A Qualitative Assessment of the Risks of Transmission of Microorganisms to Humans Resulting from the Consumption of Raw Milk and Raw Cream in Norway

Y. Wasteson, H. Blom, K. Fossum, E. Høiby, J. Narvhus, L. Håvarstein, G. Kapperud, J. Lassen, B. Lunestad, T. Nesbakken, E. Rimstad, L. Robertson, E. Skjerve, H. Kruse
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Abstract

Pasteurisation of all consumer milk became mandatory in Norway in 1953, and this has been an important component of the protective measures that have reduced the incidence of milk and food borne diseases. In 2004, a complete recast of the hygiene legislation addressing both food hygiene and veterinary aspects was adopted by the European Union, the so-called “Hygiene package”. According to this legislation, each member state may, on its own initiative, prohibit or restrict the marketing of some foods like raw milk or raw cream, intended for direct human consumption within its territory. In response to this, the Norwegian Food Safety Authority (Mattilsynet) commissioned the Panel on Biological Hazards of the Norwegian Scientific Committee for Food Safety (Vitenskapskomitéen for mattrygghet), to prepare a risk assessment regarding the consumption of raw milk and raw cream. In response, an ad hoc Working Group of experts was appointed with the mandate to draft a risk assessment which should include the following components: identification and characterization of microbiological hazardous agents present in Norwegian raw milk; characterization of the public health consequences of these agents; assessment of the probability of transmission of these agents to humans by distribution of raw milk and cream. Additionally, the risk assessment should identify potential hazards to human health from the importation of raw milk, identify hazards associated with equipment used for production and storage of raw milk, and assess the risks associated with the potential transfer of antimicrobial resistance genes.   Observations concerning infections related to consumption of raw milk and raw cream in Norway, other European countries and North America, show that a number of pathogenic microorganisms, including emerging pathogens, can occur in raw milk and raw cream. These pathogenic microorganisms and their toxins may represent a real threat to human health. The panel concluded that the risks associated with E. coli O157:H7 and other EHEC, C. jejuni and L. monocytogenes in raw milk and cream are high. Furthermore the importation of raw milk to Norway may result in the (re)introduction of microorganisms, which have been eradicated, or never previously have been present, in Norway. This can have serious consequences for both human and animal health.
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对挪威食用生奶和生奶油导致微生物向人类传播的风险进行定性评估
1953年,挪威对所有消费者的牛奶强制进行巴氏消毒,这是减少牛奶和食源性疾病发病率的保护措施的重要组成部分。2004年,欧盟对食品卫生和兽医方面的卫生立法进行了全面修订,即所谓的“卫生一揽子计划”。根据该立法,每个成员国可以主动禁止或限制在其领土内直接供人类食用的某些食品,如生牛奶或生奶油的销售。为此,挪威食品安全局(Mattilsynet)委托挪威食品安全科学委员会生物危害问题小组(vitenskapskomitsamen for mattryghet)编写一份关于食用生牛奶和生奶油的风险评估。为此,任命了一个特设专家工作组,其任务是起草一份风险评估报告,其中应包括以下内容:鉴定和描述挪威原料奶中存在的微生物危险剂;描述这些物质对公共卫生的影响;通过分发生牛奶和奶油评估这些病原体传染给人类的可能性。此外,风险评估应确定原料奶进口对人类健康的潜在危害,确定与生产和储存原料奶所用设备有关的危害,并评估与抗菌素耐药性基因潜在转移有关的风险。在挪威、其他欧洲国家和北美,对与食用生奶和生奶油有关的感染的观察表明,许多致病微生物,包括新出现的病原体,可能发生在生奶和生奶油中。这些致病微生物及其毒素可能对人类健康构成真正的威胁。该小组得出结论,生牛奶和奶油中的大肠杆菌O157:H7和其他肠出血性大肠杆菌、空肠梭菌和单核增生乳杆菌的风险很高。此外,向挪威进口原料奶可能导致(重新)引入微生物,这些微生物在挪威已经被根除,或者以前从未存在过。这可能对人类和动物健康造成严重后果。
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