A brief review of foodborne zoonoses in China

SUMMARY Foodborne zoonoses have a major impact on public health in China. Its booming economy and rapid socioeconomic changes have affected food production, food supplies and food consumption habits, resulting in an increase in the number of outbreaks of foodborne zoonoses. Both emerging and re-emerging foodborne zoonoses have attracted increasing national and international attention in recent years. This paper briefly reviews the main foodborne zoonoses that have had a major impact on public health over the last 20 years in China. Themajor causative microorganisms, including foodborne bacteria, parasites and viruses, are discussed. The prevention and control of foodborne zoonoses are difficult challenges in China. The information provided here may aid the development of effective prevention and control strategies for foodborne zoonoses. Key Words: Bacteria, China, food safety, foodborne zoonoses, parasites, viruses

THE MEDITERRANEAN ZOONOSES CONTROL PROGRAMME

* Zoonoses, diseases transmitted from animals to humans either by direct contact or through animal products, especially food of animal origin, cause public health and socio-economic problems of considerable magnitude in most of the Mediterranean and Middle Eastern areas. * The close contact of a large proportion of the human population with animals, plus the consumption of animal products such as unpasteurized milk and dairy products, changes in nutritional habits, a continuous intensification of animal production and international trade of animals and animal products, the rising number of stray dogs and wild carnivores, illegal slaughtering of animals, and inappropriate waste disposal practices, are the main factors responsible for the emergence and re-emergence of zoonotic infections worldwide and particularly in these countries. * Decades ago, the countries of the Mediterranean and Middle East areas realized that zoonotic diseases, such as brucellosis, echinococcosis, leishmaniasis, rabies and zoonotic salmonellosis, could not be efficiently controlled or eliminated if prevention, surveillance and control activities were carried out in isolation by individual countries. Surveillance and control programmes implemented in individual countries have had only partial success or have failed. Effective zoonoses surveillance and control require strong international cooperation. Timely exchange between countries of reliable information on disease occurrence, sustained intercountry technical cooperation, harmonization of surveillance and control strategies and legislation, among other factors, are essential for the success of national programmes for zoonoses prevention, surveillance and control. * This situation was first addressed by the World Health Organization=s (WHO) Member States at the 31st World Health Assembly held in 1978, which endorsed a resolution on the Prevention and Control of Zoonoses and Foodborne Diseases due to Animal Products. Following the adoption of this resolution, WHO created the Mediterranean Zoonoses Control Programme (MZCP). The Mediterranean Zoonoses Control Centre was established the following year in Athens to implement the activities of the Programme. * The MZCP closely collaborates with the Division of Emerging and other Communicable Diseases Surveillance and Control (EMC) at WHO headquarters, Geneva, as well as with the WHO Regional Office for the Eastern Mediterranean, specialized WHO Collaborating Centres and the MZCP network of National Participating Institutions. * The main objectives of the Programme are to foster, both at national and inter-regional levels, programmes for the prevention, surveillance and control of zoonoses and related foodborne diseases as an integral part of national health programmes, to strengthen the cooperation between national animal health and public health services to improve prevention, surveillance and control of these diseases, and to foster collaboration between MZCP Member States and relevant WHO Collaborating Centres and MZCP National Participating Institutions. * As an inter-regional Programme, the MZCP contributes to the protection of public health and to socio-economic development in the area. The priority objectives entrusted to the Programme remain of great topical importance because several currently-emerging diseases are zoonoses. * The MZCP depends on the annual contributions of its participating countries and on the contributions in kind of its collaborating institutions. The participating countries are Cyprus, Egypt, Greece, Lebanon, Kuwait, Portugal, Saudi Arabia, Spain, Syrian Arab Republic and Turkey; countries associated with the Programme are Algeria, Italy, Jordan, Malta, Morocco, Tunisia and Yemen. Italy is expected to join the Programme formally by the end of 1997. Participating countries meet every two years in a Joint Coordinating Committee to evaluate the activities implemented during the past two years and define the Programme's plan of work for the next biennium. The latest meeting of the Committee took place at the Centre for Training and Research on Public Health (CEFPAS) in Caltanissetta, Italy in October 1997. Representatives from the MZCP Participating Countries, observers from several other countries of the European, African and Eastern Mediterranean regions of WHO and other international organizations (e.g. the International Office of Epizootics) attended this meeting. * The MZCP recently approved its Plan of Work for the biennium 1998-1999. It includes activities concerning major zoonoses, such as brucellosis, rabies, leishmaniasis, zoonotic foodborne disease, as well as activities in the field of

veterinary public health, such as occupational hygiene, urban veterinary hygiene, public health education and veterinary emergency preparedness and crisis management. Particular emphasis is given to activities aimed at strengthening national and international cooperation and collaboration between the animal health and public health services of the participating countries. The MZCP expert consultations, training courses, country activities, coordinated studies, scientific reports and information material are sources of current information, and provide specific recommendations which greatly contribute to strengthening inter-regional capabilities to prevent zoonoses in the human population.

ZOONOSIS
A zoonosis is any disease or infection that is naturally transmissible from vertebrate animals to humans. Animals thus play an essential role in maintaining zoonotic infections in nature. Zoonoses may be bacterial, viral, or parasitic, or may involve unconventional agents. As well as being a public health problem, many of the major zoonotic diseases prevent the efficient production of food of animal origin and create obstacles to international trade in animal products. In addition, a number of well known and preventable zoonoses continue to occur in many countries, especially in the developing world where they mostly affect the poorest segment of human society; some are transmissible to humans through food (brucellosis, tuberculosis), through bites from infected mammals (rabies) and insects (Rift Valley Fever) or via environmental contamination (echinococcosis/hydatidosis). The emergence of zoonotic disease is complex and multifactorial, driven by factors which include evolving ecology, microbial adaptation, human demographics and behaviour, international travel and trade, agricultural practices, technology and industry. Addressing zoonotic risk requires multisectoral cooperation and strong partnerships with strong linkages between human and animal detection and response systems.