Considering the high prevalences of H. pylori (as discussed in the previous section) and of GERD, it could be useful to study their contributions to the development of esophageal cancer in the Iranian population.

DISCUSSION

Moderator: Mohammad Mehdi Aslani


During the discussion period, participants raised questions regarding the methods used for detecting Shiga toxin-producing E. coli (STEC) and concerning the testing that was conducted on cattle feces and foods. Aslani explained that the study on STEC in Iran did not provide a basis for determining whether the STECs are capable of causing disease in humans.

Mohammad Zali stated that the purpose of the study investigating the genotype and prevalence of rotavirus infection was to obtain information for a potential vaccination program.

Participants also raised questions about different forms of hepatitis and their possible relationship to liver disease in Iran, about possible connections between foodborne pathogens and the long-term diarrhea associated with inflammatory bowel disease, about studies comparing traditional medicine with antibiotic therapy in the control of diarrhea (none has been done), about the prevalence of norovirus infections in Iran (data unavailable), about the sources of antimicrobial resistance (e.g., self-medication with antibiotics suspected), about associations of amoebic infections in patients with Salmonella or a viral infection (no information), and about screening for sapoviruses (not routine in the United States). Responding to Keene’s comments that half or more of the diarrheal outbreaks in the United States are due to norovirus, Mohebbi discussed the limitations in Iran’s detection system for noroviruses that may contribute to that country’s low reported rate of norovirus infection. Beuchat reported on the increase in the percentage of foodborne illness outbreaks attributable to fresh and fresh-cut produce in the United States—a potential food source of illness that has not yet been investigated in Iran.

Miller emphasized that the diversity in the production, processing, and distribution of foods in Iran needs to be considered in developing and implementing foodborne illness prevention efforts.



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