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MICROBIOLOGICAL RISK ASSESSMENT SERIES ISSN 1726-5274 23 Multicriteria-based ranking for risk management of food-borne parasites For further information on the joint FAO/WHO Activities on microbiological risk assessment, please contact: Food Safety and Codex Unit Food and Agriculture Organization of the United Nations Infectious diseases caused by food-borne parasites have not received Viale delle Terme di Caracalla the same level of attention as other food-borne biological and chemical 00153 Rome, Italy hazards. Nevertheless, they cause a high burden of disease in humans, may have prolonged, severe, and sometimes fatal outcomes, Publications of the World Health Organization and result in considerable hardship Fax: +39 06 57054593 can be obtained from: negative E-mail: [email protected] WHO Press Web site: http://www.fao.org/food/food-bysa fanimalsety-qua liorty World Health Organization, 20 Avenue Appia 1211 Geneva 27, Switzerland do not capture the true or Tel: +41 22 7913264 Fax: +41 22 7914857 a E-mail: [email protected] or Department of Food Safety and Zoonoses on the Internet from http://www.who.int/bookorders World Health Organization 20 Avenue Appia te-commodity 1211 Geneva 27 Publications of the Food and Agriculture Organization of the United Nations Switzerland can be purchased from: Fax: +41 22 7914807 this Sales and Marketing Group, E-mail: [email protected] Alimentarius Food and Agriculture Organization of the United Nations Viale delle Terme di Caracalla, 00153 Rome, Italy Web site: http://www.who.int/foodsaindividualsfety Fax: +39 06 57053360 E-mail: [email protected] or on the Internet from http://www.fao.org/icatalog/inter-e.htm Cover design: Food and Agriculture Organization of the United Nations and the World Health Organization Cover picture: © Dennis Kunkel Microscopy, Inc. MRAbookCover23.indd 1 07/04/14 15:49 For further information on the joint FAO/WHO Activities on microbiological risk assessment, please contact: Food Safety and Codex Unit Food and Agriculture Organization of the United Nations Infectious diseases caused by food-borne parasites have not received Viale delle Terme di Caracalla the same level of attention as other food-borne biological and chemical 00153 Rome, Italy hazards. Nevertheless, they cause a high burden of disease in humans, may have prolonged, severe, and sometimes fatal outcomes, Publications of the World Health Organization and result in considerable hardship Fax: +39 06 57054593 can be obtained from: negative E-mail: [email protected] WHO Press Web site: http://www.fao.org/food/food-bysa fanimalsety-qua liorty World Health Organization, 20 Avenue Appia 1211 Geneva 27, Switzerland do not capture the true or Tel: +41 22 7913264 Fax: +41 22 7914857 a E-mail: [email protected] or Department of Food Safety and Zoonoses on the Internet from http://www.who.int/bookorders World Health Organization 20 Avenue Appia te-commodity 1211 Geneva 27 Publications of the Food and Agriculture Organization of the United Nations Switzerland can be purchased from: Fax: +41 22 7914807 this Sales and Marketing Group, E-mail: [email protected] Alimentarius Food and Agriculture Organization of the United Nations Viale delle Terme di Caracalla, 00153 Rome, Italy Web site: http://www.who.int/foodsaindividualsfety Fax: +39 06 57053360 E-mail: [email protected] or on the Internet from http://www.fao.org/icatalog/inter-e.htm Cover design: Food and Agriculture Organization of the United Nations and the World Health Organization Cover picture: © Dennis Kunkel Microscopy, Inc. MRAbookCover23.indd 1 07/04/14 15:49 MICROBIOLOGICAL RISK ASSESSMENT SERIES 23 Multicriteria-based ranking for risk management of food-borne parasites Report of a Joint FAO/WHO Expert Meeting, 3–7 September 2012, FAO Headquarters, Rome, Italy Food and Agriculture Organization of the United Nations World Health Organization 2014 The designations employed and the presentation of material in this information product do not imply the expression of any opinion whatsoever on the part of the Food and Agriculture Organization of the United Nations (FAO) or of the World Health Organization (WHO) concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The mention of specific companies or products of manufacturers, whether or not these have been patented, does not imply that these are or have been endorsed or recommended by FAO or WHO in preference to others of a similar nature that are not mentioned. All reasonable precautions have been taken by FAO and WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall FAO and WHO be liable for damages arising from its use. WHO Library Cataloguing-in-Publication Data: Multicriteria-based ranking for risk management of food-borne parasites: report of a Joint FAO/ WHO Expert Meeting, 3-7 September 2012, FAO Headquarters, Rome, Italy. 