Dubai takes measures to prevent epidemics

Dubai officials aim to reach the international best-practice standard of 1 per 100,000 food poisoning cases in a year.

Dr Muneer Hamad attends to a patient at the Dubai Municipality's public health services department.

DUBAI // A first-of-its-kind programme in the UAE targeted at the investigation and surveillance of food poisoning and disease has been launched by the Dubai Health Authority and the municipality.

Two years in the making, the project was designed in collaboration with the US Centers for Disease Control and the World Health Organisation.

For the project, the health authority (DHA) and the municipality have set up a two-team, 24-hour task force.

The epidemic management team is responsible for tracking cases, collecting data and working with inspectors. The environment inspection team would, among other tasks, interview patients, said Asia Abdul Wahab, the acting head of the municipality's food studies and planning section.

Khalid Sharif Al Awadi, the director of the municipality's food control section, said technological advances, emerging and virulent pathogens and the globalisation of the food supply presented new challenges in ensuring food safety. "The outbreak of a highly virulent strain of E. coli 0104: H4 linked to fenugreek sprouts in 2011 is a classic example of how pathogens have emerged and how widespread and damaging foodborne disease can be," he said.

Officials estimate that for every 100,000 patient admissions in Dubai, 88 are caused by food poisoning.

"This is not a scary figure," said Dr Aizeldin El Jack, the DHA's acting director of public health. "We have overestimated to ensure extra precaution is taken. We are aiming to reduce this number to one per every 100,000, and I'm confident Dubai will reach that goal through this project."

Hospitals are now required to fill out an investigation form for patients showing symptoms of food poisoning and submit it to the task force along with a detailed report. This will help cut identification and diagnosis time down to no longer than 24 hours.

"Previously, we had our own policies, strategies, case detection and control measures but it was limited without such important partnerships and the link was not clear," Dr El Jack said.

"We have to detect as early as possible and the key word is 'notification' so authorities can take action. Now, there is one case definition recognised by the DHA, municipality and private sector."

The parasite Entamoeba histolytica, which causes amoebic dysentery, is one of the most frequently detected pathogens, said Bobby Krishna, senior food studies and surveys officer for the municipality.

"The main reason we detect this organism is because the illness is often serious. It is very unlikely that a person can contract this infection in Dubai because the food and water is free from such organisms," Mr Krishna said.

He said it was more likely to be brought in by travellers from countries with poor sanitary conditions, and that people could get ill weeks or months after exposure.

"Giardia lamblia, which causes giardiasis, is a similar organism associated with poor sanitary conditions. The organism is not found in the food and water that is available in the UAE," Mr Krishna said.

Food control in Dubai was very strict, said Dr Fatma Al Attar, the head of the DHA's preventive services centre.

"The most common cases are not critical as opposed to other countries where typhoid and hepatitis A, for example, top the list," Dr Al Attar said.

She said food poisoning cases were most common among middle-aged men, primarily labourers.

In a case this spring, more than 200 labourers became sick, and 40 needed hospital treatment, after eating poorly prepared rice at a labour camp in Abu Dhabi.

Mr Al Awadi said Dubai Municipality might issue a rule where food could be prepared only at officially approved kitchens.

With the disease surveillance system in place, hospitals would be better equipped to provide immediate reports on suspected food poisoning illnesses to the food control department, which would then investigate, Mr Krishna said.

"Early detection of food-borne disease outbreaks is key to controlling the spread of diseases. The earlier we detect, the fewer people get sick," he said.

Investigations will also help to identify the source of contamination and what conditions led to the illness. This would be based on information provided by the hospitals, said Bashir Hassan Yousif, the municipality's senior food studies officer.