ACMSF Meeting minutes 3 December 1999

Minutes of the 35th ACMSF meeting, 3 December 1999, Department of Health, Skipton House, London SE1, 10.30am.

Present

Chairman Professor D L Georgala

Members
Mr D Clarke
Dr T Clayton
Mrs P Jefford
Professor A M Johnston
Mr D Kilsby
Dr M J Painter
Professor S R Palmer
Dr T A Roberts
Dr N A Simmons
Mrs B W Thomas
Dr T Wyatt

Assessors
Dr M Donaghy (SEHD)
Mr P J R Gayford (MAFF)
Dr R J Harding (MAFF)
Mr D Worthington (NAW)

Secretariat
Dr J Hilton (Medical Secretary)
Mr C R Mylchreest (Administrative Secretary)
Miss T Feltis

1. Chairman's introduction

1.1 The Chairman welcomed Members to this, the Committee's thirty-fifth meeting.

1.2 He reminded Members of the need to declare any interests in any of the items for discussion. None were made.

1.3 He drew attention to two tabled papers, ACM/458 and 459 dealing respectively with a MAFF-funded study of the microbiological quality and heat processing of cows' milk, and the 25 November 1999 meeting of the Epidemiology of Foodborne Infections Group.

2. Apologies for absence

2.1 Apologies for absence were received from the following :

Members
Ms Lewis
Dr Stevens
Professor Smith

Assessors
Professor McMurray
Dr Mitchell
Dr Roger Skinner

Secretariat
Mr Greig

3. Minutes of 34th meeting (ACM/MIN/34)

3.1 Two amendments were agreed. The first was that, in paragraph 7 of ACM/MIN/34, the reference to "para 13" of ACM/MIN/33 should be to "para 14". By way of clarification, the two sentences in ACM/MIN/ 33 which read

"Discussion turned to pasteurisation, which Members observed was a very efficient and very important food safety procedure provided it was carried out correctly. Members were concerned by the view promoted in the paper that pasteurisation was not an effective means of destroying pathogens in milk."

should be transferred from paragraph 13 to the end of paragraph 14.

3.2 The second amendment concerned paragraph 12 of ACM/MIN/34. The penultimate sentence of this paragraph ("This pattern had also been seen internationally.") should be replaced by "The trend was similar throughout Europe, with falling Salmonella offset by rising Campylobacter."

3.3 Members agreed ACM/MIN/34 as a correct record, subject to these two amendments.

4. Matters arising

ACMSF website

4.1 It was reported that the ACMSF website had gone "live" on 3 September. This had been announced in the 20 September edition of the Department of Health's (DH) Food Safety Update.

4.2 Members stressed the importance of making the website easy to find and updating it regularly and quickly. It was suggested that the website address should be added to ACMSF letterheads and press releases.

IID study

4.3 It was reported that DH were planning to hold a workshop on their Infectious Intestinal Disease (IID) Study on 28 February 2000. The final round of editing was currently underway, with a target of publishing the report of the study prior to the workshop. Invitation lists had not yet been drawn up. While the workshop was primarily targeted at those general practitioners who participated in the study, the ACMSF would not be over-looked.

Raw milk cheeses

4.4 Dr Harding reported that the Food Minister, Baroness Hayman, had now written to the Specialist Cheesemakers' Association with a view to jointly taking forward a number of measures for enhancing consumer safety in relation to raw milk cheeses. These related to highlighting the importance of using milk of high microbiological quality in the cheesemaking process and of implementing HACCP principles in the production of cheese from unpasteurised milk; the funding by Government of a campaign to increase HACCP awareness among small cheesemakers and enforcement officials (this in addition to the current MAFF on-farm dairy products campaign); and, finally, drawing the attention of retail trade associations to the ACMSF's advice, and the corresponding recommendation in the SCA Code of Practice, that raw milk cheese should be labelled as being "Made from raw milk".

ACMSF VTEC Report

4.5 Dr Harding reported that it was the intention to publish an omnibus progress report on implementing the Committee's VTEC and other subject-specific reports in due course. Some elements were already publicly available as ACMSF papers.

UK Food Hygiene Initiative in Schools

4.6 Dr Harding reported that the secondary school teaching resource, comprising activity sheets, posters, teacher notes, curriculum guidance, a website and an interactive CD-ROM, had now been supplied free of charge to all UK secondary schools. A primary school resource was currently being developed and was expected to be available by February 2000.

