FAO/WHO meeting warns of contamination of powdered infant formula
London Susan Mayor



People caring for infants at high risk of infection should be warned that
powdered infant formula is not a sterile product, a recent meeting
organised by the Food and Agriculture Organization (FAO) and the World
Health Organization concluded.

The joint FAO/WHO workshop on Enterobacter sakazakii and other micro-
organisms in powdered infant formula, which was attended by experts, found
that intrinsic contamination of powdered infant formula with E sakazakii
and Salmonella had caused cases of infection and illness in infant,
including severe disease, and could lead to serious developmental sequelae
and death.

Neonates (up to 4 weeks of age), particularly preterm, low birthweight, or
immunocompromised babies, were considered to be at greatest risk of E
sakazakii infection. Infants of HIV positive mothers were also at risk
because they may require infant formula and may be more susceptible to
infection.

The expert meeting recommended that carers, particularly of high risk
infants, should be encouraged to use commercially sterile liquid formula or
formula that has undergone an effective decontamination procedure, such as
using boiling water to reconstitute formula or heating reconstituted
formula.

E sakazakii has been implicated in outbreaks causing meningitis or
enteritis. In the few outbreaks reported, the death rate among infants who
contracted the disease ranged from 20% to over 50%, while some survivors
experienced severe lasting complications. The bacterium has been detected
in a range of foods, but only powdered infant formula has been linked to
outbreaks of disease. Its prevalence is unknown, but the US FoodNet 2002
survey (www.cdc.gov/foodnet/surveys/pop_cov.htm) found the rate of invasive
E sakazakii infection in infants under 1 year of age was 1 per 100 000.

An executive summary of the FAO/WHO meeting warned: "It is important to
note that powdered infant formula meeting current standards is not a
sterile product and may occasionally contain pathogens. It seems not to be
possible, using current technology, to produce commercially sterile powders
or completely eliminate the potential of contamination."

The meeting was called in response to a request made by the Codex Committee
on Food Hygiene for scientific advice to be used in the revision of the
Recommended International Code of Hygienic Practice for Foods for Infants
and Children. On the basis of its findings, the workshop recommended that
the code should include microbiological specification for E sakazakii in
powdered infant formula.

A summary report of the joint FAO/WHO workshop on E sakazakii and other
micro-organisms in powdered infant formula is at
www.who.int/foodsafety/micro/meetings/feb2004/en/

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html