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What should be done to decrease the incidence of human salmonellosis in Canada? Ross, Andrew Francis 1978

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WHAT SHOULD BE DONE TO DECREASE THE INCIDENCE OF HUMAN SALMONELLOSIS IN CANADA?  by  ANDREW FRANCIS ROSS M.B., Ch.B., University of Liverpool, England, 1966  A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE  in  THE FACULTY OF GRADUATE STUDES Health Care and Epidemiology Faculty of Medicine University of British Columbia We accept this thesis as conforming, to the required standard  THE UNIVERSITY OF BRITISH COLUMBIA July 1978 © A n d r e w F. Ross  In presenting this thesis  in partial fulfilment of the requirements for  an advanced degree at the University of B r i t i s h Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this for  thesis  scholarly purposes may be granted by the Head of my Department or  by his representatives.  It  is understood that copying or publication  of this thesis for financial gain shall not be allowed without my written permission.  Department of  H e a l t h Care and  Epidemiology  The University of B r i t i s h Columbia  2075 Wesbrook Place Vancouver, Canada V6T 1W5  Date  Sgpt-gmW 1 A, 1 Q7S  ABSTRACT  The thesis i s concerned with what should be done to decrease the incidence of human salmonellosis i n Canada. The present high incidence of Salmonella contaminated poultry i s reviewed and evidence i s given that links Salmonella contaminated poultry carcasses at the r e t a i l l e v e l to human salmonellosis.  The question i s raised as to  whether control or eradication should be the goal i n Canada, and present regulations involving various levels of Governments are examined.  The incidence of Salmonella contaminated poultry i n some other countries i s reviewed, together with some of the Salmonella control programmes that have been i n s t i t u t e d by these countries.  F i n a l l y , certain recommendations are made, as to what could be done i n Canada to decrease the incidence of human salmonellosis. These recommendations stress the need f o r further research to develop ways of decreasing the incidence of Salmonella contaminated poultry at the r e t a i l l e v e l .  The colonization of the gut of day-old chickens  with the i n t e s t i n a l f l o r a of adult chickens i s a method that shows promise.  The use of radiation and chlorination of the poultry carcasses  would also help to reduce the incidence of carcass contamination.  I f Canada i s determined to reduce human salmonellosis, then steps must be taken to coordinate the many different branches of both  ii  the Federal and Provincial Governments, and regulations, when promulgated, must be enforced.  Caterers and those cooking i n their  own homes must be educated on correct food handling practices and cooking techniques.  Human salmonellosis w i l l probably never be eradicated, but i t s present incidence could certainly be reduced.  iii  TABLE OF CONTENTS Page •••• 1  Introduction Human and Poultry Salmonellosis  20  Human Salmonellosis..  21  Poultry Salmonellosis  23  Poultry and Man Salmonella Cycles  28 32  Methods Federal Government: Health and Welfare Canada  36  Agriculture Canada  38  Environment Canada  44  B r i t i s h Columbia Provincial Government: Ministry of Agriculture  45  Ministry of Health  46  Ministry of the Environment..  50  Salmonella Control i n Some Other Countries  53  Sweden  54  Denmark  58  United Kingdom  60  Conclusions  63  Bibliography  67  iv  LIST OF TABLES TITLE Table I  PAGE  Salmonella Isolations From Processed Raw Canadian Chicken  1  Table II  Samples of Imported Poultry - Japan 1971-72  2  Table III  Ranking of Salmonella Isolations From Humans and Poultry Related Sources For the Years 1969-1973 Percentage of Poultry Related Salmonella Isolations and the Percentage of a l l Human Isolations of the Same Serotypes i n Canada - 1969-73  Table IV  Table V Table VI Table VII  4 5  Illustrations of Under Reporting of Gastroenteritis  17  Reported Human Infections by Salmonella i n Canada  18  Cost Per Year of Human Salmonellosis i n Canada as Estimated i n 1976  19  Table VIII  Percentage of Sampled Flock Positive for Salmonella  25  Table IX  Objectives for the Discharge of Effluent to Marine and Fresh Waters From Poultry-Processing Plants Percentage of Salmonella-Contaminated Raw Dressed Chicken 1973-1974 by Rank  Table X  51 53  V  LIST OF FIGURES AND ILLUSTRATIONS Page Figure 1  Salmonellae i n Food Cycle of Infection  7  Figure 2  Salmonella Contamination Cycles  8  Figure 3  Methods Whereby Salmonellae Gain Entrance to Poultry Flocks  28  Figure 4  r£ssemination of Salmonellae From Breeding Flocks  29  Figure 5  Salmonella Model  31  Illustration 1  (Appendix A) Human Salmonellosis Information Flow Chart  Illustration 2  16  (Appendix B) Flow Diagram Poultry Processing  27  1  INTRODUCTION  A news release by Health and Welfare Canada i n November 1975 was t i t l e d "Salmonella Problem Emphasized"^  The main theme of t h i s  news release was the growing problem of food-borne Salmonella i n f e c t i o n s . Early i n the New Year (1976) the Department of National Health and Welfare planned to introduce regulations under the Food and Drug Act, i n order to bring about a progressive decrease i n the incidence of Salmonella-contaminated poultry at the r e t a i l l e v e l .  The objective  as stated i n 1975 was t o reduce the incidence of Salmonella-contaminated poultry at the r e t a i l l e v e l to 5% by I960. Survey reports of Canadian processed poultry from 1970 to 1978 show a d e f i n i t e increase i n the percentage of Salmonella-contaminated poultry carcasses during t h i s time period. TABLE I SALMONELLA ISOLATIONS FROM PROCESSED RAW CANADIAN CHICKEN YEAR  NO. BIRDS OR PACKAGES OF PARTS  PERCENT WITH SALMONELLA  1970-71  144  15  1971-72  132  19  1972-73  259  20  1973-74  157  23  1974-75  45  22  1975-76  154  36  1976-77 (11 months)  365  39  HEALTH PROTECTION SURVEYS  2  Further evidence of the increase i n the percentage of Salmonellacontaminated processed poultry, can be shown from other studies. A Japanese study "during 1971 and 1972 reported that 17.6$ 1  of imported  Canadian poultry meats were found to be positive forSalmonella. Duitschaever^ i n a Canadian study done i n 1975 on cut-up raw chicken pieces found that  34.8$ of the packages were contaminated with  Salmonella, and that eleven different serotypes were isolated. In a recent study by Skura^ 21.5$ be Salmonella-contaminated.  of chicken carcasses were found to The results of the latest Health Protection  rt  Branch study  show that about 35$ of the processed chicken carcasses  that were sampled were Salmonella-contaminated. TABLE I I SAMPLES OF IMPORTED POULTRY - JAPAN 1971-72 COUNTRY OF ORIGIN  NO. OF TESTED SAMPLES  NO. OF POSITIVE SAMPLES  $  CONTAMINATED  1.  DENMARK  532  20  3.8  2.  HUNGARY  332  119  5.7  3.  CHINA  2,219  207  9-3  4.  U.S.A.  2,728  293  10.7  5.  BULGARIA  340  46  13.5  6.  CANADA  153  27  17.6  7.  NETHERLANDS  137  39  28.5  ADAPTED FROM DATA BY SUZUKI^ (1971-72)  3  As can be seen from Table II Canada was ranked i n sixth place i n the Japanese study of Salmonella-contaminated carcasses, with a rate more than four times as great as Denmark. From the information presented i n the above mentioned studies i t i s easy to understand why Health and Welfare Canada were concerned about the problem of Salmonella i n processed Canadian poultry. However since the hews release i n 1975 i t would appear that very l i t t l e has changed, and that unless very drastic measures are taken, the objective of 5% contamination rate by 1980 i s not going to be attained. This thesis w i l l deal with possible measures that Canada could take to reduce the high rate of Salmonella-contamination i n processed poultry. Finn  reported that according to studies carried out by the  Health Protection Branch of Health and Welfare Canada i n 1973, 77% of 335 cases of human salmonellosis were caused by contaminated 9  poultry.  Handzel  stated that "Chickens, turkeys, and other poultry  were a consistently f r u i t f u l source of Salmonellae and they were responsible for nearly half the common-vehicle epidemics".  Both of  these studies were done i n Canada and the authors were of the opinion that i f the incidence of Salmonella-contaminated poultry was decreased then the incidence of human salmonellosis would i n turn be reduced. Below i n Table III the ten most frequent Salmonella serotypes isolated from poultry during the years 1969 to 1973 are presented. Also included i n this table are the top ten Salmonella serotypes isolated from humans during the same five year period. From the table i t can be seen that eight of the top ten isolations of Salmonella  4  serotypes found i n poultry are the same as those found i n the top ten serotype i s o l a t i o n s found i n humans. TABLE I I I RANKING OF SALMONELLA ISOLATIONS FROM HUMANS AND POULTRY RELATED SOURCES  FOR THE YEARS 1969-73 POULTRY RELATED  HUMAN  1.  S.typhimurium  643  1.  S.typhimurium  8803  2.  S.thompson  316  2.  S.enteritidis  2387  3.  S.saint-paul  257  3.  S.thompson  2231  4-  S.infantis  245  4.  S.saint-paul  1881  5.  S.enteritidis  154  5.  S.newport  1646  6.  S.blockley  143  6.  S.infantis  1194  7.  S.san-diego  83  7.  S.montevideo  1068  8.  S.heidelberg  63  8.  S.heidelberg  757  9.  S.montevideo  50  9.  S.blockley  742  S.haardt  43  10.  S.bareilly  2217  10.  FROM HANDZEL  Further evidence that there i s a r e l a t i o n s h i p between Salmonella serotypes found i n poultry and those found i n humans, i s demonstrated i n Table IV. Although samples from poultry and poultry r e l a t e d  environments  (hatcheries, b r o i l e r houses, etc.) furnished only between 16 to 33$ of a l l i s o l a t i o n s from non-human sources i n the f i v e year period  5  1969 to 1973» the serotypes isolated from poultry accounted f o r between 85 and 89% of a l l human isolations during that same period.  TABLE IV PERCENTAGE OF POULTRY RELATED SALMONELLA ISOLATIONS AND THE PERCENTAGE OF ALL HUMAN ISOLATIONS OF THE SAME SEROTYPES IN CANADA - 1969-73 YEAR  PERCENT OF ALL NONHUMAN ISOLATES THAT CAME FROM POULTRY AND RELATED ENVIRONMEMT  PERCENT OF ALL HUMAN ISOLATES THAT WERE SAME SEROTYPES AS THOSE FROM POULTRY AND POULTRY RELATED ENVIRONMENT  1969  21.4%  85.0  1970  31.5/0  86.1  1971  22.0%  88.7  1972  15.9%  89.0  1973  27.2%  88.2  PIVNICK-  From the evidence presented so f a r , although i t i s not conclusive, i t would appear that poultry i s certainly one of the major sources of human salmonellosis i n Canada, and i t i s assumed f o r the purpose of t h i s thesis that i f the Salmonella contamination rates of poultry eaten i n Canada were reduced, then the incidence of human salmonellosis would be diminished. For the sake of completeness and realizing that Salmonellae are found throughout nature, and that man can be infected from many sources  6  including his own k i t h and kin, a brief review of the l i t e r a t u r e i s given. Many household pets have been incriminated i n human salmonellosis cases, and Salmonellae have been found to occur naturally i n d o g s , ' 10  cats, ' 1 2  1 3  horses, parakeets, pigeons,- - ' doves, 11  wild b i r d s , ' ' ' 3 4  guinea p i g s , snakes, ' 15  2 0  1 6  1 8  12  1 9  rats,  fishes, ' 2 4  2 5  and t o r t o i s e s .  20  2 0  1  mice,  21  17  hamsters,  frogs, ' ' 1 5  4  2 6  2 7  16  15  ducks,  gerbils,  turtles,  2 8  2 2  11  1 4 , 1 7  rabbits, ' ' 1 6  lizards, ' 1 8  2 0  27  18 19 20 29 Salmonellae have also been isolated from monkeys ' ' ' , , skunks, 18 racoons, 30 opossums 31 and. squirrels. 