ACMSF Minutes: 5 June 2008

Meeting held in Aviation House, 125 Kingsway, London WC2B 6NH.

Present:

Chair:
Professor S O’Brien

Members:
Mr J Bassett
Dr D Brown
Mrs V Buller
Prof J Coia
Prof M Gasson
Mrs R Glazebrook
Dr R Holliman
Prof T Humphrey
Mr P McMullin
Dr S Millership
Mrs J Morris
Mr R Rees
Prof P Williams

Assessors:
Mr S Wyllie (Defra)
Dr J Hilton (FSA)
Dr S Neill (DARDNI)

Secretariat:
Dr L Foster (Administrative Secretary)
Dr P Cook (Scientific Secretary)
Mr A Adeoye
Miss S Butler

Others (Members of the public):
Mr Stephen Abbott, Sustain
Ms Sally Barber, British Retail Consortium
Mr Steve Batchford, Brakes
Ms Naomi Boxall, HPA
Dr Yvonne Boyd, Defra
Ms Fiona Brookes, Northern Foods
Ms Bridgette Clarke, Bakkavor Limited
Ms Jane Duddle, Waitrose
Ms Kaarin Goodburn, Chilled Food Association
Ms Kathie Grant, HPA
Ms Jenny Hopwood, Marks & Spencer
Mr Christopher Lane, HPA
Dr Alan Long, VEGA
Ms Narelle Marro, Food Standards Australia New Zealand
Dr David McCleery, Food Safety Promotion Board, Ireland
Dr R Mitchell, Food safety consultant
Mr Alan Procter, Zhitz International
Ms Karen Sims, Tesco
Mr Michael Wood, Bodycote Testing Ltd

1. Chair’s introduction

1.1 The Chair welcomed ACMSF Members and members of the public to the 67th meeting of the Committee. She also welcomed Gael O’Neill (FSA) who would be presenting agenda item 7, and Mrs Rosie Glazebrook who had joined the Committee as a new member to provide expertise in consumer issues. At the Chair’s invitation Mrs Glazebrook and ACMSF Members introduced themselves.

1.2 She asked Members to identify any items for discussion under any other business at the end of the meeting. The Chair had one item.

2. Apologies for absence

2.1 Apologies for absence were received from Professor Paul Hunter and Mr Alec Kyriakides.

3. Declarations of interests

3.1 The Chair reminded the Committee of the need to declare any conflicts of interests relating to items on the agenda. She informed Members that, in relation to agenda item 7, she was the lead contractor for the IID2 study.

4. Minutes of the 66th meeting (ACM/MIN/66)

4.1 Members approved ACM/MIN/66 as a correct record of the previous meeting. The Secretariat was asked to arrange for final minutes to be posted on the Committee’s website.

Action: Secretariat

5. Matters arising

5.1 The Chair drew attention to the Secretariat information paper ACM/907 detailing matters arising from previous meetings. There were no comments raised by Members in response to this paper.

6. Interim Report on Listeria (ACM/908)

6.1 At the Chair’s invitation, Professor Tom Humphrey (Chair of the ad hoc Group on Vulnerable Groups) introduced paper ACM/908. He explained that the ACMSF had set up the ad hoc Group on Vulnerable Groups as a result of horizon scanning activity by the Committee. He thanked the Secretariat and the Group for the work to date.

6.2 He outlined the background to ACMSF’s request for the ad hoc group to consider the change in epidemiology of human Listeria monocytogenes predominantly associated with the over 60s age group. He explained that the Group had based its deliberations around 4 hypotheses. These were that:

  • The rise in case of listeriosis in compromised people over 60 years of age is an artefact associated with improved case recognition;
  • The pathogen, L.monocytogenes, has become more virulent and ‘new’ strains are better able to cause bacteraemia;
  • The population predominantly affected by the increase has become susceptible to infection with listeria; and
  • Levels of exposure have increased.

