A publication of the Centre for Advancing Journalism, University of Melbourne

Salmonella scare is only latest in long trend of rising food poisoning rates

Incidents of food poisoning in Victoria are rising ahead of the rate of population growth, despite a major review of regulations eight years ago.

Investigation by Krati Garg
 

Department of Health figures show that the rate of food poisoning caused by salmonella bacteria in Victoria almost trebled in the decade to 2015, rising to 60.1 incidents per 100,000 people compared to just 21.2 in 2005.

The number of reported cases annually rose by 570 in the last two years alone, the figures show.

Even so, Victoria lagged the national incidence rate in which cases of salmonella poisoning last year stood at 72.6 per 100,000 people (up from 31.9 in 2005).

As Narelle Fegan, a food microbiologist at the CSIRO, told The Citizen, the nationwide increase in cases of gastroenteritis triggered by bad food has occurred “at a time when it has been dropping in some other nations.”

The cost of bad food

There are an estimated 5.4 million cases of food poisoning in Australia each year, according to the Food Safety Information Council.

On average, these result in:

► 120 deaths

► 1.2m GP visits 

► 300,000 scripts for antibiotics

► 2.1m days of lost work

► $1.25bn cost to the community

Source: Food Safety Information Council

The acknowledgment coincides with the current widespread outbreak of salmonella poisoning due to contaminated packaged salad ingredients, which has trained a spotlight on Victoria’s food processing industry and the economic cost of such outbreaks, with food poisoning incidents in Australia estimated to cost the community more than $1 billion a year.

More than 100 people are known to have been hit by gastroenteritis as a result of the latest poisoning episode.

Earlier this year, a warning was issued to retailers to store raw eggs at cooler temperatures due to an increase in reported cases of egg-related salmonella poisoning.

Despite the latest scares, it is food prepared in cafes, restaurants and other outlets that would appear chiefly responsible for the rising number of reported cases of food poisoning.

A recent report by the National Notifiable Disease Surveillance System confirmed the doubling of incidence rates of salmonellosis for Australia, including the rate for Victoria.

The rise in cases is occuring despite major reforms to food regulation in Victoria that flowed from an inquiry in 2006 that was prompted both by the rising number of food poisoning incidents and a widespread perception that the level of regulation was disproportionate, especially for lower-risk and fund-raising activities.

Concerns were also raised about inconsistencies in the approach to food regulation across Victoria’s 79 local municipalities, as well as perceived gaps in the councils’ powers to enforce food laws, and the lack of publicly available information about convictions for offences. 

In 2006, Victorian doctors had notified health authorities of 7000 cases of salmonella and campylobacter (the other major bacterium causing gastroenteritis), with a study suggesting that 80 per cent of these may have been food-related.

The incidence rate of gastroenteritis triggered by campylobacter, commonly transmitted via contaminated food or water, has almost doubled in Victoria in the past 20 years, but has fallen nationally. However, campylobacter infection is not notifiable in NSW, thereby skewing national figures.

Food Poisoning StatisticsCreate your own infographicsMelbourne is widely considered the food capital of Australia, while Victoria produces almost half of Australia’s prepared food products. Meanwhile, Victorians eat more than six billion prepared meals a year, and spend 19 per cent of all household expenditure on food and drink. 

The 2006 inquiry by the Victorian Competition and Efficiency Commission on Food Safety led to changes in the Food Act aimed at streamlining and improving food safety supervision by targeting high-risk areas such as hospitals, childcare centres, aged care facilities, restaurant and cafes. 

At the same time, the commission recommended relaxing some regulations in a bid to ease the costs to business.

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Despite the reforms, the rate of food poisoning incidents continued to increase, with food-related complaints up by 26 per cent between 2012 and 2013. Meanwhile, the Department of Health was responding to about 4000 calls to its food safety hotline and receiving around 2000 emails on the issue.

Louis Papageorgiou, the president of Environmental Health Professionals Australia, a national group that provides professional development for people working in public health and environment, including food inspectors, says there are inconsistencies in applying the Food Standard Code across food outlets generally.