15,21 ' 7  7  32 Morse  makes the point that direct contact with the feces of  an infected pet i s a common source of salmonellosis p a r t i c u l a r l y i n cases involving young children, and that indirect sources of infection may be contamination of human food by material from infected pets. Other sources of Salmonellae that can produce human salmonellosis, which need not be directly related to poultry or pets, can be found 33  i n the monthly and yearly "Food-borne Outbreak Reports  compiled by  Health Protection Branch of Health and Welfare Canada. For example i n the year of 1974 there were a number of different foods incriminated such as chocolate, lamb chops, beef, cheese, bacon, ham, hamburger, pepper, and watermelon.  In some of these cases the foods concerned  were contaminated due to the use of poor hygienic practices during food preparation.  Salmonella organisms are ubiquitous i n nature, but there are some well documented cycles that involve humans and animals. Figure .1  1 7  2 3  7  and Figure 2 . demonstrate two general cycles of infection, and later in the thesis cycles involving poultry and humans will be dealt' with in more detail.  CONTAMINATED ANIMAL FEED AND -FERTILIZER.  POULTRY^  PIGS  •CATTLE  (Few Infected on Farm)' Crowded Transport (Many Infected in Lairages, Processing -Plants, Abattoirs).  BULK EGG PRODUCTS  MILK  FOWL AND MEAT  MADE  UP • P O O D S '  ANIMAL  FEED  Consumed By  MAN, DOMESTIC ANIMALS, VERMIN CASES OR CARRIERS  FIGURE I - SALMONELLAE IN POOD CYCLE OF INFECTION  BOWMER  3 4  8  Figure 1 demonstrates the more common pathways that produce salmonellosis i n man and animals, with particular-- emphasis on the food chain.  Animal  Birds  Foods of  FIGURE 2 - SALMONELLA CONTAMINATION CYCLES EDEL  35  In Figure 2; Edel stresses the environmental factors responsible for the continuing cycle of Salmonella spread.  There are many  environmental factors involved which are of importance when considering human salmonellosis, and a few of them w i l l now be discussed.  WATER Water can serve as the vehicle of Salmonella infection for both animals and man. A large water-borne epidemic of human salmonellosis occurred i n Riverside, California i n 1965, associated with contaminated  9  unchlorinated drinking water.  Hundreds of strains of Salmonella  25 have been isolated from the United States Federal River Basin Project, and a variety of serotypes common to both animals and man were i d e n t i f i e d . 37 Slanetz  i n a study of 128 samples of sea water collected from eight  sampling stations i n the United States and Canadian s h e l l f i s h waters found that nineteen (15%) were positive f o r Salmonella. In a report by the Environmental Protection Service, Environment Canada, i n 1975, i t was found that Salmonellae of various serotypes were shown to be present i n raw and treated wastes at three large, well 39  operated poultry processing plants.  Vanderpost and B e l l ,  i n Alberta  have demonstrated a potential hazard associated with the discharge of raw or partially-treated, undisinfected packing plant wastes to natural waters which may be used f o r recreational purposes, and f o r the watering of domestic animals. Hibbs^ reported an outbreak of salmonellosis i n humans, and 0  calves, associated with contaminated creek water.  DRUGS AND THERAPEUTIC AGENTS Drugs of animal o r i g i n and yeasts have been found contaminated with Salmonellae. During a two year period, 16 (24%) of 76 drugs of animal o r i g i n were examined i n the United States and 98 l o t s of such drugs were recalled because of Salmonella-contamination^ Yeasts and yeast substances have been documented as a source of salmonellosis and have been associated with human i l l n e s s .  In a two year period i n the  United States 34 (21%) of 164 samples of yeast and yeast products contained Salmonellae^"  10  VECTORS IO  Salmonella serotypes have been isolated from flies, fleas / and t i c k s 4  4  IO  cockroaches,  but there are no good epidemiological studies  45  available that demonstrate how important these vectors are. Various inanimate objects have been incriminated in Salmonella outbreaks, mostly in hospitals  46  Garden soil, fertilizers and house plant products  have been reported as being contaminated with Salmonella serotypes. in  Mittermyer  in 1969 found that nine out of 100 samples of nutrient  material for potting house plants contained Salmonella organisms. Because of the ubiquitous nature of Salmonella organisms throughout nature, a decision has to be made as to whether efforts should be made to eradicate or control these organisms. Control has been defined as "the purposeful reduction of specific disease prevalence to relatively low levels of occurrence, though transmission occurs frequently enough to prevent its permanent disappearance."  49  The term eradication literally means "pulling out  by the roots", and in any definition of eradication there must be a continued absence of transmission in a specified area. Thus control i s more relative and less absolute than eradication. In order to achieve and maintain the eradication status of a specific disease within a defined area, two conditions are necessary. 1.  No transmission of the organism which causes the disease must occur, or i f i t does, i t does no produce the disease.  2.  Adequate surveillance must be present to prevent the re-establishment of the disease from carriers, relapsing cases, or imported sources of infection.  11  Another definition of eradication i s "the extinction of the pathogen that causes the infectious disease i n question."^  Thus even  i f one member of the species survives then eradication has not been accomplished.  This definition implies action on a world-wide basis,  whereas the f i r s t definition was limited to a specified area. So far no human disease has been eradicated on a world-wide basis, although i t would appear that smallpox i s very close to being eradicated. However diseases have been eradicated i n well defined areas, for example smallpox i n North and South America, rabies i n England, but surveillance must be continued i n these countries until world-wide eradication has occurred. Thus there i s an essential difference between the concepts of control and eradication, for once a disease has been totally eradicated on a world-wide basis, the costly burden of control measureswould no longer be required.  A l l eradication programmes have many needs i n  common, the main ones being, p o l i t i c a l stability, popular support for the programme, good organization with well trained staff at a l l levels, and adequate funds. The degree of difficulty involved i n an eradication programme w i l l depend on many factors some of which are: 1.  Host specificity of the disease causing organism: A disease only found i n man, and i s spread directly by person to person contact, i s much easier to eradicate than a disease which i s present throughout the animal kingdom.  2.  Effective Vaccine: If an effective vaccine i s available, then eradication w i l l be much easier.  12  3.  Effective forms of Treatment and Prevention: If there are effective forms of treatment and prevention of carrier states then eradication will be easier.  4.  Diagnosis of the Disease: If the disease is easy to diagnose, either visually, clinically, or by a rapid laboratory test that is specific then this will be useful in eradication.  5.  Severity of the Disease: The severity of the disease will influence the priority attached to its eradication.  Having examined the concept of eradication in general, how can i t be applied to ialmonellosis. Is the eradication of Salmonellosis a realistic goal in Canada? Since many countries would not consider the eradication of salmonellosis as a health priority, the first definition of eradication will be used in which eradication was defined as the "continued absence of transmission in a specified area".  1.  Host specificity of Salmonella: A few Salmonellae are for a l l practical purposes host specific (i.e. S. pullorum and S. gallinarum for poultry and S. typhi for man).  However most of the 1,700 serotypes are 51 potentially disease producers for man and animals. 2.  Effective Vaccine: Due to the many species of Salmonella that can potentially cause disease, there is no one vaccine that is effective. Even the vaccine for S. typhi is only between 70 and 90$ effective.  51  13  3.  E f f e c t i v e Forms of Treatment and Prevention of C a r r i e r s : I t i s recommended that the treatment of most cases of human salmonellosis should be supportive, and that a n t i b i o t i c s tend to prolong the c a r r i e r stage.  However i n severe cases  52 a n t i b i o t i c s should be used. 4.  Diagnosis of the Disease: Salmonellosis cannot be diagnosed c l i n i c a l l y , with any degree of accuracy.  Laboratory confirmation i s required. In  some mild cases and i n c a r r i e r s the organism may not be present i n the specimen of s t o o l being tested, or the organisms  may  have died. 5.  Severity of the Disease: The non S. typhi and S. paratyphi i n f e c t i o n s are not usually life-threatening-, although S t a t i s t i c s Canada reports show that from the years 196'5 to 1975  about 8 people died  per year from the r e s u l t s of the disease.  Salmonellosis i s  most severe i n the very young or the elderly, or i n any age group where there i s a pre-existing medical condition which a l t e r s the immune response.  Salmonella does produce a f a i r  degree of morbidity although most cases do not l a s t longer than one week.  53 Levy  i n a study i n the early 1970's of an outbreak of food-  borne salmonellosis i n which about 125 people were affected, estimated that the economic impact was $28,733. expense was l o s t s a l a r i e s .  The largest portion of the  In the above study the i l l n e s s ranged from  mild to moderately severe and lasted an average of f i v e days.  14  Finn" did a benefit-cost analysis for the eradication of Salmonella from a l l chicken meat produced in Canada. He estimated that such an eradication programme would take ten years and that the total cost would be about $300 million.  The benefit he estimated would be  $23 million. Thus the program would cost $12.68 for every $1 benefit. In this study Finn only looked at the costs for the eradication of Salmonella from chickens, and did not look at costs for the eradication of Salmonella from turkeys, cattle, etc.  How many Canadians are infected per year with Salmonella organisms? In Canada there are two National Information systems. The first system is a physician based notification mechanism whereby clinically diagnosed cases are notified to the Medical Health Officers, and then to the Provincial Epidemiologists. They in turn report to Statistics Canada. This data published by Statistics Canada i s then incorporated into the Canadian Diseases Weekly Report, in the form of "Notifiable Diseases Weekly Summary", as well as the Statistics Canada "Annual Report of Notifiable Diseases". In the second notification mechanism, the ten Provincial Laboratories report their laboratory isolates to the National Enteric Reference Centre (N.E.R.C.) on a weekly and monthly basis. This data is then published in the N.E.R.C. Weekly and Monthly Reports, the L.C.D.C. Newsletter, as well as the CD.W.R.  15  Both national information systems are difficult to interpret because of their lack of uniformity of Provincial data notification, and by the various deficiencies with which each system is burdened. For example, North West Territories and the Yukon, are not included in the N.E.R.C. reports, but they are reported to Statistics Canada. The Federal Advisory Committee on Epidemiology is reviewing the question of Salmonella information systems. See Appendix A for Human Salmonellosis Information Flow Chart. (Bollegiaaf) There i s ample evidence to support the conclusion that salmonellosis is grossly under-reported.  