WHO United Nations World Health Organization topics: Chagas Disease Food Safety Chaired by the Honorable Sarah Heesacker, Cody Meicht, & Ciarra Nean-Marzella S i n c e HBHS April 25th, 2015 1 9 7 8 Novice hbhsmun.webs.com Huntington Beach High School Model United Nations World Health Organization April 25th, 2015 Welcome to the World Health Organization! Hi my name is Sarah Heesacker. I am a junior here at HBHS and I have been in the MUN program for 3 years. In addition to my time consuming classes, I also do a lot of volunteering with multiple organizations, both within and outside of school. I am interested in studying science in the future, so I am looking forward to watching you all debate these health related topics and come up with well-researched creative solutions! Salutations Novice delegates! I am Cody Meicht. I have been in MUN for two years and it is by far my favorite class. I also play football at HBHS so I am still assimilating to having such a busy schedule, but there is no way I would consider quitting either of them. World Health Organization is one of my favorite committees so I am looking forward to see what innovative solutions all of you will come up with! Hello delegates! My name is Ciarra Nean-Marzella. I am a sophomore here at HBHS and this is my second year in our MUN program. Outside of school, I play club volleyball and I am also involved in APA, or our HBHS’s Academy of Performing Arts. I am so excited to be chairing WHO for this conference and I can’t wait to see what great solutions you have prepared! Be as creative as you can be in your solutions. I believe you will all do amazing. Good luck and have fun researching. Position Papers must be submitted to your Dais’s central email no later than 11:59 PM on April 19th, 2015 to be considered for a Research Award. Research Awards will be presented during committee; please be sure to follow the HBHSMUN Position Paper format available on our website. Your Dais’s central email is: who.novice37@gmail.com 2 1905 Main Street Huntington Beach, CA 92648 I hbhsmun.webs.com I who.novice37@gmail.com World Health Organization April 25th, 2015 I. Chagas Disease Topic Background on the open bite wound and the parasite is deposited through its feces.v This does not immediately contaminate the victim; however, the natural human response is to agitate the wound which in turn causes it to open allowing for contamination.vi While the primary acquisition of chagas disease is through the triatomine insect, it can also be contracted via blood transfusions and organ transplants. vii In regions with medical standards that are not strict or where proper medical tests and conditions are unavailable, blood infected with the Chagas parasite as well as contaminated organs can end up in use in regional medical facilities, furthering the spread of Chagas. Also, while not the primary concern when addressing Chagas, there is the potential for pregnant women to pass it on to their children in the womb. Nonetheless, people in South and Central America are not defenseless against the spread of this pathogen and countries have undertaken simple objectives in an effort to prevent its spread. The most prominent means of protecting people in an area at risk is the use of chemical insecticides to eradicate the vectors, the two most widely used being Deltamethrin and Lambda-cyhalothrin. Despite there being no widely accessible treatment for chronic phase Chagas, there is an available treatment for its acute phase. The two medications, both of which are systemic antiprotozoals, are benznidazole and nifurtimox. viii Each medication effectively treats one hundred percent of early acute phase infections; it acts by moving through the bloodstream, targeting parasites, and killing them, but it is only effective to a point. As the infection persists and the parasite undergoes more cycles of amastigotes, producing trypomastigotes, metacyclic trypomastigotes have a higher potential of penetrating newer cells Infecting approximately sixteen to eighteen million people a year and killing upwards of fifty thousand people, the parasite Trypanosoma cruzi is responsible for the emerging Chagas endemic in over twenty one South American countries.i Poor South Americans of all ages living at or below the poverty line where their shelters may harbor vectors in them tend to be the largest demographic affected by Chagas. The protozoan parasite T. cruzi is a vector borne pathogen spread by the triatomine bug, which, up until recently, had been exclusively contained to South America. However, currently there are over eleven species that have been reported throughout the southern United States. ii Perhaps the most beneficial