Microbial Safety Of Lipid Based Ready To Use Foods For Management Of Moderate Acute Malnutrition And Severe Acute Malnutrition Second Report

The FAO/WHO expert meeting held in December 2014 considered microbial contamination of lipid-based ready-to-use foods (RUFs) and the risk of foodborne infections in the malnourished population of children that consume RUFs. The goals of the expert meeting were to: review the status of the microbiological safety of lipid-based RUFs used to manage moderate acute malnutrition and severe acute malnutrition; conduct a comprehensive risk assessment; provide guidance to producers on the general approach and requirements for manufacturing RUFs that are safe for their intended use; and provide guidance to the agencies that purchase RUFs on how best to judge their microbiological safety. The expert committee described three approaches that purchasers of RUFs might use to establish microbiological criteria to assure the safety of RUFs and to communicate to manufacturers their safety expectations. These approaches are: (i) reference to existing standards established for similar low-moisture foods; (ii) determining an acceptable increase in risk over the pre-existing baseline of illness from other sources of exposure; and (iii) process verification sampling using the moving window technique. The microbiological criteria derived by each of these approaches accomplish different purposes, and which is most appropriate is determined by the conditions of manufacture and use.

The FAO/WHO expert meeting held in December 2014 considered microbial contamination of lipid-based ready-to-use foods (RUFs) and the risk of foodborne infections in the malnourished population of children that consume RUFs. The goals of the expert meeting were to: review the status of the microbiological safety of lipid-based RUFs used to manage moderate acute malnutrition and severe acute malnutrition; conduct a comprehensive risk assessment; provide guidance to producers on the general approach and requirements for manufacturing RUFs that are safe for their intended use; and provide guidance to the agencies that purchase RUFs on how best to judge their microbiological safety. The expert committee described three approaches that purchasers of RUFs might use to establish microbiological criteria to assure the safety of RUFs and to communicate to manufacturers their safety expectations. These approaches are: (i) reference to existing standards established for similar low-moisture foods; (ii) determining an acceptable increase in risk over the pre-existing baseline of illness from other sources of exposure; and (iii) process verification sampling using the moving window technique. The microbiological criteria derived by each of these approaches accomplish different purposes, and which is most appropriate is determined by the conditions of manufacture and use.

Lipid-based ready-to-use foods (RUFs) for the nutritional management of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) are provided to children from 6 months to 59 months of age within the context of emergency feeding programmes supervised by governments. Based on the review, the expert committee considered that children with SAM have an increase in susceptibility to bacteraemia and sepsis that is probably between twofold and fivefold compared with children who are not malnourished and are of the same age and live in the same communities. On the basis of its common occurrence as a cause of infections and serious illnesses in children with SAM, and its documented ability to contaminate, survive in, and cause outbreaks of illness associated with low-moisture foods similar to RUFs, the expert committee concluded that Salmonella is the pathogen of most concern in lipid-based RUFs.Many outbreaks of foodborne salmonellosis have been determined to be associated with low-moisture foods that were contaminated at low levels. Therefore, the expert committee carefully considered the qualitative microbiological analyses of RUFs and the contamination levels that could be inferred, and entered into an extended deliberation of dose-response modelling to find a path toward a reasonable approximation of the likely morbidity and mortality in SAM children that could be anticipated from consumption of RUFs contaminated at the estimated levels and observed frequency.The expert committee described three approaches that purchasers of RUFs might use to establish microbiological criteria to assure the safety of RUFs and to communicate to manufacturers their safety expectations. These approaches are: (i) reference to existing standards established for similar low-moisture foods; (ii) determining an acceptable increase in risk over the pre-existing baseline of illness from other sources of exposure; and (iii) process verification sampling using the moving window technique. The microbiological criteria derived by each of these approaches accomplish different purposes, and which is most appropriate is determined by the conditions of manufacture and use.