For example during the  water-borne outbreak of gastroenteritis caused by serotype typhimurium 36  in Riverside, California  in  1965» there were 110 human isolations, and  approximately 200 cases of gastroenteritis were known to the health department; but the epidemiologic.evidence indicated that there were at least 16,000 cases of gastroenteritis. Another example occurred in Oxford, Nebraska, where in 1967 there was an outbreak of S. typhimurium gastroenteritis following the consumption of contaminated turkeys. There were five isolations from individuals with clinical disease reported through normal reporting channels; however, during a stool culture survey, 26l isolations were made, 158 from individuals with clinical disease and 103 from asymptomatic carriers. In fact an estimated 2,600 infections occurred as determined by epidemiological investigations, resulting in 1,900 clinically i l l individuals and 700 asymptomatic carriers.  Appendix A  rlvitY t : the local level  (illustration l).  Source of information The 10 provincial Laboratories They report the nucber and types ot" Salmonella serotypes (2)  HUMAN SALMONELLOSIS INFORMATION FLOW CHART Responsible party for information input Into the publication National Enteric Reference Centre C.D.C. Ottawa  Where data is published N.E.R.C. Weekly Report (Human Salmonellosis) N.E.R.C. Monthly Report (human and non-huxan Salnonella Isolates) L.C.D.C. Newsletter  N.E.R.C. +Prov. Epidemiologist  _t Sureau of — Epidemiology  i of cople distribute  CD.W.R. (Bureau of Epidemiology publication)(inforraation included every 4 weeks)  Bureau of Stats. Can. notifiable Diseases Epidemiology weekly sumrjry) (L.C.D.C.)  CD.W.R. (Information as a weekly inclusion)  Statistics Canada  Annual Report of Notifiable Diseases • -}(a) Hoopltal Morbidity (b) Causes of DVath  -» 125 -i liCO  :EC3  Medical Services (X.U.T. 1 Yukon) Field Epidemiologists Provincial Epidemiologist -* 875  NOTES: (1) Inspection triggered at provincial and federal levels: e.g.; (1) Veterinary Public Health Service, OntarloKliesj do not report Into th.« (11) Field Operations Directorate (federal) jnotlflcatIon systeo (2) Tlie Central Prov. Labs, generally also send rcportB to the Prov. Epidemiologists ( 1, or M.O.H.'s) as well as the physicians. The procedure varies with the provinces.  BOLLEGRAAF  54  (3) LLT.r.ND:•+-= do nothing * = Consumer Affairs, etc. Ind. c.isa.Individual Case A'Specicens tuy cither not bo taken, or the organise was not identified (due to loss In transit, or lack of lab. facilities). Priv. Lab. " Private lob, Rcj. Lai. « Ri'f.lonal provincial Lab. <• . Kosp. Lab." Hospital lab.'  17  The t h i r d example of under-reporting involved eggs contaminated with S. derby, where there would have been fewer than 100 cases reported through normal channels. However as a result of special studies over 1,000 cases were i d e n t i f i e d by bacterial culture of stool specimens.  25  TABLE V. ' ILLUSTRATIONS OF UNDER REPORTING OF GASTROENTERITIS PLACE  VEHICLE  CALIFORNIA  WATER  NEBRASKA  TURKEY  U.S.A 13 states  EGGS  CASES REPORTED  CASES BY EPIDEMIOLOGICAL INVESTIGATION  AGENT  • 200  16,000  SALMONELLA typhimurium  1,900  SALMONELLA typhimurium  > 1,000  SALMONELLA derby  5  < 100  Although the above three examples are from the United States, 3 Pivnick  when describing the Canadian scene stated " I t i s probable  that there are between 10 and 100 cases of Salmonellosis i n humans for every case that i s reported, but the unreported cases are not s u f f i c i e n t l y serious to receive medical attention or be diagnosed. Nevertheless they must reporesent a great deal of discomfort, a large number of l o s t days from school or employment, and a very large loss i n dollars to the economy".  18  From Table VI, i t would appear that between 4,000 and 5,000 people a year i n Canada are sufficiently i l l to require medical attention, and have laboratory investigations performed.  TABLE VI REPORTED HUMAN INFECTIONS BI SALMONELLA IN CANADA  3  NO.  REPORTED  NO.  REPORTED  NUMBER  (STAT  B  (N.E.R.C.)  DAYS  ESTIMATED  IN  IN COST  HOSPITAL  HOSPITAL FOR  1972  1973  1974  4,176  3,548  4,261  3,910  5,140  4,607  5,235  5,054  1,052  1,028  C  HOSPITALIZED  A V E R A G E DAYS TOTAL  CAN )  1971  HOSPITAL  14.3  13-6  15,043  13,981  1,500,000  1,500,000  15,000 ( E  15,000(EST)  1,700,000  1,900,000  PIVNICK A  TYPHI  AND PARATYPHI  STATISTICS  3  EXCLUDED  CANADA  °NATIONAL ENTERIC  Finn  REFERENCE  CENTRE  estimated the expenses resulting from human salmonellosis  to be about $8 million per year, expressed i n 1976 dollars. A breakdown of this total i s as follows:  19  TABLE VII COST PER1YEAR OF HUMAN SALMONELLOSIS IN CANADA AS ESTIMATED IN 1976  WAGES LOST DUE TO SALMONELLOSIS  4,760,724  COST OF HOSPITALIZATION  2,000,000  VALUE OF LIVES LOST MEDICAL TREATMENT  216,000 1,000,000  7,976,724  INFORMATION FROM FINN 55 Pivnick  although he did not t r y to estimate the cost of human g  salmonellosis directly related to chicken sources, as Finn d i d , instead he t r i e d to estimate the cost of human salmonellosis from a l l sources.  I t would appear that Finn's estimate of about $8 m i l l i o n i s  on the low side, for Pivnick i s of the opinion that the percentage of poultry related cases of human salmonellosis i s substantial. 55 Pivnick wrote, "We have estimated the cost to Canada of a l l human salmonellosis from data and concepts presented by Levy and 53 Mclntire,  and have arrived at a figure of not less than $25,000,000  and not more than $100,000,000 per year."  20  HUMAN AND POULTRY SALMONELLOSIS  The genus Salmonella i s within the family enterobacteriaceae and i s characterized by i t s c u l t u r a l properties, and by i t s antigens, although neither of these c h a r a c t e r i s t i c s i s wholly exclusive to the 56 genus.  The generic term Salmonella was given to these microorganisms  by Lignieres i n 1900 i n honour of Dr. D. E. Salmon, a co-discoverer of the microorganism now known as Salmonella cholerae—suis.  This generic  term was adopted by i n t e r n a t i o n a l agreement on the basis of p r i o r i t y , i n accordance with i n t e r n a t i o n a l r u l e s of nomenclature, and has been  25 employed u n i v e r s a l l y since 1933. D e f i n i t i o n of genus Salmonella: Enterobacteria (fermentative, f a c u l t a t i v e l y anaerobic oxidase—negative Gram-negative rods) that generally are motile, aerogenic, non-lactose fermenting, urease-negative,  citrate-utilizing,  57 Voges-Proskauer—negative and KCN-negative (KCN-sensitive). Laboratory diagnosis of Salmonella: A diagnosis of Salmonella i n f e c t i o n i s made by i s o l a t i o n of the organism from blood, feces, urine, or other organs.  Isolation  from blood or urine i s i n d i c a t i v e of t i s s u e invasion and o r d i n a r i l y establishes the diagnosis, but a Salmonella organism i s o l a t e d from feces, i s not n e c e s s a r i l y the cause of the i n d i v i d u a l ' s i l l n e s s . Demonstration of a s i g n i f i c a n t r i s e i n antibody t i t r e to the s p e c i f i c organism i s o l a t e d from the patient i s h e l p f u l i n confirming the diagnosis.  However there may not be any change i n the antibody t i t r e .  21 Specimens are i n i t i a l l y grown on special culture media, and f i n a l identification i s based on biochemical reactions and agglutination 58 tests with monospecific antisera.  HUMAN SALMONELLOSIS In any one year only about 150 different serotypes are isolated from humans i n Canada. Out of these 150 serotypes about 10 are responsible for over 75% of human infections and 20 serotypes are incriminated i n over 90% of a l l human cases of salmonellosis i n Canada?  51 Clinical Manifestations: Gastroenteritis or "food-poisoning',' i s by far the most common manifestation of Salmonella infection.  The infection varies i n  severity from mild to extremely severe forms.  The onset of symptoms  may vary from a few to 72 hours after the ingestion of contaminated food.  Nausea, vomiting and diarrhoea are associated with severe  abdominal cramps. Fever and prostration may be pronounced.  The  stools are numerous, watery, and may contain mucus, pus, and blood. Such cases are clinically indistinguishable from bacillary dystentery. The physical findings are scant, Rose spots and menigismus, are sometimes observed.  In about half the patients, the temperature  f a l l s to normal within 1 or 2 days, and recovery i s uneventful. In others the disease may last for a week or more. Protracted or recurrent diarrhoea i s not rare.  In very severe infections the patient may  become dehydrated and emaciated; a shocklike picture, with cyanosis,  22  hypothermia, and c i r c u l a t o r y collapse, may  precede death.  In some cases the gastroenteric type of i n f e c t i o n i s followed by the enteric fever syndrome, or the septicemic syndrome or by signs of l o c a l i z a t i o n , such as meningitis, pneumonia, and  osteomyelitis.  Pathogenesis and,Pathology of G a s t r o e n t e r i t i s : Salmonella organisms attach themselves to the mucosal e p i t h e l i a l c e l l s and they also penetrate i n t o the deeper submucosal tissues of the g a s t r o - i n t e s t i n a l t r a c t .  The m u l t i p l i c a t i o n of the  organisms at t h i s s i t e i s responsible f o r the inflammation reaction and subsequent disease.  The mucosa of the stomach and small i n t e s t i n e  i s inflamed and edematous. In s p i t e of the ingestion of the Salmonellae by polymorphonuclear leukocytes and macrophages, the organisms may presence of a n t i b i o t i c therapy.  survive, even i n the  I t i s t h i s phenomenon that may  be  responsible f o r the persistent c a r r i e r state which i s found i n some patients, e s p e c i a l l y newborn i n f a n t s .  Inapparent Infection and the Carrier State: Of a t o t a l of 7,779 p o s i t i v e Salmonella cultures, reported i n 59  1957  by Saphra and Winter ,  1,209  (15«5%) were derived from c a r r i e r s  or persons with inapparent i n f e c t i o n s .  Gastroenteritis caused by  the same Salmonella type preceded the c a r r i e r state i n h a l f the instances.  In many c a r r i e r s , the source of i n f e c t i o n remains unknown.  The c a r r i e r state has been estimated to be present i n about 0.2%  of the  23  population.  The c a r r i e r state may clear spontaneously or p e r s i s t  f o r several years, and the e f f e c t s o f antimicrobial agents i n  57 clearing t h i s state has been disappointing.  POULTRY SALMONELLOSIS Poultry salmonellosis i s a c o l l e c t i v e term used t o describe i n f e c t i o n s with any organism of the Salmonella group other than, S. pullorum (pullorum disease) or S. gallinarum although the most important Salmonella types causing c l i n i c a l disease i n poultry, do not have an association with human food poisoning.  These two types  of Salmonella organisms are quite d i f f e r e n t from the many other Salmonella serotypes that i n f e c t poultry.  An important method of  spread of these two types, and p a r t i c u l a r l y of S. pullorum, i s the d i r e c t r e s u l t of i n f e c t i o n becoming l o c a l i z e d i n the ovaries of breeding hens.  