Nationwide potential: New Indian food safety system could cover ‘entire country’

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A food safety system trialled in north-east India in response to child deaths linked to food and waterborne diseases found that 3-4% of all samples tested contained enteric pathogens. © Getty Images (Getty Images)

A food safety system trialled in north-east India in response to child deaths linked to food and waterborne diseases found that 3-4% of all samples tested contained enteric pathogens, with researchers now hopeful the scheme has the potential to be rolled-out nationwide.

It comes after the Indian Council of Medical Research (ICMR) established a surveillance network, FoodNet, for India’s Northeastern Region (NER) to develop a food safety policy in response to child deaths linked to food and waterborne diseases.

The ICMR-FoodNet generated NER-specific data with close to real-time reporting of foodborne disease and outbreaks, and facilitated the updating of food safety management protocols, policy reforms, and public health outbreak response.

“Foodborne diseases and outbreaks are a neglected subject. Given the frequent outbreaks leading to the deaths of children, it is crucial to generate robust data through well-established surveillance networks so that a strong food safety policy can be developed for better public health,” said researchers in BMC Public Health.

Developing countries such as India suffer from severe foodborne disease outbreaks, often with multidrug-resistant pathogens.

Due to factors such as limited infrastructure and shortage of safe drinking water, foodborne diseases and outbreaks are prevalent in the NER. Furthermore, the region’s inclination towards preserved, fermented, or raw foods might also have contributed to the frequent disease outbreaks.

Therefore, implementing regular surveillance of the NER is urgently required for developing a food safety policy that can reduce disease burden in the country.

To do so, the ICMR established FoodNet, a network of laboratories for the identification of major food and waterborne pathogens prevailing in the northeast region of India through integrated surveillance of animal, food, human, and environment.

FoodNet also investigated the antimicrobial susceptibility pattern of the pathogens, i.e. identifying the antibiotics that work best to treat infections caused by these pathogens.

The establishment of the ICMR FoodNet was done in two phases. Phase I started in October 2020 and was achieved through eight systematic steps:

(1) Formulation of a standard protocol; (2) Identify potential investigators and collaborating centres; (3) Development of Standard Operating Procedures, Case Report Form, Guidelines, Memorandum of Agreement and ethical clearance; (4) Identification of project sites and finalisation of sample size; (5) Performance monitoring and the evaluation of surveillance systems; (6) Development of a FoodNet website and Web-based Data Repository, Mobile App, strain repository, retrieval and analytics platform; (7) Strengthening the technical capacity and data management of the Centres; (8) Expansion of the network for Integrated Foodborne Disease Surveillance in Northeast India.

FoodNet was established in Assam, Arunachal Pradesh, Tripura, and Sikkim (Phase I). Subsequently, it was extended to other four states Manipur, Mizoram, Meghalaya, and Nagaland (Phase II), covering the entire NER which includes nine medical and three veterinary centres.

All centres are strengthened with periodic training, technical support, funding, capacity building, quality assurance, monitoring, centralised digital data management, and website development.

“During 2020 to 2023, 13,981 food samples were tested and the detection of enteric pathogens ranged from 3 to 4%. In clinical samples, the detection rate of the pathogens was high in the diarrheal stools (8.9%) when 3,107 samples were tested. Thirteen outbreaks were investigated during the study period,” wrote the researchers.

Early detection and response to foodborne disease outbreaks and effective control measures are critical to prevent mortality and morbidity.

Additionally, the researchers warned that risks emerging from the human-animal-environment interface, such as food safety risks, and the threat of antimicrobial resistance need to be addressed regularly. Antimicrobial resistance develops when bacteria, viruses, fungi and parasites no longer respond to antimicrobial medicines.

“The overarching plan is to systematically and progressively extend the network to encompass other states, with the ultimate goal of providing comprehensive coverage of the entire country,” concluded the researchers.

Source: BMC Public Health

DOI: 10.1186/s12889-024-18007-w

“An integrated FoodNet in North East India: fostering one health approach to fortify public health”

Authors: Madhuchhanda Das, Venencia Albert et al.