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FOOD POISONING: LISTERIA AND LISTERIOSIS RESPONSEOFTHEGOVERNMENTTOTHESIXTH REPORT FROMTHESOCIALSERVICES (1988-89) COMMITTEE PresentedtoParliamentbytheSecretaryofStatefor HealthandtheMinisterofAgriculture,FisheriesandFood byCommandofHerMajestyNovember 1989 LONDON HER MAJESTY’S STATIONERY OFFICE Cm 848 £2.30net PrintedimagedigitisedbytheUniversityofSouthamptonLibraryDigitisationUnit Food Poisoning: Listeria and Listeriosis RESPONSE OFTHEGOVERNMENTTOTHESIXTHREPORT(1988-89) FROMTHESOCIALSERVICESCOMMITTEE Introduction 1. ThismemorandumsetsouttheGovernment’sresponsetotheSixthReport oftheSocialServicesCommittee,HC257,Session1988—89,onfoodpoisoning: listeriaandlisteriosis. 2. TheGovernmentwelcomestheCommittee’sexaminationofthetrendsin foodpoisoningand,inparticular,listeriosis.TheGovernmenthastakenaction onmanyoftherecommendations. 3. TheGovernmentisconcernedthatsomeoftheCommittee’sconclusions appeartobebasedonincorrectscientificinterpretationsoftheevidence(Con- clusions2and7)oronevidencewhichwasnotavailableatthematerialtime (Conclusion16).TheGovernmenthasbeenworkingwithallinterestsincluding themedicalprofession andfoodindustrysincetheendof1987toassessand decidehowbesttodealwithpotentialhazardsfromListeriamonocytogenes (Lm)asevidenceofcasesoflisteriosislinkedtocontaminationoffoodemerged inEurope. 4. TheGovernment’spolicyhasbeentoinitiateactionbasedonestablished facts as soon astheyhaveemerged and as soonasitisclearwhatthemost appropriateactionis.Thissamepolicyhasbeenfollowedwhendecidingonthe needfor advicetobegiventothepublic. The Governmentwillcontinueto monitorevidenceontheriskoffoodpoisoningfromwhateversourceandtotake theappropriatelegislativeandotheractionassoonasitisappropriate. 5. TheGovernmenthasencouragedandassistedtherelevantsectionsofthe foodindustrytopreparecodesofpracticeinrespectofthemanufactureofsoft andfreshcheese(August1988andFebruary1989*).Similarindustryguidelines feoartegnoocdolhdygioerniacftperracrteihceeaitnitnhge,mwahniucfhacwtiulrles,udibssterqiubeunttilonyabnedssatloeroefdfoatodsatcohiblel temperature, are nearing completion. Meanwhile the Department has been takingexpertadviceontheneedforandtheformoflegislationrequiredinthis areaandisnowconsideringtheresultofconsultationondraftregulationsto controlthetemperatureofthesefoodsindistributionandretailsale. 6. TheGovernment’sresponsetotheCommittee’sdetailedrecommendations andconclusionsissetoutbelow. FoodPoisoning Conclusion1. Wearedisturbedbytheapparentincreaseinfoodpoisoningand listeriosisandtheuncertaintywhichseemstohavearisenregardingthesafetyof variousfoodproducts(para2) Conclusion2. Theupwardtrendinfoodpoisoningisalmostentirelyduetothe increaseinsalmonella(para6) *GGuu1ii9dd88ee.lliiTnnheeessfMfooirrlGkGoMooaodrdkHeyHtygiginiegennBeioPcarraPdcr,taicTctheicaienmetfhosreDMtiahtentuoMfna,ancSutufurarrceetyoufrKSeTo7fotfOaSEnoLdft.FraensdhFCrheesehsCehse—epsuebsliisnhSemdaAlulguasntd Farm-basedProductionUnits—publishedFebruary1989.TheCreameryProprietors’Association, 19CornwallTerrace,LondonNW14QP. 1 PrintedimagedigitisedbytheUniversityofSouthamptonLibraryDigitisationUnit . 7. TheGovernmentsharestheCommittee’sconcernovertheupwardtrendin foodpoisoningbutdoesnotagreethatitisalmostentirelyduetoanincreasein salmonella.Theincreaseisalmostequallysharedbetweenreportsofsalmonel- losisandofCampylobacter.Asfarastheformerisconcernedtherecentincrease ismainlyduetoasinglestrainofSalmonellaenteritidis(PT4).TheCommittee willbeawareoftherangeofmeasurestakenbeforeandafteritsenquirytodeal with that particular problem which, in cases when it has been possible to determine thecause,has beentraced mainlytotheconsumption ofcontam- inatedeggsandchicken.Inhisevidence, theChiefMedicalOfficeralso drew attentiontotheupwardtrendinreportsofCampylobacterinfectionwhich,asthe Committeepointsout,rosefrom12,878in1982to28,714in1988.Between1982 and1988salmonellaenteritidisPT4andCampylobactertogetheraccountedfor thevastmajorityofreportedfoodpoisoningcases. 