and dangerous characteristic of T. cruzi is that its stages of infectivity, the acute phase and the chronic phase, allow an ample amount of time, two to twelve months, for treatment if it can be identified, yet it makes it extremely difficult to locate those who are carrying the parasite. iii Symptoms of Chagas disease during its acute phase are mild and range only from swelling around infected sites, to slight fever, fatigue, and nausea; this closely mimics common ailments. However, symptoms become more critical entering the chronic phase; in most cases thirty percent suffer from cardiac disorders as a result of the parasite breaking down cardiac tissue and ten percent suffer from neurological or digestive irregularities. In both situations, the infection is ultimately fatal. iv Another beneficial characteristic of the Chagas parasite is that it is exclusively spread by the triatomine bug through its feeding process. Unlike other pathogens, T. cruzi is not directly injected into the bloodstream by the triatomine insect. Instead, after feeding on a person the triatomine insect defecates 3 1905 Main Street Huntington Beach, CA 92648 I hbhsmun.webs.com I who.novice37@gmail.com World Health Organization April 25th, 2015 efficiency when treating cases. xii PAHO is also working with the WHO and the governments of a few countries in Central America on the Chagas Disease Vector Control Initiative. The objective of the initiative is to reduce the transmission of the disease in Central America. xiii Chagas disease is one of the ten diseases targeted for elimination by PAHO and WHO between 2015 and 2020. In addition, the WHO issued a report titled “Investing to Overcome the Impact of Neglected Tropical Diseases,” which is an outline of their plan to combat many diseases, including Chagas. xiv The WHO, United Nations Childrens’ Fund (UNICEF), United Nations Development Programme (UNDP), and World Bank all sponsor the Special Programme for Research and Training in Tropical Diseases (TDR). TDR uses research and training in order to fight diseases of poverty, which includes Chagas. One of their reports details research priorities for three vectorborne disease, including Chagas, and presents certain focuses such as vector control and improved health systems.xv furthering the infection beyond the capabilities of known systemic antiprotozoals. ix Of course, most effort should be directed toward halting the disease early on. There is an emerging way to slow the onset of chronic Chagas, sadly it is often disregarded as a means of large scale use by South American countries because it is significantly more expensive. It does not function as a complete treatment as the disease remains in the patient, but it can prevent the onset of fatal symptoms. The method consists of the use of an antifungal azole compound and sulfoximine antiprotozoal molecule to destroy pathogens in the blood stream.x United Nations Involvement The United Nations (UN) has recognized the extent of Chagas disease and is committed to the goal of complete eradication of the disease. The World Health Organization (WHO) has been successful in reducing the transmissions by vectors as well as blood transfusions in Latin America. The WHO plans to reach their goal of elimination by focusing on global informational systems, preventing transplants or transfusions between countries with the disease and those without, supporting diagnostic tests, and promoting case management of all cases. xi Another organization that is very involved in preventing and controlling Chagas disease is the Pan American Health Organization (PAHO). They work closely with the WHO with the formation of strategies and plans. In 2010, PAHO passed the “Strategy and Plan of Action for Chagas Disease Prevention, Control and Care.” The first goal detailed in the document is to interrupt transmission of T. Cruzi by vectors and transfusions, which they plan to execute by broadening the prevention and control measures. The next goal is to decrease morbidity and mortality by increasing access to health care, including improving diagnosis, quality, and Case Study: Bolivia Bolivia is the country where Chagas disease is the most common. In small Bolivian communities, such as Palmarito, between 30 and 40 percent of children under the age of 15 have the disease and the numbers are only higher in adults. The triatomine bug that causes Chagas disease is called “el timbucu” by the locals, but it is difficult to detect much like the disease itself, which may not show symptoms. The disease threatens the simplistic lifestyle in these small villages that live in mud huts and carry water by hand. In Palmarito and three other Bolivian villages, a