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In the Caribbean region, foodborne diseases continue to increase and have huge impacts on public health and the economy.  Thousands of people in the Region experience one or more episodes of foodborne illness.

Each year, roughly 1 in 49 persons in the Caribbean (approximately 142,000 persons) will acquire a foodborne illness due to possible consumption of a contaminated food or drink.  This number is increased to 1 in 11 persons during the frequent mass gathering events such as carnival, cricket, “limes’, food festivals and holiday celebrations that the multi-cultural Caribbean is well noted for.   Moreover, over 40% of the cases are children aged 1-4 years of age. The estimated economic cost of gastroenteritis (the major symptoms of foodborne illness) was USD $21M/year, indicating the huge health and economic burden that gastroenteritis and foodborne diseases pose to the Caribbean[1].

We all have a role to play to ensure that the food we consume is safe and does not cause damage to our health.  Food safety involves all the steps taken from farm to table to prevent contamination and foodborne illness. Food handlers should be vigilant about preparing and cooking food properly, whilst consumers should be aware of safe food practices, foods which may be unsafe for consumption and must practice proper hygiene before consuming foods. It is a shared responsibility between food handlers and consumers. Undoubtedly, food safety is everybody’s business.

A person can get a foodborne illness or food poisoning by consuming food or drink that is contaminated with bacterial, viral and parasitic germs like Salmonella, Norovirus and Giardia, chemicals such as cleaning agents or physical hazards such as glass, nails, hair, stones.  The most common symptoms of foodborne illnesses are diarrhoea (3 or more loose stools/bowel movement in 24 hours), nausea, abdominal cramps, and vomiting, with or without fever.  Symptoms can start  as quickly as 30 minutes- 6 hours after ingestion, or as delayed as 12-72 hours, depending on the type and amount of germ with which the food is contaminated .  Food contaminated with heavy metals or with naturally occurring toxins can also cause long-term health problems including cancer and neurological disorders.

Infections caused by contaminated food have a much higher impact on populations with poor or fragile health status and can easily lead to serious illness and death. Higher risk groups such as infants, pregnant women, the sick and the elderly may suffer more severe and fatal consequences of foodborne diseases (FBD).

The World Health Organization (WHO) estimated that 1.8M people die from diarrheal illness with 70% being foodborne causing over 3000 deaths/day.  Diarrheal diseases are the most common illnesses resulting from the consumption of contaminated food, causing 550 million people to fall ill and 230 000 deaths every year. These alarming facts have caused food safety to become an essential and global public health priority. 

Food safety is a global public health issue and priority since food and water borne diseases are a major cause of morbidity, mortality and economic burden.  Some pathogens commonly transmitted to humans through contaminated food and water include Salmonella, Campylobacter, Shigella, Staphylococcus aureus, Escherichia coli 0157, Listeria, Norovirus and Giardia. Most FBDs are zoonoses which are infectious diseases transmissible under natural conditions between animals and humans, This is a function of  their source occurring at the farm level.

Food safety is also a significant health security issue since FBDs can rapidly spread across borders  through travel and trade. Consequently, food safety is among the top priorities for most CARPHA Member States. 

In the Caribbean, FBDs are an increasing public health concern, as reflected by the increasing number of reported cases and outbreaks of gastroenteritis and FBDs. The Caribbean Public Health Agency (CARPHA) collates a record of reported cases of foodborne diseases (FBD) for the Caribbean region.   Data from CARPHA demonstrates the increasing prevalence of diarrhoeal illness and ongoing occurrence of FBD outbreaks Data for 21 CARPHA Member States from 2005-2016 indicate that reported FBD pathogens increased by 31%. Salmonella was the most common infection, followed by Ciguatera poisoning, Shigella, Campylobacter and Norovirus.