8. PreliminaryresultsforsalmonellaenteritidisPT4isolationsfor1989suggest thateducationalmeasuresaffectingcateringpracticesinandoutsidethehome, andthevariousGovernmentmeasures,couldnowbebeginningtohaveaneffect onthenumberofhumaninfections.Thesetrendswillneedtobesustainedfor some time, and particularly through the Summer of 1990, before any firm conclusionscanbemade Recommendation 3. In cases of miscarriage and stillbirth listeriosis is not routinelylookedfor:werecommendthatitshouldbe(para7) 9. FollowingtheDepartment’spublicwarningaboutlisteriacontaminationof SwissVacherinMontd’OrcheeseanditswithdrawalbytheSwissGovernment, theDepartmentdrewtheattentionoftheRoyalCollegeofObstetriciansand Gynaecologiststothepossibilitythattherewasunder-reportingoflisteriosisasa causeofmiscarriage.Webelievethatthesubsequentinterestinthissubjectwill haveservedtoremindcliniciansoftheneedtoconsiderthispossiblediagnosis. Furthermore,theChiefMedicalofficerwrotetoalldoctorson16February1989 givingclinicaladviceandremindingthemthattheriskoflisteriosisinpregnancy, althoughsmall(1in7000),wasmuchgreaterthanamongtheremainderofthe healthypopulation. In its planning objectives for the NHS for 1989-90, the Government has required the Regional Health Authorities to ensure the appointmentofatleastonepaediatricpathologistperregion. Conclusion4.Mostcasesoffoodpoisoningarepreventable(para16) 10. TheGovernmentagreesandistakingallpossiblestepsbothtodealwith sources ofcontamination and to give advice tothe public where necessary. However,astheCommitteehaspointedout,althoughitisnowwidelyagreed thatinthecaseoflisteriosis“Theprimarymeansoftransmissionoflisteriato humansisthoughttobethroughcontaminationoffoodstuffsatanypointinthe foodchain”(para13ofSixthReport)itremainsunclearwhatproportionofcases originate directlyfrom food, which foods are involved and what determines whetherornotaninfectionwithLmleadstoillness.Itmustbeborneinmindthat Itisestimatedthatatleast1in20ofthepopulationcarryLmwithintheirgutat anyonetimeandonlyaverysmallminorityoftheseevermanifestsymptomsof illness. Lmis almostubiquitous insamplesofsoil,vegetationetcandawide rangeoffoodstuffsarecontaminatedwithit,yetlisteriosisisararedisease. Conclusion5. Therisksoffoodpoisoninggenerallyandlisteriosisinparticular cannotbequantifiedexactly. Therisksofahealthypersoncontractinglisteriosis aresmall. Forthose whofallinto one ofthe atriskgroups, women who are pregnant, theelderlyandpeoplewith impairedimmunesystems, theremaybe somedangersinvolvedineatingcertaintypesoffood. Butweareconvincedthat theseriskscanbecontrolledandkeptto aminimumifproperprocedures are followed(para17) 11. The Government agrees that all reasonable steps should be taken to minimisethecontaminationoffoodbyLmduringfoodprocessingandhandling ttoheenpsruordeuctthiatonfooofdfsocoodnsswuhmiecdhbayrethpearptuibcluilcaralryelfiraebeleoftoLcmo.nCtoamdiensaotfioprnawctiitcheLfomr PrintedimagedigitisedbytheUniversityofSouthamptonLibraryDigitisationUnit havebeenagreedinrespectofsoftandfreshcheeses,andacodeinrespectof pre-cookedchilledmealsisnearingcompletion.Formalconsultationhasbeen completedonproposalstocontrol,byregulation,thetemperatureatwhichthese foods are distributed, stored and sold. The Government recently published