research program has been implemented in order to prevent and control the disease. One of the main techniques they are utilizing is 4 1905 Main Street Huntington Beach, CA 92648 I hbhsmun.webs.com I who.novice37@gmail.com World Health Organization April 25th, 2015 destroying the nesting sites of the bugs. The doctor there shows the locals certain habits they can maintain in order to control the nesting areas. These practices include checking their mattresses where the bugs reside as well as moving their farm animals further away from their houses since the bugs hide in the animals’ fur. The bugs can even stay in cracks in the mud walls, so residents need to ensure they cover all cracks in a timely manner. The village elder in Palmarito is in charge of organizing meetings and informing the rest of the community. Also, the local government has periodic screenings of the walls for bugs. Insecticides are sprayed which has had some success, but unfortunately the bugs re-colonize quickly and therefore have been difficult to control. The health supervisor of the region hopes to expand this program to other communities due to the benefits the research has provided in improving the lives of the locals.xvi Médecins Sans Frontières (MSF) is a private international program for humanitarian aid that has worked with the UN in the past. They are working in Narciso Campero in Bolivia to provide treatment for people infected with Chagas disease. In addition to treating the disease, MSF also works to prevent, such as with vector control in the form of fumigation, and diagnose it. Since the disease can be hard to detect, they also hold informational meetings for the people who live in the rural areas, which is where most of their projects for Chagas disease in Bolivia occur.xvii In 2013, doctors, specialists, and researchers met in Cochabamba, Bolivia to talk about Chagas disease. More than one million people have Chagas disease in Bolivia and the Minister of Health of Bolivia, Dr. Juan Carlos Calvimontes, spoke about the disease often goes undetected. Fortunately, he also stated that the infestation rate of the bugs has gone from 70 percent to 3 percent due to their efforts. However, the prevalence rate is still 20.4 percent, with most of the infections occurring in rural areas. xviii Nevertheless, Chagas disease in Bolivia is not limited to rural areas as it is also prevalent in urban areas. More than half of Cochabamba’s population lives in peripheral urban districts, also known as popular zones. The rates of infection were especially high in children between the ages of five and thirteen. This is due to a high vector infection rate, which led to heart problems in children of the same ages.xix Overall, the issue of Chagas disease in Bolivia is a very serious one and while measures have been taken to combat it, it remains prevalent throughout the country. II. Food Security Topic Background actions of growers or producers from virtually anywhere can have a detrimental affect to consumers around the world. There is no exact statistic due to a wide range data that is unavailable, however the WHO Foodborne illnesses are a serious threat to a globalized world where the 5 1905 Main Street Huntington Beach, CA 92648 I hbhsmun.webs.com I who.novice37@gmail.com World Health Organization April 25th, 2015 and CDC estimate that millions potentially billions suffer from some form of an illness related to food each year. With diarrheal diseases alone killing over two million, the death toll from improper food safety awareness is staggering, not even accounting for the hundreds of thousands hospitalized every year. xx Also, it is critical to examine the economic toll that improper food safety regulations can have. Outbreaks of foodborne diseases such as E. coli can devastate the entire crop population in a region costing farmers or industrial plantations millions of dollars in lost produce. This principle especially applies to internationally traded crops that have become a major industry; for example, the WHO reported that the 2011 E. coli outbreak in Germany cost the US one point three billion dollars in farmer’s losses and two hundred and thirty six million in emergency aid payments made to other European countries.xxi There is a vast spectrum of diseases contractible from food safety misconduct, some of which are the fault of growers and producers, others the consumers, because they each play a critical role in ensuring the prevention of foodborne illness. The most common microbial pathogens that contaminate food are bacteria. xxii Bacteria such as E. coli and Salmonella typically enter food supplies via undercooked poultry or other animal related products