Mycobacterium paratuberculosis

5.1 Members received paper ACM/429 summarising the results of a survey of raw sheep and goats' milk for Mycobacterium paratuberculosis (MPTB). They were pleased to note that MPTB had not been detected by immunomagnetic PCR, or isolated by culture, from any of the 90 goats' and 14 sheep milk samples collected from bulk tanks in England, Wales and Northern Ireland over the period January-May 1998. The Committee welcomed these results.

5.2 At the Committee's request, MAFF had also provided interim MPTB results from a national study on the microbiological quality and heat processing of cows' milk (ACM/458). Approximately 1,000 samples (a third of the total) were being examined for the presence of MPTB. To date, results had been received for 59 raw milk samples and 133 pasteurised milk samples. Three samples of raw milk and 4 of pasteurised milk had tested positive for MPTB.

5.3 The Committee noted that these results reflected earlier indications from the pilot study that MPTB might be present in pasteurised milk. Whilst acknowledging that the relevance of this organism to human illness was unknown, Members expressed some concern that MPTB had been detected in pasteurised milk. The Committee agreed that it was important to establish whether MPTB had survived the pasteurisation process, or whether there was some other explanation for the positive results. Further work was needed to establish the conditions under which MPTB could be eliminated from milk. The ACMSF stood ready to offer further advice in the light of future research results.

6. National study of Ready to Eat Meats and Meat Products Part 5

6.1 The Committee received a draft report of MAFF-funded surveillance of cooked, chilled ready-to-eat chicken products on retail sale in England and Wales carried out in August/September 1996 (ACM/430). Four hundred and eighteen products had been sampled. Seven hundred and fifty eight samples had been examined microbiologically. All products had been examined at the end of their allocated shelf lives for a range of bacteria. There had been no Campylobacter isolations. Listeria monocytogenes, Staphylococcus aureus and Escherichia coli had been detected at low levels in a minority of products. Clostridium perfringens had been detected in one product. Even at low levels, the presence of any of these bacteria in ready to eat products was undesirable.

6.2 Salmonella typhimurium had been detected in two products and this was unacceptable. In accordance with customary practice, the local Environmental Health Department had been informed of the results and the manufacturer concerned had been visited by MAFF and DH officials. Product from the affected batch had been withdrawn from sale and the company concerned had undertaken a period of voluntary closure in order to take the necessary remedial measures.

6.3 The Committee expressed serious concern that pathogens had been detected in ready to eat products and disappointment with regard to the microbiological quality of these products in general. The quality of operations in this sector of the market was seen as very variable. Consideration was needed as to what opportunities existed for further advice and initiatives aimed at enhancing the microbiological status of ready to eat meats and meat products and providing added protection for consumers.

6.4 The Committee offered a number of general comments about the role and design of microbiological food surveillance studies and stressed the importance of prompt publication of results. The Committee would be happy to cooperate in any way it could in the planning of future projects.

7. Good practice in the use of statistics in microbiological food surveillance

7.1 The Committee considered a MAFF/DH Joint Food Safety and Standards Group (JFSSG) paper (ACM/431) explaining the principles on which the Group proposed to use statistics in microbiological food surveillance. Dr Harding explained that it was intended that this should be an evolving document which would be publicly-available. Members made a number of observations about the importance of good study design, in particular, random sampling, and agreed to submit any detailed points in writing. They stressed the importance of deciding first what questions a proposed survey should answer and then designing the survey, with appropriate statistical input, to answer those specific questions.

8. Openness

8.1 Ministers had agreed that, as part of the Government¿s commitment to greater openness, the Committee should hold one open meeting a year. A paper (ACM/432) had been prepared which presented various options and the Committee's views on these options were sought.

8.2 By way of background, various Members and Assessors provided information about openness arrangements in other fora. The Food Advisory Committee had held an "open forum" on food labelling in November 1999 attended by 75 delegates including representatives from industry, enforcement bodies, consumer groups and academia. A similar event was planned for February 2000. The Advisory Committee on Novel Foods and Processes had established a sub-group to consider issues related to post-market surveillance of GM foods which was open to an audience that was mostly invited. The Consumer Panel had held an open meeting in October 1999 attended by around 50 external representatives. It was the practice of the Spongiform Encephalopathy Advisory Committee to hold regular press conferences after each meeting rather than open meetings as such. The National Assembly for Wales had opted to conduct all of its business as openly as possible. The EC Scientific Veterinary Committee (ie. the Scientific Committee on Veterinary Measures relating to Public Health) conducted its scientific work in private but any resultant opinion or decision was immediately made public.