advicefortheconsumerintheleaflet, “FoodSafety—FoodSense”whichhas beenwidelydistributed. Listeriainfood Conclusion6.Onthelimitedinformationavailable,cook-chillmealspreparedfor hospitalconsumptionappearrelativelysafe.Althoughthisprovidessomereassu- rance,webelievethatfurthermonitoringofhospitalcateringisrequired(para20) 12. Theupdatedguidelines,“ChilledandFrozen: GuidelinesonCookChill andCookFreezeCateringSystems”,publishedon22June1989,hasachapteron managementofqualityassurancewhichrecommendsastrictmonitoringsystem basedonhazardanalysisandincludesessentialcontrolchecksandmicrobiolog- icalguidance. WehaveaskedRegionalHealthAuthoritiesto implement the guidelines and report back on their programmes of implementation by December1989.Whenwehavereceivedthisinformationwewillthenconsider whatfurthermonitoringoftheircookchillsystemsisrequired. Conclusion7. Theevidencesuggeststhatcontaminationofsoftcheesesbylisteria occurspost-productionandisderivedfromenvironmentalsources(para21) 13. ThereisevidencethatcontaminationofsoftcheeseswithLmmayoccur eitherbefore, duringorafterproduction. Inviewoftheirlongshelflife, soft cheesesatpointofsalemaycontainhighlevelsofLm.Becausethesecheesesare usuallyconsumeduncooked,itiscrucialthatactionbetakentocontroltemper- atures at which theyarekeptat all stages and the proposed Food Hygiene RegulationsonwhichtheGovernmenthasconsulted, areintendedtoensure this. Conclusion8. Cookchillproductswhicharereheatedbeforeconsumptionmay stillpresentarisktotheconsumeriftheproductiscontaminatedwithLm. The risks are twofold. First, cross-contamination may occur in the kitchen ifthe infectedproductis broughtinto contact with otherfoods, orifpoorhygiene practicesarefollowed;second,ifthefoodisnotheatedtoandheldlongenoughat asufficientlyhightemperaturethensomebacterialcontaminationmayremain (para24) 14. TheChiefMedicalOfficer’sadviceof10February1989,aimedparticularly atthevulnerablegroups,wasthatthelattershouldavoidtheconsumptionof certaintypesofsoftcheesesandreheatcookedchilledmealsandready-to-eat poultryuntiltheyarepipinghot. The adviceincludedaplainman’sguideto hygienicpracticeswhichwouldhelptoavoidcross-contamination.TheGovern- menthasalsoexpandedthisinthefoodsafetyleafletreferredtoearlier. The MinistryofAgriculture,FisheriesandFoodidentifiedapotentialproblemwith microwaveovensandhasissuedinterimadvicetoconsumersonthepreparation offoods inmicrowave ovensso asto avoid therisks associatedwithunder- cooking.Ithasalsocommissionedresearchintotheproblem. FoodSafety Recommendation9.Whilstresponsibilityforfoodsafetydoesnotonlyrestwith CentralGovernment,theGovernmentshouldtaketheleadandtakeallreasonable stepstoensurefoodsafetyissuesaregivenpriority(para28) t1o5.fooTdhesafGeotvyeirsnsumees.ntThfuellGyoavcecerpntmsetnhtathiatsshaocutleddtparkoemtphtelyleoanditnhegiavdivnigcperiiotrhiatsy receivedandistakingarangeofmeasurestoensurefoodsafetyinthelonger term: — ithasintroducedacomprehensiveandwide-rangingpackageofmeasuresto controltheproblemassociatedwithsalmonellaandeggs; —ithasissuedaleaflettothepublicgivinggeneralfoodsafetyguidanceonsafe storageandcookingprocedures.Ithasalso,astheoccasiondemands,issued adviceonfoodswhichpeopleatspecialriskshouldavoid; — itsetuptheWorkingPartyonBovineSpongiformEncephalopathyandacted quicklyonitsrecommendations; 3 PrintedimagedigitisedbytheUniversityofSouthamptonLibraryDigitisationUnit — ithasestablishedanindependentcommitteetoconsiderthemicrobiological safetyoffood; — it has reviewed and revised the guidelines on cook-chill and cook-freeze cateringandthesehaverecentlybeenpublished; — ithasreviewedprimaryfoodlegislationandhasalreadystateditsintentionto