“How [local] councils interpret, assess and rate their businesses varies,” he said.

He added that there was still a need for standardising food safety regulation, with wide variations between local government areas.

According to Mr Papageorgiou, who works for the City of Whitehorse, council inspections were expected to be stringent and thorough.

“There is a general consensus on what is considered to be critical non-compliance and what is compliance. There are standard guidelines and definitions around those which every council has to follow.”

However, keeping tabs on the food industry is complex. A simple hamburger, for example, is subject to a complex web of regulation.

The sale of the hamburger is governed by the Food Act. But each component — the meat, bun, sauce and cheese — together with the way the ingredients are packaged and transported, is subject to different industry-specific laws.  

memorandum of understanding signed by Victoria’s many food regulators, including Dairy Food Safety Victoria, Prime Safe (which oversees meat and seafood), the Municipal Association of Victoria and the Department of Health, gives each a stake in ensuring that the hamburger is fit for consumption.

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However, this sort of industry collaboration appears to have failed to avert a rise in number of food poisoning incidents.

In July last year, 90 people fell ill and 16 were hospitalised after eating raw egg mayonnaise in chicken sandwiches served during high tea at Melbourne’s Langham Hotel. A pregnant woman, who had been celebrating her baby shower at the hotel, was forced to deliver her baby five weeks early as a result of the salmonella-induced food poisoning.

The Herald Sun reported that the Langham’s kitchen had failed multiple Melbourne City Council inspections last year, with cockroaches allegedly found in the kitchen 12 months before the salmonella outbreak.

Department of Health and Human Services media spokesman Bram Alexander said that councils were usually prompt in responding to the majority of complaints related to food poisoning, but the extent of the outbreak at the Langham had forced the department to intervene immediately.

Meanwhile, the true cost of food poisoning to the community may be partly hidden.  

Said Ajlouni, an associate professor in the faculty of Veterinary and Agricultural Sciences at the University of Melbourne, said that salmonella bacteria could cause long-term symptoms such as irritable bowl syndrome and reactive arthritis even when they didn’t trigger immediate food poisoning.  

At the same time, the response of councils to food-related complaints can apparently vary widely, something Dr Ajlouni says he has experienced personally. He says it took three weeks and multiple phone calls for the City of Melbourne to follow up a complaint he lodged about a tub of yoghurt he had bought in the city that contained a layer of mould and carried no expiry date on its label.

A spokesperson for the City of Melbourne told The Citizen that the council investigated all complaints and ensured that all registered food businesses were inspected at least once a year. Complaint response times varied depending on the type and nature of the problem and the potential risk, she added.

Jody Bosman, Director City Planning, Design and Amenity at the City of Greater Dandenong, offered a similar response to questions about compliance.

“City of Greater Dandenong is one of the leading Australian municipalities in terms of in-field food safety inspection data capture and the ability to use that data for risk profiling. There are currently no food safety concerns within our food courts. Any observed non-compliance is followed up within 14 days.”

While [Victorian health authorities claim] great strides in food safety policy and regulation . . . there were still 505 offences recorded against food businesses for breaches of the law in 2015. At the same time, the incidence of gastroenteritis continued to rise, doubling over the previous 10 years.

But Dr Ajlouni said that in some cases official figures could be misleading. “If someone has symptoms that are not reported, then you could assume that the business was safe, but in reality that may not be the case,” he said.

Meanwhile, figures from the Department of Health suggest that Victorians are more likely to get sick from eating at a family-run café than at a franchised food chain such as McDonald’s or Subway.

Last year, 27 of the 32 convictions for breaches of food safety standards involved non-franchised outlets.

This could possibly be explained by more regular visits to franchised outlets by parent company representatives, with outlets typically getting monthly inspections and surprise visits, according to the owner of three franchised outlets in NSW.

Independent food outlets could expect yearly or, at most, six-monthly inspections from local government officers. But a franchisee of a prominent food chain told The Citizen that the inspections for non-franchised outlets were often routine and it was often easy to by-pass required labelling laws by simply changing dates with a marker pen.