1.Food contamination. 2.Food parasitology. 3.Parasites. 4.Risk management – methods. I.World Health Organization. II.Food and Agriculture Organization of the United Nations. ISBN 978 92 4 156470 0 (WHO) (NLM classification: WA 701) ISBN 978-92-5-108199-0 (print) (FAO) E-ISBN 978-92-5-108200-3 (PDF) (FAO) ISSN 1726-5274 Recommended citation: FAO/WHO [Food and Agriculture Organization of the United Nations/World Health Organization]. 2014. Multicriteria-based ranking for risk management of food-borne parasites. Microbiological Risk Assessment Series No. 23. Rome. 302pp FAO and WHO encourage the use, reproduction and dissemination of material in this information product. Except where otherwise indicated, material may be copied, downloaded and printed for private study, research and teaching purposes, or for use in non-commercial products or services, provided that appropriate acknowledgement of FAO and WHO as the source and copyright holder is given and that their endorsement of users’ views, products or services is not implied in any way. All requests for translation and adaptation rights, and for resale and other commercial use rights should be made via www.fao.org/contact-us/licencerequest or addressed to [email protected]. FAO information products are available on the FAO website (www.fao.org/publications) and can be purchased through [email protected]. © FAO/WHO 2014 Contents Acknowledgments x Contributors xi Abbreviations used in the report xiv Executive Summary xv 1 Background 1 2 Objectives and approach 4 2.1 Identification of parasites 7 2.2 Definition of primary and secondary parasite and food pathways 7 2.3 Definition of criteria for parasite scoring 8 2.4 Scoring parasites according to criteria 11 2.5 Definition of criteria weights 12 2.6 Calculation of parasite scores 13 3 Results 14 3.1 The global ranking of food-borne parasites 3.2 Trade scores for the ranked parasites 14 3.3 Socio-economic impacts for the ranked parasites 18 3.4 Conclusions 20 4 Risk management options for the higher ranked parasites 23 4.1 General risk management considerations 23 4.2 Generic risk management options 24 4.3 Some specific considerations for risk management 26 5 Conclusions and recommendations 32 References 35 ANNEXES Annex 1 Identification of food-borne parasites for consideration 40 Annex 2 Food-borne parasite ranking exercise: summary card 44 Annex 3 Food-borne parasite ranking exercise form: explanation of criteria 45 Criterion No. 1. Number of global food-borne illnesses 45 Criterion No. 2. Geographical distribution (endemic regions) 46 Criterion No. 3. Acute Morbidity Severity 47 Criterion No. 4. Chronic Morbidity Severity 48 Criterion No. 5. Fraction chronic 49 Criterion No. 6. Mortality rate 50 Criterion No. 7. Increasing trend in disease 50 Criterion No. 8. International trade 50 Criterion No. 9. Distributional impacts (socio-economic impact) 51 Criterion No. 10. Quality of evidence 52 Comments 52 References 52 Annex 4. Criteria weights worksheet 53 Annex 5. Sensitivity analysis 54 Annex 6. Risk management actions 62 Annex 7. Specific information for the ranked parasites 63 A7.1 Anisakidae and anisakiasis 63 General information 63 Geographical distribution 63 Disease 64 Trade relevance 65 Impact on economically vulnerable populations 65 References 65 A7.2 Ascaris spp. 66 General information 66 Geographical distribution 67 Disease 67 Trade relevance 68 Impact on economically vulnerable populations 68 Other relevant information 68 References 69 A7.3 Balantidium coli 70 General information 70 Geographical distribution 70 Disease 70 iv Trade relevance 71 Impact on economically vulnerable populations 71 References 71 A7.4 Cryptosporidium spp. 72 General information 72 Geographical distribution 73 Disease 74 Trade relevance 74 Impact on economically vulnerable populations 74 References 75 A7.5 Cyclospora cayetanensis 77 General information 77 Geographical distribution 78 Disease 78 Trade relevance and impact on economically vulnerable populations 79 References 79 A7.6 Diphyllobothrium spp. 82 General information 82 Geographical distribution 82 Disease 83 Trade relevance 84 Impact on economically vulnerable populations 84 Other relevant information 84 References 84 A7.7 Echinococcus granulosus 88 General information 88 Geographical distribution 89 Disease 89 Trade relevance of cystic echinococcosis 90 Impact of CE on economically vulnerable
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