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Legislation and policy analysis on management of listeriosis epidemic disaster in South Africa

Eunice Paidamoyo Vhiriri, BPharm, Yoland Irwin, MSc, Richard Laubscher, MSc, Roman Tandlich, PhD

Abstract


During the 2017-2018 listeriosis outbreak in South Africa (SA), the total number of cases reached 1,060. In this study, the disaster management response to the 2017-2018 South Africa listeriosis outbreak is analyzed. The hazard was in part the contamination of a brand of a ready-to-eat (RTE) “polony” with a strain of Listeria monocytogenes ST6. The initial phase of the 2017-2018 listeriosis outbreak was characterized by a rapid increase in the number of detected human cases. The listeriosis outbreak was officially proclaimed in December 2017, resulting in listeriosis being added to the list of notifiable diseases in SA. The delay between onset and proclamation was a result of the difficulty in identification of the actual number of cases of listeriosis in the country. The response to the disaster included the coordination of the National Department of Health, the National Institute of Communicable Diseases (NICD), businesses/producers of the contaminated brand of RTE products, and the public. Some of these activities led to the removal of the contaminated products from the retail sector in March 2018, resulting in a decrease in the number of cases found in SA. In response to the outbreak, the National Department of Health formed a multisector incidence response team and implemented the Emergency Response Plan. Impacts of future listeriosis outbreaks could be mitigated by the adoption of international listeriosis guidelines such as the WHO/FAO and FDA. Practical steps in this context should include setting a limit of L. monocytogenes in RTE products. WHO/FAO and FDA listeriosis policies which are described “zero tolerance” where a limit of < 100 L. monocytogenes cells/g at the moment of consumption is acceptable can be adopted. Additional resources must be provided for research into infectious doses and the various routes of human exposure.


Keywords


listeriosis, institution response, health policies, L. monocytogenes

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References


Farber JM, Peterkin PI: Listeria monocytogenes, a food-borne pathogen. Microbiol Rev. 1991; 55(3): 476-511.

Kayode AJ, Igbinosa EO, Okoh AI: Overview of listeriosis in the Southern African Hemisphere-Review. J Food Saf. 2020; 40(1): e12732. https:doi.org/10.1111/jfs.12732.

Welch DF, Sword CP, Brehn S, et al.: Relationship between superoxide dismutase and pathogenic mechanisms of Listeria monocytogenes. Infect Immun. 1979; 23: 863-872.

Junttila JR, Niemelä SI, Hirn J: Minimum growth temperature of Listeria monocytogenes and non-haemolytic Listeria. J Appl Bacteriol. 1988; 65(4): 321-327.

Gottlieb SL, Newbern EC, Griffin PM, et al.: Multistate outbreak of listeriosis linked to Turkey deli meat and subsequent changes in US Regulatory Policy. Clin Infect Dis. 2006; 42(1): 29-36.

World Health Organization, Listeriosis—South Africa. 2018. http://www.who.int/csr/don/02-may-2018-listeriosis-south-africa/en/. Accessed May, 28, 2018.

Food and Agriculture Organization/World Health Organization (FAO/WHO): Microbiological risk assessment series 4: Risk assessment of Listeria monocytogenes in ready-to-eat foods: Interpretative summary. 2004. Available at http://www.fao.org/fileadmin/templates/agns/pdf/jemra/mra4_en.pdf. Accessed January 12, 2020.

Rocourt J, Jacquet C, Reilly R: Epidemiology of human listeriosis and seafoods. Int. J. Food Microbiol. 2000; 62(3): 197-209. Available at https://www.sciencedirect.com/science/article/pii/S0168160500003366. Accessed June 10, 2018.

National Institute of Communicable Diseases (NICD): Listeriosis: Clinical recommendations for diagnosis and treatment, (12/ 2017). 2018, from NICD-South Africa: 2017. Available at https://sahivsoc.org/Files/clinical%20guidelines_20171206_v2.pdf. Accessed April 20, 2020.

