Analysis of Foodborne Disease Outbreaks for Improvement of Food Safety Programs in Seoul, Republic of Korea, from 2002 to 2006
Lee, Jib Ho, Lee, Joon-Hak, Kim, Moo Sang, Park, Seog Gee, Journal of Environmental Health
Food safety management has been an important public health issue in every country. Foodborne diseases (FBD) have posed growing public health threats and caused economic impacts to many countries during the past three decades. Foodborne diseases are not only a primary concern of public health in developing countries; they also pose a significant public health threat in developed countries (Tauxe, 1997).
Lack of intensive FBD surveillance often hampers measuring the magnitude of impacts of FBD on public health, which is particularly true in developing countries. As many occurrences of FBD are undiagnosed or unreported, the true dimension of FBD impacts on public health is unknown. It has been estimated that in 2005 alone 1.8 million people died from diarrheal diseases (Rocourt, Moy, Vierk, & Schlundt, 2003). It is suggested that each year more than 10% of the population suffers from FBD in industrialized countries (Kaferstein, Motajemi, & Bettcher, 1997). For example, it is estimated that each year FBD causes approximately 76 million cases, 325,000 hospitalizations, and 5,000 deaths in the U.S. (Schlundt, 2002).
Seoul, Republic of Korea, is one of the world's largest cities, with a population of 10.3 million. It hosted the summer Olympic Games in 1988 and the World Cup soccer tournament in 2002 (Seoul City, 2007). South Korea (Republic of Korea) has been a member country in the Organization for Economic Cooperation and Development (OECD) since 1996. The OECD facilitates further economic, environmental, and social developments in the country.
Many factors have contributed to the increase in FBD. Industrialization and urbanization have led to revolutionary changes in the food supply system, as well as mass production and an increase in the number of food service establishments and food outlets (Collins, 1997; Kaferstein, Motajemi, & Bettcher, 1997). The globalization of food trade and international travel have increased the risk for cross-border transmission of infectious diseases. South Korea has increased its trade with neighboring countries. Since the Asian economic crisis in 1997-1998, much of South Korea's agricultural products have been imported from neighboring countries such as China, Thailand, and Vietnam. Foreign laborers have increased in manufacturing, farming, and construction as well.
Recent changes in the social and economic environments of Korea have changed patterns of food consumption and have increased the risk of foodborne illnesses, which therefore requires improvements in food safety programs. Hence, recent FBD occurrences in Seoul were analyzed to identify focus areas in order to improve the efficiency of food safety programs.
Materials and Methods
This report summarizes data on the outbreaks and human cases of FBD reported to Seoul City from 2002 through 2006. Foodborne diseases are reportable diseases in South Korea. Laboratory confirmation of human cases was made in, and related data were obtained from, the Seoul Metropolitan Government Institute of Health and Environment. An FBD outbreak is defined as the occurrence of a gastrointestinal illness among two or more people in which an investigation links the consumption of a common meal or food items. For botulism, however, even one case is considered an outbreak. The number of cases is defined as the number of laboratory-confirmed cases.
The protocol in FBD outbreak investigations is to collect fecal samples from suspected cases when FBDs are reported. Samples are not collected if the person had been treated with antibiotics before sampling. All the collected samples of FBD outbreak cases were tested according to the infectious disease guideline of Korea Center for Disease Control and Prevention (KCDCP). The collected samples were tested for bacterial and viral organisms and parasites. Bacterial tests included Salmonella spp., pathogenic E. coli, Staphylococcus aureus, Vibrio parahaemolyticus, Listeria monocytogenes, Campylobacter jejuni, Clostridium perfringens, Yersinia enterocolitica, and Bacillus cereus. …