Illnesses were primarily associated with botulism and trichinosis.
Most studies reported that illnesses occurred primarily in children up to 14 years and females, and that overcrowded housing and food sharing may be potential vehicles for transmission.
Indigenous populations at higher risk
In Canada, it is estimated foodborne illness affects about one in eight (four million cases) each year.
However, the risk of enteric illness is believed to be higher in many Indigenous communities compared to the national average.
There are several reasons for this, according to the review.
“A large proportion of Indigenous people are included in the groups at most risk: infants, young children, pregnant women and the elderly.
“However, another reason for the higher prevalence can be linked to preparation methods and consumption of traditional foods. For example, the consumption of meat - such as seal, whale, walrus and caribou - in raw form is common among some Indigenous groups, which poses a health risk from pathogens normally destroyed by proper cooking.”
From the 1,718 unique records identified, 21 documents (20 journal articles and one report) were included for the qualitative analysis.
Of the 21 documents reviewed, eight (38%) reported trends between age and the occurrence of foodborne and waterborne illness. Six noted higher prevalence in children up to 14 years old.
Of the six documents that reported some form of trend by male/female gender, half noted equal distribution for botulism, E. coli and hepatitis A.
Two studies reported tight social networks in small remote communities may be another possible mode of transmission for foodborne illness.
One document suggested food sharing after a hunt or harvest with family and community members, as a potential vehicle for illness transmission.
Foods and type of illness
Of the 18 relevant studies, walrus (44%), seal (39%), caribou (39%) and whale (33%) were the most commonly mentioned traditional foods tied to illness, especially when eaten raw.
Other foods linked to illness included fermented salmon eggs (stink eggs) and fish (such as char, salmon and trout).
It was noted that the fermentation methods used by the First Nations and Inuit do not produce lactic acid, acetic acid or ethanol to inhibit the growth of pathogens.
Traditional Indigenous fermentation methods may not achieve the low pH required to inhibit the growth of pathogens.
Almost one third of seven articles discussed botulism. Trichinosis was mentioned in almost 15% of studies.
Brucellosis, E. coli and hepatitis A were identified in about 10%. Brucellosis was specifically linked with caribou populations.
The influence of climate change on foodborne illnesses in Indigenous communities and its impact on the health care system merits further examination, said the review.
“This is particularly relevant as higher temperatures may result in increasing temperature-sensitive foodborne illnesses such as botulism which in turn may result in significant financial costs to the health care system.”
The authors concluded food safety guidance is more likely to be effective if designed with community input and respect for Indigenous knowledge systems and cultural food ways.
“For example, it is important to acknowledge that although foodborne illness may be linked to the consumption of traditional foods, these foods also have many health benefits and are essential to wellbeing.
“Likewise, although food sharing was associated with foodborne infections, Indigenous populations value social connectedness which brings many benefits to their health, well-being, spirituality and community spirit.”
Source: Can Comm Dis Rep. 2017; 43(1):7-13
“Foodborne and waterborne illness among Canadian Indigenous populations: A scoping review”
Authors: Jung JKH, Skinner K