Paper ACM/908 summarised the evidence considered by the Group within a framework covering areas around hazard identification and characterisation, exposure assessment and some aspects of risk management.

6.3 Based on their deliberations to date, the Group considered that the change in the epidemiology of L.monocytogenes was unlikely to be artefactual. There was also no evidence to support a change in virulence of the organism. However it was noted that the necessary virulence surveillance methodology was not available to test this hypothesis. Similarly evidence was lacking to suggest that the susceptibility of the population group affected by the increase had changed. Lastly, the Group had identified that there was insufficient evidence to fully assess exposure to the organism. Information on food consumption and storage in the home for the over 60’s age group was lacking. However, listeria was known to occur in ready to eat foods, and in comparison with two decades ago, the level and frequency of contamination was lower. These low levels were more difficult to detect. Summing up, Professor Humphrey informed Members that the Group was currently drawing together its conclusions and recommendations with a view to presenting its draft Report to the ACMSF September meeting.

6.4 The Committee discussed food surveys at point of sale and queried whether more surveillance work could be carried out (possibly by EHOs) in the home. Members considered that more information was also needed on consumer perception and domestic food hygiene practices. Results from a domestic fridge survey considered by the ad hoc Group had shown that fridges were often held at higher temperatures than those recommended by manufacturers to control the growth of food pathogens. It was also noted that the impact of recent trends in keeping food in the fridge for longer could also have an effect on growth of the organism.

6.5 Members discussed information on food purchase patterns in the over 65’s considered by the ad hoc Group, highlighting that these data appeared to relate to well individuals only. More information was needed on the food purchase and storage behaviour patterns of unwell individuals within this age group in the home, as the reported increase in listeriosis related to both well individuals and those suffering from an underlying condition.

6.6 Members discussed the hypotheses presented by the ad hoc Group. These were welcomed. It was acknowledged that in relation to the change in virulence of the bacterium, consideration also needed to be given to whether the susceptibility of individuals to the organism had also changed.

6.7 The Chair thanked Professor Humphrey for his presentation. She concluded that the Committee supported the approach being taken by the ad hoc Group to address this issue. She noted that the Committee had highlighted several areas where information was lacking in relation to food hygiene practices in the domestic setting and food behaviour and purchase patterns of the frail elderly.

7. IID2 Study (ACM/909a and 909b)

7.1 The Chair informed the Committee that, due to her role as lead project contractor for this study, she would not actively participate in the discussion on this work. Professor Williams would chair this item.

7.2 At Professor Williams’ invitation (Chair for this item), Ms O’Neill introduced papers ACM/909a and 909b. She outlined the background to the original study of infectious intestinal disease (IID) and the problems associated with attributing causes of foodborne illness. She also outlined the rationale behind the Agency’s decision to fund a second IID study. She explained that in order for the FSA to reflect on recent trends in foodborne disease and measure future progress to reduce foodborne illness further, work was needed to evaluate whether or not the relationship between disease burden in the community and official statistics had changed. Since the original IID had taken place, national surveillance systems had undergone structural changes which might have altered that relationship. Ms O’Neill summarised the budget, scope, case definition and planned approach for the new 4-year study. The work was being undertaken by the University of Manchester in collaboration with the Health Protection Agency, Medical Research Council General Practice Research Framework, London School of Hygiene and Tropical Medicine, University of East Anglia, University of Nottingham, Communicable Disease Surveillance Centre Northern Ireland, National Public Health Service for Wales, Health Protection Scotland and NHS Direct/NHS24. Lastly she summarised the work undertaken in the pilot study for the project. She reviewed problems and limitations identified by the pilot and briefed the Committee on outcomes and project findings to date.

