Abstract
Cost-efficient monitoring of food contamination and surveillance of food-borne diseases requires a coordinated multidisciplinary approach with the participation of stakeholders from all sectors of the "farm-to-fork" continuum including the public health sector. To facilitate communication and coordination, establishment of a coordinating body with the participation of relevant stakeholders is recommended. Furthermore, relevant surveillance data from all stages in the food production chain and from the surveillance of human disease should be continuously collected and analyzed to evaluate trends and sources of food-borne disease. The establishment of a dedicated multidisciplinary surveillance unit involving epidemiological and microbiological expertise from all sectors can facilitate this type of coherent data analysis and feed back. Systems such as these can be operated at the national, regional and global level.
Monitoring And Surveillance as Tools in Food Safety Assurance
In order to address and manage food safety, it is imperative to have knowledge on the current situation and trends with regard to the occurrence and spread of human pathogens in the food production chain. This knowledge needs to be updated continuously so that appropriate responses can be prepared. Activities involved in such a system are gathered under the terms 'monitoring' and 'surveillance' (Fig. 1). Monitoring can be defined as: "the performance and analysis of routine measurements, aimed at detecting changes in the environment or health status of populations". Surveillance can be defined as: "the ongoing systematic collection, collation, analysis and interpretation of data, followed by the dissemination of information to all those involved so that directed actions may be taken" (WHO/CDS/CSR).
Surveillance refers to a specific extension of monitoring where obtained information is utilized and measures are taken if certain threshold values related to disease status have been passed (Noordhuizen and Dufour, 1997). The main objectives of surveillance are outbreak detection, monitoring trends in endemic disease, evaluating interventions, and monitoring programme performance and progress towards a predetermined control objective. However, surveillance is not merely a routine measure of the current situation (as opposed to monitoring), but a basis for giving qualified feed-back to producers, tracing back contamination to its origin, pin-pointing critical (control) points during production and initializing targeted action.
Figure 1. Graphic presentation illustrating the relation between monitoring and surveillance.
There are various levels of intensity and coordination in surveillance systems. Surveillance can be active or passive, general or sentinel, continuous or intermittent, disjointed or integrated. In general, the intensity of surveillance is a product of social (i.e. priority of disease, societal impact), practical (i.e. availability of epidemiological knowledge) and financial parameters.
The Need
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