Many of the yolks of the eggs l a i d by these hens are,  as a consequence, also i n f e c t e d .  These two types are seldom recovered from non-avian sources. Another unique feature of these two types i s that they cannot colonize the alimentary t r a c t , t h e i r presence i n the t r a c t always being a consequence of an i n f e c t i o n i n the t i s s u e s .  I t i s this tissue  i n f e c t i o n that gives r i s e to the presence of antibodies detectable i n routine agglutination t e s t s ^  I t i s f o r these reasons that i t i s  much easier to eradicate S. pullorum and S. gallinarum from p o u l t r y . At one time i n B r i t i s h Columbia a l l breeder f l o c k s were blood tested f o r S. pullorum and S. gallinarum, however t h i s has been discontinued f o r quite some time, f o r the B r i t i s h Columbia Poultry Branch consider  24  British Columbia to be Pullorum-Typhoid f r e e  6 1  A l l hatchers i n British Columbia are routinely sampled by the hatchery inspector.  Fluff samples and dead embryos are examined  for Salmonella pullorum i n the Provincial veterinary laboratory. This type of sampling has replaced the former blood testing on breeder farms. No reactors to S. pullorum have been found since 1964 i n 62  British Columbia. Well over one hundred different Salmonella serotypes have been isolated from p o u l t r y  60  Salmonellosis i n young chicks can  result i n fatality of up to 80% i f infected i n the f i r s t three weeks 47  of l i f e .  62  Chicks that survive may be long term carriers,  and adult  birds exposed to excretors or contaminated feed, or environment may also become excretors. In Salmonella infected flocks, the surface of the egg shell frequently becomes contaminated from nest or fecal material. Subsequent penetration of the intact or cracked shell results i n multiplication of the bacteria within the egg. eggs hatch further dissemination  Should such infected  occurs.  It has not been possible to develop a general agglutination test for Salmonella organisms because of the large number of different serotypes involved and because many infected birds do not develop significant antibody levels. i s now a v a i l a b l e  An agglutination test for S. typhimurium  63  The exact incidence of salmonellosis i n poultry i s d i f f i c u l t  25 to ascertain since i n many cases the mortality i s so low that specimens are not submitted for diagnosis.  Although mortality from infection  with endemic salmonellae such as S. typhimurium can be high, the exotic and rare serotypes generally speaking result i n only low mortality, often about 2 or 3 per cent, but once the environment becomes contaminated an increase i n mortality can take p l a c e d From May to August 1977  Skura investigated eleven flocks of u  chicken fryers entering Pancho Poultry Limited, i n Surrey, British Columbia.  Samples were taken from the f i r s t flock k i l l e d each day,  and thirty birds per flock were examined. These birds were examined at 3 different stages as they passed through the processing plant.  At  the f i r s t stage (before entering the scalding tank) Site A, none of the flocks were completely free of Salmonella (Table VTIl).  TABLE VTII FLOCK  PERCENTAGE OF SAMPLED FLOCK POSITIVE FOR SALMONELLA (AT SITE A)  55.6  #2  25.0 96.2  #5  10.7 46.2 88.5 22.2 51.7 11.5 16.0  m  #6 #7 m #)  #L0 #L1  3.5  SKURA Five flocks were very heavily contaminated with an incidence of Salmonella isolation greater than 50% of the sampled birds.  Heavy  26  contamination at this point in the poultry processing plant indicated that the exterior (body, feathers and feet) of the birds harboured Salmonella. Skura also found that flocks heavily contaminated at the first examination point (Site A) also had high incidences of contamination at the other two points in the processing plant. At the third point (Site C) (after the birds had been through the chill tank, see 65 Appendix B for flow chart of the Pancho plant  and the sites at  which the birds were examined) the average incidence of Salmonella contaminated birds was 21.5 percent, compared with 38.8 percent at the first examination point. In his summary of results Skura stated that "Flocks heavily contaminated at Site A also had high incidences at Sites B and C. Regression equations devised allow prediction of the incidence at one site with knowledge of the incidence at another site." It is evident from the above study that the incidence of Salmonella found internally and externally on chickens shipped from the farm, significantly influenced the incidence of contaminated carcasses after processing.  Thus i f contaminated birds enter a  processing plant i t is very likely that their carcasses at the retail level will also be contaminated. The average percentage of contaminated birds entering the plant was 38.8, and for the same birds leaving the plant i t was 21.5 percent. Thus there had been some reduction in the incidence of Salmonella contamination as the birds passed through the plant.  APPENDIX B - FLOW DIAGRAM POULTRY PROCESSING (illustration 2)  GIZZARD SKINNER  Sites I, II and III represent sites where Skura examined chickens for Salmonella  PRODUCT CHILLER  GRADER  III (Site C)  LEG & FOOT  PACKAGING  SHIPPING  FINISHED PRODUCT  28  POULTRY AND MAN SALMONELLA CYCLES  As can be seen from the material so far presented a large percentage of processed poultry i s contaminated with Salmonella organisms which can potentially lead to human salmonellosis. 66 Snoeyenbos  when describing Salmonella infection at the  farm level stated, "information i s woefully inadequate to allow accurate assessment of the incidence of Salmonella infection i n poultry at the farm level i n North America.  It i s remarkable that  national Salmonella control programmes are being considered i n both Canada and the United States without a clear picture i n either country of the incidence of infection at the farm level." When examining the Salmonella cycle involving poultry and man, i t i s assumed that Salmonella from contaminated poultry carcasses 67 68 69 are responsible for a large percentage of human salmonellosis cases.  ' '  But how do poultry flocks become infected? 60 H. Williams Smith  described the methods by which Salmonellae  gain entry to poultry flocks, and this i s shown i n Figure 3 . Rodents  Man  Other animal hosts  Free—flying birds  Introduction of stock from other sources  FLOCK OF ANY Flies & fomites—  DESCRIPTION *  Originally, exhatchery  Water  1*  'Food Housing  FIGURE 3  - METHODS WHEREBY SALMONELLAE GAIN 60 ENTRANCE TO POULTRY FLOCKS  29  He also went on to describe that once Salmonella organisms had infected some birds, how i t then could be further spread within a flock, and this i s shown graphically i n Figure 4.  Contaminated shell BREEDING FLOCK  >EGGS-  t  From ovary  HATCHERY-  •CHICKS-  Lateral spread  Lateral spread  X  1  Broiler flock • Commercial egg flock  FIGURE 4 - DISSEMINATION OF,^ALMONELLAE FROM BREEDING FLOCKS b  McGarr  U  studied the relationship between the parent flock,  the hatchery, the progeny broiler flock, the processing plant and the consumer product i n Ontario. He found that contaminated carcasses at the consumer outlets were associated with infected broiler chicken flocks which introduced the Salmonella organisms into the processing plant.  However the Salmonella infection of the broiler flocks was  not associated with salmonellae i n their parent breeding flocks or with hatchery contamination.  He concluded that broiler chicken  flocks i n Ontario were commonly infected with salmonellae of undetermined origin. 71  Hacking  investigated the possible sources of introduction of  Salmonellae to broiler chicken flocks i n Ontario. He found evidence that indicated that day-old chicks, new wood shavings, broiler feed and residual contamination of the buildings from the previous flock were involved i n the subsequent infection of the broiler flocks. He also investigated a feed m i l l , and found that the principle sources of  30  feed contamination were the animal protein ingredients such as meat meal and feather meal. The pelleting process as used at the particular mill he investigated was inadequate to completely eliminate salmonellae from the feeds, as shown by a 4«3 percent contamination rate found in the finished feeds. 72 Gordon  in earlier studies demonstrated with S. menston that  the percentage of carriers in chicks fed artificially-infected feed increased as the numbers of infecting organisms increased, and was almost doubled in those group of chickens whose water supply became contaminated. It becomes increasingly clear that further studies are required to demonstrate the sources of poultry infection, in order to effectively reduce the number of infected birds entering the processing plant. Many Salmonella cycle models involving poultry and man have been developed and the one depicted below (Figure 5/) demonstrates the major pathways by which Salmonella can infect poultry and man. It i s not known which of the various routes is the most important, and i t will vary with different environmental, agent and host factors. It i s only by examining each part of the cycle and instituting corrective measures throughout the whole cycle that the incidence of infected poultry will be drastically reduced.  31  Figure 5 - SALMONELLA MODEL (POULTRY  F e r a l Animals Insects  }  MAN)  Contaminated Poultry Feed  A  Sewage, Garbage Contaminated Lakes ^~  y * B  /  Contamination of buildings from* previous f l o c k s ^  Poultry <  \ Poultry Imported Infected day-old chicks  Poultry Products (Meat - Eggs)  Man  •f  32  METHODS Before suggesting methods by which the human salmonellosis rate can be reduced i n Canada, i t i s necessary to find what i s being done at the present time to control Salmonella i n both humans and animals.  Because of the system of Government we have i n Canada,  both Federal and Provincial agencies are involved and i n one or two  73  instances even municipalities.  It had originally been my intent to send out a questionnaire to both the Federal and Provincial agencies involved requesting specific information as to what their departments or ministries were doing i n trying to control salmonellosis i n humans and animals. This method did not work very well for some questionnaires were not answered at a l l , some were answered i n a very superficial way,  and  only occasionally did I obtain any really useful information. When I tried to obtain information from countries other than Canada, i t became obvious that countries that were looking at the problem seriously and adopting control programmes could supply me with abundant information of what was being done, whereas countries where very l i t t l e was being done either didn't reply or their letters were of such a general nature as to be useless.  Examples of countries  from where I received good information were Sweden and Denmark, and examples of countries that supplied l i t t l e or no. information were New Zealand, and Australia. In a letter from a Mr. Lancaster  who works i n the Health of  Animals Branch i n Ottawa, and who has been involved with poultry diseases for the last 25 years as a veterinarian wrote:  "I find i t rather  33  d i f f i c u l t myself to understand who does what i n the way of routine screening f o r Salmonella, and I think your question should be rephrased to, 'How much do they do?'" After the Minister's news release i n 1975 the Interdepartmental 1  r  Salmonella Committee (i.S.C.) was formed to come up with recommendations on how to reduce the incidence of Salmonella on processed poultry carcasses. I received a copy of the minutes of one of these I.S.C. 75 meetings.  