cases in 1970. possibly not related to hygienic condition but improper food handling.

imported seafood items (2004) • 24% of cholera cases : imported foods.partially cooked green mussel (1993) .8%) (Wong. Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University . cholerae O1 biotype El Tor and serotype Ogawa (83.Singapore • Cholera cases have been declining from 17 cases in 1992 to 7 cases a year in 2007 • During 1992-2007 : 210 cholera cases due to V. 2010) • Food associated with outbreaks : .iced banana flavored drink (contaminated crushed ice (1999) .

S. Typhimurium • S.2% of non-typhoid salmonellosis..S. Stanley . Enteritidis . including a cream cake outbreak (Solhan et al.S. Enteritidis : the most important foodborne pathogen responsible for 62. 2011) Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University . Typhimurium DT104L resistant to multiple antibiotic • In 2007 S.S.Singapore • Salmonellae continues to cause foodborne illnesses • Serotypes found in 2000 : . Weltervreden .

Indonesia Reported Foodborne Disease in Indonesia 2001-2009* Year Number of outbreaks Number of cases 2001 2002 2003 2004 2005 2006 2007 2008 2009 ** 26 43 34 164 184 159 179 197 109 1955 3635 1843 7366 8949 8733 7471 8943 3050 *BPOM. 2009 **incomplete Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .

1% 13.7% 20.8% 36.4% 21.2% microbiology chemical expired not known not identified no sample n = 119 *Suratmono. 2010 Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .5% 4.Indonesia Foodborne Diseases in Indonesia 2009 5.8% 2.

26% 26.72% 13.67% 42.Indonesia Foodborne Diseases in Indonesia 2009 1.21% Home made Street Food Industry Food service industry Others n = 119 Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .14% 15.

jejuni (3.Salmonella (17. 2005): ...6%). Paratyphi (0.3%) .ETEC (18%) Others V. 2002. Typhi (3.5%.Tjaniadi et al.Indonesia • Four • • most frequently isolated pathogens from diarrheal patients (Oyofo et al.V.C.1%. Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .8% and Endolimax nana. V.4%).S. cholerae O1 (37.7%) . Giardia lamblia 0. parahaemolyticus (7. cholerae non O1 (2.7%) Protozoa and parasites: Blastocystis hominis 5. Ascaris lumbricoides 1.3%).Shigella flexneri (27. Trichuris trichuria 2. Clostridium difficile 1%.7%.1%) . S. EHEC 1%.9%).

S. S flexneri.75-95% of Shigella resistant to ampicillin. Typhi.Indonesia • Some of V. cefotaxine. cholerae. Paratyphi : sensitive to all antibiotic E. tetracyclin. • .S. ciprofloxacine and trimethoprim-sulfamethoxazole was isolated from carriers in hospital and community Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University . ciprofloxacine and ceftriaxone. Salmonella : resistant to various antibiotic . but sensitive to nalidixic acid. coli resistant to ampicillin. trimethoprim-sulfamethoxazole.chloramphenicol. gentamicin.

no washing prior to eating and recent consumption of ice cubes Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University . • Typhoid fever was less associated with food.Indonesia • Street food vendor is more likely to cause infection from S. 2001. 2004a) • Street food vendors were characterized by poor hand washing practices/facility.. male worker and low education (Vollaard et al. and related to : other case in the home.. direct contact with hand. Paratyphi based on 2 separate studies conducted in Semarang and Jakarta (Gasem et al. Vollaard et al. 2004b)..

emerging pathogens such as E. improper handling (temperature. time) are likely to support the growth and toxin production • Prior to 2008. respectively Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University . Enterobacter sakazakii (Cronobacter spp) have been reported from ground beef.Indonesia •Consistent with studies in clinical isolates. Salmonella is often isolated in food. coli O157:H7 and or EHEC. sometimes at low concentration (<105 CFU/g). slaughterhouse and dry food.RASFF) •Staphylococcus aureus are commonly isolated from ready-eat-food. especially from seafood for export (Dewanti-Hariyadi. USDA. 2005.

Campylobacter 5% . 2002) .Shigella 11% .Also Protozoa : Cryptosporidium and Giardia Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .Aeromonas 5% .Malaysia • Four bacterial pathogen species most commonly isolated frim stool samples examination (Lee.non typhoid Salmonella 57% .enteropathogenic E. coli 14% .