Todd EC, Notremans S: Surveillance of listeriosis and its causative pathogen, Listeria monocytogenes. Food Control. 2011; 22(9): 1484-1490. Available at https://www.sciencedirect.com/science/article/pii/S0956713510002422#bib41. Accessed June 11, 2018.

Hoelzer K, Chen Y, Dennis S, et al.: New data, strategies, and insights for Listeria monocytogenes dose-response models: Summary of an interagency workshop, 2011. Risk Anal. 2013; 33(9): 1568-1581. Available at https://onlinelibrary.wiley.com/doi/full/10.1111/risa.12005. Accessed April 20, 2018.

Skogberg K, Syrjänen J, Jahkola M, et al.: Clinical presentation and outcome of listeriosis in patients with and without immunosuppressive therapy. Clin Infect Dis. 1992; 14(4): 815-821. Available at https://academic.oup.com/cid/article-abstract/14/4/815/352993?redirectedFrom=fulltext. Accessed June 10, 2018.

Goulet V, Hebert M, Hedberg C, et al.: Incidence of listeriosis and related mortality among groups at risk of acquiring listeriosis. Clin Infect Dis. 2012; 54(5): 652-660.

Kathariou S: Listeria monocytogenes Virulence and Pathogenicity, a Food Safety Perspective. J Food Protect. 2002; 65(11): 1811-1829. Available at http://jfoodprotection.org/doi/pdfplus/10.4315/0362-028X-65.11.1811?code=fopr-site. Accessed June 10, 2018.

Gravani R: Listeria in food-processing facilities. In: Ryser T, Marth E, eds. Listeria, listeriosis, and food safety. New York: Marcel Deckker 1999: 657-709.

Buchanan RL, Gorris LGM, Hayman MM, et al.: A review of Listeria monocytogenes: An update on outbreaks, virulence, dose-response, ecology, and risk assessments. Food Control. 2017; 75: 1-13.

Walker SJ, Stringer MF: Growth of Listeria monocytogenes and Aeromonas hydrophila at chill temperatures, United Kingdom: Campden Food Preservation Research Association; 1987: 23.

Smith AM, Tau N, Smouse SL, et al.: Outbreak of Listeria monocytogenes in South Africa, 2017–2018: Laboratory activities and experiences associated with whole-genome sequencing analysis of isolates. Foodborne Pathog Dis. 2019; 16(7): 524-530. DOI: 10.1089/fpd.2018.2586.

Hunter-Adams J, Battersby J, Oni T: Fault lines in food system governance exposed: Reflections from the Listeria outbreak in South Africa. Cities Health. 2018; 2(1): 17-21.

Adams H, Toxopeus H: Neonatal Listeria monocytogenes meningitis: A case report. S Afr Med J. 1978; 53(12): 463-464.

Parliamentary Monitoring Group (PMG): Proceedings of National Assembly (minutes): Unrevised Hansard, National Assembly. 2018. Available at https://pmg.org.za/hansard/26032/. Accessed January 16, 2020.

National Institute of Communicable Diseases (NICD): Situation Report: Listeriosis outbreak situation report—May 14, 2018. Available at https://j9z5g3w2.stackpathcdn.com/wp-content/uploads/2018/05/Listeriosis-outbreak-situation-report-draft-_14May2018_fordistribution.pdf. Accessed April 20, 2020.

Mead PS, Slutsker L, Dietz V, et al.: Food-related illness and death in the United States. Emerg. Infect. Dis. 1999; 5(5): 607-625.

National Institute of Communicable Diseases (NICD): Situation report: Listeriosis outbreak situation report—July 26, 2018. Available at https://j9z5g3w2.stackpathcdn.com/wp-content/uploads/2018/07/Listeriosis-outbreak-situation-report-_26July2018_fordistribution.pdf. Accessed January 23, 2020.

Thomas, J., Govender, N., McCarthy, K. M. et al.: Outbreak of listeriosis in South Africa associated with processed meat. N Engl J Med. 2020; 382: 632-643. doi: 10.1056/NEJMoa1907462.

