International investigations have found two outbreaks of illness in Uganda were likely caused by food aid contaminated with tropane alkaloids.
Five people died and about 300 fell sick after eating Super Cereal distributed in Karamoja in March and April. An August outbreak of sickness in Palabek refugee settlement in the north of the country affected 33 people.
The United Nations World Food Programme (WFP) is to destroy global stocks of the blended food product.
Distribution of Super Cereal, produced by one of WFP’s suppliers, was suspended following the outbreak and pending investigations that have identified the product as the most probable cause of illness. WFP is substituting Super Cereal Plus for Super Cereal in Uganda.
Mistake means contaminated stock distributed
Peter Smerdon, a WFP spokesperson, told Food Safety News distribution of Super Cereal from the Turkish supplier involved and all other firms remain suspended in Uganda and there are no plans for it to resume soon.
“Globally WFP would be disposing of 20,000 metric tons of Super Cereal, valued at $12 million U.S. These stocks have been kept secure in WFP or partner warehouses since April 9 as investigations continued. WFP halted the distribution globally of all products from the supplier involved and is not procuring any food from the company,” he said.
The investigation, involving international food safety experts, indicated the probable cause of sickness was contamination of Super Cereal by tropane alkaloids during harvesting or production. This can occur when wild plants from the Solanaceae family enter the food supply chain.
Smerdon said the smaller August outbreak has also been attributed to contaminated Super Cereal.
“Laboratory testing commissioned by WFP indicates the presence of tropane alkaloids and is consistent with the product involved in the Karamoja outbreak. From ongoing investigations into how that came about, it appears that a single 25-kilogram bag of contaminated stock mistakenly found its way into a consignment for distribution, despite concerted efforts globally to isolate all stocks from the suspended supplier.”
The Ministry of Health in Uganda, the World Health Organization, and the Centers for Disease Control and Prevention in the United States have been investigating and testing samples since the first outbreak to determine the cause. The U.S. Food and Drug Administration detected traces of alkaloids, specifically atropine. Other tests found aflatoxin B1, low levels of yeast and mold, Bacillus cereus and Salmonella.
“The women and children whose lives are saved and changed through food assistance remain our priority and this was an extremely unfortunate and unprecedented event in the history of WFP food assistance. WFP is deeply saddened by the loss of life and suffering among vulnerable communities who count on food assistance in one of the poorest areas of Uganda,” said Amir Abdulla, deputy executive director of WFP.
Action to prevent a repeat incident
Super Cereal is distributed as part of a program to protect and improve the health and nutrition of mothers and children by WFP. It is corn or wheat blended with soya beans, fortified with vitamins and minerals and processed into flour.
WFP has increased oversight of the production cycle of Super Cereal, including spot checks and sampling of cargo along the supply chain to test for potential contamination.
“There is growing demand for specialized nutritional food products globally, particularly as conflict drives food crises. Operating in challenging environments, we must intensify efforts to improve our supply chain management and food quality. We are already communicating with suppliers about phasing in new standards and upgraded specification expectations to meet new demands,” said Abdulla.
Smerdon said WFP is working with suppliers to mitigate risks and prevent future contamination from tropane alkaloids.
“WFP is now testing for tropane alkaloids right after production and before distribution. Retained samples from previous production of all Super Cereal suppliers have been tested and from the vast amount of data points collected so far, it is clear that the issue is linked to a specific supplier and was very exceptional. The rest of the Super Cereal distributed worldwide is not at the same risk levels,” he said.
“At present, there are no clear food safety regulations or global standards for tropane alkaloids in processed foods. WFP’s current specifications for food suppliers comply with Codex Alimentarius international food standards, as well as national food standards in the country where the food is consumed. The sole existing food safety regulation related to tropane alkaloids is a European one for infant foods. Other products are not regulated and Super Cereal was not monitored for this risk in the past.”
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