This was the 25th meeting of t h i s committee held on  July 6th, 1976. The meeting was e n t i r e l y concerned with "Federal Salmonella Control Programmes" and the minutes were b a s i c a l l y an information exchange of what the various Federal Departments were doing.  From these minutes i t would appear that after 21+ meetings of  the Interdepartmental Committee, members were s t i l l not f u l l y informed as to who was doing what i n the area of Salmonella c o n t r o l .  I have  requested an interim or f i n a l report of the deliberations of t h i s committee (I.S.C.) but so f a r i t has not arrived. 76 Also a committee was formed by the Canadian Poultry Industry, with the t i t l e , "The Canadian Poultry Industry Salmonella Committee". This committee consists o f s i x sub-committee chairmen, who are responsible f o r d i r e c t i n g and co-ordinating the e f f o r t s within a s p e c i f i c section of the poultry industry. The s p e c i f i c sections are: (I)  Breeder and Hatchery  (II)  Feed and Feed Ingredients  :(lll)  Egg and Poultry Meat Production  (IV) (V) (VI)  Processing and D i s t r i b u t i o n R e t a i l and Food Service Consumer Awareness  34  Each of these subcommittees i s chaired by some industry leader, in his or her respective area of specialization. The one objective of the Canadian Poultry Industry Salmonella Committee i s , through cooperation, to economically reduce the incidence of Salmonella on poultry and poultry products at the retail level in order to meet the proposed regulations. The first official progress report should have been issued in September 1977» and i t i s either not completed or is unavailable, for I have requested a copy on two occasions, without success. Obviously, both the Federal Government, and the Canadian Poultry Industry, are concerned about the Salmonella problem, and are working together to do something about i t , but to try and obtain information from either of these two groups at the present time i s almost impossible. In fact I have had no information from the Canadian Poultry Industry Salmonellae Committee, and very l i t t l e from the Interdepartmental Salmonella Committee. Thus the information given below is certainly not complete, and i s liable to be out of date, i f new regulations are promulgated by the Canadian Government i n the near future. As far as I could determine the following branches of the Federal Government are involved in some way or another with the Salmonella problem. 1.  Bureau of Microbial Hazards, Health Protection Branch, Health and Welfare Canada  35  2.  Food Inspection Division, Health Protection Branch, Health and Welfare Canada  3.  National Enteric Reference Centre, Bureau of Bacteriology, Health Protection Branch, Health and Welfare Canada  4.  Food and Marketing Branch, Agriculture Canada  5.  Poultry Diseases, Contagious Diseases Division, Health of Animals Branch, Agriculture Canada  6.  Poultry Division (B.C.) Production and Marketing Branch, Agriculture Canada  7.  Animal Pathology Division, Health of Animals Branch, Agriculture Canada  8.  Regional Veterinary Director (B.C.) Health of Animals Branch, Agriculture Canada  9.  Division of Feeds and Fertilizers, Agriculture Canada  10.  Fish Inspection Branch, Fisheries and Oceans Pacific Region, Environment Canada  There could well be more Federal agencies involved but these were the only ones from whom I received letters.  From the above  information there appear to be three main Federal Departments involved i n Salmonella control and they are: 1.  Health and Welfare Canada  2.  Agriculture Canada  3.  Environment Canada  Although i t would appear that the Federal Government i s the main regulatory agency involved i n Salmonella control, the Provincial  36  Government i n British Columbia also i s involved. There are three main Ministries involved i n British Columbia. 1.  Ministry of Agriculture  2.  Ministry of Health  3.  Ministry of the Environment  A brief summary w i l l be given of the involvement of the various Federal and Provincial agencies, i n the control of Salmonella.  I  FEDERAL GOVERNMENT  (l)  Health and Welfare Canada The Department of National Health and Welfare has the overall  responsibility of ensuring the safety and wholesomeness of the Canadian food supply.  The Federal Food and Drugs Act which i s the  responsibility of the Department of National Health and Welfare states ihapart: Section 4»  (a)  No person shall s e l l an article of food that has in i t or upon i t any poisonous or harmful substance.  Section 5 -  No person shall label, package, treat, process, s e l l or advertise any food i n a manner that i s false, misleading or deceptive or i s likely to create an erroneous impression regarding i t s character, value, quantity, composition, merit or safety.  Section 7.  No person shall manufacture, prepare, preserve, package  37 or store for sale any food under unsanitary conditions.  The Health and Welfare Canada has formulated regulations, which have been promulgated, that prohibit the sale of the following products i f they contain Salmonella: and frogs legs.  cocoa, chocolate, dry milk, egg products,  It i s the intention of the Department to add to this  l i s t a regulation making i t an offence to s e l l Salmonella contaminated poultry meat. Such a regulation for chicken may read as follows: " No person shall sell the meat of chickens (Gallus domesticus) or chicken meat by-products for use as food unless i t i s free from bacteria of the genus Salmonella as determined by the O f f i c i a l Method. "  A similar regulation w i l l be prepared for turkey. Method  The O f f i c i a l  includes both the method of analysis and the sampling plan.  The method of analysis has been chosen but the sampling plan i s s t i l l under consideration.  The above information was obtained from  77 Dr. H. Pivnick.'' 78 In a personal communication from Dr. H. Pivnick,  who i s the  Director of the Bureau of Microbiological Hazards, Food Directorate, Health Protection Branch, he wrote: "In my view the main source of Salmonella i n the Canadian food supply results from the high incidence (about 35%) i n poultry carcases. This high incidence results from contaminated feed and infected breeder flocks.  The regulations recommended by the Minister's Advisory Committee  would i f enacted under the Food and Drugs Act, put the pressure on those segments of the poultry industry to take the steps necessary to improve. However as these industries are under the control of  38  the Department of Agriculture, the Department of National Health and Welfare has no jurisdiction for direct intervention." The regulation recommended by the Minister's Advisory Committee that Dr. Pivnick refers to i s as follows: It i s recommended that an ad hoc committee be established to determine and implement practical ways of controlling Salmonella i n dressed poultry.  The poultry industries  and involved government agencies should be represented on this committee.  79  Health Protection Branch i s well aware of the Salmonella problem but i s hampered i n i t s efforts to reduce the incidence of Human salmonellosis because of the complexity of the problem and also the involvement of other agencies.  However i t i s monitoring the  incidence of Salmonella contaminated poultry carcasses at the r e t a i l level, and i s proposing microbial standards, and sampling techniques that could be used i f legislation ^'forthcoming. The National Enteric Reference Centre i s also part of the Department of National Health and Welfare and information on foodborne outbreaks i s prepared by this agency. These reports include Salmonella food poisonings, and contain information on the etiology, locality, number of people affected, number of people at risk, 33  c l i n i c a l symptoms, laboratory results and some comments.  (2)  Agriculture Canada Through i t s various branches Agriculture Canada i s involved  in, poultry feeds, rendering plants, hatcheries, importation of chicks, egg and egg products, poultry processing and many other agricultural  39  matters.  [A]  Poultry Feeds: 78 Pivnick  wrote "As f a r as I know there are presently no  Federal regulations concerning Salmonella i n feeds." 80 In a l e t t e r from Mr. Heney,  Assistant Deputy Minister of  Agriculture Canada, he makes the following p o i n t s . 1.  The Plant Products Division's Salmonella sampling program i s  directed towards protein feed ingredients as well as f i n i s h e d feeds. Meat meal, bone meal and f i s h meal ingredients are considered the most suspect and therefore, receive the greatest attention.  An annual  quota of 525 samples are presently a l l o t t e d to the s i x d i s t r i c t s i n the' d i v i s i o n .  2.  The D i v i s i o n i d e n t i f i e s sources of contaminated feeds or  ingredients and puts f o r t h measures to eliminate the contamination.  3.  The past programs have i d e n t i f i e d an accumulated  contamination  rate of approximately 30% with 25% attributed to rendered products and 6% to f i n i s h e d feeds.  4.  The sampling program and the regulations governing the presence  of Salmonella i n feeds i s currently under review.  I t would appear from Mr. Henney's l e t t e r that there are only guidelines r e l a t i n g to the contamination of feeds with Salmonella rather than regulations, although he doesn't state what i s done when  40  the feeds are found to be contaminated with Salmonella organisms.  77 However as Pivnick  has pointed out unless regulations are enforced  i t i s u n l i k e l y that they w i l l be complied with.  I f new regulations  are drawn up f o r animal feeds they w i l l have to be properly enforced i f they are to be e f f e c t i v e . [B]  Rendering Plants: The Meat Inspection D i v i s i o n works j o i n t l y with the Plant  Products D i v i s i o n i n routinely inspecting and sampling packing house rendering operations and i n e d i b l e rendering p l a n t s .  Bacteriological  80 t e s t i n g i s done on the rendered products. No mention i s made as to what happens when Salmonella organisms are found i n the rendered materials. Presumably  t h i s question i s  currently under review as w e l l .  [D]  Hatcheries: 81 Information f o r t h i s section was supplied by Mr. J . Raff a,  D i s t r i c t Director Poultry D i v i s i o n (B.C.) Production and Marketing Branch, Agriculture Canada. Under the Federal and B.C. Hatchery Regulations there i s a program of f l u f f sampling of a l l hatcher incubators from each hatchery. Samples are taken every s i x weeks and the f l u f f samples are analysed f o r Salmonella.  I f Salmonella i s i d e n t i f i e d then discussions take  place between the Poultry D i v i s i o n of Agriculture Canada, and the B.C. Poultry Branch as to the source of the i n f e c t i o n .  41  In a report prepared by Dr. D'Aoust and Dr. Pivnick i t was stated that f l u f f samples collected from hatching machines by federal inspectors are tested i n provincial laboratories. When Salmonella contaminated f l u f f i s identified, the multiplier flock(s) producing the contaminated hatching eggs i s traced and tested; i f found 82 to be highly infected, the flock i s destroyed. In addition fumigation with formaldehyde i s routinely used to sanitize hatching eggs and hatchery equipment.  M  Importation of Young Chicks: Information for this section was also supplied  81 by Mr. J . Raffa of Agriculture Canada. "We do not have a program for testing of imported chicks for Salmonella  Very recently we have arranged with Dr. W.  