Food safety in a globalized world Fukuda, Keiji
Bulletin of the World Health Organization,
2015-Apr-01, 2015-04-01, 20150401, Volume:
93, Issue:
4
Journal Article
Peer reviewed
Open access
Access to sufficient safe food is a basic requirement for human health. Ensuring food safety and security in a highly globalized world presents increasingly difficult, and often under-appreciated ...challenges, for governments, commercial organizations and individuals alike. World Health Day is one of a series of actions that WHO is taking to raise awareness about the food safety agenda and to galvanize action. There is a need to refocus attention and to re-energize commitments on food safety. In the 21st century, collaboration is vital to achieving safe food-chains that cross national borders. This is why WHO works closely with FAO, the World Organization for Animal Health and other international organizations to ensure food is safe to eat.
Estimating the global burden of disease from infections caused by pathogens that have acquired antimicrobial resistance (AMR) is essential for resource allocation and to inform AMR action plans at ...national and global levels. However, the scarcity of robust and accepted methods to determine burden is widely acknowledged. In this Personal View, we discuss the underlying assumptions, characteristics, limitations, and comparability of the approaches used to quantify mortality from AMR bacterial infections. We show that the global burdens of AMR estimated in previous studies are not comparable because of their different methodological approaches, assumptions, and data used to generate the estimates. The analytical frameworks from previous studies are inadequate, and we conclude that a new approach to the estimation of deaths caused by AMR infection is needed. The innovation of a new approach will require the development of mechanisms to systematically collect a clinical dataset of substantial breadth and quality to support the accurate assessment of burden, combined with decision-making and resource allocation for interventions against AMR. We define key actions required and call for innovative thinking and solutions to address these problems.
Alongside antibiotic resistance, co-selection of antibiotics, biocides, and metal resistance is a growing concern. While hospital wastewater is considered a hotspot for antibiotic-resistant bacteria ...(ARB) and genes (ARGs), the scenario in India, one of the biggest consumers of antibiotics, remains poorly described. In this study, we used metagenomic sequencing to characterize ARGs and biocide/metal resistance genes (BMRGs) in four wastewater treatment plants (WWTPs) in Jaipur City of India. We observed a significantly lower richness and abundance of ARGs in the influent of a WWTP exclusively receiving hospital wastewater when compared to other three WWTPs involving municipal wastewater treatment. Several tetracycline and macrolide-lincosamide-streptogramin resistance genes were enriched in influents of these three municipal wastewater-related treatment plants, whereas hospital wastewater had a higher abundance of genes conferring resistance to disinfectant-related compounds such as synergize and wex-cide-128, reflecting the patterns of antibiotic/disinfectant use. Of note, in the wastewater system with more chemicals, there was a strong correlation between the numbers of ARGs and BMRGs potentially harbored by common hosts. Our study highlights significant influxes of ARGs from non-hospital sources in Jaipur City, and thus more attention should be paid on the emergence of ARGs in general communities.
Abstract Influenza vaccines form an important component of the global response against infections and subsequent illness caused in man by influenza viruses. Twice a year, in February and September, ...the World Health Organisation through its Global Influenza Surveillance Network (GISN), recommends appropriate influenza viruses to be included in the seasonal influenza vaccine for the upcoming Northern and Southern Hemisphere winters. This recommendation is based on the latest data generated from many sources and the availability of viruses that are suitable for vaccine manufacture. This article gives a summary of the data and background to the recommendations for the 2009–2010 Northern Hemisphere influenza vaccine formulation.
During the 2003–2004 influenza season in the United States, 153 influenza-associated deaths were reported in children (median age, three years). Fifty-three percent of the children had a condition ...conferring a high risk of influenza or had another chronic condition, and 47 percent were classified as “previously healthy.” Infants younger than six months of age had the highest mortality rate. Improvements in vaccination, diagnosis, and treatment should be given high priority in the effort to reduce childhood mortality from influenza.
During the 2003–2004 influenza season in the United States, 153 influenza-associated deaths were reported in children. Infants younger than six months of age had the highest mortality rate.
It has been estimated by the Centers for Disease Control and Prevention (CDC) that more than 200,000 hospitalizations and 36,000 deaths attributable to influenza occur annually in the United States.