and poor quality drinking water.xxiii They usually cause symptoms such as headache, abdominal pains, vomiting, and profuse diarrhea, all of which in many cases are fatal. The growing concern on an international level is antimicrobial resistant bacterial strains that are becoming increasingly common due to the improper usage of veterinary or human antimicrobials used to combat the bacteria. The second most common cause of foodborne illnesses are viruses, particularly noroviruses that are characterized by nausea, fever, abdominal pain, and explosive vomiting. xxiv The most common cause of noroviruses entering the food supply are infected handlers, most of which undergo no medical evaluation before handling food. Parasites are the third most common biological contaminant of food and are found in two forms: protozoa, which are unicellular organisms, and helminths, which are larger multicellular worms that can be seen without a microscope. xxv They are spread primarily by the improper storage of meats making it vital to store meats at temperatures at or below forty degrees Fahrenheit in order to ensure that parasitic contaminants are neutralized. xxvi While less likely parasites can also be spread to fresh produce via contaminated water or soil. After infecting a person, parasites have a vast array of symptoms and while they usually include diarrhea, abdominal pains, and vomiting there are certain cases in which the infections can lead to severe damage of major internal organs, which if untreated leads to organ failure. xxvii Finally, the last major biological contaminants are prions, which are microscopic organisms viral in nature but composed entirely of proteins which allows for their rapid manifestation in the brain matter of organisms. xxviii Though prions are rare and affect only about one out of every million people in a population it is important that they be controlled since there is no medical treatment of any kind.xxix Once a prion has manifested inside a brain, it will ultimately lead to the degeneration and dysfunctionality of neurons, resulting in a fatality. There are many ways people can come to be infected by prions, however the most common means through food is the infection of cattle with bovine spongiform encephalopathy (BSE) which can then be acquired by people through the consumption of the contaminated tissues from the cow. xxx The resulting effect is the development of Creutzfeldt-Jakob disease in the consumer, and while in developed nations regulations are put in place to ensure the safety of the meat being sold to 6 1905 Main Street Huntington Beach, CA 92648 I hbhsmun.webs.com I who.novice37@gmail.com World Health Organization April 25th, 2015 consumers, in less developed nations where food is scarce there is a higher potential disease factors, such as BSE, go ignored. Aside from harmful biological agents that can affect the safety of food there is also a growing concern in the international community about certain chemical agents. A major concern is naturally occurring toxicants such as cyanogenic glycosides, ciguatera, and histamines. xxxi Cyanogenic glycosides are found primarily in bamboo chutes, yuca, and certain pits and seeds of fruits. The particular foods that harbour this toxicant are in most cases selective to Asian culture where they are used in a wide variety of dishes; however, the concentrations of cyanogenic glycosides only pose a real threat when the foods are not prepared accordingly and the proper temperature is not reached. Since it does not pose a significant threat to adults, steps are often neglected, though it can result in hydrogen cyanide poisoning in infants leading to underdeveloped muscle groups and lessened cognitive abilities. xxxii Ciguatera and histamines are both transmitted via fish. Ciguatera is a toxic compound that causes severe abdominal pains, vomiting, and diarrhea and is acquired through the consumption of predatory reef fish typically weighing greater than six pounds.xxxiii Fish such as barracuda, hogfish, and yellowfish grouper naturally have a higher concentration of ciguatera as a result of their diet which consists of smaller fish that feed on Gambierdiscus toxicus, the marine algae responsible for the production of the ciguatoxin. xxxiv The best way to prevent ciguatera poisoning is either to educate people to avoid consuming large amounts of these fish species or to refrain from certain organs where the compound builds up from being processed into food. No cure exists for ciguatera poisoning however one gram of twenty percent intravenous mannitol solution can greatly reduce symptoms. xxxv Another example of naturally occurring toxicants are histamines which build