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<< back to the 2003 archive listing << Food Protection Trends Thoughts from the President Foodborne diseases kill more people than SARS has to-date The spring of 2003 brought to Canada, and other parts of the world, a nasty surprise. We were aware of its coming, although its exact name and arrival date were unknown. But it did arrive, and its name was SARS, Severe Acute Respiratory Syndrome. In Canada, as of May 2, it has caused 23 deaths, with 346 probable or suspect cases across the country. The “minidemic” is thought to be largely under control, but there are still some mysteries about SARS and its etiology. The agent is believed to be a specific coronavirus, and a particularly hardy one, but the virus has not been detected in all suspect cases, and it has been identified in a number of individuals that remained healthy after being exposed in a SARS-infected environment. It is at this time suggested that infection might cause mild cases without any symptoms, and with no evidence to-date that such cases transmit the virus to others. However, more than 10,000 people in the Toronto area were quarantined for up to 10 days, the estimated maximum incubation time for symptoms to arise, if any exposure at all had occurred. The media in Canada has not been lacking for headlines or issues for commentaries, and occasionally the news arises across the border. An editorial in USA Today, April 28th, noted that “the newness of the virus and the uncertainty about its virulence” has made it difficult to separate “precaution from unnecessary panic”. This was in reference to a travel advisory issued by the World Health Organization (WHO) warning against unnecessary travel to Toronto, the apparent epicentre for SARS in Canada. However, the editorial continued with a comment about putting the disease into perspective by comparing the approximately 320 SARS-related deaths worldwide with the 36,000 people killed by the flu in the USA, annually, and the estimated 2.7 million people worldwide that die from malaria each year. Journalist André Picard of the Canadian national newspaper The Globe and Mail noted similar statistics for Canada, and included the 2,583 deaths in a year that are attributable to infectious and parasitic diseases. While not all these deaths were associated with foodborne pathogens, the statistics provide a reality check: foodborne diseases kill more people than SARS has to-date. Of course, foodborne illness is not the top of the list of causes of death, but, it is largely preventable. In addition, few of us live isolated from the global community. Our foods come from anywhere in the world, and, although rarely considering the volume in international trade, foods can bring along nasty surprises of the foodborne pathogen genre. Whenever something unexpected like the SARS outbreak happens, the finger-pointing begins once the issue has been brought under control. On Saturday May 3rd, The Globe and Mail published a story that dissected what went wrong in the early days of the outbreak. The primary focus was on the government’s lack of an adequate public health care system. Funding cuts had dismantled research and testing facilities. There was a notable quote from a Health Ministry spokesperson, prior to SARS, to justify cutting back on public health scientific expertise, “ It would be highly unlikely that we would find a new organism in Ontario” (Ontario is a province in Canada, where the city of Toronto is located, in case you weren’t sure...!). Understandably, the officials of the city of Toronto were openly outraged by the travel advisory issued by the WHO. It devastated tourism, affecting hotels and service industries, the film industry, and more, even as the outbreak was being contained. Although the travel warning was lifted in a matter of days, on May 1st it was reported that WHO acknowledged, somewhat apologetically, that “The travel advisory imposed on Toronto could ultimately harm the fight against SARS and other infectious diseases because less-transparent countries will be afraid to report outbreaks... for fear of economic consequences”. Were the actions of WHO right or wrong? Clearly, in our global community, an effective international surveillance system must rely on nations to be forthcoming with statistics on infectious diseases that can be exported to other countries. A close friend commented to me that “SARS” could have been an acronym for something else, such as “Safety Awareness & Response System”. His observation was that it seems we were and we still are completely unprepared for control and eradication of nasty surprises of the infectious disease type. Another friend discussing the SARS issue pondered that, most important of all, we need to “Capture the lessons... how can we do better the next time?” Neither of these individuals are in the line of public health work, yet, the simple facts seem to speak for themselves. Lessons learned from SARS should include the need for continuing vigilance through effective national surveillance, maintaining the intelligence and laboratory capabilities to respond to new, emerging, and re-emerging infectious diseases quickly, close communications between epidemiologists and laboratory personnel, efficient linkages and reporting systems among public health facilities at every level of government, and the need for an effective global surveillance system. But then, I think that most of us in the field of food safety protection already
knew all that.... |