Typhi was found to be resistant to ampicillin and • • chloramphenicol All Shigella flexneri were resistant to ampicillin and cotrimoxazole.ampicillin. nalidicic acid. sulfametoxazole-trimethoprim. tetracyclin.2% of E. norfloxacin. coli strains was resistant to kanamycin. Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .Malaysia • S. while 80% was resistant to chloramphenicol 61. cefetoxin. and to ciprofloxacin. gentamicin. chloramphenicol.

7 21.4 3. 1. 206 165 117 43 37 18 15 15 11 10 % 25. 2006 Bogor Agricultural University .9 12.9 0.9 0.2 1.2 2005 Serotype No.1 1.3 6.8 1.2 5.0 20.9 1.0 14.1 25.4 1.7 10.3.6 5.Malaysia Salmonella Serotype Isolates in Malaysia 2003 Serotype No.3 1.5 2.9 *Thong.2 2. Enteritidis 233 Weltervreden 200 Corvallis 115 Typhimurium 49 Stanley 32 Tshongwe 29 Biegdam 19 Albany 17 Braenderup 12 Newport 10 Ratih Dewanti-Hariyadi/2011 2004 % 26. Enteritidis 155 Weltervreden 142 Corvallis 57 Typhimurium 37 Limete 9 Stanley 8 Agona 7 Albany 5 Rissen 5 Virchow 5 % 28.3 0.2 3.2 4.3 1.1 Serotype Enteritidis Weltervreden Corvallis Typhimurium Albany Limete Braenderup Tshongwe Stanley Bovismorbifican s No.7 3.8 1.

E. 2009) . coli O157:H7 was isolated from 36% of beef samples (Son et al.V.. Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .Campylobacter in 3-18. 43.5% of local beef and 56% of fermented fish (Hassan et al.Listeria monocytogenes from 74% of imported beef. 2001) C ..Malaysia • Several studies on foodborne pathogens in specific foods have been reported .8% of fresh vegetables (Chai et al..cholerae is carried by shellfish which has been implicated in the cholera outbreaks. 1998) .

rotavirus : the most frequently isolated (30. -Salmonella.2%) and enterotoxigenic E.6%) .4% had one or more enteric pathogen . 1987) : . C. 2010).bacterial pathogens : Shigella (11.. 32% with one parasite.30% had multiple pathogens. .jejuni isolated from healthy people • Foodborne nematodes : 73. Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .58. coli (7. ETEC. and 41% with more than one parasite (Belizario et al.3% contained parasites.6%).8%). Salmonella (9..Philippines • Stool samples of diarrheal patients (Adkins et al.

lack of personal hygiene and consumption behavior(e. 26 cases of hepatitis • Number of acute diarrhea started to decrease in 2003 • V.g. eating raw or underprocessed food product) Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .Thailand • 1.000 /year during 1990 -1995 (Pitisuttithum (2003) ) • 110 cases of foodborne intoxication. 140 cases of dysentery. Shigella flexneri or S.493 cases of diarrhea per 100. cholerae. 20 cases of enteric fever. dysenteriae and Salmonella • Reasons for outbreaks: unsafe drinking water.

57 0 Bogor Agricultural University .79 0 0 9633 3 3.26 0.05 23113 12685 3 11 12.44 67.Thailand Foodborne diseases in Thailand 2003 Foodborne diseases Acute diarrhea Dysentery Foodborne intoxications Enteric fever Ratih Dewanti-Hariyadi/2011 No of Death Morbidity Mortality cases rate rate 956313 146 541.

Stanley. Rissen. Anatum. Rissen. Hadar Weltervreden. Emek Emek. Enteritidis. Anatum Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .Thailand Salmonella serotype most commonly isolated in Thailand Source Pig Pork Chicken Chicken meat Human Salmonella serotype Rissen. Enteritidis Weltervreden. Derby Weltervreden. Rissen. Emek.

2008) A very rare outbreak of botulism was reported in Thailand in 2006 : 91 victims.. attack rate 37% Shigella sonnei as well as Salmonella group C were etiologically linked to the outbreak (Chanachai et al. no fatality..Thailand • • A large foodborne disease outbreaks linked to school meals in 2005 :1. Improperly home-canned bamboo shoots was the source of the intoxication (Witoonpanich et al. 42 needed mechanical ventilator due to respiratory failure. 2010). Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .598 cases associated with mixed chicken-rice dish.

