Fortifying bowel movement patterns -
The overarching plan is to systematically and progressively extend the network to encompass other states, with the ultimate goal of providing comprehensive coverage of the entire country.
Research in NER of India is challenging due to its geographical and infrastructural constraints, including difficult terrain, road conditions, heavy monsoon, land sliding, limited transportation, electricity shortage, lack of internet access in remote areas, and political unrest.
The socio-cultural diversity and language barriers of the region requires effective communication. Furthermore, there is limited research infrastructure, opportunity and research funding, sparse networks, data collection, and quality control, especially in less developed regions.
Additionally, The COVID pandemic impacted foodborne disease surveillance through changes in food consumption patterns, food handling practices, and access to healthcare.
Decline in the reporting of foodborne illness was a notable effect of the lockdown during [ 12 ]. Foodborne diseases and outbreaks are neglected public health problems.
As quality food and water are an integral part of healthy human life, there has been a growing emphasis on prioritizing research in the field of food safety in recent years. The government and public health organizations are working mutually to improve data collection, and analysis and to develop more effective interventions to prevent foodborne disease outbreaks.
Early detection and response to foodborne disease outbreaks and effective control measures are critical to prevent mortality and morbidity. Also, the risks emerging from the human-animal-environment interface, like food safety risks, and the threat of AMR need to be addressed regularly. This underlines the need to promote the OH approach and create a framework for AMR stewardship and focus on enhancing primary health care, strengthening the health workforce, and improving essential health services and systems to address and combat various diseases, including waterborne illnesses [ 13 ].
In , the United States successively established the Foodborne Diseases Active Surveillance Network for population-based sentinel surveillance to track trends for infections transmitted commonly through food [ 5 ].
FoodNet in the US accomplishes its work through active surveillance, surveys of laboratories, physicians, and the general population; and population-based epidemiologic studies collecting data on infections caused by the major pathogens such as Campylobacter, Listeria , Salmonella , Shiga toxin-producing Escherichia coli , Shigella , vibrios, and Yersinia.
Other systems like PulseNet [ 14 ]. a nationwide network for molecular subtyping in the surveillance of foodborne diseases, CDC, initiative have also been successfully functional in identifying, investigating, tracing, and warning of foodborne disease outbreaks.
The European Food Safety Authority EFSA collects data on zoonoses, zoonotic agents, AMR, microbiological contaminants, and foodborne outbreaks across Europe [ 15 ]. Several other countries have foodborne disease surveillance programs to improve the safe food supply and prevent foodborne infections [ 6 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ].
including, Japan [ 16 ]. Iran [ 17 ]. and Canada [ 18 ]. The OzFoodNet network was established by the Australian Government Department of Health in to collaborate nationally to investigate foodborne disease [ 20 , 21 ]. Under this program, epidemiologists investigate outbreaks of enteric infection conduct studies on the burden of illness, and coordinate national investigations into foodborne disease outbreaks FBDOs.
The system highlighted the misrepresentation of the true burden of outbreaks of gastroenteritis due to under-reporting. There are two foodborne disease surveillance systems in Japan, one for food poisoning, and the other cover pathogens identification [ 16 ].
Since , China has established a web-based foodborne disease surveillance platform for FBDOs, early warning of sudden food safety incidents, and research on foodborne disease burden [ 23 ]. This platform includes the Foodborne Disease Outbreaks Surveillance System FDOSS , the Foodborne Disease Surveillance and Reporting System FDSRS , the National Molecular Traceability Network for Foodborne Diseases TraNet , and other surveillance systems.
The main surveillance system in India is the IDSP, a decentralized system that collects data on various diseases, including foodborne disease outbreaks throughout the country. The IDSP uses a syndromic surveillance approach that includes an increase in the number of people reporting diarrhea, vomiting, or other foodborne illness symptoms.
The IDSP collects data on these outbreaks through laboratory confirmation. In addition to the IDSP, several other surveillance systems collect data on foodborne pathogens in India. These include, the FSSAI surveillance system, the National Rural Drinking Water Programme NRDWP [ 24 ].
which ensures safe and potable drinking water for all, under the Swachh Bharat Mission campaign that makes initiatives in maintaining cleanliness and hygiene. However, the IDSP is a resource-intensive system and reports only foodborne disease outbreaks.
Currently, India does not have any systematic investigation on major foodborne pathogens prevailing in each region and their potential to cause foodborne diseases and outbreaks.
In a country like India with a huge population, different cultures and food practices, it is difficult to make specific food safety guidelines and policies, without strong evidence and data support.
The ICMR-FoodNet database is a valuable resource for public health officials and researchers in the NER. Significant efforts have been made to support and upscale laboratory services in northeast India.