National Institute of Communicable Diseases (NICD): Situational report: Listeriosis outbreak situation report—April 20, 2018. Available at https://foodsafetynewsfullservice.marlersites.com/files/2018/04/Listeriosis-outbreak-situation-report_22April-2018_fordistribution.pdf. Accessed April 20, 2020.

World Health Organization: Listeriosis—South Africa. Disease outbreak news, 2018. Available at http://www.who.int/csr/don/28-march-2018-listeriosis-south-africa/en/. Accessed January 25, 2020.

South African Government: Government Gazette Republic of South Africa, December 2017, Vol 630, Issue number 41330. Available at http://www.gpwonline.co.za/Search/Pages/Results.aspx?k=Issue%20number%2041330. Accessed October 1, 2018.

National Institution of Communicable Diseases-National Health Laboratory Services (NICD-NHLS): NICD-NHLS handbook for diagnosis of foodborne illness clusters/outbreaks. Division of Public Health Surveillance and Response, Outbreak Response Unit, NICD-NHLS, Centre for Enteric Diseases, Centre for Emerging and Zoonotic Diseases (Bacteriology) and NHLS Public Health Laboratories. 2016. Available at http://www.nicd.ac.za/assets/files/NICD-NHLS%20Handbook%20for%20Diagnosis%20of%20Foodborne%20illness%20Outbreaks_2016.pdf. Accessed February 12, 2020.

Day C, Gray, A: Health and related indicators. South African Heal Review, 2016. Available at https://www.hst.org.za/publications/South%20African%20Health%20Reviews/SAHR%202016.pdf. Accessed February 10, 2020.

National Department of Health (NDOH): Government Gazette No. 40688 of 15 March 2017, National Public Health Institute of South Africa Bill, 2017.

Parliamentary Monitoring Group (PMG): National Health Laboratory Services Amendment Bill [B15B-2017]. Final Mandates; National Public Health Institute of South Africa Bill [16B-2017]: briefing. 2018. Available at https://pmg.org.za/committeemeeting/27288/. Accessed January 16, 2020.

NHLS: National Health Laboratory Service Act no. 37 of 2000. Available at https://www.gov.za/sites/default/files/gcis_document/201409/a37-000.pdf. Accessed April 27, 2020.

Parliamentary Monitoring Group (PMG): Medical Research Council, Office of Health Standards, Council for Medical Schemes and National Health Laboratory Services Annual Performance Plan 18 April 2018. Available at https://pmg.org.za/committeemeeting/26149/. Accessed January 14, 2020.

NHLS: National Health Laboratory Service Amendment Act no 5 of 2019. Available at https://www.gov.za/sites/default/files/gcis_document/201905/42442gon5nationalhealthlaboratoryserviceamendmentact5of2019.pdf. Accessed April 27, 2020.

Parliamentary Monitoring Group (PMG): TC191028: Budgetary Review and Recommendations Report (BRRR) of the Portfolio Committee on Health, October 18, 2019. Available at https://pmg.org.za/tabled-committee-report/3971/. Accessed April 15, 2020.

National Institute of Communicable Diseases (NICD): Division of Public Health, Surveillance and Response—NICD. 2020. Available at http://www.nicd.ac.za/centres/division-of-public-healthsurveillance-and-response/. Accessed January 14, 2020.

National Environmental Health Policy: Government Notice Department of Health No. 37112 (Department of Health Notice No. 951). 2013. Available at https://cer.org.za/wp-content/uploads/2014/03/national-environ-health-policy-dec-2013.pdf. Accessed April 27, 2019.

South African Government: Government gazette Vol. 469, No. 26595. Act No. 61 of 2003: National Health Act. 2004-present.

EHRN.CO.ZA: Regulation no. 328 published in terms of the Foodstuffs, Cosmetics and Disinfectants Act, 1972 (Act no. 54 of 1972). 1998-2007. Available at https://www.ehrn.co.za/download/act_food.pdf. Accessed February 12, 2020.