Dorward, Director, Health of Animals Branch Laboratory, Vancouver, to provide him with imported chick specimens. He w i l l be diagnosing these for Salmonella.  This w i l l be a  three month program of an unofficial nature to determine whether there i s any Salmonella i n imported chicks."  83 Dr. D. J. Hawkins,  Regional Veternary Director (B.C.)  Agriculture Canada, wrote: "Poultry imported into Canada are from Salmonella pullorum free flocks only as far as Salmonella i s concerned.  On  arrival birds are examined visually, and last ' year 443,000 chicks were imported into British Columbia."  42  LXI  %S  Ef>% Products:  Information for this section has been supplied by Mr. J . Raffa  81  of Agriculture Canada.  There are no regulations pertaining to the testing of commercial 8ZL  eggs for Salmonella.  March  i n a study where she sampled the contents  of (3)995) intact eggs (i.e. not cracked) for Salmonella found no Salmonella, even though many of the intact egg shells were contaminated with Salmonella organisms. Federal Egg Regulations state that eggs graded Canada C (this grade now includes cracks as well as eggs of "C" quality) when moving to another province must be conveyed to a registered egg product station (egg breaking plant), i n that other province. Federal Processed Egg Regulations stated that "No person shall s e l l any egg product for use as food unless i t i s free from bacteria of the genus Salmonella as determined by the O f f i c i a l Method. (Food and Drugs Act) Sampling of egg products i s done on a randomized basis. However a l l egg products are sampled extensively, and there are definite sampling procedures.  When the Poultry Division has been informed that  a l o t i s positive for Salmonella, Health Protection Branch i s notified and the l o t i s seized. In 1977 there were 2,783 analyses performed on liquid and frozen processed egg products, and 1,101 analyses on dried processed egg products which includes a small percentage of imports with less  43  t h a n 0.5%  p o s i t i v e for  a l l types of processed e g g .  0 0  These r e g u l a t i o n s o n l y came i n t o e f f e c t i n Canada i n November 1976  [F]  so i t i s t o o e a r l y y e t t o j u d g e how  e f f e c t i v e they are.  Poultry Processing:  Although p o u l t r y carcasses  are monitored f o r the presence of  S a l m o n e l l a b o t h by t h e H e a l t h o f A n i m a l s Branch, A g r i c u l t u r e Canada, and by H e a l t h P r o t e c t i o n Branch, H e a l t h and W e l f a r e Canada, t h e r e  are  no regulations. I n f o r m a t i o n below has been s u p p l i e d by Mr. G. B. Morgan^of the Health P r o t e c t i o n Branch. "Some p o u l t r y p r o c e s s i n g p l a n t s f a l l under t h e F e d e r a l  Health  o f A n i m a l s , o r P r o v i n c i a l V e t e r i n a r y S e r v i c e I n s p e c t i o n programs. S m a l l f i r m s t h a t a r e n o t i n s p e c t e d by P r o v i n c i a l o r A g r i c u l t u r e Departments f a l l under o u r  Federal  jurisdiction,  however  our i n s p e c t i o n o f t h e s e p l a n t s would n o t exceed one i n s p e c t i o n p e r y e a r . Our  r e g i o n ^ a l s o c o v e r s A l b e r t a and i n t h a t  a l l p o u l t r y p l a n t s a r e under t h e  jurisdiction  of the  Province Federal  o r P r o v i n c i a l Agriculture Departments. Our  sampling of p o u l t r y  l e v e l and  includes  registered plants.  products t a k e s  place at the  b o t h F e d e r a l l y r e g i s t e r e d and  producer  non-Federally  Three f i r m s i n B r i t i s h Columbia w i l l  sampled t h i s y e a r , and our s a m p l i n g r e q u i r e m e n t s a r e t h a t specimen w i l l c o n s i s t o f f i v e whole f r e s h b i r d s .  be one  These a r e  44  to be chosen at random from one l o t and a l o t i s defined as the daily shipment from an individual grower."  At the present time Agriculture Canada has no regulations that help to control the incidence of Salmonella-contaminated poultry carcasses at the r e t a i l level.  (3)  Environment Canada The following information i s about f i s h meals and was supplied  by Mr. C. Campbell, Operations Manager Fish Inspection Branch.^ "In 1976 almost 10,000 tons of f i s h meal was produced i n British Columbia.  Although we don't have any figures on the ultimate  uses of this meal, we could say a significant proportion would be used as a supplement for poultry feeds. A l l fish meal i s tested for Salmonella before marketing. Sampling by our Fish Inspection staff i s on a daily basis and consists of 1 sample per date code.  The sample size i s 1 kg  from which 50 g i s used as an inoculum. The Feeds Act and Regulations, enforced by Agriculture Canada, requires meal be Salmonella-free.  Our Fisheries  Inspection Branch has agreed to carry out the monitoring, analyses and enforcement of the regulations regarding fish meal. If a l o t of f i s h meal i s found to be contaminated with Salmonella, the l o t i s placed under detention and the meal must be destroyed or reprocessed under supervision.  The  reprocessed l o t i s then heavily sampled and tested and must  U5  be Salmonella-free before i t i s released for marketing. Normally, under good commercial practice, the first 30 minutes of production each day i s re-cycled back through the driers. Salmonella contamination usually originates after the meal has left the drier as the meal temperature in the drier i s sufficient to k i l l Salmonella organisms. Pish oils are marketed for use in margerines, cosmetics, paints, etc. and because of the heat process involved in refining, they are not likely to contain Salmonella. Testing for Salmonella i s therefore not conducted."  From the above description by Mr. Campbell, fish meals would appear not to be a very likely source of Salmonella organisms when added to poultry feeds, unless they had been mishandled between the fish reduction plant and the poultry feed plant.  II  BRITISH COLUMBIA PROVINCIAL GOVERNMENT  (l)  Ministry of Agriculture 87  The following information was supplied lay Mr. S.' B. Peterson Deputy Minister of Agriculture, Province of British Columbia. "There are two areas in which some form of Salmonella i s controlled, the first being the Hatchery Regulations under the Poultry and Poultry Products Act. These regulations require that all breeders' be free of Salmonella pullorum. Blood testing of breeder flocks was carried out for years to the point where over one million chickens were tested with no reactors. A  46  monitoring program i s continuing. The other area is that of meat inspection where any poultry carcass showing any lesions is discarded. There is no specific test for Salmonella.  11  62  A letter from Mr. C. W. Wood,  Head, Poultry Branch, Ministry  of Agriculture, Province of British Columbia, makes the same points and adds that the regulations are the same for chickens and turkeys. 81  Mr. J. Raffa  in a letter states:  "The B.C. - Shell Egg Regulations state that no person shall sell, offer for sale, send or convey from any place to any other place eggs marked Canada 'C*, except to an egg product station for the purpose of processing into egg product. This now means that "cracks" now included in Canada 'C» grade are regulated and can only move to an egg products station. However, egg producers in the province are eligible to sell "cracks" produced on their own farms at the farm gate only."  In summary there i s no routine testing for Salmonella serotypes other than pullorum in the poultry industry. Carcasses in poultry processing plants are inspected for gross evidence of Salmonella infections, but no bacteriological testing is performed. Salmonellae other than S. pullorum are not reportable.  (2)  Ministry of Health Human salmonellosis i s a reportable disease in British Columbia.  Upon notification the physician reporting the case i s requested to f i l l  47  out a form, which seeks further epidemiological information, together with information on household contacts and treatment. The regulations f o r salmonellosis (other than typhoid and paratyphoid) as printed i n the "Regulations f o r the Control of Communicable Diseases",  89  are as follows:  Salmonellosis (other than typhoid and paratyphoid (i)  fever)  The person s h a l l be placed i n modified i s o l a t i o n , as defined i n clause (b) of subsection ( l ) of D i v i s i o n 4» during the period of acute i l l n e s s .  (ii)  The person s h a l l be excluded form occupations i n v o l v i n g contact with young c h i l d r e n or the preparation or serving of food u n t i l three consecutive s t o o l cultures, taken not l e s s than 24 hours apart and i n the absence of recent a n t i b i o t i c or chemotherapeutic treatment, have f a i l e d to reveal the i n f e c t i o u s agent.  (iii)  The s t o o l of the person s h a l l be concurrently d i s i n f e c t e d .  (iv)  The equipment used i n the care of the person and the room wherein the person has been cared f o r s h a l l , on the releasedof the person from i s o l a t i o n , be subjected to terminal cleaning.  (v)  The household contacts of the person s h a l l be excluded from occupations i n v o l v i n g contact with young c h i l d r e n or the preparation or serving of food u n t i l three consecutive s t o o l cultures, taken not l e s s than 24 hours apart and i n the absence of recent a n t i b i o t i c or chemotherapeutic treatment, have f a i l e d to reveal the i n f e c t i o u s agent.  These regulations apply both to the person who has salmonellosis and the household contacts as stated i n subsection ( 5 ) .  48  Although no s p e c i f i c mention of Salmonella i s made i n the B r i t i s h Columbia "Regulations Governing the Sanitation and Operation 90 of Food Premises"  there are c e r t a i n sections of the regulations, which  i f c o r r e c t l y c a r r i e d out w i l l help to ensure that commercial food establishments ( i . e . restaurants, catering businesses) handle the preparation of food i n a sanitary way.  Below are some of the sections  of the above mentioned r e g u l a t i o n s . 2.05  No person s h a l l operate a restaurant or catering business unless  he i s the holder of a v a l i d subsisting permit, issued annually by the Medical Health O f f i c e r i n the form shown i n Appendix A, and unless these regulations are complied with.  Such permits s h a l l not  be transferable and s h a l l only be issued a f t e r the Medical Health O f f i c e r i s s a t i s f i e d that the applicant has s u f f i c i e n t knowledge of modern food-handling practices and has available adequate equipment to enable him to operate i n a safe and sanitary manner.  2.06  Notwithstanding section 2.05 of D i v i s i o n I I of these regulations,  where the Medical Health O f f i c e r i s s a t i s f i e d that the applicant has s u f f i c i e n t knowledge of modern food-handling practice and has available adequate equipment to enable him to operate i n a safe and sanitary manner, the Medical Health O f f i c e r may issue a nontransferable interim permit f o r a period not exceeding one year.  2.07  Every voluntary caterer acting i n accordance with section  2.06  s h a l l , before performing the act of voluntary catering, obtain, from the Medical Health O f f i c e r , an interim permit i n the form shown on Appendix A.  49  4.01  No person s h a l l be employed i n a food premises who i s suffering  from or i s the c a r r i e r of, any communicable disease, and i t s h a l l be the duty of the proprietor t o suspend any person who i s suffering from, or i s the c a r r i e r of, a communicable disease and to report the suspended person's name and address t o the Medical Health O f f i c e r . 