This ICMR endeavor is focused on producing scientific evidence to describe risk management decisions and holds significant national importance. ICMR-FoodNet plays a vital role in strengthening India's food control systems with the strategic priorities delineated in the WHO Global Strategy for Food Safety roadmap [ 4 ].
Furthermore, this initiative actively addresses the three global indicators established by WHO [ 4 ]. to assess the efficacy and appropriateness of national food safety systems. It involves the collection of accurate data on the incidence of diarrheal diseases and outbreaks originating from contaminated food consumption through an integrated sentinel surveillance of foodborne disease pathogens.
This strategy will establish the foundation for fostering multisectoral collaboration with key stakeholders for food safety reforms and policy, promoting a unified approach to food control.
The recommendations and scientific evidence generated from this study would strengthen national food safety and management, ensuring conformity with global standards. Although distinct studies were conducted in India previously, this is the first systematic study, with a uniform methodology, focused on major pathogens.
ICMR-FoodNet gives reliable data to compare with global estimates of foodborne illnesses and contributes to the formulation of plans for responding to food safety incidents and emergencies, ensuring effective preparedness and response to emergencies related to foodborne disease.
Moreover, the project aims to create a surveillance and research platform that can be customized and employed in various regions across India.
Additionally, it can be adopted by other developing countries, thereby contributing to the generation of global data on foodborne pathogen surveillance.
The burden of foodborne diseases in India is huge, and hence early identification, and monitoring through a strong surveillance system for identification of trends, risk factors, and disease burden is the need of the hour.
Also, in the era of AMR, it is important to understand the transmission of genes encoding antimicrobial resistance, by tracing the food chain through the one health approach and multidisciplinary action to comprehend the AMR transmission.
ICMR initiated this project to reduce the incidence of foodborne diseases and outbreaks in northeast India. Also, to strengthen the foodborne pathogen survey and research network in the country.
Arunachal Pradesh, Assam, Sikkim, and Tripura were the first four northeastern states in India to establish the ICMR-FoodNet program, followed by Mizoram Manipur, Meghalaya, and Nagaland, which will serve as the cornerstone for future country-wide scale-up of this surveillance program.
Thirteen foodborne disease outbreaks have been identified in this study. About bacterial strains were identified and stored in the microbial repository.
We are in the process of in-depth data analysis including extensive genetic characterization of bacteria strains. The program's contribution to the nation encompasses several key aspects 1 Enhancing State-Level Laboratories : capacity enhancement of the state-level laboratories to be able to function as state-of-the-art facilities for isolating and identifying foodborne pathogens, and serve as reference centers for foodborne outbreak investigations.
Real-time data generated by these centers during public health emergencies, such as foodborne disease outbreaks, will help the state governments and policymakers in implementing evidence-based interventions promptly.
The ICMR-FoodNet program has already recognized the significance of public awareness and has integrated a dedicated awareness initiative into its framework. Specifically, we have been actively conducting school health and community awareness programs across the four states involved in the initiative.
Furthermore, we are currently in the process of developing a comprehensive education campaign tailored to the specific needs of the target audience. This campaign, entitled "Analysis of knowledge, perception, and practice of food hygiene among school-going children, food handlers, and community leaders: A study in eight states of North East India," is accompanied by a detailed questionnaire.
The selection of study sites has been informed by outbreak data collected from state health authorities, ensuring a targeted and effective approach in educating communities about foodborne diseases and preventive measures. All data underlying the results are available as part of the article and no additional source data are required.
World Health Organization. WHO estimates of the global burden of foodborne diseases: foodborne disease burden epidemiology reference group Accessed on 3. GBD Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for diseases and injuries for a systematic analysis for the Global Burden of Disease Study The World Health Organization Estimates of the Global Burden of Foodborne Diseases: FERG Project Report.
WHO global strategy for food safety towards stronger food safety systems and global cooperation. License: CC BY-NC-SA 3. Henao OL, Jones TF, Vugia DJ, Griffin PM; Foodborne Diseases Active Surveillance Network FoodNet Workgroup. Foodborne Diseases Active Surveillance Network-2 Decades of Achievements, Emerg Infect Dis.
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Iddya Karunasagar T, Ramamurthy Madhuchhanda Das, Devi Utpala, Baruah Pranjal, Panda Samiran. Standard Operating Procedures ICMR Foodborne Pathogen Survey and Research Network North-East India.
Akil L, Ahmad HA. Socioeconomic impacts of COVID pandemic on foodborne illnesses in the United States. Eur J Environ Public Health. Press Information Bureau, Government of India. G20 Series 51 India's G20 Presidency 2nd G20 Health Working Group Meeting Goa - April 17 - 19, Centers for Disease Control and Prevention.
PulseNet CDC. html ] Accessed on date Kumagai Y, Gilmour S, Ota E, et al. Estimating the burden of foodborne diseases in Japan [published correction appears in Bull World Health Organ.
