1. 1 Risk Surveillance and Assessment of Food Safety in Shanghai

2. 2 Resume Name: Chunfeng Wu Position: Shanghai Municipal Center for Disease Control and Prevention Education: 1999~2004 Bachelor of Medical Sciences Public Health College, Fudan University 2008~ Reading for MPH in Fudan University

3. 3 Work Experience 2004.7~ Work in Department of Food Hygiene and Food-borne Disease Control 2008.5.22~2008.6.11 Go to Sichuan province to provide health and epidemic prevention after “Wenchuan Earthquake” 2008.8.24~2008.9.2 Participate in a workshop held by U.S. CDC Epi-Ready Team : Foodborne Illness Response Strategies

4. 4 Framework of our jobs Food-borne Disease Surveillance Surveillance Food Contamination Food Contamination Monitoring Monitoring Risk Assessment Risk Assessment Prevention, Intervention Prevention, Intervention Research Research Evaluate Evaluate Food-borne Outbreaks Investigation and Response Food-borne Outbreaks Investigation and Response

5. 5 Food-borne Diseases Surveillance Food Contamination Monitoring Others

6. 6 Food-borne Disease Surveillance In order to estimate the incidence of food-borne diseases in Shanghai Refer to the theory of FoodNet Establish the surveillance in the beginning of 2006

7. 7 FoodNet The project consists of active surveillance for foodborne diseases and related epidemiologic studies Covers population of 37.6 million or 13.8% of the United States population

8. 8 Burden of Illness Pyramid Cases reported through passive surveillance represent fraction of actual number of cases in community

9. 9 Food-borne Disease Surveillance Passive surveillance system Hospital (pathogen surveillance ) Community (food-borne diarrhea symptom surveillance) The Current Surveillance Pyramid SchoolDrugstore

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11. 11 Select 4 communities every district Sample 120 residents every community Face to face investigation every month Collect the data of food-borne diarrhea symptom Deduce the incidence of food-borne diseases in general population Community symptom surveillance

12. 12 Select 6 hospitals every district Report all the cases in Enteric Diseases Clinic obtain specimen such as stool test Salmonella/E coli/Vibrio/Shigella Collect chemical food poisoning cases in emergency room Conclude the main causes of food-borne disease Hospital pathogen surveillance

13. 13 Drugstore surveillance 2 stores every district Explore the status of antidiarrhoeal drug and enteric antiseptics One kind of data to estimate the burden School surveillance 4 schools every district Determine the proportion of student absence for diarrhea Incidence in a particular population No formal surveillance

14. 14 Report the food-borne outbreaks online In a prescriptive time Hospital district CDC municipal CDC Passive surveillance

15. 15 During 1990 and 2000 in Shanghai, 68.8% foodborne outbreaks caused by bacterial, 23.9% caused by chemical

16. 16 63.7% bacterial food-borne outbreaks caused by Vibrio parahaemolyticus

17. 17 Food Contamination Monitoring Determine the level of food contamination and its dynamic trend According to Global Environment Monitoring System - Food Contamination Monitoring and Assessment (GEMS/Food) and national monitoring programme Establish the monitoring in 2002

18. 18 urban Sample the monitoring sites such as supermarkets based on population distribution and living standard 2007

19. 19 Consumers’ routine purchases were imitated in those places for sampling food commissariat and commissariat products vegetable and vegetable products fruits and fruit products meat and meat products aquatic products milk and milk products Etc. About 100 kinds and 5,000 pieces of food sample every year

20. 20 Chemical contamination: Heavy metal Pesticide Veterinary drugs Food additive Etc. Food contamination Bacterial contamination: Salmonella Listeria monocytohenes Vibrio parahaemolyticus E coli O157 Staphylococcus Etc.

21. 21 Others Risk assessment : Finish the assessment of lead and cadmium The main sources of lead and cadmium were rice, tint vegetables, fish and shrimp Overall, the dietary lead and cadmium intakes were safe in Shanghai residents Dietary cadmium intake was on a high level in children in whom P 90 of cadmium intake is over PTWI

22. 22 My study: Quantitative risk assessment of heavy metal in aquatic product Finished gathering the data of aquatic product consumption testing the concentration of lead and cadmium Next to do Monte Carlo simulation ? software @RISK 5.0 analysis ?

23. 23 0.078 0.2 0.41 0.036 0.091 0.19 0.13 0.27 0.81 0.092 0.24 0.39 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 Marine fish Fresh water fish mollusc crustacean Status of Pb in aquatic product(mg/Kg) mean P90 max Pb concentration in mollusc is higher than in fresh water fish Primary results

24. 24 0.015 0.031 0.16 0.013 0.022 0.081 0.15 0.55 0.079 0.18 0.91 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1 mean P90 max Status of Cd in aquatic product(mg/Kg) Marine fishFresh water fishmollusc crustacean Cd concentration in mollusc and crustacean is much higher than in marine and fresh water fish

25. 25 《 Food Safety Law 》 had brought into effect from Jun 1 st CDC has responsibility of food-borne outbreaks investigation FDA do this job now, we have little experience to deal with the field epidemiological investigation Current situation

26. 26 2010 World Expo will be held in Shanghai will be held from May to Oct 70~75 millions person-times will visit food consumption increase food consumption increase more people will eat in restaurants more people will eat in restaurants bacteria proliferate befittingly bacteria proliferate befittingly pesticide using increase pesticide using increase food contaminated incident food-borne outbreaks

27. 27 Development Increase the quality and sensitivity of surveillance and monitoring Practice food-borne outbreaks investigation and response Accumulate experiences of risk assessment Enrich the methods of intervention

28. 28 Activities Be familiar with Epidemiological methods and applications in food-borne outbreaks investigation and response Understand more about FoodNet, PulseNet…… How California conduct and act? Know some fast-testing methods of food contamination Participate in some jobs or workshops of exposure assessment, especially the use of model and software Learn to do intervention such as health education and communication

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