Access to drinking water in rural (29%) and urban community (69. Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .5-14 years 4% .56% resistant to ampicillin.Access to hygienic facilities 8. 49% ( urban) • The number of diarrhea & dysentery cases .55%) .9% the samples of diarrheal patients . 81% to trimethoprim-sulfametoxazole • 2001 school related outbreak and outbreak of toxic fish.0-4 years 17.3 % • S.6% (rural).Cambodia • Diarrhea :leading cause for morbidity and mortality • Inadequate water and sanitation program . 56% to chloramphenicol. Typhi 0.5% .>15 years 8.

16% of death in children • Studies in 1996 and 1997 Shigella 16. jejuni for 4.1% Rotavirus 6.4% • Almost all Shigella &diarhegenic E.1% C. coli were resistant to ampicillin.8% Diarhegenic E.000 Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University . tetracyclin and erythromycin. coli 17. •January-August of 2007 : 7 diarrheal cases/100.Lao PDR • Diarrhea : very important health problem.

6% of stool samples were positive for V.Water was the vehicle of the outbreak. 2010) .Lao PDR • During cholera epidemic : .e.. i. cholerae O1 Ogawa (Lenglet.pork meals. • A human trichinellosis outbreak due to Trichinella species was reported in 2004 . uncooked minced pork with mint and fermented pork were the implicated vehicles for of the nematodes (Sayasone et al. 2006) Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .58.

2004). foodborne intoxication. typhoid & paratyphoid In 2000 typhoid fever outbreak : drinking unboiled river water.Myanmar • • • • 70 percent of diarrheal diseases was due to food contamination Most frequent illnesses : diarrheal diseases.noodle 100% coliform.contamination : mixing noodles with warm soup and addition of fresh ingredients (Aung et al. 80% fecal coliform. no fecal coliform or pathogen . 2% EPEC/S. Typhi . Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .soup : 20% coliform. Food survey on mohinga : .. contact with other patients before illness and failing to wash hands with soap after defecation (Aye and Siriarayapon. 2004).

coli and Shigella resistant to ampicillin.In children > 2 years old enterotoxigenic Bacteroides fragilis 7. chloramphenicol and trimethoprim-sulfamethoxazole.Vietnam • Study on 587 diarrheal children & 249 age-matched healthy controls : 60% had pathogenic bacteria . Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University . respectively • E. • Children with diarrhea : poor families.5%) .3% Shigella 4. low education and or little information on hygienic habits (Vu Nguyen. mothers not washing hands. lack potable water &latrines.7%) diarrhegenic E.Children <2 years old : group A Rotavirus (46.7%. coli (22. 2006).

000 population (Ochiai. • Typhoid fever 24. coli (Hien et al. and aquatic plants (Thanh et al.2008) .Enteroinvasive E.8%). 2009). coli (EAggEC) 8. 2008). coli (2.8% .Enteroaggregative E.8%) .Attaching and effacing E.Enteropathogenic E. • Infection due to flukes linked to consumption of raw fresh water fish or crabs.. coli (AEEC) (9. coli (0. Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .Vietnam • Diarrhegenic E.. coli (4%) .2%) .Enterotoxigenic E.2/100.

Clostridium botulinum. E. Vibrio cholerae O1 • Strains resistant to multiple resistant antibiotic are common for nontyphoid Salmonella.coli • Rotavirus is the viruses commonly associated with diarrhea • Helminthic parasites are also reported • Sporadic foodborne intoxication reported are Staphylococcus aureus. Shigella.Common Foodborne Infections and Intoxications • Bacterial pathogens most commonly reported to cause food infection : Shigella flexneri. toad and fish poisoning Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University . cassava poisoning (cyanide). typhoid and non typhoid Salmonella.

RTE foods involved are non specific • Street food vendors and schools are common setting Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .Foods and Conditions associated with Foodborne Infections and Intoxications • Several conditions shared in (mostly) developing countries within SEA are contributors to food safety status .freshwater and brackish water fish.Unsafe water . aquatic insects/plants • When hygienic handling is the reason.g. open defecation or use of night soil for fertilization of fish ponds ) • Raw or undercooked food associated with outbreaks .Unhygienic practices (e.amphibians. snails . terrestrial snake.

Thank You Thank You Thank You Thank You Thank You Thank You Thank You Ratih Dewanti-Hariyadi/2011 Bogor Agricultural University .