The source said that franchise corporations, by contrast, also had a motive to put more money into safety and compliance. “Who wants to pay for the multi-million-dollar law suit following a food poisoning incident?” 

Mr Papageorgiou, of Environment Health Professionals Australia, agreed that franchises probably had more resources to monitor standards, compared to non-franchised family-run businesses.

“But there have been complaints registered against franchised outlets, too,” he said. “It all depends on business owners. Council inspectors cannot be present 24 hours, seven days-a-week.”

In 2013, a total of 44,655 fixed food premises were registered with Victorian councils, three-quarters of which were class 1 or class 2 premises, classified according to the perceived level of food safety risk associated with their food handling activities.

Cafes and restaurants are considered class 2 premises when their main activity is handling unpackaged, potentially hazardous foods that need correct temperature control during the food handling process, including cooking and storage, to keep them safe. 

Before 2012, there had been no provision for registering non-fixed food premises such as mobile food vans and trucks. But by 2013, almost 13,000 proprietors of mobile services had an account with Streattrader, a program launched to encourage online registration and notification.

As a result of amendments to the Food Act, class 1 and 2 premises must employ a suitably qualified food safety supervisor and adopt a food safety program that is part of a quality assurance system approved by the Department of Health.

Mr Papageorgiou said: “A trained food safety supervisor is a mandatory requirement under the Food Act. The training of all other food handlers [in the food premises] is highly recommended and strongly encouraged. This can be done by the food safety supervisor or by external training (including free online training made available through the Department of Health and Human Services).’’ *

Vishal Mawani, who used to run Misht Indian restaurant in Glen Iris, said that it was easy to cut corners in the food business. Council visits tended to be flagged, ahead of time, making it easy for owners to clean up their premises pre-inspection. 

But he said he had chosen to be the food safety supervisor for his own business. “We always complied with the food standard code. At the end of the day, we would throw away all the leftover curries. One cannot take chances with people’s health.”

In fact, some recommended changes to the Food Act were watered down by the previous State Government in a bid to decrease the regulatory burden on food businesses; for example, by reducing the number of council inspections of food premises and by making the employment of a food safety officer optional.

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How local councils can ratchet up the pressure on food outletsSource: Victorian Dept of Health

Mr Papageorgiou said that despite the many positive changes stemming from the 2006 inquiry, there was “definitely scope for improving the process.”

He added that Whitehorse Council had a performance-based assessment scheme for the municipality’s food businesses — a five-star rating system that rewarded top performers on food safety while warning — and in some cases penalising — poor performers.

But not all councils had the necessary resources to deal with shoddy operators.

“Rural councils do not have sufficient staff to support growing food businesses,” Mr Papageorgiou said. “Often, they do not have enough inspectors to conduct frequent inspections.”

But inspectors realistically cannot catch everything, only reduce risk, leaving open the prospect of food posioning outbreaks such as that which occurrred at The Bottle Milk Torquay company in 2014, which left 200 diners ill.

The company subsequently pleaded guilty to two counts of conducting a food business that failed to comply with food requirements and 10 counts of failing to comply with food standards provisions. It also pleaded guilty to a charge of failing to ensure food safety conditions.

And while the Health Department’s most recent annual report on food safety regulatory activities stated that Victoria had made great strides in food safety policy and regulation, pointing to major changes to the Food Act 1984 and the Food Standards Code, there were still 505 offences recorded against food businesses for breaches of the law in 2015. At the same time, the incidence of gastroenteritis continued to rise, doubling over the previous 10 years.

Mr Papageorgiou said: “The challenge lies not with the regulation so much or by reducing the burden on records. Records can be fudged. It is about practices. The challenge lies on focusing on new proprietors coming in, making sure they know the rules and that they follow them consistently.”

* CORRECTION This story has been amended to correct a suggestion that a trained food supervisor was not mandatory for class 1 and 2 food premises. The quotation attributed to Mr Papageorgiou, which originally suggested that a food safety supervisor was only recommended, has also been altered.

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