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Introduction
Food safety is of major international morbidity and mortality concern with unsafe food a growing global threat (WHO, 2015). It has been conservatively estimated that over 600 million people worldwide (one in ten) become ill annually from foodborne diseases resulting in 420,000 deaths with children at particular risk. A worldwide problem the highest rates occur in Africa with an estimated 91 million cases and 137,000 deaths (WHO, 2015).
Foodborne diseases can be acquired both inside and outside the home. Consumers have more control over home prepared food, although they may not always adopt good food hygiene practices (Redmond and Griffith, 2003), however, when they eat outside the home they may literally be putting their life in someone else’s hands. Some consumers eating out have little choice in where to eat, e.g. hospitals, care homes, and these are often the most vulnerable whilst those eating in cafes, restaurants and hotels do have a choice. In addition to the millions of local South African consumers the magnitude of the problem is greatly increased due to many thousands of tourists who visit South Africa every year who also utilise the food service sector. This is of particular concern as foodborne diseases are largely preventable and food safety is a shared responsibility between governments, the food industry and the public (WHO, 2015). The responsibilities of governments include the need to pass and enforce appropriate food safety legislation. However, more frequently overlooked is the role that governments should play in research, surveillance and the collection of other relevant food safety data, e.g. on causative pathogens, implicated foods, risk factors and in consumer education (Griffith, 2005). Some countries have sophisticated reporting and surveillance systems leading to a greater understanding of the frequency, causes and costs of foodborne disease (Scallen et al., 2011; Tam et al., 2012). However, concerns have been expressed that South Africa does not have the capacity to track and manage foodborne disease (Malgas, 2016). In South Africa foodborne diseases tend to be poorly reported and this can limit risk reduction (Griffith, 2005) although some localised and unrelated cases do attract publicity (Powell, 2014; Dayimani, 2016; ENCA, 2015).
The food industry is a large and diverse global industry with foods and consumers moving relatively freely between...