introduceaFoodBillassoonasParliamentarytimepermits; — ithasconsultedonproposalstoamendFoodHygieneRegulationssoasto applytemperaturecontrolstocertainfoodindistributionandatretailsale; — itactedpromptlytocontroltherecentoutbreakofbotulismduetocontam- inatedhazelnutyoghurt; — itactedpromptlytogiveadviceontherisksfromlisteriainpate. Conclusion10.ItisessentialthatGovernmentpoliciesonissuesassociatedwith foodsafetyandhygieneareco-ordinated(para29) Recommendation 11. Werecommendthataninter-departmentalcommitteeof ministersandofficialsfromalltherelevantdepartmentsshouldbeestablishedto reviewfoodsafetyissues,consideranyactionthatmaybenecessary,andensure thattheobjectivesofdifferentDepartmentalpoliciesdonotconflict(para29) 16. The Government agrees on the importance of co-ordination between Departments.Themeasuressetoutabove,andmanyothers,havebeenhandled withfull co-operation betweenDepartments atMinisterial andofficiallevel. Therearewellestablishedmechanismsforobtainingtheadviceofexpertsand forthisinformationtobeshared.Apartfromjointmembershipandservicingof standingcommittees,majorissuesarereviewedinter-departmentallysoasto co-ordinatetheassessmentofinformationandthenecessaryaction.Thisranges fromroutinejointMinisterialdiscussion(meetingtheCommittee’srecommen- dationforaninter-departmentalcommitteeofMinistersandofficials)todaily contactsbetweenofficials. Recommendation12.Inviewoftherecentmisunderstandingssurroundingfood hygiene andfoodsurveillance and the deficiencies ofexisting regulations and guidelines, we recommendthatthe Governmentactspromptly andbrings the FoodBillbeforetheHouseinthenextParliamentarysession(para38) 17. TheGovernmenthasalreadystateditsintentionofbringinganewFood BillbeforeParliamentattheearliestopportunity.Thiswillreinforceexisting legislative powers to enable UK food law to deal with future food control requirementsandwillimprovetheenforcementpowersoflocalauthorities. It willseekpowerstorequirethetrainingoffoodhandlers,buildingonthetraining alreadyprovidedbyindustryandotherbodies,andallowinglocalauthoritiesto provideitwherenecessary. Recommendation 13. WerecommendthattheRichmondCommitteeconsiders scientificevidence, theviewsandneedsofconsumers, andcurrentpoliciesand practiceoffoodsafetyissuesfollowedbydifferentgroups(farmers,manufactur- ers,distributors,caterersetc)andmakesrecommendationstotheGovernmentas soonaspossible(para39) 18. TheCommitteeontheMicrobiologicalSafetyofFoodchairedbySirMark Richmond said in a Press Statement that it would make its first report to Ministersassoonaspossibleandprobablytowardstheendof1989.TheCom- mittee’srecommendationshavebeenbroughttotheattentionoftheRichmond Committee. Recommendation14.WerecommendthattheRichmondCommitteeplaysakey roleinthepreparationoftheproposedFoodBill(para39) Conclusion19.WeexpectthattheRichmondCommitteewilllookindetailatthe issueoffoodstorageandrefrigerationtemperatures(para46) PrintedimagedigitisedbytheUniversityofSouthamptonLibraryDigitisationUnit . Recommendation 32. We recommend thatone ofthe tasks oftheRichmond Committeeshouldbetooverseeresearchinthefieldoffoodhygieneandfood safety,toconsiderthebalanceoffundingandmakerecommendationsaccordingly (para74) 19. Sir Mark Richmond has been askedby Ministers toletthemknow in advance of his report of possible recommendations which might affect the proposedFoodBill.TheGovernmentwouldexpecttheRichmondCommittee toincluderesearchamongthemattersitconsiders.TheGovernment’sproposed regulationsonfoodstorageandrefrigerationtemperatures,werealsoreferredto theRichmondCommitteeduringtheconsultationprocess. Conclusion 15. ToomuchinformationIssuedtothepubliconfoodsafetyand