Nkosi VD, Bekker JL, Hoffman LC: Factors affecting registration of slaughter facilities as abattoirs, South Africa. 21st Annual Conference of the South African Institute of Environmental Health, held in Cape Town, from November 16-18, 2018. Available at https://www.saieh.co.za/Publication/GetFile.aspx/2a94d8b9-bda7-4f59-b48b-347bd3a4b089. Accessed April 20, 2020.

South African Government: Meat Safety Act, Act No 40 of 2000. Issue No 1106. The Presidency. 2000. Available at https://www.nda.agric.za/doaDev/sideMenu/APIS/doc/MEATSAFETY.pdf. Accessed April 19, 2020.

South African Government: Statutes of the Republic of South Africa—Agriculture. Agricultural Products Standards Act No. 119, 1990. Available at https://www.nda.agric.za/docs/NPPOZA/APS%20Act.pdf. Accessed April 19, 2020

Parliamentary Monitoring Group (PMG): Committees. National Assembly. Heath. SA Health Products Regulatory Authority (SAHPRA) Annual Performance Plan; Health Department APP: analysis. 2018. https://pmg.org.za/committee-meeting/26138/. Accessed October 13, 2018.

Analytical and Diagnostic Products: Foodborne pathogens. Available at https://adpsa.co.za/pathogen-detection-kits/?gclid=CjwKCAiAvonyBRB7EiwAadauqcf9AWuMuMfmhmeUgbJv5ahaGEvV9KXltXH1.MGSvSaixdoo6h3N4PRoCEBYQAvD_BwE. Accessed February 11, 2020.

Ramalwa N: Listeriosis Outbreak Management, South Africa: 2017-18 [PowerPoint presentation]. 2018. South Africa: National Institute of Communicable Diseases.

National Institute of Communicable Diseases (NICD): Advisory: Listeria and what the government is doing, 2018. Available at http://www.nicd.ac.za/wp-content/uploads/2018/01/NICD-Listeria-Press-Statement-20180117_final.pdf. Accessed January 22, 2020.

Department of Agriculture, Forestry and Fisheries (DAFF): Power Point Slides, The 2017-2018 listeriosis outbreak, South Africa. Joint sitting of the portfolio committees for Agriculture, Forestry and Fisheries; Health; and Trade and Industry. 2018. Available at https://pmg.org.za/files/180328DAFF.pptx. Accessed January 12, 2020.

National Department of Health (NDOH): National Department of Health Annual report 2013/2014. Available at https://www.gov.za/sites/default/files/gcis_document/201410/departmentofhealthannualreport2014.pdf. Accessed December, 18, 2018.

National Department of Health (NDOH): Government gazette Vol. 469, No. 26595. Act No. 61 of 2003: National Health Act; 2004.

Parliamentary Monitoring Group (PMG): Agriculture, Land Reform and Rural Development: Listeriosis outbreak and recall of certain products by retailers; with Ministers of Trade and Industry & Agriculture, Forestry and Fisheries. 2018. Available at https://pmg.org.za/committee-meeting/26087/. Accessed January 24, 2020.

National Institute of Communicable Diseases (NICD): NCID services: outbreak response, 2018. http://www.nicd.ac.za/index.php/services/outbreak-response/. Accessed October 1, 2018.

Richard Spoor, Inc.: Attorneys: Listeria class action. 2019. Available at www.listeriaclassaction.co.za. Accessed January 14, 2020.

Parliamentary Monitoring Group (PMG): Committees: National Assembly. Small business development. Access to markets-major issues for consideration. 2019. Available at https://pmg.org.za/committee-meeting/29202/. Accessed January 15, 2020.

National Department of Health (NDOH): National norms and Standards Relating to Environmental Health in terms of National Health ACT, 2003 (Act no 61 of 2003) Government Gazette, 20 September 2013 Notice 943. 2014. Available at http://www.health.gov.za/index.php/2014-03-17-09-09-38/legislation/yj-mega-cssdropdown?download=44:national-norms-and-standards-relating-toenvironmental-health-in-terms-of-national-health-act-2003-act-no-61-of-2003. Accessed December, 18, 2018.