8.3 The general consensus among Members was that the ACMSF should be as open as possible, although it was recognised that care would be needed to avoid compromising the quality of advice the Committee gave to Ministers, creating unwarranted public anxieties about the safety of the food supply, or inhibiting the flow of relevant information from Departments. It was recognised that there were resource implications for Departments.

8.4 Members' preferred option was to make one of the routine quarterly meetings in 2000 an open meeting. Whilst it was not envisaged that the public would participate in such a meeting in the manner of Members, there should be an opportunity for some feedback to be provided by those who attended and provision should be made for this to occur in the course of the meeting. Dr Harding noted the Committee's views and undertook to take the matter forward.

9. Campylobacter review

9.1 Dr Hilton introduced ACM/437, a progress report on the recommendations contained in the Committee's Interim Report on Campylobacter. This was supplemented by papers on PHLS Campylobacter reference typing (ACM/434), seasonality in the colonisation of food-producing animals with campylobacters (ACM/435), and new developments in the subtyping of Campylobacter strains (ACM/436). Dr Hilton also reported that the Microbiological Safety of Food Funders' Group (MSFFG) were preparing a paper on UK publicly-funded research, which it was hoped could come to the ACMSF in March 2000, and that the Epidemiology of Foodborne Infections Group would be considering Campylobacter as a special topic at its next meeting. Departments sought advice from the ACMSF on the direction and focus of the research programme on Campylobacter.

9.2 Members welcomed these papers. Little progress had been made in understanding the epidemiology of Campylobacter infections compared with what had been achieved in relation, for example, to Salmonella. Although typing had thus far been of limited use in identifying and investigating outbreaks, it had been helpful in showing why this was the case. Whilst the ultimate objective was the reduction of consumer exposure to Campylobacter, work was currently very much centred on research. It was suggested that the ACMSF could help provide greater definition and understanding of the public health issues by participating in a stock-take of progress on research and by helping identify where changes of direction and fresh initiatives might be required. It was the intention of Departments to hold a workshop on Campylobacter after the MSFFG had produced its paper. It was agreed that the ACMSF should participate in this workshop. The Committee would need to consider its advice to Departments in the light of this.

9.3 In response to a request by the Chairman, Dr Donaghy explained the decision to close the Campylobacter Reference Laboratory in Scotland. The funder (NHS National Services Division) had reviewed the current contract for the work, discussing this with clinicians and public health specialists, and had concluded that the facility was not cost effective in terms of its value for clinical care or effective public health response. The decision had therefore been taken to withdraw the contract, a decision which had been ratified by Ministers. However, there was a wish that Scotland should participate, on a UK-wide basis, in the development of appropriate use of typing systems. Contacts had been made with PHLS about collaboration in a sentinel surveillance scheme. The feasibility of this scheme was currently being investigated by the Campylobacter Reference Unit (CRU) at the Laboratory of Enteric Pathogens.

9.4 The Chairman recalled that ACMSF had consistently supported a UK-based approach to Campylobacter reference typing and was encouraged that Scotland was actively looking to cooperate with CRU. He noted Dr Donaghy's explanation that the ACMSF had not been consulted on the decision to close the Scottish Reference Laboratory because the decision had been regarded as solely operational and not one on which the ACMSF's expert advice had been required. He emphasised that the ACMSF was mindful of its advisory role in relation to the devolved administrations in other parts of the UK and was always ready to provide such advice as considered appropriate.

10. Future work programme

10.1 The Committee held an initial discussion on its future work programme and the associated resource implications. The Departmental proposal in paper ACM/456 was that the Committee should examine the underlying reasons why sound food hygiene principles in food preparation were not observed in practice. This attracted a measure of support amongst Members but the Committee also commented that it was essential not to lose sight of the importance of effective action at all points of the food chain.

10.2 It was agreed that, to help elaborate the Committee's future work programme more precisely, an ad hoc Group should be set up comprising the Chairman, two or three Members, and the Assessors.

11. Annual Report 1999

11.1 Members considered a first draft of the Committee's 1999 Annual Report. It was agreed that the draft should be further elaborated to reflect the Committee's December agenda and that the Secretariat should then clear the second draft with Members in correspondence at the earliest opportunity. The aim should be to be in a position to submit the report to Ministers early in 2000, with the aim of having the report published by Spring 2000.

12. Listeria monocytogenes

12.1 The Committee considered the EC Scientific Veterinary Committee's Opinion on Listeria monocytogenes (ACM/440) and Members were asked to consider whether, given the development of long shelf-life products which may be contaminated with L. monocytogenes, current views on acceptable levels of this microorganism in food should be reviewed. To inform their consideration of this question, Members also received a Codex Alimentarius discussion paper on management of L. monocytogenes in foods.

