La PREVENZIONE… un valore imprescindibile per il Sistema HACCP

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Il caso della Sindrome Emolitico Uremica (SEU)

Nel 2016 l’Europa si è trovata ad affrontare diverse situazioni di emergenza, tra le quali alcuni episodi di tossinfezione legati alla Sindrome Emolitico Uremica (SEU) e all’insorgenza in Italia, a Roma e Verona, di due focolai di Botulismo.

In particolare i focolai infettivi di Escherichia Coli O26:H11 associati alla sindrome emolitica uremica (SEU), che avevano colpito nel 2016 alcuni bambini piccoli, erano stati segnalati in Romania nei mesi di febbraio e marzo, mese quest’ultimo nel quale anche l’Italia era stata costretta a segnalare un caso di SEU avente un collegamento epidemiologico con la Romania, portando così (mediante la rete del RASFF e delle autorità di sicurezza alimentare dei Paesi coinvolti), al richiamo dei prodotti alimentari sospetti.

Purtroppo anche nel 2017 l’Italia si trova ancora una volta ad affrontare questo tipo di emergenza. Quello che cambia sono le regioni coinvolte: lo scorso anno erano il Lazio, la Toscana e la Campania mentre, nei primi mesi estivi di questanno la regione interessata dalla SEU è la Puglia.

Anche in questa circostanza a essere colpiti sono nuovamente dei bambini, tra i 16 ed i 19 mesi. E sì, perché questa sindrome è provocata da uno dei ceppi appartenenti all’E. Coli (batterio che prende il nome dal suo scopritore), naturalmente presente nel tratto intestinale umano e animale che in condizioni normali risulta un commensale innocuo, anzi in alcuni casi anche utile (contribuendo alla produzione di vitamine del complesso B e della vitamina K). In caso però di indebolimento delle resistenze naturali o in classi di popolazioni più deboli quali i lattanti o gli anziani, una infezione invasiva può portare a peritoniti, meningiti nei lattanti, infezioni delle vie urinarie e da parte di determinati ceppi risulta altresì molto frequente la capacità di causare infezioni intestinali.  Come per l’appunto nel caso degli E. Coli enteroemorragici (EHEC) che si riferiscono al nostro caso.

Questi E.Coli enteroemorragici sono dei batteri produttori di Shiga-tossina (STEC) o verotossina che in presenza di ulteriori fattori di patogenicità hanno la capacità di provocare nell’uomo una Sindrome emolitico-uremica (SEU o HUS), oppure una colite emorragica.

È stato dimostrato, infatti, come questo ceppo di E. Coli se ingerito, non riuscendo a sopravvivere all’interno dello stomaco (che risulta per il batterio un ambiente ostile in quanto fortemente acido), si sposta immediatamente a livello dell’intestino localizzandosi nel duodeno dove comincia a distruggere le cellule dei microvilli, e a liberare tossine che a livello degli endoteli vascolari possono determinare l’emorragia.

La Sindrome emolitico-uremica inoltre è una malattia molto temuta perché spesso è associata a lesioni terminali a livello dei reni, capaci di manifestarsi ad ogni età, ma soprattutto nei bambini al di sotto dei 6 anni ed in alcuni casi può rilevarsi letale, come accaduto purtroppo in Puglia con il decesso di una bimba di 16 mesi.

Le VIE di CONTAMINAZIONE

L’infezione generata da questi ceppi patogeni si trasmette prevalentemente attraverso il consumo o la manipolazione di cibi contaminati oppure attraverso il contatto con animali infetti.

Molto spesso i ceppi E. Coli enteroemorragici (EHEC) possono albergare nell’intestino dei ruminanti, quali pecore e capre e nelle feci dei manzi. Di conseguenza l’attenzione deve essere rivolta al consumo di tutti quei prodotti a base di carne di manzo, come hamburger, carne di manzo trita, roastbeef, ma anche al latte crudo e ai prodotti da esso derivati come i formaggi, senza escludere i prodotti quali gelati e pasticcini, yogurt, maionese e succhi di frutta non pastorizzati. Perfino l’acqua di irrigazione se contaminata, per le deiezioni animali, può risultare fonte certa di contaminazione diretta e quindi primaria.

Come contaminazione indiretta e quindi secondaria invece, può essere associata ad una scorretta gestione dei bagni.

Il contagio avvenire per via orale seguendo il ciclo oro-fecale e la bassa dose infettante (per provocare l’infezione nell’uomo basta un numero ridotto di questi batteri) favorisce il rischio di trasmissione da un individuo ad un altro, spiegando in questo modo come lattanti e bambini possano essere infettati da familiari asintomatici che espellendo gli agenti patogeni con le feci trasmettono poi le infezioni per contatto.

LA PREVENZIONE UN’ARMA VINCENTE

Ci sorprende come, nonostante la presenza della normativa europea e nazionale, nata con lo scopo di prevenire e tutelare, episodi come questo si ripetano negli anni. Probabilmente nel sistema agroalimentare qualche falla ancora c’è e da parte di coloro che lavorano in questo settore l’impegno per l’applicazione di sistemi preventivi a tutela dei consumatori deve avvenire con maggiore responsabilità e competenza.

È evidente, in questo caso, che risultando impossibile poter ottenere la disinfezione da ceppi di E. Coli enteroemorragici (EHEC) negli allevamenti, e quindi nella fase a monte della catena produttiva, tutta l’attenzione debba essere rivolta alle adeguate misure preventive effettuate nelle fasi successive della filiera: mediante corretta applicazione del Sistema HACCP, dei sistemi di qualità e di quant’altro.

Dopo tutto Escherichia coli è un batterio molto noto, perché utilizzato quale indicatore della qualità e della sicurezza microbiologica degli alimenti, impiegato per evidenziare una situazione potenzialmente pericolosa per la salute umana, che merita perciò la giusta attenzione. Proprio per tale ragione le azioni preliminari e i sette principi alla base dell’autocontrollo igienico, devono servire a garantire che alla fine di un processo produttivo giungano sulle tavole dei consumatori prodotti salubri per la salute pubblica.

Ricordiamo come consulenti del settore che quand’anche la responsabilità, come ci ricorda il Regolamento n. 178 del 2002, è demandata all’operatore del settore alimentare (OSA) che attraverso le azioni preventive e l’attenta e scrupolosa applicazione di quanto scritto all’interno del Manuale di Autocontrollo igienico aziendale, dovrà garantire gli aspetti igienico-sanitari in ogni fase della produzione, a noi consulenti spetta comunque il compito di vigilare l’azienda che seguiamo e di intervenire ove necessario.

Termino ricordando, in modo breve e sintetico, alcuni punti da tenere sempre bene a mente per evitare che situazioni pericolose per la salute pubblica non si ripetano. Ovviamente lasciando ai Consulenti tutti gli approfondimenti del caso.

L’attenzione rivolta alla:

  • importante scelta dei fornitori i quali devono essere qualificati e sicuri;
  • verifica anche analitica delle qualità delle materie prime utilizzate;
  • adeguata sanificazione, applicata sia sulle attrezzature/utensili/piani di lavoro che a livello dei locali di lavorazione;
  • formazione e sensibilizzazione del personale che dovrà risultare competente e preparato in ogni momento lavorativo;
  • ai controlli analitici dettati dalla normativa vigente (europea e nazionale), se e quando previsti.

© Produzione riservata

—————

——-

Dr.ssa Sabina Rubini

Biologa ed Esperta in Sicurezza degli Alimenti

Consulente Aziendale

Co-founder ISQAlimenti.it

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