Parliamentary Monitoring Group (PMG): Sugar Regulations; DTI 2017/18 Annual Report & Quarter 1 performance with AGSA input. National Assembly. Trade and Industry. 2018. Available at https://pmg.org.za/committee-meeting/27087/. Accessed October 13, 2018.

Foodfocus: Foodstuffs, Cosmetics and Disinfectants Act, 1972 (Act no. 54 of 1972)—Regulation no. 638. 1972-2018. Available at https://www.foodfocus.co.za/assets/documents/Regulation%20638.pdf. Accessed February 14, 2020.

South African Bureau of Standards (SABS): South African National Standard: Efficacy of cleaning plant, equipment and utensils: Swab technique. 2006. Available at https://store.sabs.co.za/pdfpreview.php?hash=9a1e16c5c1c68e85f3d4f069a0bbafd2cc7e716c&preview=yes. Accessed February 14, 2020.

Foodfocus: Draft South African National Standard 10049:2019 (Edition 5). 2019. Available at https://www.foodfocus.co.za/assets/documents/DRAFT_SANS10049ED5_for_comment2.pdf. Accessed February 14, 2020.

Jackson KA, Gould LH, Hunter JC, et al.: Listeriosis outbreaks associated with soft cheeses, United States, 1998–2014. Emerg Infect Dis. 2018; 24(6): 1116-1118.

United States Department of Agriculture: FSIS Listeria Guideline: FSIS Compliance Guideline: Controlling Listeria monocytogenes in post-lethality exposed ready-to-eat meat and poultry products. 2014. Available at https://www.fsis.usda.gov/wps/wcm/connect/d3373299-50e6-47d6-a577-e74a1e549fde/Controlling-Lm-RTE-Guideline.pdf?MOD=AJPERES. Accessed January 14, 2020.

National Department of Health (NDOH): Government Gazette, 14 June 2018 General Notices. Notice 607 of 2018, Regulations relating to the Hazard Analysis and Critical Control Point System (HACCP system): Amendment Department of Health, 2018. Available at http://www.gpwonline.co.za/Gazettes/Gazettes/41707_14-6_Health.pdf. Accessed April 19, 2020.

Parliamentary Monitoring Group (PMG): Question NW1748 to the Minister of Health. 2018. Available at https://pmg.org.za/committee-question/9651/. Accessed January 24, 2020.

Parliamentary Monitoring Group (PMG): Committees: Western Cape Provincial Parliament—Health. Western Cape Department of Health 2018/19 Annual Report. 2019. Available at https://pmg.org.za/committee-meeting/29068/. Accessed January 22, 2020.

Parliamentary Monitoring Group (PMG): Committees: The National Council of Provinces (NCOP) Health and Social Services. Department of Health 2019/20 Annual Performance Plan; with Minister. Available at https://pmg.org.za/committee-meeting/28529/. Accessed January 22, 2020.

National Department of Health (NDOH): Annual Report 2018/2019. Available at http://www.health.gov.za/index.php/2014-03-17-09-09-38/2014-03-17-09-24-31. Accessed January 27, 2020. p. 28.

Matle I, Pierneef R, Mbatha KR, et al.: Genomic diversity of common sequence types of Listeria monocytogenes isolated from ready-to-eat products of animal origin in South Africa. Genes. 2019; 10(12): 1007.

International Food Safety Authorities Network (INFOSAN): INFOSAN Information Note No. 4/2009—PulseNet International/ PulseNet International. 2009. Available at https://www.who.int/foodsafety/fs_management/No_04_PulseNet_Nov09_en.pdf. Accessed January 22, 2020.

United States Centre for Disease Control and Prevention (CDC): Listeria and whole genome sequencing: Whole genome sequencing improves the detection and investigation of foodborne. 2011. Available at https://www.cdc.gov/listeria/pdf/whole-genomesequencing-and-listeria-508c.pdf. Accessed April 20, 2020.

United States Centre for Disease Control and Prevention (CDC): National Enteric Disease Surveillance: The Listeria Initiative. Available at https://www.cdc.gov/listeria/pdf/ListeriaInitiativeOverview_508.pdf. Accessed January 22, 2020.

