FAO/WHO meeting warns of contamination of powdered infant formula
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《英国医生杂志》
People caring for infants at high risk of infection should be warned that powdered infant formula is not a sterile product, a recent meeting organised by the Food and Agriculture Organization (FAO) and the World Health Organization concluded.
The joint FAO/WHO workshop on Enterobacter sakazakii and other micro-organisms in powdered infant formula, which was attended by experts, found that intrinsic contamination of powdered infant formula with E sakazakii and Salmonella had caused cases of infection and illness in infant, including severe disease, and could lead to serious developmental sequelae and death.
Neonates (up to 4 weeks of age), particularly preterm, low birthweight, or immunocompromised babies, were considered to be at greatest risk of E sakazakii infection. Infants of HIV positive mothers were also at risk because they may require infant formula and may be more susceptible to infection.
The expert meeting recommended that carers, particularly of high risk infants, should be encouraged to use commercially sterile liquid formula or formula that has undergone an effective decontamination procedure, such as using boiling water to reconstitute formula or heating reconstituted formula.
E sakazakii has been implicated in outbreaks causing meningitis or enteritis. In the few outbreaks reported, the death rate among infants who contracted the disease ranged from 20% to over 50%, while some survivors experienced severe lasting complications. The bacterium has been detected in a range of foods, but only powdered infant formula has been linked to outbreaks of disease. Its prevalence is unknown, but the US FoodNet 2002 survey (www.cdc.gov/foodnet/surveys/pop_cov.htm) found the rate of invasive E sakazakii infection in infants under 1 year of age was 1 per 100 000.
An executive summary of the FAO/WHO meeting warned: "It is important to note that powdered infant formula meeting current standards is not a sterile product and may occasionally contain pathogens. It seems not to be possible, using current technology, to produce commercially sterile powders or completely eliminate the potential of contamination."
The meeting was called in response to a request made by the Codex Committee on Food Hygiene for scientific advice to be used in the revision of the Recommended International Code of Hygienic Practice for Foods for Infants and Children. On the basis of its findings, the workshop recommended that the code should include microbiological specification for E sakazakii in powdered infant formula.
A summary report of the joint FAO/WHO workshop on E sakazakii and other micro-organisms in powdered infant formula is at www.who.int/foodsafety/micro/meetings/feb2004/en/(London Susan Mayor)
The joint FAO/WHO workshop on Enterobacter sakazakii and other micro-organisms in powdered infant formula, which was attended by experts, found that intrinsic contamination of powdered infant formula with E sakazakii and Salmonella had caused cases of infection and illness in infant, including severe disease, and could lead to serious developmental sequelae and death.
Neonates (up to 4 weeks of age), particularly preterm, low birthweight, or immunocompromised babies, were considered to be at greatest risk of E sakazakii infection. Infants of HIV positive mothers were also at risk because they may require infant formula and may be more susceptible to infection.
The expert meeting recommended that carers, particularly of high risk infants, should be encouraged to use commercially sterile liquid formula or formula that has undergone an effective decontamination procedure, such as using boiling water to reconstitute formula or heating reconstituted formula.
E sakazakii has been implicated in outbreaks causing meningitis or enteritis. In the few outbreaks reported, the death rate among infants who contracted the disease ranged from 20% to over 50%, while some survivors experienced severe lasting complications. The bacterium has been detected in a range of foods, but only powdered infant formula has been linked to outbreaks of disease. Its prevalence is unknown, but the US FoodNet 2002 survey (www.cdc.gov/foodnet/surveys/pop_cov.htm) found the rate of invasive E sakazakii infection in infants under 1 year of age was 1 per 100 000.
An executive summary of the FAO/WHO meeting warned: "It is important to note that powdered infant formula meeting current standards is not a sterile product and may occasionally contain pathogens. It seems not to be possible, using current technology, to produce commercially sterile powders or completely eliminate the potential of contamination."
The meeting was called in response to a request made by the Codex Committee on Food Hygiene for scientific advice to be used in the revision of the Recommended International Code of Hygienic Practice for Foods for Infants and Children. On the basis of its findings, the workshop recommended that the code should include microbiological specification for E sakazakii in powdered infant formula.
A summary report of the joint FAO/WHO workshop on E sakazakii and other micro-organisms in powdered infant formula is at www.who.int/foodsafety/micro/meetings/feb2004/en/(London Susan Mayor)