The Caribbean burden of food borne diseases confirmed it was not only a common health problem, but that children were at increased risk, and that FBD was posing a huge economic burden and potential threat to tourism.   Only a small proportion of people who have contracted illness from food seek medical care. Only a fraction of those cases had a sample taken by their health care provider and associated with a hazard in food and  a fraction is reported to the public health surveillance system. 

FBD in the Caribbean was grossly (>80%) under-reported, under-diagnosed and there was an urgent need to improve the surveillance of AGE and FBD and implement appropriate and targeted food safety measures in the countries. However, ensuring food safety in the Caribbean is a complex challenge. The Region is characterized by small populations, varying levels of epidemiological and laboratory skills and capacities and intense movement via trade, labour, and tourism. The Caribbean also imports 55-85% of its food and is the most tourism-dependent region in the world. FBD not only affects the health of the Caribbean population, but that of its visitors and can have significant economic and social and reputational impact on trade and tourism.

Proper food preparation and handling, and hygiene can prevent most foodborne illnesses. To adequately address FBD and food safety in the Caribbean, the CARPHA is implementing an  integrated foodborne diseases program, integrating the epidemiological, laboratory, environmental and veterinary aspects of FBD surveillance and response into a coordinated programmatic approach, regionally and nationally.  Its multifaceted components of surveillance, training, capacity building, outbreak investigation and research, preparation and control are addressing FBD in a wholistic manner to promote food safety in the Region.  

CARPHA has  also trained and certified over 500 persons  in 9 of its Member states in advanced food safety and has developed a suite of hospitality health, food safety and environmental standards, to provide a basis for the development of an effective food safety program for the hospitality industry.  The standards address all aspects of food safety including hygiene, protective wear, clean kitchen facilities and utensils, contaminated food, waste disposal and storage, response to emergencies, training of staff and monitoring to ensure food safety is kept up to standard.

Sunday June 7 2020, marks the second observance of World Food Safety Day.  This year’s theme “Food safety, everyone’s business” calls attention to the fact that food safety is a shared responsibility among policy makers, farmers, food businesses and consumers.  Whether you grow, process, transport, store, distribute, sell, prepare, serve or consume food, you have a role to play in keeping it safe.

To promote food safety, CARPHA recommends that Food Handlers should strictly adhere to the following WHO “five keys to safer food” when preparing and handing food.[2]

1. Keep clean (Hygiene)
   • Wash your hands before handling food and often during food preparation
   • Wash your hands after going to the toilet
   • Wash and sanitize all surfaces and equipment used for food preparation
   • Protect kitchen areas and food from insects, pests and other animals

2. Separate raw and cooked foods

• Separate raw meat, poultry and seafood from other foods
• Use separate equipment and utensils such as knives and cutting boards for handling raw foods
• Store food in containers to avoid contact between raw and prepared food

3. Cooks foods thoroughly

• Cook food thoroughly, especially meat, poultry, eggs and seafood (undercooked meat is pink inside)
• Bring foods like soups and stews to boiling to make sure that they have reached 70°C. For meat and poultry, make sure that juices are clear, not pink. Ideally, use a thermometer
• Reheat cooked food thoroughly

4. Keep food at safe temperatures

• Do not leave cooked food at room temperature for more than 2 hours after cooking
• Do not hold food without proper temperature control: Keep cooked food piping hot (> 60°C) prior to serving and cold foods (including salads and drinks) should be kept cold <5C.
•  Promptly refrigerate all cooked and perishable food (preferably below 5°C)
• Do not store food too long even in the refrigerator
• Do not thaw frozen food at room temperature

5. Use safe water and raw materials

• Use safe water or treat it to make it safe
• Select fresh and wholesome foods
• Choose foods processed for safety, such as pasteurized milk
• Wash fruits and vegetables, especially if eaten raw
• Do not use food beyond its expiry date

So…... YES. Food Safety is EVERYBODY’S Business. Every food handler has the responsibility to prepare clean food and operate in a hygienic manner, every consumer has the responsibility to wash their hands properly before eating, to purchase food from safe sources.