Psareva EK, Egorova IY, Liskova EA, et al.: Retrospective Study of Listeria Monocytogenes Isolated in the Territory of Inner Eurasia from 1947 to 1999. Pathogens. 2019; 8: 184.

Human Sciences Research Council (HSRC): The South African National Health and Nutrition Examination Survey (SANHANES-1). Cape Town, South Africa: HSRC Press. 2013. Available at http://www.hsrc.ac.za/uploads/pageNews/72/SANHANES-launch%20edition%20(online%20version).pdf. Accessed January 22, 2020.

Dikgole T, Luvhengo U, Lekunze JN: Consumption patterns of processed cold meat after listeriosis (Listeria monocytogenes) outbreak: A case study of North-West University (NWU) students, Mmabatho Campus, South Africa. IOP Conference Series: Earth Environ Sci. 2019; 383(1): 012016. Available at https://iopscience.iop.org/article/10.1088/1755-1315/383/1/012016/pdf. Accessed April 20, 2020.

Drimie S, Faber M, Vearey J, et al.: Dietary diversity of formal and informal residents in Johannesburg, South Africa. BMC Public Health. 2013; 13: 911.

Mhlongo NC: The catastrophic Listeriosis outbreak in South Africa. 2018. Available at https://www.researchgate.net/publication/331642871_The_catastrophic_Listeriosis_outbreak_in_South_Africa. Accessed April 27, 2020.

National Institute of Communicable Diseases-National Health Laboratory Services (NICD-NHLS): Quick Reference Guide for the Investigation of Foodborne Disease Outbreaks. 2012. Available at http://www.nicd.ac.za/assets/files/NICD_Quick_guide_to_foodborne_outb7reak_investigation_v2.pdf.

Food and Drug Administration: Control of Listeria monocytogenes in Ready-To-Eat Foods: Guidance for Industry (Draft Guidance). 2017. Available at https://www.fda.gov/media/102633/download. Accessed January 12, 2020.

Association of Public Health Laboratories (APHL, undated): PulseNet. Available at https://www.aphl.org/programs/food_safety/Pages/PulseNet.aspx. Accessed January 22, 2020.

Gandhi M, Chikindas ML: Listeria: A foodborne pathogen that knows how to survive. Int J Food Microbiol. 2007; 113(1): 1-15.

Jensen AK, Björkman JT, Ethelberg S, et al.: Molecular typing and epidemiology, of human listeriosis cases, Denmark, 2002–2012. Emerg Infect Dis. 2016; 22(4): 625-633.

Malilay J, Heumann M, Perrott D, et al.: The role of applied epidemiology methods in the disaster management cycle. Am J Public Health. 2014; 104(11): 2092-2102.

McIntyre L, Wilcott L, Naus M: Listeriosis Outbreaks in British Columbia, Canada, caused by soft ripened cheese contaminated from environmental sources. BioMed Res. Int. 2015; 2015: 131623.

Melo J, Andrew PW, Faleiro PA: Listeria monocytogenes. In cheese and the dairy environment remains a food safety challenge: The role of stress responses. Food Res. Int. 2015; 67: 75-90.

National Institute of Communicable Diseases (NICD): About us—NICD. 2020. Available at http://www.nicd.ac.za/about-us/. Accessed January 14, 2020.

Nilsson R, Latham R, Mellefont L, et al.: MudPIT analysis of alkaline tolerance by Listeria monocytogenes strains recovered as persistent food factory contaminants. Food Microbiol. 2012; 30(1): 187-196.

South African Government: National Disaster Management Framework. Introduction: A policy framework for disaster risk management in South Africa, 1-131. 2005. Available at http://www.ndmc.gov.za/Documents/Legislation/framework.pdf. Accessed April 20, 2020.

Swaminathan B, Gerner-Smidt P: The epidemiology of human listeriosis. Microbes Infect. 2007; 9(10): 1236-1243. Available at https://www.sciencedirect.com/science/article/pii/S1286457907001876. Accessed April 28, 2018.




DOI: https://doi.org/10.5055/ajdm.2020.0361

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