Workgroup Report: Public Health Strategies for Reducing Aflatoxin Exposure in Developing Countries

Abstract

Consecutive outbreaks of acute aflatoxicosis in Kenya in 2004 and 2005 caused > 150 deaths. In response, the Centers for Disease Control and Prevention and the World Health Organization convened a workgroup of international experts and health officials in Geneva, Switzerland, in July 2005. After discussions concerning what is known about aflatoxins, the workgroup identified gaps in current knowledge about acute and chronic human health effects of aflatoxins, surveillance and food monitoring, analytic methods, and the efficacy of intervention strategies. The workgroup also identified public health strategies that could be integrated with current agricultural approaches to resolve gaps in current knowledge and ultimately reduce morbidity and mortality associated with the consumption of aflatoxin-contaminated food in the developing world. Four issues that warrant immediate attention were identified: a) quantify the human health impacts and the burden of disease due to aflatoxin exposure; b) compile an inventory, evaluate the efficacy, and disseminate results of ongoing intervention strategies; c) develop and augment the disease surveillance, food monitoring, laboratory, and public health response capacity of affected regions; and d) develop a response protocol that can be used in the event of an outbreak of acute aflatoxicosis. This report expands on the workgroup’s discussions concerning aflatoxin in developing countries and summarizes the findings.

An outbreak of Aspergillus species in response to environmental conditions in Serbia

“…Preharvest interventions should include resistant crops (Strosnider et al, 2006), crop rotation (Jaime- Garcia and Cotty, 2004;Razzaghi-Abyaneh et al, 2006;Accinelli et al, 2008), early sowing, growing early maturity hybrids (Jones et al, 1981;Bruns, 2003), proper plant nutrition (especially with nitrogen), optimum plant populations, irrigation and early harvesting (Bruns, 2003;Jaime-Garcia et al, 2006). Integration of these approaches in a cost-effective manner may be the greatest challenge we will face in providing safer food and feed production in the 21 st century (Abbas et al, 2009).…”

“…A. flavus Link, the most widespread toxigenic species of the genus Aspergillus, is very important, particularly in some African countries, due to its high potential for synthesizing aflatoxins, which are very toxic to humans and animals (Probst et al, 2007;Donner et al, 2009;Muthomi et al, 2012). Consecutive outbreaks of acute aflatoxicosis in Kenya in 2004 and 2005 caused more than 150 human deaths (Strosnider et al, 2006).…”

Crops that feed the world 6. Past successes and future challenges to the role played by maize in global food security

“…Semi-arid to arid and drought conditions in tropical countries are associated with high levels of mycotoxin contamination. Changes in climate may lead to acute aflatoxicosis and deaths from the consumption of poor crops as occurred in Kenya in 2004 (Strosnider et al, 2006). High incidences of aflatoxin have been reported in Kenya, especially in years of severe droughts (Lewis et al, 2005).…”

Hepatocellular carcinoma and the risk of occupational exposure

“…Chronic exposure causes the development of liver cancer. This could be caused by the aflatoxin ability to determine the mutation of the p53 tumor suppressor gene, which in normal conditions induces the apoptosis processes [74][75][76][77] . The risk of HCC increases when the exposure occurs in the presence of HBV infection, as occurs in the Chinese population [78][79][80][81][82][83][84][85][86][87][88][89][90][91][92][93][94][95][96] .…”