Consistent with the need to provide safe food for young children, particularly during the complementary feeding period between 6 and 24 months and the period of rapid development to age 59 months, FAO and WHO convened a technical meeting in FAO headquarters, Rome, Italy, from 11 to 14 December 2012 that addressed the microbial safety of ready-to-use foods (RUF) for the management of acute malnutrition. The meeting was held at the request of the WFP and UNICEF to help them formulate a science-based response to the finding of Cronobacter spp. in lipid-based RUF and to provide guidance on appropriate microbiological specifications to include among other purchase requirements to enhance the safety of lipid-based RUF. This report provides an overview of the assessment of the risk posed by Cronobacter spp in this product and provides guidance to agencies distributing the product as well of the producers on how to manage this problem and minimise the risk to the vulnerable consuming popula tion.

Low-moisture foods (LMF) are foods that are naturally low in moisture or are produced from higher moisture foods through drying or dehydration processes. These foods typically have a long shelf life and have been perceived for many years to not represent microbiological food safety risk hazards. However, in recent years, a number of outbreaks of foodborne illnesses linked to LMF has illustrated that despite the fact that microorganisms cannot grow in these products, bacteria do have the possibility to persist for long periods of time in these matrices. Responding to a request from the Codex Committee on Food Hygiene (CCFH), the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) implemented a series of activities aimed at collating and analysing the available information on microbiological hazards related to LMF and ranking the foods of greatest concern from a microbiological food safety perspective. Seven categories of LMF which were ultimately included in the ranking process, and the output of the risk ranking, in descending order was as follows: cereals and grains; dried protein products; spices and dried herbs; nuts and nut products; confections and snacks; dried fruits and vegetables; and seeds for consumption.

Water is used for a wide range of activities in the dairy sector, which consumes a substantial volume of first-use drinking water for production processes, cleaning and disinfection. There is a great potential to exploit possible sources of reusable water in the dairy sector. In 2020, the 43rd session of the Codex Alimentarius Commission approved the new work entitled ¡°Development of Guidelines for the Safe Use and Reuse of Water in Food Production¡± proposed by the 51st session of the Codex Committee on Food Hygiene. To support this work, the Joint FAO/WHO Expert Meeting on Microbiological Risk Assessment (JEMRA) was asked to provide scientific advice regarding safe use and reuse of water in the dairy sector. JEMRA convened an online meeting from 14 June to 2 July 2021 to provide clear and practical guidance on risk-based approaches to assess and manage fit-for-purpose water sourcing, use and reuse in the dairy sector. This report describes the output of this meeting to support the decision-making when applying the concept of fit-for-purpose water for use in the production and processing of dairy products.

Since the publication of the 2004 risk assessment, outbreaks of illness and resultant deaths due to L. monocytogenes continue to occur across the globe. Continued effort is needed to summarize and critically evaluate the most recent information on L. monocytogenes in RTE foods. New data to improve and further inform the 2004 Risk Assessment is available for nearly every factor considered previously, including new quantitative data on L. monocytogenes contamination of foods. To facilitate this work, an FAO/WHO expert meeting was held by virtual means from 20 October to 6 November 2020 to review and discuss the available data and background documents, and to assess the need to modify and update risk assessment models/tools. This report focuses on the deliberations and conclusions of the expert meeting.

In 2020, the 43rd Session of the Codex Alimentarius Commission approved the “Development of Guidelines for the Safe Use and Reuse of Water in Food Production” proposed at the 51st Session of the Codex Committee on Food Hygiene. To support this work, JEMRA was asked to provide scientific advice on sector-specific applications and case studies for determining appropriate and fit-for-purpose microbiological criteria for water sourcing, use and reuse in fish and fishery products from primary production to retail. This report presented the outcome from the JEMRA meeting, which includes the: situation analysis concerning water use and reuse in the production and processing of fish and fishery products, analysis of case studies for different risk-based water use and reuse processing scenarios and species, water quality monitoring and the use of non-culture based microbiological methods, recommendations concerning the safety and quality of water used in fish production and processing, and critical research gaps and policy developments.