Bull World Health Organ. Masoumi Asl H, Gouya MM, Soltan-Dallal MM, Aghili N. Surveillance for foodborne disease outbreaks in Iran, Med J Islam Repub Iran. Published Nov 3. Thomas MK, Murray R, Flockhart L, et al. Estimates of the burden of foodborne illness in Canada for 30 specified pathogens and unspecified agents, circa Foodborne Pathog Dis.
Gkogka E, Reij MW, Havelaar AH, Zwietering MH, Gorris LG. Risk-based estimate of effect of foodborne diseases on public health. Greece Emerg Infect Dis.
Article PubMed Google Scholar. Ashbolt R, Givney R, Gregory JE, et al. Enhancing foodborne disease surveillance across Australia in the OzFoodNet Working Group. Commun Dis Intell Q Rep. PubMed Google Scholar. Hall G, Kirk MD, Becker N, Gregory JE, Unicomb L, Millard G, Stafford R, Lalor K; OzFoodNet Working Group.
Estimating foodborne gastroenteritis, Australia. PMID: ; PMCID: PMC van Pelt W, de Wit MA, Wannet WJ, Ligtvoet EJ, Widdowson MA, van Duynhoven YT. Laboratory surveillance of bacterial gastroenteric pathogens in The Netherlands, — Epidemiol Infect.
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Int J Food Microbiol. Download references. Indian Council of Medical Research ICMR , Ansari Nagar, New Delhi, , India. Center for Development of Advanced Computing, Kolkata, India.
Sikkim Manipal Institute of Medical Sciences, Sikkim, India. Agartala Government Medical College, Tripura, India. ICMR-Regional Medical Research Centre, Dibrugarh, Assam, India. ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India. You can also search for this author in PubMed Google Scholar.
and T. conceptualized and designed the outline for the manuscript. wrote the manuscript with contributions from T. and V. provided the graphics from the manuscript. All authors reviewed the manuscript. Correspondence to Madhuchhanda Das. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Das, M. et al. An integrated FoodNet in North East India: fostering one health approach to fortify public health. BMC Public Health 24 , Download citation. Received : 20 September Accepted : 06 February Published : 13 February Anyone you share the following link with will be able to read this content:.
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Abstract Background Food safety is a critical factor in promoting public health and nutrition, especially in developing countries like India, which experience several foodborne disease outbreaks, often with multidrug-resistant pathogens. Objective To establish a network of laboratories for the identification of major food and waterborne pathogens prevailing in the northeast region of India through integrated surveillance of animal, food, human, and environment and investigate the antimicrobial susceptibility pattern of the pathogens of public health significance.
Methods The Indian Council of Medical Research ICMR has identified FoodNet laboratories; based on their geographical location, inclination to undertake the study, preparedness, proficiency, and adherence to quality assurance procedures, through an 8-step process to systematically expand to cover the Northeastern Region NER with comprehensive diagnostic capacities for foodborne pathogens and diarrhea outbreak investigations.
Findings This surveillance network for foodborne enteric pathogens was established in Assam, Arunachal Pradesh, Tripura, and Sikkim, and expanded to other four states, i. Results The ICMR-FoodNet will generate NER-specific data with close to real-time reporting of foodborne disease and outbreaks, and facilitate the updating of food safety management protocols, policy reforms, and public health outbreak response.
Conclusion Foodborne diseases and outbreaks are a neglected subject. When choosing a time, keep in mind your current daily elimination habits, diet, and lifestyle, including your work schedule. Your doctor may recommend a bowel retraining program to help you regain control of bowel patterns, pass stools regularly, and pass stools of an expected consistency.
Bowel retraining can be very effective for many people. However, some people may not benefit from bowel retraining, including those who:. Before you begin a bowel retraining program, your doctor will recommend that you keep a symptom diary.
A bowel retraining program involves addressing all the factors that might affect your ability to have a more normal bowel elimination pattern. While your doctor may make different recommendations based on your particular situation, bowel retraining programs typically consist of the following steps:.
An enema is a fluid that can be injected through the rectum to help encourage bowel movements. You may also want to consider drinking prune juice or inserting a rectal suppository to trigger a bowel movement. Some bowel retraining programs also involve working with a therapist on biofeedback, a type of therapy that helps you learn more about how your body works.
This knowledge can enable you to gain more control over bodily functions, including bowel movements. Biofeedback can help you identify the differences between stomach pain and pain from needing to go to the bathroom.
It can also teach you how to use different muscles in your body to pass stool without straining. However, approaching a bowel retraining program with a more relaxed attitude can be vital to your success. Sticking to your regular pattern after bowel retraining can help you maintain your results.
This may involve consuming the same amount of foods and liquids as well as taking your medications each day. Learn what typical bowel movements should include, as well as tips to poop more…. Bowel habits are the time, size, amount, consistency and frequency of bowel movements throughout the day.
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