4.02  The Medical Health O f f i c e r may, i f he believes any person i s  suffering from, or i s the c a r r i e r of, a communicable disease, p r o h i b i t the person from performing the duties of a food-handler.  The person  s h a l l be excluded from employment i n any food premises u n t i l the Medical Health O f f i c e r i s s a t i s f i e d that the person i s free o f any communicable disease that may be spread through the medium of food. 4.03  A proprietor who permits a^person to handle or prepare food  a f t e r having received an order p r o h i b i t i n g the employment of the person f o r the purpose of handling or preparing food s h a l l be g u i l t y of an offence against these regulations. 4.04  Every food-handler s h a l l (a)  observe good personal hygiene;  (b)  wear clean garments and clean footwear;  (c)  while on duty r e f r a i n from smoking i n any area o r room where food i s prepared, processed, stored, or served;  (d)  wash h i s hands thoroughly before commencing duty and a f t e r using the t o i l e t .  91 There i s also a Managers Manual  available through the Ministry  of Health, and t h i s i s made available t o a l l restaurants and catering businesses.  At the back of t h i s manual i s an examination section that  50  the Medical Health O f f i c e r may wish to use i f he i s doubtful that an applicant f o r a permit has s u f f i c i e n t knowledge of modern food-handl i„ng practices.  (3)  Ministry of the Environment P o l l u t i o n Control Objectives f o r food-processing,  agriculturally 92  orientated, and other Miscellaneous Industries was published i n  1975.  The purpose behind the establishment and use of these objectives i s to maintain and preserve the land, water, and a i r environment of B r i t i s h Columbia at the highest possible l e v e l .  These objectives are  now the P o l l u t i o n Control Board's p o l i c y , and below are two  excerpts  from the published objectives. 4.6.3  Poultry-Processing Effluent objectives are given i n TableVTIand cover the operations  of k i l l i n g , bleeding, scalding, plucking, eviscerating, washing, and chilling.  The rendering operation i s not included.  The objectives cover the processing of chickens, ducks, turkeys, and geese and are given as pounds of pollutant per 1,000 of l i v e weight k i l l e d .  pounds  When objectives are expressed i n t h i s form, the  same values can be used f o r a l l p o u l t r y .  For chickens and ducks,  i t may be u s e f u l to express objectives i n terms of pound of contaminant per 1,000  birds and the appropriate b i r d weight to be used f o r the  conversion i s given as a footnote to Table IX. The treatment required to reach these objectives may combination  comprise  of blood—recovery systems, grease traps, screens f l o t a t i o n  processes, t r i c k l i n g f i l t e r s , activated sludge processes, and Disposal of effluent to the  lagoons.  ground should be encouraged, e s p e c i a l l y f o r  51  small operations.  In such instances measures must be taken to remove  fat which can cause s o i l plugging.  A l l discharges should be monitored  for nitrogen either i n the ammonia or nitrate form.  TABLE IX r OBJECTIVES FOR THE DISCHARGE OF EFFLUENT TO MARINE AND FRESH WATERS FROM POULTRY-PROCESSING PLANTS  Level  Monitoring Frequency  A  B  C  B0D lb./l,000 l b . live weight k i l l e d  0.64  1.9  6.4  Weekly  Suspended solids, lb./l,000 l b . live weight k i l l e d  0.54  0.81  2.7  Weekly  Grease, lb./l,000 l b . live weight k i l l e d  0.18  0.21  0.6  Weekly  Parameter 5  NOTE - To convert l i v e weight to number of birds i n Table VII, use the following values: Chicken average weight = 4*8 pounds. Duck average weight =6.5 pounds. POLLUTION CONTROL OBJECTIVES It i s interesting to note that there i s no mention about the bacteriological content of the effluent.  Tennant  when he studied  Salmonella i n poultry packing plant effluents found that "1.  Salmonellae were present i n raw and treated liquid  wastes from three large, well-operated Ontario poultry packing plants.  The presence of these pathogenic bacteria i n effluents  discharged to the environment should not be permitted;  52  2.  E f f e c t i v e c h l o r i n a t i o n of treated effluent before  discharge, as observed at one processing plant, appeared to eliminate salmonellae from the e f f l u e n t .  Further study of  c h l o r i n a t i o n e f f i c i e n c y , and of a l t e r n a t i v e methods of d i s i n f e c t i o n , including ozonation, i s required."  Tennant further went on to recommend t h a t : "1.  D i s i n f e c t i o n of poultry processing plant wastes be  required before discharge of the treated wastes to receiving streams or to land; 2.  The Environmental Protection Service support studies  designed to assess, and e s t a b l i s h e f f e c t i v e procedures f o r , the treatment and d i s i n f e c t i o n of poultry processing plant wastes which w i l l eliminate the discharge of effluents containing salmonellae to the environment."  53  SALMONELLA CONTROL IN SOME OTHER COUNTRIES Suzuki i n Japan examined samples of imported chicken f o r 4  Salmonella contamination from seven countries and found that there was a great variation between countries, ranging from 3*8% contaminated to 28.5% contaminated. Table I I ) . (Table X )  This study was done i n 1971 and 1972 (see  Since that time further studies have been done, and below contains information from four sources. Because t h i s  information i s from four sources the actual figures are not t r u l y comparable duetto different techniques used, but i t does give an indication of which countries are controlling the Salmonella problem better than others. TABLE X .  PERCENTAGE OF SALMONELLA-CONTAMINATED RAW DRESSED CHICKEN 1973-1974 BI RANK Rank 1. 2. 3• 4« 5. 6.  7.  Country Sweden (Findus Co.) A Denmark g Hungary Turkey China U. S. A. Bulgaria^ fBelgium \France B Canada Netherlands Germany B  B  A  A  10. 11. 12.  A  Percent 0 / 4 6 8 10 11 14 17 17 18 29 6l  54  The sources for Tablev X A  are as follows:  Siems et al 1974; 503 carcasses produced in or imported into 93  Germany. B.  Suzuki et al 1973; 6,523 carcasses imported into Japan.^  C  . Lundbeck 1974; 8,415 samples produced by Findus A B in Sweden.^  D  Health Protection Branch, Canada; 157 carcasses from 3  5 geographical areas in Canada. From this data in Table X  Canada i s ranked in tenth position  out of the twelve countries used for this comparison. Since this study was done Health Protection Branch Canada, changed i t s analytical methodology in 1974» and the percentage of contaminated poultry for the 1976 - 1977 period was reported as being 39%, which i f there was no change in the other countries listed, would place Canada in eleventh position. In the next part of this paper control measures being used in some countries will be examined.  SWEDEN Information on control measures being employed by the Findus AB 94  Company in Sweden has been supplied by Holgar Lundbeck  and the  following i s a brief description of the different measures by which an industry of moderate size (approximately 3 million chickens a year) was able to reduce the frequency of Salmonella infections to insignificant levels.  55  It was realized by the company that there were seven important ways in which Salmonellae was spread among chickens, and these were; 1.  The breeding flocks  2.  The Feeds and Water  3.  Transportation  k*  Slaughter  5.  Control of Rodents and Insects  6.  Waste Disposal  7.  Examination of Plant Personnel Of these seven points listed above the first two were considered  to be the most important.  1.  The Breeding Flocks: Animals for breeding were secured by contract with special  producers within the country. These producers deliver chickens one day old which are reared separately under rigid control for 12 weeks and then transported to the breeding stations. The eggs are fumigated with Formalin as are the newly hatched chickens. The health condition of the breeding stock i s continuously checked by veterinarians, and a special agreement with the health authorities involving insurance for losses due to the occurrence of Salmonellae in the chickens has been arranged.  2.  Feeds and Water: The Findus Company were of the opinion that i t i s absolutely  essential to have feeds which are free of Salmonella organisms.  Only  pellets, heated to a minimum temperature of 70°C for half a minute  56  are used f o r feeding purposes. b a c t e r i o l o g i c a l examination.  The p e l l e t s are r e g u l a r l y checked by The p e l l e t e d feed i s d i s t r i b u t e d by  automatic mechanical devices, and these are cleaned between each f l o c k o f chickens. Water i s d i s t r i b u t e d automatically and only potable water s a t i s f y i n g o f f i c i a l c r i t e r i a f o r human consumption i s used.  R i l l s and cups are  cleaned d a i l y .  3.  Transport: Cages f o r transport, because they move between d i f f e r e n t  rearing houses, are cleaned i n a s p e c i a l washing machine.  4.  Slaughter: There are four stations within the processing plant which are  separated from each other.  The t o o l s and personnel i n each of the  four stations are not interchanged.  During evisceration, i f there i s  any damage to the abdominal contents, then that p a r t i c u l a r b i r d i s discarded.  After evisceration the carcasses are rinsed and c h i l l e d i n spin c h i l l e r s , and the water used i n t h i s process i s c h l o r i n a t e d to a concentration of 1 to 5 p.p.m., and the chlorine concentration i s checked twice a day.  Specimens of the s p i n - c h i l l e r water are examined once a day f o r Salmonella.  The processing plant i s cleaned every night and the equipment and  57  conveyor belts are cleaned with chlorinated water (10 p.p.m.) from high pressure hoses. 5»  Control of Rodents and Insects: A specialized firm i s employed to deal with this problem.  6.  Waste Disposal: Waste i s collected i n r i l l s of stainless steel and transported  with the aid of highly chlorinated water to containers outside the slaughter house, and these wastes are transported twice a day to special stations for disposal.  7.  Personnel: Fecal specimens are examined for Salmonella, from a l l personnel  working i n the plant twice a year.  Also i f any personnel have travelled  out of the country they are rechecked before starting work again at the plant.  In conclusion the Findus Company states that, "Salmonella contamination of chicken products can be practically completely ruled out by systematic planning of the whole production chain. The costs are well within tolerable limits."  The above description applied to the Findus Company, but Sweden has other nation wide controls and some of these are: 1.  There i s a voluntary programme for Salmonella control i n poultry  58  and 90% of a l l broiler producers are members of the scheme. 2.  All Salmonella isolations from animals, food, feedstuffs, and  the environmentamust be notified. The National Veterinary Institute acts as the national reference centre and passes information to the Board of Agriculture, the state epizootiologist, and county veterinary organizations. 3.  In the control of Salmonella, compensation i s paid by the  government for production losses, and for animals slaughtered. 4.  