New directions in foodborne disease prevention.

Food safety is an important part of public health linking health to agriculture and other food production sectors. For over a century, developments in food production and new control philosophies have contributed to food safety systems in most developed countries perceived by many to be efficient in the prevention of foodborne disease. Nevertheless, a number of problems still remain dominant, one of these being the high level of foodborne microbiological diseases which seem, for some pathogens, to have increased over the last decades. Although there is an urgent need for better foodborne disease data in most countries, the paper attempts an analysis of the background to these problems using available data to illustrate the developments for some of the major foodborne pathogens. Some of the shortcomings of present food safety systems are discussed, as are new principles to improve food safety strategies. A new paradigm for the integration of research data, food-control monitoring, epidemiological investigations and disease surveillance in a renewed effort to manage and lower foodborne risk is presented. Within this paradigm, the development of an interdisciplinary approach with direct interaction between surveillance and risk analysis systems is described as a potential basis for improved foodborne disease prevention. Specific consideration is given to the situation in developing countries, suggesting a leap forward past the experience of noncollaboration between the disciplines in many developed countries. Today, food safety is one of WHO's top 11 priorities and the Organisation calls for more systematic and aggressive steps to be taken to significantly reduce the risk of microbiological foodborne diseases. Dealing with this challenge is one of the major challenges for the 21st century in regard to food safety, implying a significant redirection of food microbiology efforts in many parts of the world.