hygienehascomeoutindribsanddrabs. TheDepartmentofHealthshouldhave takenamoreproactivestance(para42) 26. AtthetimeoftheSelectCommitteeReporttheGovernmenthadissued advice onlisteriosis onthreeoccasions: November 1987,February 1988 and February 1989. The first two occasions relatedto the need to publicise the withdrawaloftwospecificcheeseswhichhadbeenlinkedtocasesoflisteriosis: VacherinMontd’OrandAnari.Thetimingofthetwowarningswasdetermined bytheidentificationineachcaseofaspecificproblemrelatedtoaparticular cheesewhichwasoutsidetheGovernment’scontrol. 27. Thethirdwarning,inFebruary1989,gavegeneraladviceontheimplica- tionsoflisteriacontaminationoffood,reassuredthegeneralpublicandidenti- fiedtheneedforspecialcaretobetakenbysusceptiblegroupswithrespectto certaingeneralcategoriesoffood,iecertainsoftcheesesandcookchilledmeals andready-to-eat poultry. Thetimingofthiswarningwasdeterminedby the expected publication ofthe results ofthe PublicHealthLaboratory Service (PHLS)surveyofcookedpoultryandchilledmeals,andbyare-evaluationofthe positioninthelightofevidencewhichhadbecomeavailablein1988(seebelow). 28. Since the Select Committee Reportwaspublishedthe Departmenthas issuedtwofurtherpressreleasesonlisteriainpate.Thefirst,inJuly1989,related topateinwhichalocalsurveyhadidentifiedlisteria.Itwarnedpregnantwomen and susceptible groups to avoid this product while the PHLS carried out a nationalsurvey.Thesecond,inAugust1989,reportedtheresultsofthePHLS surveyandreiteratedtheneedforthesespecialgroupstoavoidpate. 29. Whendecidingontheneedtoissueanyadviceabalancehastobestruck betweentheneedtowarnofapotentialhealthhazardassoonasinformation becomesavailableandtheneedtoverifythefactsandtheirimplications.The GovernmentbelievesthateachofthesePressNoticeswasnecessarytoenableit todischargeitsresponsibilityforsafeguardingthehealthofthepublic. Conclusion 16. We believe thatpregnant women could have been alerted to possiblehazardsfarsooner(para42) 30 TheGovernmentdisagreesstronglywiththeopinionoftheSelectCommit- teeonthisquestionanddoesnotbelievethattheCommitteehadanyfactual basisfortheirassertion.TheexpertscientificadviceavailabletotheGovern- ment’sChiefMedicalOfficerdidnotsupporttheneedforawarningtopregnant womenandothervulnerablegroupsbeforeFebruary 1989. The evidenceon whichtheadvicewasbasedwasasfollows: w1itThihnetrheepoUrtKsilninNkoedvetmobfeorod,19(8re8spoefctthievefliyrsltitnwkeodcatosecsooofkfeedtaalnldistcehriilolseids chickenandvegetablerennet) 2o.ftThheeprreesvulatlsenocfeaPofHLLSmsiunrvreeyad(yc-atror-ieeadtopuotualtttrhyeaGnodvecronomkeendt’asndrecqhuielslte)d meals Theresults,whichbecameavailableinJanuary1989showedthat Lmwaspresentinbetween10to20percentofthesamplesofpre-cooked rferaodmy-rtetoa-ielaptrepmoiusletsr.yParnidorctooo1k9e8d8,aenvdidcehnilcleeadboorutfrLomzeinnmpoeualltsryphuracdhbaeseend limitedtoinformationoncontaminationofrawcarcasses. 5 PrintedimagedigitisedbytheUniversityofSouthamptonLibraryDigitisationUnit 3. ThepublicationinTheLancetinOctober1988ofanAmericanstudy whichprovidedthefirstepidemiologicalevidencethatintheUSAatleasta substantialproportionofsporadic(ienon-outbreak-related)oflisteriosis mightbefoodborne. 