up in marine organisms, causing scombroid poisoning which is identified by burning sensations, palpitations, blurred vision, and vomiting. In order to prevent scombroid poisoning, fish must be kept at or below four degrees Celsius from the time of being caught to being cooked.xxxvi Treatment is often only required in extreme cases, due to most symptoms residing in a few days. Another class of chemical contaminants are persistent organic pollutants or POPs which reside in food due to the continued application of herbicides and pesticides which build up and then are consumed by humans. While there are hundreds of POPs the prominent example are dioxins which build up in meat and other animal products as a result of their high concentration in the environment due to unregulated industrial processes such as burning waste and the overuse of pesticides in the animals’ food supply. Dioxins are responsible for a number of cancers and have been known to damage kidneys and reproductive organs as well. Currently people’s consumption of dioxins worldwide is rising and the majority of people are unaware of a simple method that drastically reduces dioxin levels in meat: broiling. Broiling is a realistic short term solution to high dioxin levels aside from a vegan diet, but long term waste management and pesticide control must be used to regulate this chemical. xxxvii Lastly, heavy metals such as lead and mercury make up the third sphere of non-biological contaminants that are detrimental to people who consume the foods that contain them. They are found in water and soil often as a result of old or unregulated pipe usage where eroded foundations may expose water to dangerous heavy elements that then contaminate the soil and ultimately the food it is grown in. xxxviii Heavy metal exposure can be deadly and in many cases results in kidney damage, organ failure, and reproductive harm.xxxix The most crucial step in preventing heavy metals from entering a 7 1905 Main Street Huntington Beach, CA 92648 I hbhsmun.webs.com I who.novice37@gmail.com World Health Organization April 25th, 2015 region’s food supply is implementing regulations that test water and soil and hold growers accountable for keeping the pollutants out of their produce. protocol and has analyzed cases in which liability with harmful LMOs has been seen as an issue. The harmful effects of food not only come from manmade chemicals, but it can also be affected by natural disasters due to climate change. Climate change disasters include droughts, flooding, excess amounts of rain, or no rain at all. This is why the World Food Programme (WFP) is aiding a variety of countries in Asia and Africa adapt to the hanging weather patterns due to CO2 emissions. WFP has aided developing countries such as Bangladesh and Niger work to increase the number of crops in their country and given them the tools and skills needed in order to allow it to be long term. Resolution 1984/63 mentions the aid to developing countries and briefly discusses their needs as well as the elaborations of set and strict guidelines for product distribution and the protection of the buyer. WFP has also create the Climate Adaptation Management and Innovation Initiative (C-ADAPT) in order to create climate-induced food insecurity checks in order to teach these countries how to adapt to the unstable climate as well as well as come up with backup plans in case a devastating natural disaster occurs. This programme has been created for more developing countries to aid already povertystricken areas from losing any more of its agriculture.C-ADAPT is currently being funded by the Swedish Government and has been successful with the help of other UN organizations such as FAO and IFAD.xlv United Nations Involvement The Cartagena Protocol on Biosafety on Biological Diversity, adopted in January 2000, is an international agreement that ensures the safety of all foods, assures the correct use of Living Modified Organisms (LMOs) that could potentially have harmful effects on biodiversity, and scales the risks that could occur to humans if there is an effect in the safety measures.xl The Protocol’s goal is to stop any biodiversity from harming any type of natural organism and informs countries on what is considered proper methods used in order to keep food from becoming a risk. A/RES/39/248 mentions similar issues concerning education on hazardous, products, protecting buyers from damaging economic interest, and physical safety regulations which should be implemented by the government. xli This resolution focuses on the safety guidelines which should be strictly abided by. A/Res/38/147 also has similar economic and social policy as well as the