Vírus transmitidos por alimentos: Maria São José Nascimento

Apresentação em tema: "Vírus transmitidos por alimentos: Maria São José Nascimento"— Transcrição da apresentação:

1 Vírus transmitidos por alimentos: Maria São José Nascimento
uma potencial ameaça uma ameaça real Unlike bacteria viruses cannot grow in food. Food acts as a vehicle to transport the virus between infected and uninfected people. Food must be directly contaminated with human stool or vomit to transmit a human enteric virus Maria São José Nascimento

2 Doenças transmitidas através dos alimentos
Bactérias têm sido tradicionalmente responsabilizadas por este tipo de doenças MAS HOJE: In recent years, however, it became clear that the majority of such outbreaks are caused by viruses, especially the Norovirus (NV, previously named Norwalk-like viruses). Os vírus são reconhecidos como os principais responsáveis pelos surtos epidémicos associados à ingestão de águas e alimentos

3 Foodborne Illnesses by etiology
(in thousands) 67,2% 2,6% 14 milhões 62 milhões _________ 76 milhões vírus 30,2% Transmission of these viruses is primarily from person to person, but numerous examples illustrate that NV are efficiently transmitted via food, water, or contaminated environmental surfaces. NV similar but not identical to the human strains have been found in cattle and in pigs (reservatório animal) Outbreaks are often linked to raw oysters 76 milhões doenças transmitidas por alimentos nos EUA por ano ( hospitalizações e mortes) Só em 14 milhões foi identificado o agente Sem agente etiológico Mead et al, Emerging Infectious Diseases 1999:5(5);

4 NOROVÍRUS (Norwalk-like virus)
66,6% Astrovírus Rotavírus Vírus hepatite A 0,6 % Many viruses could potentially be transmitted via food, but two viruses,account for the vast majority of reported cases: Noroviruses and Hepatitis A virus. The food most commonly associated with viral gastroenteritis are shellfish, particularly oysters which are eaten raw *emergentes

5 Most common causes of foodborne Illness
2,000,000 4,000,000 6,000,000 8,000,000 10,000,000 Norwalk-like virus Campylobacter Salmonella C. perfringens Giardia S. aureus Mead et al, Emerging Infectious Diseases 1999:5(5);

6 Norwalk-like virus Outbreaks
Settings Mode of transmission Not given Other 58% 16% 3% 23% Food borne Water Person-to- person Not determined Vacation/ cruise ships 5% 5% Restaurants/ catered events 10% Schools/ daycares 16% 38% Nursing homes 26% Total: 229 Total: 172 Mead et al, Emerging Infectious Diseases 1999:5(5);

7 Top etiologies of Foodborne Outbreaks (1998 – 20051)
Falar da emergência que não é real mas que se deve ao desenvolvimento e aplicação dos processos de detecção dos vírus nos alimentos e nas águas Gentimente cedido por Jan Vinjé, Head Calivirus Laboratory, CDC

8 Os norovírus são hoje reconhecidos como o principal agente da
gastrenterite aguda epidémica transmitida pelos alimentos Nos EUA estima-se que causem 23 milhões de casos de gastrenterite/ano São responsáveis por extensos surtos epidémicos devido: - elevada infecciosidade (dose infectante baixa / viriões ) - muito estáveis no meio ambiente - muito resistentes aos desinfectantes comuns - alta transmissibilidade pessoa-a-pessoa Difícil controlar a sua transmissão através das medidas sanitárias habituais Os norovírus, conhecidos anteriormente como “Norwalk-like viruses”, são hoje considerados o principal agente da gastrenterite aguda epidémica transmitida pelos alimentos e a causa mais frequente da doença entérica esporádica. A alta transmissibilidade pessoa-a-pessoa e a baixa dose infectante explica a frequência com que os norovírus originam surtos epidémicos extensos sobretudo em ambientes onde é elevada a concentração de pessoas, como lares, enfermarias, escolas, hotéis e até mesmo barcos de cruzeiro, o que já os levou a serem apelidados de “vírus dos cruzeiros”. Noroviruses are increasingly being recognized as leading causes of foodborne disease in the UK, Europe and the United States Noroviruses are passed in the stool of infected persons. People get infected by swallowing stool-contaminated food or water. Norovirus infection is an intestinal illness that often occurs in outbreak. Outbreaks are often linked to raw oysters. Infected people usually recover in 2 to 3 days without serious or long-term health effects Noroviruses are estimated to cause 23 million cases of acute gastroenteritis (commonly called the "stomach flu") in the U.S. each year, and are the leading cause of gastroenteritis. Of viruses, only the common cold is reported more often than viral gastroenteritis (norovirus). Noroviruses may cause more outbreaks of foodborne illness than all bacteria and parasites. They can cause extended outbreaks because of their high infectivity, persistence in the environment, resistance to common disinfectants, and difficulty in controlling their transmission through routine sanitary measures. Das infecções víricas apenas a gripe sazonal consegue superar a gastrenterite por norovírus

