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Hazards associated with Enterobacter sakazakii in the consumption of dairy foods by the general population

Draft Report to the New Zealand Dairy Technical Consultation Committee

May 2004

A technical working group of the New Zealand Dairy Product Safety Advisory Council’s Technical Consultation Committee has developed the following draft report regarding the Enterobacter sakazakii hazard associated with the consumption of dairy foods by general ( non- infant ) populations. The draft report summarises the New Zealand Food Safety Authority’s policy position on the food safety evaluation of E. sakazakii in the consumption of dairy foods by general populations, excluding foods for infants.

Summary

Enterobacter sakazakii is one of the large coliform groups of bacteria in the Enterobacteriaceae family.  Coliform bacteria are frequent contaminants of many foods, so it is not surprising that E. sakazakii can sometimes be isolated from some foods.

E. sakazakii is a micro-organism that has come to worldwide attention as the occasional cause of a very rare form of food-borne illness in premature or otherwise ‘at-risk’ infants.  In the past 40 years only about 60 cases of such illness have been reported.  Many of these incidents have been linked to powdered soy or dairy based infant formula, or to their contamination during preparation.

There is no evidence however that E. sakazakii poses any significant risk to general populations consuming food products that comply with recognised international food processing or public health standards.  While there have been eight cases of E. sakazakii infection reported in adults suffering from underlying health problems, no connections to food could be made in any of these episodes.  Hence there is no public health justification for testing for the presence, or for setting microbiological limits for E. sakazakii in any products destined for general consumption.

The general principles that govern appropriate microbiological testing of food have international consensus.   In particular, the Codex clauses related to appropriate testing specify that such tests should only be carried out for organisms of significance in a particular food (Codex Alimentarius Commission, CAC/GL 21-1997. Principles for the Establishment and Application of Microbiological Criteria for Foods).  As E. sakazakii has no special significance in general purpose foods, no regulatory authority is known to have carried out a risk analysis for E. sakazakii in such foods.  Reports published by FAO/WHO and Codex specifically limit E. sakazakii food safety concerns to infant formula.

Links to key information sources

• Joint FAO/WHO Workshop on Enterobacter Sakazakii and Other Microorganisms in Powdered Infant Formula, Geneva , 2-5 February 2004
  http://www.who.int/foodsafety/micro/meetings/feb2004/en/print.html
  which includes:-
  Report of the workshop
  http://www.who.int/foodsafety/micro/meetings/en/report.pdf
  Executive summary of the workshop
  http://www.who.int/foodsafety/publications/micro/summary.pdf
  E. sakazakii questions and answers
  http://www.who.int/foodsafety/publications/micro/en/qa2.pdf
• Codex Alimentarius Commission – Risk profile for Enterobacter sakazakii and Other Microorganisms in Powdered Infant Formula, presented at the Thirty-sixth Session of the Codex Committee on Food Hygiene, held Mar. 29-Apr. 3, 2004, at Washington DC, USA
  ftp://ftp.fao.org/codex/ccfh36/fh04_12e.pdf
• FAO/WHO - Key findings from: Joint FAO/WHO Workshop on Enterobacter sakazakii and Other Microorganisms in Powdered Infant Formula, presented at the Thirty-sixth Session of the Codex Committee on Food Hygiene, held Mar. 29-Apr. 3, 2004, at Washington DC, USA
  ftp://ftp.fao.org/codex/ccfh36/fh0412ae.pdf
• International Commission on Microbiological Specifications for Foods (ICMSF)
  http://www.icmsf.org/
• FDA/CFSAN – Health Professionals Letter on Enterobacter sakazakii Infections Associated With Use of Powdered (Dry) Infant Formulas in Neonatal Intensive Care Units, April 11, 2002; Revised October 10, 2002
  http://vm.cfsan.fda.gov/~dms/inf-ltr3.html

Related Links

• E sakazakii in infant formula