implementation of guidelines for the safety of the consumer. xlii The Cartagena Protocol has create risk assessment which is then completed by countries to ensure the safety of the LMO as well as LMOs being imported and exported mentioned in Article 15. Countries will use scientific and factual evidence in order to check for possible dangers in LMOs in order to prevent it from risking the lives of humans. xliii The Cartagena Protocol also adopted the Nagoya Kuala-Lumpur Supplementary Protocol on Liability and Redress that discusses the international liability if LMOs create serious damage in another country. xliv The Ad-Hoc Working Group has contributed to the legality of this Case Study: Food Pollution Food pollution is the presence of toxic chemicals within food or the contamination of crops and livestock. Some instances of food pollution can be soil poisoning, water poisoning, and air poisoning. The harmful effects to these crops can lead to severe sickness to 8 1905 Main Street Huntington Beach, CA 92648 I hbhsmun.webs.com I who.novice37@gmail.com World Health Organization April 25th, 2015 humans who consume this product. This could then lead to severe health issues hormonally, mess with one's nervous system, and affect the metabolism. The pollution of crops through harmful pesticides can also increase the risk of cancer. Some of the pollution in the soil is due to the effects of the environment, but it is strengthened by the irresponsibility of man. For example, the soil from the Atacama Desert in Chile is considered polluted due to the vast percentage of perchlorate in the soil, but the reason the levels of perchlorate are so high is because of the chemicals put into the soil which then raise the levels of the natural chemical. The release of perchlorate would be fine if they were released at a natural level, but due to the rise, it can become dangerous. One man-made chemical that contributes to soil pollution is xenobiotics. These are commonly found in water runoff from farms using pesticides- and radioactive sludge. Crops and agriculture are not the only food consumed by humans that suffer from the harmful effects of pollution. Marine life such as eel, tilapia, clams, and shrimp suffer from murky and toxicated waters in local streams and farms. For example, in Fuqing China located in the Fujian Province, massive water shortages and sewage infested waters harm the local fish in the area. xlvi Due to the increase of marine life farms, the water has been to spread out and has become more infested with agricultural run-off. This could lead to an increase in an unhealthy liver and a higher risk of acquiring cancer. Local workers claim that their waters are brown and covered in a thick layer of pollution. Nutrient pollution has also seen to be fatal to the fish we eat which not only affects humans, but also other animals who feed off these fish. Nutrient pollution causes the creation of thick, green algae in the water restricting oxygen from enter the water, suffocating the fish, blocking out sunlight and killing them. xlvii Many times these algae release toxins that remain inside the fish after it is already dead. Animals such as seagull, sea lions, dolphins and turtles that feed upon these animals are soon affected after they consume them and the effects can then be fatal. These blossoms of algae have quickly spread across U.S waterways and lake creating dead zones. Dead zones are areas of water that are so thick with algae that their a lack of oxygen in the water. From the Chesapeake Bay to the Gulf of Mexico, there are over 166 dead zones.xlviii The dead zones from the Gulf of Mexico then empty into 31 different streams and lakes in the US, threatening the fish and other marine life in the area. Food pollution to crops, livestock, and marine life do have the potential to harm human consumers. If someone consumes a large amount of food filled with harmful toxins without knowing they are present, they are at a higher risk of liver damage and a variety of cancers. The raising of awareness for the pollution of crops and fish has occurred for cases such as the Fuqing polluted waters which focusing on decreasing the pollutants in water areas. 9 1905 Main Street Huntington Beach, CA 92648 I hbhsmun.webs.com I who.novice37@gmail.com World Health Organization April 25th, 2015 Questions to Consider Chagas Disease: 1. What actions has your country taken towards eliminating Chagas disease in your country and/or others? 2. What techniques have or have not been successful in treating Chagas disease (including early and later stages of disease)? 3. What ways can Chagas disease be prevented? 