Foodborne Diseases: A Study before and during the COVID-19 Pandemic in Brazil.

Foodborne Diseases (FBDs) are a worldwide problem and occur after contaminated food has been ingested, signaling a lack of food quality. Even though the SARS-CoV-2 virus is not transmitted through food, the COVID-19 pandemic has caused several challenges worldwide that have had direct implications on food production and handling, stimulating and reinforcing the adoption of good manufacturing and food handling practices. The aim of this study was to analyze data on notifications of FBD in Brazil in the years before (2018 and 2019) and during (2020 and 2021) the COVID-19 pandemic. Secondary data from the National System of Notifiable Diseases was analyzed, evaluating: overall incidence rate, lethality and mortality, contamination sites, and criteria for confirming the etiological agent. There were 2206 records of FBDs, and the mortality rate was 0.5% in both periods. The incidence rate before the pandemic was 6.48 and during the pandemic was 3.92, while the mortality coefficient was 0.033 before and 0.019 during the pandemic, both per 100,000 inhabitants. There was no significant difference in the number of FBD notifications in the evaluated periods. There was a migration of the location of FBD, with a significant increase in FBD notifications in hospitals and health units and a reduction in notifications from social events. There was a significant increase in the type of criteria used to confirm outbreaks, with an increase in clinical laboratory tests and clinical reports for bromatology. The increase in notifications in hospitals and health units demonstrates the necessity of improving food safety knowledge and the attitudes and practices of food handlers and healthcare professionals.

Unhygienic Practices of Health Professionals in Brazilian Public Hospital Restaurants: An Alert to Promote New Policies and Hygiene Practices in the Hospitals.

This study aimed to evaluate health professionals' unhygienic practices and the stages of behaviour change in Brazilian public hospital restaurants. We evaluated all medium/large-sized public hospital restaurants (HRs) from the Brazilian Federal District (n = 9); a representative sample of 128 users). We evaluated the HRs' physical structures, their consumers' socio-demographic characteristics, their unhygienic practices, as well as the stages of behavioural change concerning unhygienic practices. All the HRs presented their menus for self-service distribution, so customers entered in lines to serve themselves. All the HRs had hand-wash sinks for customers; 77.8% offered antiseptic liquid soap; 33.3% offered alcohol gel; and 77.8% offered storage for professional accessories before serving food. Almost half (46.8%) of the customers did not sanitise their hands (with water and antiseptic soap and/or use of alcohol gel) immediately before serving, and 24.2% wore professional uniforms at HRs. Almost half (43.5%) of the customers spoke with each other in line while serving their plates and arranged the food on their plates with the serving utensils from the distribution counter. The declaration of behavioural change was inversely associated with the hygiene practices. Almost half of the individuals did not sanitize their hands; however, 90.4% declared "changed behaviour" when this contaminant practice was presented to them. We verified a high percentage of hygiene practices inconsistent with most of the customers´ answers about their stage of behaviour change. Based on the observations of this study, it is necessary for an awareness program to be developed that is focused on customers of HRs in order to reduce unhygienic practices. Also, it is important to promote new policies for proper hygiene practices in hospital restaurants.

Brazilian Foodborne Disease National Survey: Evaluating the Landscape after 11 Years of Implementation to Advance Research, Policy, and Practice in Public Health.

The poor control of public and private agencies regarding the quality of foods offered to populations has a significant impact on the occurrence of foodborne diseases. Precise information about foodborne diseases (FBD) can adequately inform policy-makers and help to allocate appropriate resources for the control of food safety. This study aimed to evaluate the Brazilian foodborne disease landscape after 11 years of implementation of the Epidemiological Surveillance System of Foodborne Diseases. The study analyzed secondary data from the National System of Injuries and Notifications (SINAN-NET), available from the Health Department. We evaluated the characteristics of FBD, such as the food involved, the location of ingestion, the total time to the outcome investigation, the microorganism involved and deaths. We also calculated the global incidence, mortality and lethality rates of the country. There were 7630 FBD outbreaks in the National Epidemiological Surveillance System of Foodborne Diseases (VE-DTA). Of the registered reports, a total of 134,046 individuals were sick with FBD; 19,394 were hospitalized, and there were 127 registered deaths. We found a coefficient of incidence of FBD of 67.57 per 100,000 inhabitants; a mortality coefficient of 0.06 per 100,000 inhabitants and lethality of 0.09% over the 11 years investigated. Data are probably underreported since the VE-DTA system lacks completeness, and because FBD symptoms are mostly mild, a large part of the population does not seek care from health services.

Epidemiological Surveillance System on Foodborne Diseases in Brazil after 10-Years of Its Implementation: Completeness Evaluation.

This study aimed to evaluate the data quality of the Brazilian Epidemiological Surveillance System on Foodborne Diseases (VE-DTA) through the evaluation of the completeness of the record after 10-years of its implementation. The study evaluated the measurement of completeness by quantifying ignored, incomplete or blank responses of the data items filled. The evaluation used the percentage of completion of these items regarding the total number of notifications registered in the system. We organized the results according to the general Category of completeness of the database, by year of notification and region of occurrence. We also evaluated the overall completeness percentages of the database and the completeness levels according to the degree of recommendation of completion of each variable (mandatory, essential, and complementary) by the VE-DTA manual. The system presented 7037 outbreaks of foodborne diseases. According to the completeness classification, the database presented general classification as Category 1 since it has 82.1% (n = 5.777) of variables with the level of completion up to 75.1%. We observed that 8.6% of the database was classified as category 2; 9.2% as category 3 and 0.1% as category 4. The improvement on database quality regarding completeness can positively impact on public health and public policies, reducing the number of FBDs deaths.

Controversies of antioxidant vitamins supplementation in exercise: ergogenic or ergolytic effects in humans?

The aim of this commentary was to discuss the last studies regarding the effect of antioxidant vitamins supplementation on oxidative stress in exercise in humans. The inclusion criteria encompassed published studies done in adult males and females between 2006 and 2013. The keywords used in the search engine were: endurance athlete, diet, oxidative stress, physical activity, diet, nutrition, antioxidant, antioxidant status, vitamin C, vitamin A, vitamin E, ß-carotene and combinations. Twelve studies were identified and organized according to the methodology and results of supplementation: ergogenic, ergolytic, partial or no difference between groups. The results of these studies showed no effect on physiological parameters and activity of antioxidant enzymes (n = 07), better response of the placebo treatment (ergolytic effect; n = 02), partial results (n = 01) and ergogenic results of antioxidant supplementation (n = 02). It is concluded that supplementation with antioxidant vitamins has controversial effects to oxidative damage induced by endurance exercise. The discordances among the studies are presented and discussed.