(P18-025-24) Clinically Vulnerable Groups in Foodborne Disease Prevalence and Definitions Across Global Food Safety Agencies

Objectives: Food safety advice is especially important for groups within society who are at greater risk of severe illness, commonly referred to as clinically vulnerable groups. Food Standards Scotland commissioned independent researchers to review the definition of “clinically vulnerable groups” to evaluate the appropriateness of current definitions of clinically vulnerable groups in Scotland based on incidence data and global definitions.

Methods: A systematic review was undertaken to establish the prevalence of Campylobacter, Salmonella, Escherichia coli, Listeria monocytogenes and norovirus among the clinically vulnerable groups. Additionally, a review of clinically vulnerable definitions utilized by global food safety agencies were analyzed for content, and put into a context of physiological conditions in vulnerable groups.

Results: The study yielded 515 definitions from 14 of the 30 global food safety agencies. Children were most frequently referred to as being vulnerable in general definitions (43%), and specifically E. coli, Salmonella, Campylobacter, norovirus. Pregnant women were mentioned in 13% of general definitions and 41% of definitions in relation to listeriosis. The elderly, were frequently referred to in relation to listeriosis (36%,). Of peer-reviewed studies reporting foodborne disease prevalence (n=2,805), 135 were identified for data extraction. The majority (61%) included older adults and children (53%) and Listeria was the most included pathogen (41%). Although studies provided data detailing prevalence of all five pathogens among older adults and children, information about other vulnerabilities (e.g., diabetes, cancer) were lacking. Scottish prevalence data suggested an increased risk of foodborne illness among people prescribed proton-pump inhibitors (34% campylobacteriosis, 25% salmonellosis, 20% listeriosis).

Conclusions: Findings indicate adjustments to communication regarding clinically vulnerable groups are required and should be based on incidence data. Including reasons for elevated vulnerability may enhance consumer understanding.

Funding Sources: This study was funded by Food Standards Scotland grant FSS/2022/034.