4. If your country suffers from Chagas disease, what are some of the contributing factors to the spread of the parasite? 5. Is your country aided by any organization (WHO, ECOSOC) that has been able to lower the percentage of people affected by Chagas? 6. Can your country afford the vaccine for Chagas? If they can, have they been able to distribute it to countries in need? Food Safety: 1. What regulations does your country have on food safety, such as with food production labeling? 2. What actions have been successful in preventing and dealing with outbreaks of foodborne diseases? 3. Has there been an issue in your country regarding food violations that did or could have harmed your people? 4. Has your country signed any documents or treaties regarding food safety? 5. Has your county had any damage due to LMOs? 6. How many resources (financial, samples, and/or researchers) has your country allocated toward finding solutions to biological or non biological agents that contaminate food? 7. To what degree is your country affected by improper food safety regulations? Is it primarily biological or chemical? What steps, if any, have been taken to combat it? i http://www.who.int/mediacentre/factsheets/fs340/en/ http://www.cdc.gov/parasites/chagas/gen_info/vectors/ iii http://www.efpia.eu/diseases/27/59/Chagas-Disease iv http://whqlibdoc.who.int/hq/1999/WHO_CDS_WHOPES_GCDPP_99.1.pdf v http://www.cdc.gov/parasites/chagas/gen_info/vectors/ vi http://www.cdc.gov/parasites/chagas/biology.html vii http://www.efpia.eu/diseases/27/59/Chagas-Disease viii http://whqlibdoc.who.int/hq/1999/WHO_CDS_WHOPES_GCDPP_99.1.pdf ix http://www.cdc.gov/parasites/chagas/biology.html x http://www.efpia.eu/diseases/27/59/Chagas-Disease xi http://www.who.int/mediacentre/factsheets/fs340/en/ xii http://www.paho.org/hq/dmdocuments/2011/CD50-16-e.pdf xiii https://sustainabledevelopment.un.org/index.php?page=view&type=1006&menu=1348&nr=1496 ii 10 1905 Main Street Huntington Beach, CA 92648 I hbhsmun.webs.com I who.novice37@gmail.com World Health Organization April 25th, 2015 xiv http://www.paho.org/hq/index.php?option=com_content&view=article&id=10440%3A100-millonespadecen-alguna-enfermedad-infecciosa-desatendida-en-las-americas&Itemid=1926&lang=en xv http://www.who.int/tdr/about/en/ xvi http://www.who.int/tdr/research/vectors/community_based_interventions/ecohealth/chagas-bolivia/en/ xvii http://www.msfaccess.org/content/treating-chagas-rural-bolivia-photo-story xviii http://www.dndi.org/media-centre/press-releases/1582-chagas-week.html xix http://www.ncbi.nlm.nih.gov/pubmed/18797753 xx http://www.scidev.net/global/health/opinion/time-to-count-the-burden-of-foodborne-disease.html xxi http://www.who.int/mediacentre/factsheets/fs399/en/ xxii http://www.cdc.gov/foodborneburden/ xxiii http://www.who.int/features/factfiles/food_safety/en/ xxiv http://www.who.int/mediacentre/factsheets/fs399/en/ xxv http://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-factsheets/foodborne-illness-and-disease/parasites-and-foodborne-illness/ xxvi http://www.health.state.mn.us/foodsafety/cook/temperature.html xxvii http://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-factsheets/at-risk-populations xxviii http://www.ncbi.nlm.nih.gov/books/NBK57084/ Legname G, Baskakov IV, Nguyen HO, Riesner D, Cohen FE, DeArmond SJ, Prusiner SB. Synthetic mammalian prions. Science. 2004;305(5684):673–676. [PubMed] xxix http://www.ncbi.nlm.nih.gov/books/NBK57084/ xxx http://www.who.int/zoonoses/diseases/bse/en/ xxxi http://www.fda.gov/Food/FoodborneIllnessContaminants/ChemicalContaminants/default.htm xxxii http://www.foodsafety.asn.au/resources/natural-toxins-in-food/ xxxiii http://www.hc-sc.gc.ca/pphb-dgspsp/tmp-pmv/2002/ciguat_e.html xxxiv http://oceanworld.tamu.edu/resources/oceanography-book/harmfulagalblooms.htm xxxv http://www.foodsafety.asn.au/resources/natural-toxins-in-food/ xxxvi http://www.health.state.mn.us/foodsafety/cook/temperature.html xxxvii http://abcnews.go.com/Health/story?id=117531 xxxviii http://www.who.int/mediacentre/factsheets/fs399/en/ xxxix http://emedicine.medscape.com/article/814960-overview xl http://bch.cbd.int/protocol/background/ xli http://www.un.org/documents/ga/res/39/a39r248.htm xlii http://www.un.org/documents/ga/res/38/a38r147.htm xliii https://bch.cbd.int/protocol/cpb_art27_info.shtml xliv http://bch.cbd.int/protocol/supplementary/ xlv http://www.wfp.org/c-adapt xlvi http://www.nytimes.com/2007/12/15/world/asia/15fish.html?pagewanted=all&_r=1& xlvii http://www2.epa.gov/nutrientpollution/effects-environment xlviii http://serc.carleton.edu/microbelife/topics/deadzone/index.html 11 1905 Main Street Huntington Beach, CA 92648 I hbhsmun.webs.com I who.novice37@gmail.com
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