Imported feedstuffs of animal origin are examined bacteriologically  before entry, and any consignments found to be contaminated with Salmonella are not accepted.  From the above description the problem of the control of Salmonella organisms in the poultry industry has been taken seriously in Sweden. The effectiveness of these measures can be seen by looking at the very low percentage of Salmonella- contaminated processed poultry.  DENMARK Since 1954, bone meal, meat and bone meal, blood meal and composite feed containing these ingredients are resterilized when imported into the country. Since 1957 fish meal and certain other fish products, other than those from a limited number of countries of low risk, are sterilized at the time of importation. There are 18 sterilization plants, and they are a l l closely  59  supervised by the veterinary service. These plants are used for the sterilization of protein material, a l l carcasses and inedible offal including poultry waste.  Breeding Stock: There i s only one large breeding centre for broilers, which i s monitored for Salmonella. Imported birds are quarantined before being mixed with the other breeding stock.  Hatcheries: In 1964 an Order was issued that stated "geese, ducks and turkeys must at no time be found on a property on which there i s a hatchery, or from which hatching eggs or poultry are supplied to a hatchery."  Special Control Measures for Salmonellosis: These five control measures were mentioned by Marthedal inaa 95  paper presented at an International Symposium on Salmonella. 1.  Breeding Centres - The breeding stock of the centres shall be  blood tested for specific S. typhimurium reaction, a l l animals being examined at the age of 5 months, when they have just started laying, and before the eggs are taken for hatching. If the S. typhimurium reaction i s positive, the reactors are sent for bacteriological control. 2.  A representative selection from each hatching (2 x 10 to 15 chickens)  60  are forwarded at 8 - 10 day i n t e r v a l s , beginning one week a f t e r hatching to the I n s t i t u t e of Poultry Diseases f o r b a c t e r i o l o g i c a l examination. 3.  From the age of 1 month a representative selection of animals  i s sent i n f o r laboratory t e s t i n g , including b a c t e r i o l o g i c a l examination.  4.  Shortly before the breeding stock i s sent to the processing plant  blood samples are again taken from a l l animals and examined f o r 5. typhimurium 5.  infections.  Grandparent animals are mostly subjectedCto the same examinations  described i n the above four points.  I f samples reaching the I n s t i t u t e of Poultry Diseases are p o s i t i v e f o r Salmonella the epidemiological studies are performed to t r y and determine the source of the o r i g i n a l i n f e c t i o n , and further control measures can then be applied i f necessary. 95 Marthedal  i n h i s discussion states that "There i s no doubt  that the introduction of a number of preventive measures i n Denmark during the years has contributed to reduction of the frequency of Salmonellosis i n Danish poultry and consequently i n man.  Total  eradication i s by now probably impossible as the p o t e n t i a l r i s k s of i n f e c t i o n are numerous."  UNITED KINGDOM In the early 1970*s there was a serious outbreak of S. paratyphi B. which involved both dairy c a t t l e and humans, and at the time i t became  61  apparent that the Agricultural Department had no powers to control the outbreak. The absence of such powers meant that the Departments were unable to act compulsorily to safeguard human health from infection in animals, no matter how serious. Because of this inability to protect the public the Zoonoses Order (1975)^ was promulgated. The Order designates diseases of animals, or organisms carried in them, that are considered to constitute a risk to human health. Under these powers, cases involving a designated disease of animals or poultry, or the presence of designated organisms in them, can be dealt with by compulsory measures to safe guard human health. The Zoonoses Order (1975) is the first Order to be made under these powers and designates the Salmonella and Brucella organisms specifically. The Order provides for: 1.  A compulsory reporting procedure.  2.  The investigation of cases.  3.  96 The emergency measures to protect human health. 97  In a letter from Mr. A Brown, Chief Veterinary Officer, of the Ministry of Agriculture, Fisheries, and Food, in England, the following information is given. "1.  There are as yet no specific regulations regarding poultry  feeding stuffs. It had been our intention to introduce a Protein Processing Order at the same time as the Zoonoses Order, with the object  of ensuring that a l l ingredients incorporated into a l l animal  62  feeds were rendered Salmonella free by heat treatment.  Unfortunately  this was not possible, but we are optomistic that such an Order will be introduced later this year (1978). 2.  There are no special regulations regarding Salmonella infections  in poultry flocks in the Ministry's Poultry Health Scheme. This scheme ensures that a l l flocks are free of S. pullorum and S. gallinarum only."  Thus i t would appear that the United Kingdom is making efforts to control human salmonellosis, through a compulsory reporting system, together with investigation, of animal salmonellosis, and that the importance of Ssalmonella organisms in the feeds i s recognized.  63  CONCLUSIONS  Many individuals and national committees have made extensive recommendations regarding the control of salmonellosis both in poultry and .25,55,98,99,100,101 man  These recommendations apply to every aspect of the poultry industry from the egg to the poultry processing plant, and include feed stuffs and the disposal of waste material. Also recommendations have been made for the correct handling and cooking of poultry both in food catering establishments and the home. There i s no doubt that i f a l l these recommendations were put in to practice, human salmonellosis resulting from poultry would be a very rare event indeed. However a l l these recommendations would i f implemented, lead to some additional cost, which would eventually be borne by the consumer. If, because many of these recommendations were put into practice, the price of poultry was greatly increased then the consumption of poultry would decrease, for people would tend to consume cheaper and alternate foods. Thus i t i s possible that poultry could become too expensive even though i t was completely free of Salmonella contamination. Thus some happy medium has to be reached or alternatively some relatively inexpensive method found, so that poultry at the retail level would be free of Salmonella contamination. When dealing with the question of whether eradication or control of Salmonella should be the goal in Canada, there would appear to be very l i t t l e doubt that eradication is probably impossible and that control i s a l l that can be expected, at the present time, with the  64  present technology at our disposal. However i t may be possible to produce Salmonella free poultry at the retail level even though Salmonella is not well controlled in the poultry flocks. This possibility will be dealt with later under research. If Canada is really serious about the control of salmonellosis in poultry and man, then both poultry salmonellosis and human salmonellosis must be reportable diseases, as is the case in some countries (Sweden and Denmark). Once salmonellosis i s reported an epidemiological investigation should be carried out, as is the case in Denmark where veterinary and medical personnel work together as a team in such investigations, and regulations such as the Zoonoses Order in England be available to deal effectively with such outbreaks. It is my personal impression that there are too many branches of both Federal and Provincial Governments involved in Salmonella control, and that there i s no control co-ordination of these efforts. If Salmonella is to be effectively controlled, a Canada-wide "Salmonella Control Program", must be established. This program, because of the nature of the Canadian political system, would have to be policed at the Federal level, and such parts of the program as reporting of cases, enforcement of regulations, and evaluation of methods, would have to be rigidly controlled at the Federal level. New regulations would have to be drawn up and these would have to be made in consultation with Federal and Provincial Governments together with input from the poultry industry. Once such a program has been set up there must be very definite methods employed to make 77 sure that i t i s adhered to. As Pivnick  pointed out unless regulations  65  and guidelines are enforced and definite penalties can be, and are applied to those not conforming to the program, then such a program w i l l be ineffective. Before any such program i s f u l l y operational a research team should be set up.  There are two reasons for this.  First of a l l ,  there i s a voluminous amount of literature dealing with Salmonella control which should be evaluated, and secondly studies should be carried out on those methods which appear to be most cost-effective, and further research into new methods of control should be carried out.  Some areas where I feel research should be undertaken could  include: 1.  The effectiveness of colonizing young chicks intestinal flora  i n order to prevent poultry salmonellosis. carried out by Hurrrri. 2.  102  Rantala  103  Such studies are being  and by some groups i n Canada ; ' 1  04  105  The use of ionizing radiation should be investigated, and i f  found to be effective and acceptable, then new regulations w i l l have to be promulgated.  It i s interesting to note that i n Canada onions  and potatoes can be teated with ionizing radiation before being sold, 7  but poulty cannot be.  106  The work of Mulder and others should be followed  up, for i t may be possible by the use of radiation, to completely decontaminate poultry before they reach the r e t a i l level, without any risk to human l i f e .  Such a method could possibly solve the problem  that i s the subject of this thesis. 3.  The chlorination of rinse water i n processing plants i s another  107 108 area that might be very effective i n decontaminating poultry.  66  These are just a few of the possible ideas that should be researched, for i f they are found to be effective an entire program such as i s being used in Sweden would not be necessary, and probably i t would be a much less expensive method of controlling the problem. If poultry cannot be completely decontaminated at the retail level, then educational programs will be required for consumers and food handlers on the importance of food safety during food preparation and storage.  In this thesis I have attempted to demonstrate the present situation in Canada regarding the involvement of Salmonella contaminated processed poultry and human salmonellosis, and the costs to the country of this preventable situation. Methods used for Salmonella control in some countries have been described, and finally some recommendations have been presented on how this problem could be dealt;., with in Canada.  67  BIBLIOGRAPHY  1.  Health and Welfare Canada: News Release (146), Salmonella Problem Emphasized. November 20, 1975.  2.  McBride, G., Brown, B., Skura, B.J.,: Effect of Bird Type, Grower and Season on the Incidence of Salmonellae i n Turkeys. Journal of Food Science, 43: 323-326, 1978.  3.  Pivnick, H.: Salmonella - A National Health Problem. 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