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Dairy, Food and Environmental Sanitation Abstracts - February, 2001 Foodborne and Waterborne Disease in Developing Countries — Africa and the Middle East Ewen C. D. Todd* Bureau of Microbial Hazards, Health Products and Food Branch,
Health Canada, Summary Foodborne and waterborne diseases are a worldwide problem. Yet, little is known about those affecting developing countries, where they are probably most prevalent and most life threatening. In an attempt to collate existing information and look for data gaps, published literature concerning enteric diseases, including those that are foodborne and waterborne, affecting African and Middle Eastern countries was collected and reviewed. Risk factors reflecting people’s environmental and cultural conditions are apparent. In rural areas, sanitation facilities are often inadequate, and once pathogens get into a community, fecal-oral spread of disease can be rapid and extensive. In addition, because keeping food hot or cold is not usually practical, pathogens may be able to grow in both home-prepared foods, and those sold at markets in foodservice operations, and by street vendors. Many countries in Africa and the Middle East are exposed to disaster situations, such as flooding and drought, international conflicts, civil unrest, and the conditions of refugee camps, more frequently than industrialized nations. These situations compound the risks of exposure to enteric infections. Understanding of food safety concepts in general is lacking, particularly concepts of proper home food preparation. Problems in the food processing and foodservice industries result from a high turnover rate of food workers and from language differences that make effective communication difficult. Once these issues are recognized and understood, targeted resources can be directed to the most effective control measures. Impediments to Global Surveillance
of Infectious Diseases: Consequences of Open Reporting In a Global Economy Summary Globalization has led to an increase in the spread of emerging and re-emerging infectious diseases. International efforts are being launched to control their dissemination through global surveillance, a major hindrance to which is the failure of some countries to report outbreaks. Current guidelines and regulations on emerging and re-emerging infectious diseases do not sufficiently take into account the fact that when developing countries report outbreaks they often derive few benefits and suffer disproportionately heavy social and economic consequences. In order to facilitate full participation in global surveillance by developing countries there should be: better and more affordable diagnostic capabilities to allow for timely and accurate information to be delivered in an open and transparent fashion; accurate, less sensationalist news reporting of outbreaks of diseases; adherence by countries to international regulations, including those of the World Trade Organization and the International Health Regulation; financial support for countries that are economically damaged by the diseases in question. The article presents two cases – plague in India and cholera in Peru – that illuminate some of the limitations of current practices. Recommendations are made on measures that could be taken by WHO and the world community to make global surveillance acceptable. |