31. InDecember1987,therewasnoscientificconsensustosupporttheview thattheevidentincreaseincasesoflisteriosiswasduetotheconsumptionof contaminatedfoodorthatageneralwarningtothepublicortopregnantwomen was necessary. Although a survey of soft cheeses conducted by the PHLS published in February 1988 showed that about 10 per cent of soft cheeses sampledintheUKcontainedLm,thepredominantserotypedidnotmatchthat inhumancasesandthesignificanceofthefindingstohumanlisteriosiswasatthat timeuncertain. During1988itemergedthat, aswellasthewell-definedout- breakssuchasthat due toSwissVacherinMontd’Orcheese, some sporadic humancasesoflisteriosis(includingmaterno-fetallisteriosis)couldalsobedue tocontaminatedfood.Thisviewwassupportedbytheevidenceoutlinedabove andtheReportofaWHOInformalWorkingGrouponFoodborneListeriosis. Recommendation17.Coronersandpathologistsmayexamineforthepresenceof pLramctiincet.heWpeosrte-cmoormtmeemnsdotfhsattililtbsihrtohuslodrbneeo(npaatraal43d)eaths,butitisstillnotaroutine 32. The Committee draws attention to the need to keep under review the reportingarrangementsforfoodpoisoning.Thishasalreadybeenidentifiedin thereportentitled“PublicHealthinEngland”whichalsorecommendedthatthe listofnotifiablediseasesshouldbereviewed.Thisreviewisunderway. When newregulationsaremadetheGovernmentintendstodrawthesetotheattention ofhealthauthoritiesanddoctorsinordertoencourageahigherproportionof casesofnotifiablediseasestobereported,andwillconsidertheneedtoadvise coronersandpathologists. Recommendation18.Werecommendthatthecurrentarrangementsforreporting listeriosisthroughthePHLSarekeptunderreviewtoensurethattheinformation uponwhichpreventiveandcontrolpoliciesarebasedisasfullandasaccurateas possible(para45) 33. TheGovernmentagreeswiththeCommittee’sviewonthis.ThePHLS is currentlyrestructuringitsreporting,informationandanalysissystems. Recommendation20.Werecommendthatallcommercialrefrigeratorsbefitted with a thermometer, thathouseholds seriously considerpurchasing a suitable thermometerandthatallnewrefrigeratorsbefittedwiththermometers(para46) 34. TheGovernment’sfoodsafetyleafletadviseshouseholderstostorefoodin therefrigeratorbelow5°C,andtobuyafridgethermometertocheckthis.The Governmenthasconsultedonproposalstoregulatethetemperatureatwhich chilledfoodsarestoredanddisplayedforretailsale.Manycommercialdisplay cabinetsalreadyhavethermometersanditseemslikelythatallwillneedtodoso whentheproposedregulationshaveeffect.Thepositioningofsensorsisimpor- tantandthisisunderdiscussionwiththemanufacturers. Manufacturershave alsoshownsomewillingnessvoluntarilytodesignnewrangestoincludeintegral thermometers. Recommendation21.WerecommendthattheDepartmentlowerthecriticalsafety limitinstoragefrom10°Cto4°C(para51) 35. The Committee hasmade this recommendationinthe context ofNHS cateringandcook-chillinparticular.The1980Guidelinesonpre-cookedchilled food(incatering)saidatemperatureof+10°Cshouldberegardedasthecritical safetylimitforchilledfood.TheupdatedGuidelinesonCook-ChillandCook- FreezeCateringSystemsnolongerusethatexpression.The1989guidelinessay thatthetemperatureofcookedfoodafterchillingshouldbemaintained at or below3°C;ifthetemperatureofthefoodduringstorageanddistributionexceeds 5°Cthefoodshouldbeusedwithin12hours;ifthetemperatureexceeds 10°C thefood should be destroyed. These tolerances are intended to allow for PrintedimagedigitisedbytheUniversityofSouthamptonLibraryDigitisationUnit unavoidableincreasesintemperature,forexampleduringdefrostcycles,andthe systemisbasedonanintentiontostoreanddistributeatorbelow3°Cbefore reheating. Recommendation22.WerecommendthattheGovernmentextendstheapplica- tionoftheDHSSguidelinesonthepreparationandstorageofcook-chillmealsto theretailandcateringsectors(para52) 36. Theproposed amendmentoftheFoodHygiene Regulationswillhavea shuabvsetainntdiiaclaitmepdabcottohntthhatehLamndmlianygbofecphrielsleedntfoiondaswoindreetraailngsaeleo.fRfeocoednstasnudrvtehyast suchfoodsareoftendistributed,storedand/ordisplayedforsaleattemperatures whichwouldnotnecessarilyrestrainthefurthermultiplicationoftheseandother