12.2 For enforcement purposes, PHLS Guidelines had traditionally been the point of reference. While these were relevant in relation to short shelf-life products, the advent of, eg. vacuum packaged long shelf-life cheeses, in which L. monocytogenes could grow, presented different problems. The views of the ACMSF would help not only in relation to enforcement activity but also in developing the UK's negotiating position in relation to EU consideration of the issue in the Scientific Veterinary Committee.

12.3 Members were pleased to note that the papers supported the Committee's stated view that, for public health purposes, all strains of L. monocytogenes should be regarded as potentially pathogenic. Levels in food must be kept low in view of the potential for serious illness. However, it might not be appropriate to express the objective as absence at point of production. On the one hand, non-detection in 25g at the time of production was no guarantee of absence and, on the other, some food maturation processes could be shown to destroy L. monocytogenes. HACCP was the key to controlling L. monocytogenes in the production process. The aim should be to institute appropriate measures in the production stage which would guarantee compliance with a limit value of

13. Oral reports

Publication of the Committee's Report on Microbial Antibiotic Resistance

13.1 The Chairman reported that this Report had been launched at a well-attended media briefing on 18 August. He, Professor Johnston and Dr Simmons had given a series of press, radio and television interviews and there had been extensive media coverage in the UK and further afield. He had subsequently been interviewed by RTE for a current affairs programme in the Republic of Ireland. To date, Stationery Office had sold some 303 copies of the full Report and 209 copies of the Synopsis. This was in addition to the 400 copies of each purchased by JFSSG for official use.

Sewage sludge in French animal feed

13.2 The Chairman reported that he had been asked at very short notice to provide a view for the Agriculture Minister Nick Brown on the potential microbiological risks to consumer safety from French animal feed contaminated with sewage sludge. There had been no time to consult formally with the Committee although he had taken soundings from a small number of Members individually. It had been clear from the briefing papers provided that the practice was illegal and had subsequently ceased. It had also been made clear that the animal feed concerned had been heat-treated. On that basis, the Chairman had advised that pathogenic microorganisms which might have been present in the waste material would have been killed by the heat process. There was thus no immediate microbiological risk to public health through food chain exposure pathways. However, it was noted that the practice was not only illegal but repugnant to consumers.

Salmonella in Eggs Working Group

13.3 Dr Painter reported that the Group's work was proceeding apace. The Group still had some oral evidence to take, and some risk assessment work was still in train. It was nevertheless hoped that a draft would be ready for submission to the full Committee at its June 2000 meeting. As Chairman of the Group, he had been approached by the British Egg Industry Council (BEIC) to see whether the Group's work could be accelerated or an interim report could be issued. He had explained in his reply to BEIC why this was not possible, in view of the need for the process by which the Working Group formulated its conclusions and recommendations to be seen to be objective, thorough and based on sound scientific principles.

Microbiological Food Surveillance Group

13.4 Dr Harding reported that the Microbiological Food Surveillance Group (MFSG) had met on 14 September 1999. There had been an exchange of information on publicly-funded microbiological food surveillance, on the basis of information provided by MAFF, DH, DANI, PHLS and LACOTS. There had also been a progress report on the development of a surveillance database, the aim of which was to bring together basic information from different sources about surveillance studies. It was intended that this information would be placed on the MAFF website for reference purposes. The MFSG had also considered the paper on good practice in the use of statistics in microbiological food surveillance, which the ACMSF had considered under item 7 of the agenda.

Epidemiology of Foodborne Infections Group

13.5 Dr Hilton reported, on the basis of ACM/459, that the Epidemiology of Foodborne Infections Group (EFIG) had met on 25 November 1999. The Group had reviewed human and animal data from England and Wales, Scotland and Northern Ireland and had agreed to take a closer look at Campylobacter at its next meeting. EFIG members had felt that the decline in salmonellosis should be promoted as the good news story it undoubtedly was. A list of current veterinary research activities was provided. The Group considered a US paper on food-related illness and death from known pathogens (ACM/454) and was concerned at the lack of robust data underlying the analysis. In response to a PHLS paper on GI infection and published papers from the IID study, the Group endorsed the need to draw together surveillance data in an integrated way and agreed that, as far as the clinical notification system was concerned, a system based on clinical syndromes was more useful than the current system based on food poisoning. Consideration was also given as to how Group outputs might be published and this would be given further attention.

14. Any other business

14.1 There was none.

15. Date of future meetings

15.1 Meetings in 2000 are scheduled for:

17 March
21 June
19 September
5 December.