9 EVENT = Food- and waterborne transmission play an important role in the spread of norovirus (NV, previously named Norwalk-like viruses) throughout Europe. NV are ubiquitous, highly contagious, and cause large international outbreaks of gastroenteritis. This is of concern: current quality control for food and water in Europe measures bacterial contamination, and does not monitor viral contamination. Therefore, food can pass microbiological quality control, but still contain viruses. Matched with the virtual absence of a surveillance system for detection of common-source outbreaks of illness due to enteric viruses, this highlights a weak spot in European infectious disease control. The NV in fact serve as sentinels: when present, common-source outbreaks will relatively easily be detected due to the high attack rate and short incubation period. More insidious, however, are the enteroviruses and fecally-transmitted hepatitis viruses with a high proportion of asymptomatic infection after an incubation period of up to 2 months. These viruses cause illnesses like hepatitis (hepatitis A and E viruses) and infections of the central nervous system (enteroviruses). Signaling common source outbreaks with these viruses is virtually impossible without a strong (molecular) laboratory component to underpin the epidemiological investigations, aided by international exchange of laboratory data. The work in this proposal aims at providing the laboratory tools needed for successful (epidemiological) surveillance networks on food-borne outbreaks, hepatitis A viruses, and rare and emerging diseases (attributable to enteric viruses) that are being developed under DG Sanco’s Communicable Disease Surveillance Network. We build on information gathered through a previously funded (FP5) research network, in collaboration with coordinators of surveillance networks in DG Sanco, to help put the research findings into practical use for the above mentioned activities. Food-related illness is common world-wide, and bacterial pathogens have historically been associated with this mode of transmission. In recent years, however, it became clear that the majority of such outbreaks are caused by viruses, especially the human caliciviruses belonging to the genus Norovirus (NV, previously named Norwalk-like viruses). Transmission of these viruses is primarily from person to person, but numerous examples illustrate that NV are efficiently transmitted via food, water, or contaminated environmental surfaces. NV similar but not identical to the human strains have been found in cattle and in pigs. Different variants co-circulate in the community, but occasionally shifts occur, in which a single variant dominates. It was found that norovirus outbreaks occur internationally, and that (international) food and waterborne transmission may play an important role in the dissemination of new variants. The detection of 4 novel (recombinant) viruses in the course of the past 3 years, associated with increased burden of illness, and in the absence of robust control measures for viral contamination of food and water, stresses the need for surveillance. This project will help build capacity across Europe for national and transnational surveillance of outbreaks due to Noroviruses, particularly outbreaks associated with contaminated foods, water, and environmental exposures. This information is essential for acute control and long term prevention of norovirus outbreaks and to inform and promote best practice. In contrast to other disease specific networks, the EC can not rely on data aggregation of laboratory test reports from individual sick patients at the national level, because methods for norovirus detection are not used routinely in many countries. While epidemiological criteria can be used to identify outbreaks of illness due to noroviruses (as piloted in the FBVE project), the lack of underpinning laboratory data would result in a surveillance activity of little value for early warning purposes. Timely strain characterisation is essential for detection of emerging novel viral strains and to provide an early warning for the emergence of more aggressive strains. Therefore, this project seeks to build on the highly successful collaboration achieved by the Food Borne Viruses in Europe (FBVE) project in which national expert virology and epidemiology combined to strengthen competence in norovirus outbreak detection and control, and develop the necessary laboratory tools and databases. In this proposal we will seek further partners in existing member states and applicant countries, so extending EU surveillance and will build competence through training in surveillance epidemiology and in viral diagnostic methods.