pathogenicorganisms.Thedraftregulationsresultfromextensiveexpertadvice andwideconsultationand,webelieve,willbemoreappropriatethanguidelines. Guidelinesforgoodhygienicpracticeinthemanufacture,distributionandsale offoods,tobeeatencoldorafterreheating,whichwillsubsequentlybestoredat achilltemperature,arenearingcompletionbyindustrywiththeassistanceofthe DepartmentandtheMinistry. Thoseonthesafeproductionofsoftandfresh cheesehavealreadybeenproduced.TheGovernmentdoesnotacceptthatthe cook-chill guidelines are appropriate for application to the distribution and displayofretailfoods.Theyaredesignedforcook-chillcateringsystemsboth withintheNHSandelsewhere. Recommendation23. Thereshouldbegreaterfreedomintheexchangeofinfor- mation on matters relatingtopublichealth betweenstatutory bodies to enable problemareastobeidentifiedandeffectivesolutionstobedevised(para57) 37. Thereareworkingarrangementsinplacebetweenappropriatestatutory bodiesonrelevantpublichealthmatters. Closerelationshipsexistbetweenthe DepartmentofHealth(DH)andtheInstitutionofEnvironmentalHealthOffic- ers(IEHO). Workingpartiesexistonspecificissues,forexample,inspection guidelinesforcookchillcentralproductionunitswithmembershipdrawnfrom DH,theIEHO,healthauthoritiesandlocalauthorities.Theseactivitiesencour- ageexchangeofinformationandthisisongoing. Recommendation 24. Werecommendthatthe Governmentensures thatlocal authoritieshavesufficientfundsandqualifiedstafftofulfiltheirimportantrolein monitoringandenforcingfoodhygienelegislation(para58) 38. The Governmentrecognisestheimportanceofmonitoringandenforce- mentoffoodhygienelegislation.Discussionshavebeenheldwithlocalauthor- itiesonthemonitoringandenforcementimplicationsoftheproposedFoodBill. TheGovernmenthasalreadystateditsintentionofbringinganew FoodBill beforeParliamentattheearliestopportunity. Recommendation25.WerecommendthattheGovernmentreviewsthepowersof EHOsinthefieldoffoodhygieneinthepreparationoftheforthcomingFoodBill (para58) 39. AreviewofprimarylegislationhasbeenunderwaysinceDecember1984 andtheGovernmenthasalreadysaidthatitwillbringlegislationbeforeParlia- mentasearlyaspossible.Therehasbeenextensiveconsultationwithenforce- ment interests and it is expected that the Food Bill will reinforce existing legislativepowersinfoodhygiene. Recommendation 26. Werecommendthatthe Governmenttakes theexisting practiceofgoodemployersinscreening,treatmentandtraininginfoodhandling asthebasisforacodeofpractice(para61) 40. Manygoodemployersundertakehealthchecksbeforeemployment.Thisis partofoccupationalhealthservicesprovidedbyemployersand,whilstnotan explicitrequirementunderHealthandSafetyatWorklegislation,maywellbe necessarytomeetthedutyofanemployertosafeguardthehealthofemployees andofthose members ofthe publicwho maybe affectedbythework. The proposedFoodBillwillseekpowerstorequirethefoodhygienetrainingoffood handlers. 7 PrintedimagedigitisedbytheUniversityofSouthamptonLibraryDigitisationUnit Recommendation27. In viewofthepossibleconfusion which may arise over differenttypesoflabelingandstorageinstructions,werecommendthattheDepart- mentofHealthandMAFFensurethattheterm“sellby”isphasedoutassoonas possibleandisreplacedwithlabellingmoreeasilyunderstoodbyconsumers. The terms“useby”or“eatby”shouldbeusedwhereverpossible(para65) 41. TheGovernmentagrees.TheUKlawimplementstheECDirective. In June,theInternalMarketCounciladoptedadirectivewhichamendstheFood Labellingdirective(79/112/EEC)torequire,interalia,thephasingoutofthe thiegrhmly“speelrlibsyh”abbleyf1o9o9d3s.anOdnctehetihentdriordeuccttiivoenhoafsabeceonmpiumlpsloermyen“tuesedbinyt”odUaKtelfaowr aapnpdlytatkoemsoesftfefcototdhsearnedwi“lulsbeebyt”wofosrotrthsehoifgdhalytep-emrairskh:ab“lbeefsotodbse.foWree”bewlhiiecvhetwhiallt