ARCHIVED - Chloramphenicol in Food Products

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What is the problem?

The Canadian Food Inspection Agency (CFIA) detected Chloramphenicol in honey originating from China. Chloramphenicol is an antibiotic drug which is banned in Canada, as well as in many other countries, for use in food-producing animals, including honey bees.

What action has the Government of Canada taken?

The Veterinary Drugs Directorate at Health Canada promptly undertook a health risk assessment in consultation with the CFIA and other experts within the department.

The CFIA has taken measures to detain honey of Chinese origin until it is tested and shown to be in compliance with standards, prepared honey from China.

Recall activities have been initiated to remove all honey of Chinese origin and blends containing honey from China from the marketplace. This includes honey at the importer, manufacturing and retail levels.

Health Canada is continuing to monitor the situation and to actively collect new information to ensure that the Health Risk Assessment reflects the most up-to-date evidence.

What is the advice to Consumers?

The CFIA now has evidence to suggest that all honey from China may contain chloramphenicol, but at uniformly low levels. Health Canada and the CFIA are therefore advising consumers not to eat any honey from China or Canadian honey which has been blended with honey of Chinese origin.

The CFIA originally warned consumers not to eat products manufactured with honey from China based on the link between Chloramphenicol and aplastic anaemia. Since that time, and with additional information, Health Canada revised it's health risk assessment.

Since the levels of the drug are extremely low in food products made with honey from China, such as baked goods, consumers may continue to eat these products.

Is Chloramphenicol banned in Canada?

This drug is banned for use in food-producing animals in Canada as well as in a number of other countries. However, it is approved for human use in Canada as a last resort drug in the treatment of life-threatening, severe bacterial infections where no other treatment is available.

What are the effects of Chloramphenicol?

The drug is associated with random cases (one in 30,000 to one in 50,000 persons) of aplastic anaemia, a serious blood disorder for which there is no cure, and which is usually fatal. It is not known why some people contract this condition and others do not. It is not dose-related. In addition, there are concerns related to potential carcinogenicity and genotoxicity of the drug as well as the potential to cause antimicrobial resistance.

What dosage can cause aplastic anaemia?

The dosage that causes this condition is unknown.

What were the results of the CFIA's testing?

The CFIA has now completed testing of over 100 samples of the liquid honey and has found uniformly small amounts of contamination with chloramphenicol residues (0.3 to 34.0 parts per billion). Based on new information from other countries and new testing data from the CFIA, there is now added assurance that the residues of the honey in question are uniformly low and pose a low risk.

What is the CFIA doing to find these products at risk?

The CFIA is currently tracking imported honey and is recalling all honey of Chinese origin.

Why was pure honey not included on the recall list previously issued by the CFIA?

None of the honey covered by the previously issued health hazard alerts were sold directly to consumers as honey. All the contaminated honey was used in its entirety in the production of manufactured foods (e.g. muffins, bagels and cookies).

Why is the CFIA issuing a recall for bottled honey but not products sweetened with honey?

The CFIA originally recalled products containing honey based on the link between Chloramphenicol and aplastic anaemia, a potentially fatal reaction in a small number of people. Protecting public health and safety is always the key consideration, and therefore with limited information at the time, a decision was made to recall all secondary products in which the tracked shipment of honey was used. Health Canada has since refined its advice that people can continue to consume products that may contain honey as the risk is extremely low. Based on this additional information, the CFIA has revised its alert.

What is the advice in other countries?

The UK has advised consumers that, given the extremely small risk, people continue to eat any honey they have already bought, irrespective of country of origin. This advice also applies to other foods that contain honey, where the risk is even lower.

The US is currently completing a health risk assessment and reviewing other data before making a decision.

Why would this honey be risky?

It is not known what a safe dose of Chloramphenicol would be in humans. In addition, the use of the contaminated honey over a long period would increase the risk. In comparison, 2 Tsp of contaminated honey would contain less than one ten-millionth of a daily dose used to treat typhoid fever in adults. There is sometimes a delay in the onset of aplastic anaemia.

What do I do if I've already eaten some of this honey?

Because the risk is low, consumers do not need to take any further action.

How can I tell if the honey I have in my home is affected?

Consumers should be aware that honey sold in Canada labelled "Canada No.1" could be blended with honey from China. It is important to read the entire label to determine if it contains honey from China, for example, the label could read, "A blend of Canadian and Chinese honey," in which case it should not be consumed.

Consumers who are unsure if their honey is from China should verify with their retailers, restaurants or suppliers whether their honey is affected by this advisory. Canadian honey and honey imported from countries other than China are not included in this advisory.

Should I stop eating honey and associated products?

Since honey sold in Canada may be blended with honey from other countries, it is best to check the label. The risk is low, however, the CFIA and Health Canada are recommending, as a precautionary measure, that consumers not eat honey from China or blended honey made with honey from China. Because the risk from products manufactured with honey, such as bakery products, is extremely low, consumers may continue to eat these products

Should I avoid eating in Chinese restaurants?

Local authorities are being advised of the problem, and the CFIA is tracking the products. There should be no risk in eating in Chinese restaurants.

Should I stop using other products such as cosmetics and over the counter medications that may contain honey?

Because the risk from using these products is extremely low, consumers may continue to use these products.

Are over the counter medications such a cough syrup or lozenges made with honey safe?

At this time we do not have evidence that such products pose a significant health risk.

Are there any other products that may contain Chloramphenicol?

CFIA continually monitors the entry of all products being imported into Canada. When a product is in violation, CFIA requests Health Canada to provide a Health Risk Assessment. The public is advised whenever there is a health concern.

Are there any other issues about honey that I should know about?

Children under the age of 12 months should not be given honey, since there is a small risk of botulism.

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