10 FFUP The aim of the Action is to increase the knowledge of the impact on health of pathogenic viral contamination of the environment increase the knowledge of the role of the environment and food in the transmission of enteric viral disease. The principal objective of the Action is to construct a Network of expert European scientists, who will cooperate to promote the study of, and to tackle the issues associated with, food- and environmentally transmitted pathogenic viruses increase the knowledge of the impact on health of pathogenic viral contamination of the enviro. Maria São José Nascimento, Faculdade de Farmácia da Universidade do Porto, nomeada no passado dia 16 de Abril, a representante Portuguesa da Acção COST 929 – ENVIRONET (European Network for Environmental and Food Virology Esta rede Europeia, que teve início em Setembro de 2006 e desenvolverá a sua acção até Dezembro de 2010, pretende constituir um fórum de intercâmbio de informação e de cooperação científica entre os vários Estados Membros da União Europeia com o objectivo de melhorar o conhecimento do papel dos alimentos e do ambiente na transmissão das infecções víricas entéricas e ao mesmo tempo reforçar a área da Virologia Ambiental e do Alimento na Europa. Esta rede permitirá ao mesmo tempo a transferência de conhecimentos e informação técnica dos laboratórios Europeus, com reconhecida competência nesta área da Virologia, para países em que tal “know-how” é escasso ou mesmo inexistente, como é o caso de Portugal. Esta participação constitui portanto para o nosso país uma oportunidade excelente para o desenvolvimento de uma área com importantes implicações em saúde pública. Fórum de intercâmbio de informação e de cooperação científica entre os vários Estados Membros Objectivo: -aumentar o conhecimento do papel dos alimentos e do ambiente na transmissão das infecções víricas entéricas - reforçar a área da Virologia Ambiental e do Alimento na Europa

11 Projecto Europeu 6º PROGRAMA QUADRO Comissão Europeia 1 Janeiro 2006
Métodos para a Concentração e Detecção de Adenovírus e Norovírus em Águas Balneares Europeias como referência para a revisão da Directiva das Águas Balneares 76/160/EEC Projecto Europeu 6º PROGRAMA QUADRO Comissão Europeia Specific Targeted Research Project Estes estudo foi resultado da participação portuguesa no Projecto Europeu VIROBATH financiado pelo 6º Programa Quadro da Comissão Europeia e decorreu entre 1 de Janeiro de 2006 e 31 de Março de 2007. 1 Janeiro 2006 31 Março 2007

12 Área de Cooperação : Galiza – Norte de Portugal
Universidade de Santiago de Compostela - Institución Jefe de Fila Centro Tecnológico del Mar - Fundación CETMAR Instituto de Investigaciones Marinas Instituto de Investigação das Pescas e do Mar (IPIMAR) Escola Superior de Biotecnologia da Universidade Católica Portuguesa (ESB-UCP) Escola Superior de Tecnologia e Gestão - Instituto Politécnico de Viana do Castelo (ESTG-IPVC) Centro Interdisciplinar Investigação Marinha Ambiental - Universidade do Porto (CIIMAR-UP) Programa Operativo de Cooperación Transfronteriza España – Portugal

13 PORQUE a qualidade dos alimentos e da água na Europa só mede a
contaminação bacteriana e não monitoriza a contaminação viral … É nosso objectivo neste Projecto: Avaliar a contaminação de bivalves e águas conquícolas da Costa Peninsular por norovírus GI e GII e vírus da hepatite A. Demonstrar a eficácia de novos indicadores virais (adenovírus e poliomavírus humanos) na avaliação da contaminação viral fecal de bivalves e suas águas de cultivo e evidenciar a ineficácia dos indicadores bacteriológicos (E. Coli) impostos pela Directiva 91/492/CEE nesta avaliação. Contribuir para o aumento da qualidade e segurança alimentar de bivalves garantir produtos de maior segurança no mercado impacto positivo Saúde Pública e a nível económico

14 Avaliação da contaminação de bivalves da Costa Peninsular por Norovírus humanos (GI e GII)
C+ S1 S2 S4 S5 S6 C – (GII) 327bp S1 = Ostra / Estuário Rio Lima S2 = Berbigão / Rio Douro S4 = Amêijoa Tellina / Aguda S5 = Amêijoa Branca / Aguda S6 = Amêijoa Boa / Estuário Rio Lima FFUP/ IPIMAR Junho 2008