7.3 Members discussed the GP recruitment for the study noting that the GP practices involved in the study might not be representative (as they volunteered), and emphasised that it was important to obtain representative population data. Using other sources of patient information including the THIN database, GP research databases and school absence records were suggested as alternative approaches. However, the importance of undertaking a prospective microbiologically confirmed study was emphasised. For example, work could not be not undertaken with Local Authorities to assess school absence records as it was not possible to follow-up these cases.

7.4 The quality assurance measures applied to the study were discussed. Members sought reassurance that the study was robust. The Committee was informed that the study protocol followed the FSA guidance procedures on research procurement. An Executive Committee for the project met quarterly to monitor the work and assess progress against defined deliverables. Some Members commented on the impact of potential biases occurring in the study. For example, only those patients who were severely ill with food poisoning visited the GP. Therefore mild cases would not be picked up or included in the data set. However it was pointed out that the cohort study component of IID2 would detect these milder cases.

7.5 Members reviewed the selection and recruitment of participants via the telephone survey. It was noted that for the pilot, only one person per household was selected based on the occupant with the next forthcoming birthday. In the main study selection would be by rank (determined by age) within the household. It was found that the pilot dataset was too small to assess whether there were telephone survey biases associated with language problems attributed to some ethnic groups. Members commented that higher rates of disease tended to be reported in telephone surveys compared to cohort studies.

7.6 The Committee discussed the retention and archiving of samples from the study in relation to opportunities for linked work on gut microflora. It was noted that for IID2, stool samples would only be retained for the life of the project. Extracted DNA and RNA would be archived and maintained beyond the end of the project and research organisations would be able to submit proposals to access the nucleic acid archives. Members also noted that the project team was trying to calibrate the molecular microbiology methods used to establish causative agents of infection.

7.7 The Chair thanked Ms O’Neill for her report. Summing up he welcomed this well-planned and structured study and requested that the Committee receive an interim update on the work of the project prior to its completion in 2010.

Action: FSA

8. Botulism in sheep and goats (ACM/910)

8.1 At the Chair’s invitation, Professor Williams (Chair, Ad hoc Group on botulism in cattle, sheep and goats) presented paper ACM/910. He reminded Members that in 2006 the ACMSF published its report on botulism in cattle. In this report ACMSF recommended that it was no longer necessary to restrict meat and milk from healthy cattle from farms were cases of botulism were suspected. In 2007 the Committee reconvened its ad hoc Group on botulism in cattle to consider the potential risk to human health from botulism or suspected botulism in sheep and goats via the food chain. The Group met on three occasions and recommended that there was also no need to restrict milk and meat from healthy animals on farms were cases of botulism were suspected. The reasons supporting this recommendation were that:

  • The toxin types C and D associated with sheep and goats were not associated with the disease in humans. However monitoring of toxin types in these animals was recommended in case these toxin types were subject to change;
  • The onset of disease in sheep and goats was very rapid. Therefore the likelihood of affected animals entering the food chain was low as any signs of disease would be picked up at an early stage;
  • The toxin in meat was not present to a form rendering it capable of causing disease in other animals and humans;
  • There were no cases (as far as the Group were aware) of suckling lambs acquiring the disease. Similarly there were no reports of suckling calves becoming affected by the disease;
  • Botulinum in sheep was rare in the UK. Only 14 outbreaks in sheep had occurred since 1997. There was only one case reported in goats;
  • In all the reported botulism in sheep outbreaks, poultry litter was identified as the suspected source of the disease;
  • Advice on the production and disposal of poultry litter should be reiterated to reduce the risk of occurrence of this condition in ruminants.

8.2 Summing up, Professor Williams thanked the ad hoc Group and the Secretariat for their work to produce the draft report. He sought the Committee’s view on the Group’s proposal to subject the report to public consultation prior to publication.

8.3 In discussing the geographic evidence for cases of botulism, Members noted that most of the cases occurred on the western side of the UK, as farming practices were more likely to store and use poultry litter on or close to grazing land in these regions (as there is more grazing and less arable).

