The Food Standards Agency’s chief scientific advisor has said potential trends in foodborne infections must be monitored after a decline during the COVID-19 pandemic.

Robin May said data from the past 12 months shows a substantial drop in foodborne disease rates for four major pathogens but this is likely because of fewer patients going to general practioners’ (GP) offices and reduced diagnostic testing during the coronavirus pandemic.

May said understanding the true level of foodborne disease in 2020 and early 2021 will require detailed analysis, work which the FSA has started.

“An accurate benchmark will be invaluable as we start to monitor post-COVID trends and establish, for instance, whether changes in domestic and commercial hygiene practices may ultimately lead to a lasting change in foodborne disease rates,” he said.

“In terms of foodborne disease reporting, the bottom line is we don’t know what the data really looked like for last year because so much of our data comes from things like GP reporting, which people were not doing. So we don’t yet know whether the apparent dip is totally spurious and is just because people weren’t going to their GPs to report it, or partially true and partially spurious or entirely true as a result of changed hygiene practices.

“That is something we hope will come out of the data. As we go forward now and start to emerge we will start to see a pattern of data that we can use to reflect back. So, if we suddenly go back to exactly like before we can start to ask the question about whether that dip was just artificial or is it because people have forgotten to wash their hands again. I think we will get some answers there but it will take some time for the data to fall out.”

Attempts to understand the figures
The FSA is doing surveys on infectious intestinal disease during COVID-19 covering self-reported infection rates, access to medical care, likely sources of infection and related behaviors as well as analyzing hospital admissions for severe illness where underreporting should be less of an issue.

May recommended that the FSA collect data from local authorities, healthcare services and others to identify potential trends in incidence as the UK recovers from the pandemic.

There were 49,222 laboratory confirmed cases of Campylobacter infection during 2020, 4,442 for Salmonella, 566 for E. coli O157 and 136 Listeria monocytogenes infections.

A number of other studies in different countries have suggested a fall in foodborne infections because of COVID-19 measures, but all have warned about the impact of how the data is interpreted.

While presenting an annual update to the FSA Board, May also revealed the agency submitted a bid to the Treasury, a government department which controls public spending, at the start of the year to create an infrastructure for genomic surveillance of foodborne pathogens.

If funded, the project will enable FSA, Food Standards Scotland, Defra, the Department of Health and Social Care and UK Research and Innovation to use whole genome sequencing technology to map wildtype and antimicrobial-resistant foodborne pathogens from farm to fork.

Such work could help link cases of foodborne disease to potential sources and help with understanding pathogen transmission chains within the food system. May added he was hopeful there would be an update on development of the project in the near future.

Delay to burger consultation and risk assessment work
A new foodborne disease framework is under development to inform future risk management approaches to tackle the problem, building on work published in 2020.

The depth of knowledge about the prevalence and social and economic impact of foodborne disease provides an evidence base to develop and target interventions and measure their impact, according to the FSA.

May also said it was important to have access to national lab capacity to ensure food standards and the continued safety and authenticity of food.

A public comment period on updated guidance on less than thoroughly cooked burgers has been delayed because of the pandemic but is still expected to happen. Work on triggers to monitor and provide assurances that controls are being applied effectively has also been slowed down because of COVID-19.

In the past six months, 110 incidents have required a risk assessment, according to an annual report on the topic.

One food safety assessment to inform risk-based standards and controls is on Campylobacter in small broiler slaughterhouses.

Two import risk assessments have been commissioned by Defra to FSA. One involves assessing 19 categories of products of animal origin to support decisions on the level of import checks in England, Scotland, and Wales.

The other is an assessment of raw meat products imported from EU and other countries to help decision making on transportation conditions.

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