in the 7-year period 20012007 , 14 ( 1.8% ) of 768 foodborne outbreaks were associated with foods that were distributed internationally ( appendix table ) . in total , these outbreaks affected at least 542 persons in australia , 4.4% ( 542/12,423 ) of all those affected by foodborne disease outbreaks during the period . the number of persons affected in other countries as a result of these events was unknown . given the nature of foodborne disease , more outbreaks that we were unable to identify were likely associated with internationally distributed foods . several point - source outbreaks were related to each other by a common food source , even though the foods were often branded differently and supplied by different companies . the outbreaks of suspected norovirus infection ( outbreaks 4 , 6 , and 9 ) were associated with individually quick frozen ( iqf ) oysters all harvested from the same region in japan ; this association was later confirmed after a national investigation into 3 related outbreaks ( outbreaks 7 , 8 , and 10 ) ( 9 ) . these outbreaks occurred over a 3-year period and resulted in australia s imposing restrictions on importation of iqf oysters from this growing area . no outbreaks was considered to be of  serious public health impact  because of their small size and moderate severity . in 4 ( 29% ) of 14 outbreaks , the event was considered however , agents considered novel in australia were common causes of disease in the country exporting the food ( 10 ) . in 5 ( 36% ) of the 14 outbreaks , food had been distributed to other countries , resulting in multinational food recalls ; 4 more events had the potential to spread to other countries . we identified the implicated food for 2 outbreaks ( outbreaks 1 and 14 ) because other countries rapidly published reports in eurosurveillance weekly . we alerted other countries to the implicated food for 3 other common - source outbreaks ( outbreaks 3 and 5 , by using rapid reports in the same publication and outbreak 2 through promed mail ) ( 1114 ) . during these investigations , we attempted to identify other countries that had also received contaminated food . before the inception of infosan , we relied on diplomatic communications with the exporting country , which were often unsuccessful . in a recent incident in which persons became infected with toxigenic vibrio cholerae after eating raw whitebait ( outbreak 13 ) , infosan emergency made inquiries of the exporting country and confirmed that fish had not been exported to other countries and that no outbreak was observed locally ( 15 ) . during a multicountry outbreak of drug - resistant shigellosis ( outbreak 14 ) , infosan emergency focal point at who gained the exporting country s cooperation to trace back the produce to the facility concerned and informed other countries receiving the same batch of produce ( 11 ) ( appendix table ) . although ihr ( 2005 ) only came into force in june 2007 , we consider that there would have been a basis for reporting 6 ( 43% ) of 14 imported food outbreaks , with 3 of these being part of the same iqf oyster contamination event . although national ihr focal points may decide not to notify or report an outbreak under ihr ( 2005 ) , it is vital that they publish rapid reports involving imported and exported foods , given the potential of these foods to spread disease internationally , and consult with who through infosan emergency . in this report , we considered only those events that resulted in human illness , but it is important for national ihr focal points to consult with the infosan emergency contact point for their country and to consider notifying and/or reporting events in which food is contaminated in the absence of human illness . serious , unusual , or unexpected events associated with domestic food may also trigger the criteria , even when foods are not exported . note that under article 9.2 of ihr ( 2005 ) , public health risks associated with importation of contaminated goods may be reported to who independent of the event s meeting the annex ii criteria . this stipulation would allow reporting when available information is insufficient to make an adequate assessment under annex ii . the role of who and other agencies in these events of potential international importance will undoubtedly continue to evolve . outbreaks of illness that implicated internationally distributed foods and assessment of questions on the ihr ( 2005 ) decision instrument , australia , 2001 - 2007 *
every year , australia identifies 23 outbreaks associated with imported foods . to examine national authorities obligations under the international health regulations ( 2005 ) , 
 we reviewed outbreaks in 20012007 that implicated internationally distributed foods . under these regulations , 6 ( 43% ) of 14 outbreaks would have required notification to the world health organization .