8.4 The Chair thanked Professor Williams for his presentation. She confirmed that the Committee endorsed the Group’s request to publicly consult on the Report prior to its final publication.

Action: Secretariat

9. Good Practice Guidance (ACM/911)

9.1 At the Chair’s invitation Dr Foster briefed Members on a requirement for ACMSF to publish its self-assessment of its compliance with the FSA’s Good Practice Guidance for Scientific Advisory Committees which was published in July 2007. She outlined the background to this requirement, and reminded Members that the Committee first commented in the Good Practice Guidance in September 2006. She reported that, in preparing paper ACM/911, Members were asked to review their assessment of ACMSF’s performance against the 27 key principle set out in the Guidance. Paragraph 7 of the paper summarised their views.

9.2 In the ensuing discussion, Members suggested that the Committee would benefit from an external assessment of its performance against the Guidance. In addition, in the spirit of openness and transparency, ad hoc Groups should consider broadening its requests for scientific evidence to include a call for data from interested parties. The Committee recognised that it was difficult to shorten the work of ad hoc Groups but suggested that the Secretariat might consider reducing the information that it collated and provided these groups to focus on key evidence which related more closely to the Groups terms of reference.

Action: Secretariat

9.3 The Chair thanked Dr Foster for her update. She requested that the Secretariat include these views and a summary of the ACMSF’s assessment outlined in paper ACM/911 in the ACMSF’s 2007 Annual Report. She also requested that the Committee revisit how they would address some of the issues they had raised at the December meeting.

Action: Secretariat

10. Committee sub-groups

10.1 The Chair informed Members that, since the work of two of the sub-groups was covered on today's agenda, there was little additional work to report.

Working Group on Surveillance

10.2 At the Chair’s invitation, Professor Humphrey (Chair, Working Group on Surveillance) reported that the Group had not met since the last meeting.

11. Dates of future meetings (ACM/912)

11.1 The Chair brought to Members’ attention paper ACM/912 which listed the dates for 2008 and 2009. She reminded Members that all meetings were open to members of the public.

12. Any other business

12.1 The Chair informed Members that John Bassett, David Brown, Vivianne Buller and Robert Rees had been re-appointed to the Committee. She thanked them for their ongoing commitment to ACMSF and the support that they provided to the Committee.

12.2 Dr Hilton updated Members on a recent outbreak on Avian Influenza on a layer farm near Banbury. She explained that on 3 June Defra confirmed the presence of the H7 strain on farm. Results suggested that the virus had been on the farm for two weeks. 3 and 10 kilometre restriction zones had been established. An on-site cull of birds had taken place. ACMSF was not required to consider this outbreak at the present time but to maintain its watching brief on Avian Influenza.

Public questions and answers

13.1 Mr Alan Proctor (member of the public) commented on the link between MAP and Crohns Disease. He asked whether the Government had any plans to carry out a survey of MAP in milk, meat and salad. He also asked whether the ACMSF would be reviewing MAP in the future. The Chair explained that ACMSF considered MAP in 2005 in light of newly published research on this issue by the University of East Anglia. ACMSF had no plans to review MAP again although it was keeping a watching brief on this topic. Dr Hilton confirmed that the FSA had no plans to test meat or milk for MAP pending results of the herd survey. The University of East Anglia study showed that milk had a protective effect against MAP.

13.2 Ms Kaarin Goodburn (Chilled Food Association) queried why the publication of the FSA guidance on vacuum-packaged foods was delayed as the ACMSF last considered this issue in December 2006. Dr Hilton replied that the Guidance was delayed as it was currently undergoing additional procedures as part of government’s better regulation initiative. She agreed to provide Ms Goodburn with a revised estimated publication date.

Action: FSA/Secretariat

13.3 Mr Alan Long (VEGA) commented on the transmission of zoonotic disease to humans.

13.4 There being no further business, the Chair thanked Members and members of the public for attending and closed the meeting.