thesegiveclearadvicetoconsumers.Thereisnochangeintherequirementthat anyspecialstorageconditionsorconditionsofusemustbegiven. Recommendation28. Werecommendthatifcontaminationofsoftcheesepro- ducts is to be avoided, orcontaminatedproductspreventedfrom reachingthe consumer, consistentqualitymustbeensuredbyregularbacterialmonitoringof products(para66) 42. Qualityisbestensuredbyadherencetogoodmanufacturingpracticesand notbyendproducttesting.Thecodesofpracticeproducedbytheindustry,with theassistanceofGovernment,aredesignedtoeliminatecontaminationduring production and the proposed regulations on temperature control will apply duringdistribution,storageanddisplayforretailsale. Conclusion 29. Irradiation is no substitutefor goodfood hygiene practices (para69) 43. The Government is in complete agreement with this observation. The arrangementsproposedforfoodirradiationin—thiscountryincludeprovisionfor the examination offoodpriorto treatment and it will be a condition of a Licencetooperateanirradiatingplantthatonlyfoodofnormal,soundaccep- tablequalityshallbeirradiated. Recommendation30.WerecommendthattheGovernmentreassessesitspolicyto withdrawfundingfromagriculturalandfoodresearchinthe“publicgood”and ensuresthatsuchresearchiscontinuedandcentrallyfunded,evenwhenitfallsinto thecategoryof“nearmarket”research(para73) 44. The Government does not have a policy ofwithdrawing funding from agricultural and food research in the public good. Public expenditure plans indicatethattheGovernmentwillcontinuetospendover£200millionayearon agricultural and food research when support for “near market” research is phasedoutin1991/92.Thewithdrawa—lofpublicfundingforcom—mercialresearch relatedtotheneedsoftheindustry “nearmarket”research doesnotaffect ourcommitmenttoresearchofdirectrelevancetoissuessuchasfoodsafetyor protectionoftheenvironmentwhereversuchworkfallsintheRandDconti- nuum. But in ourview industry itselfis best placed to fund and decide on prioritiesforpurelycommercialorientatedresearch. Conclusion31.Wewouldnotwishtoseeresearchonissuesoffoodsafetyandfood hygienedominatedbytheinterestsofthefoodindustryalone(para74) 4in5t.erePsutbsloifcstehcetofroofdooidndsuasftertyy.anOdnfotohedhcyognitreanreyrethsiesarrcehseisarncohtdisomdientaertmeidnbeydtbhye Ministersactinginthepublicinterest. Advicefromscientistsintheacademic world,inresearchinstitutes,industryandconsumerorganisationsistakeninto accountindeterminingthepriorities. Recommendation33.Moreepidemiologicalresearchshouldbecommissionedby stthiellDbeirptahrstamnednnteoofnHaetaalltdhe.atThhseiisnocniedeanrceeaoffo,rafnudrtfhaecrtoirnsveasstsiogcaitaitoend(wpiatrha,7li5s)teriain 8 PrintedimagedigitisedbytheUniversityofSouthamptonLibraryDigitisationUnit 46. Anumberofprojectsontheepidemiologyandmicrobiologyoflisteriosis parreopboesiinnggtuonudnedretratkaeknebaynetxhteenPsiHvLeScaswehicconhtrioslfsutnuddye:dtbhyeyDarHe.alTsohedePveHlLopSinigs monoclonalantibodies andusingmolecularbiologicaltechniquesto assist in epidemiological tracing; monoclonal antibodyis also being usedfor antigen detectionandforrapididentificationoflisteria.Proposalsforastudyonlisterio- sisinpregnancywhichmayprovidefurtherinformationontheprevalenceof ininnaffneecccytt,iiootnnhwewiipttohhssLLiibnmleinarnpedrleegvsanpnoacnnetcayon,fetodhuieestnaaartbyuorrfaatlcitohoinrsstaonardnydopfetrhtiehneartedalilastediaoesnaesthdhiuprairbneegtbpwereieengng- considered. PrintedintheUnitedKingdomforHerMajesty’sStationeryOffice Dd50372011/89,C20,3382/9A,Ord8237543/15464 PrintedimagedigitisedbytheUniversityofSouthamptonLibraryDigitisationUnit