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,
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Although most influenza-related deaths occur among elderly persons, rates of influenza-related hospitalization among young children are similar to those among the elderly.
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–
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Each year an estimated average of 92 influenza-related deaths occur among U.S. residents younger than five years of age,
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but the clinical features of such deaths have been described in only a few cases,
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–
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and national data concerning pediatric mortality associated with laboratory-confirmed influenza have . . .
New mechanisms, new worries Sprenger, Marc; Fukuda, Keiji
Science (American Association for the Advancement of Science),
03/2016, Volume:
351, Issue:
6279
Journal Article
Peer reviewed
The increasing spread of colistin resistance is resulting in untreatable infections
Growing levels of resistance to available antimicrobial medicines are causing tens of thousands of deaths each year ...across the world (
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). By 2050, the overall costs associated with antimicrobial resistance (AMR) could reduce global gross domestic product (GDP) by 2 to 3.5% (
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). One concern is the development of resistance to the carbapenem antibiotics among Gram-negative bacteria, in particular, the carbapenemase-producing Enterobacteriaceae (CPE) (see the image). Enterobacteriaceae are the source of community- and hospital-acquired infections and commonly cause opportunistic infections, including pneumonia, and sometimes death (
3
). CPE are resistant to nearly all available antibiotics, with the exception of colistin. Emerging resistance to colistin therefore has troubling implications for patient care.
We estimated the possible effects of the next influenza pandemic in the United States and analyzed the economic impact of vaccine-based interventions. Using death rates, hospitalization data, and ...outpatient visits, we estimated 89,000 to 207,000 deaths; 314,000 to 734,000 hospitalizations; 18 to 42 million outpatient visits; and 20 to 47 million additional illnesses. Patients at high risk (15% of the population) would account for approximately 84% of all deaths. The estimated economic impact would be US$71.3 to $166.5 billion, excluding disruptions to commerce and society. At $21 per vaccinee, we project a net savings to society if persons in all age groups are vaccinated. At $62 per vaccinee and at gross attack rates of 25%, we project net losses if persons not at high risk for complications are vaccinated. Vaccinating 60% of the population would generate the highest economic returns but may not be possible within the time required for vaccine effectiveness, especially if two doses of vaccine are required.
•Where and how policymakers focus when there are so much contention on prioritizing political and financial resources in the contemporary world of infectious disease mitigation and public health ...protection?•There are plenty of antimicrobial resistance policies formulated in the past decade, but the implementation of these policies have met hurdles. One of the antimicrobial resistance policy discussion is what and where policies can be implemented.•This short communication highlights three strategies that can help facilitate policy implementation.
Little is known about the overall trend and prioritisations of past and current antimicrobial resistance (AMR) policies. Here we introduce a quantitative method to analyse AMR policies. The ...AMR-Policy Analysis Coding Toolkit (AMR-PACT) uses several categorical variables. Thirteen AMR action plans from five countries (China, Japan, Norway, the UK and the USA) were used to develop the tool and identify possible values for each variable. The scope and capability of AMR-PACT is demonstrated through the 2015 WHO’s Global Action Plan and 2017 Hong Kong AMR Action Plan (HKAP). Majority of policies were aimed at either human or animal sector with less attention given to the environment, plant or food sector. Both plans shared the same two strategic focus areas, namely the conservation of antibiotics and the improved surveillance of resistance. There were no policies dedicated to improving access to antibiotics in the HKAP. These empirical results provide useful insights into the priorities and gaps of AMR policies. The method proposed here can help understand countries’ priorities regarding AMR, support the creation of AMR policy database and foster innovative policymaking.
Annual vaccination against influenza is recommended for all persons six months of age or older who have chronic conditions that increase their risk of complications from influenza.
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During past ...epidemics of influenza, hospitalization rates among high-risk children have ranged from 200 to 500 per 100,000 persons.
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,
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,
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During the 1970s and 1980s, Mullooly and Barker
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and Glezen et al.
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showed that hospitalization rates for children younger than five years of age who had no known high-risk conditions were elevated during winter months when influenzaviruses were in circulation. However, these studies did not address the possibility that some of . . .
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