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Expert elicitation as a means to attribute 28 enteric pathogens to foodborne, waterborne, animal contact, and person-to-person transmission routes in Canada.
Foodborne Pathog Dis. 2015 Apr; 12(4):335-44.FP

Abstract

Enteric illness contributes to a significant burden of illness in Canada and globally. Understanding its sources is a critical step in identifying and preventing health risks. Expert elicitation is a powerful tool, used previously, to obtain information about enteric illness source attribution where information is difficult or expensive to obtain. Thirty-one experts estimated transmission of 28 pathogens via major transmission routes (foodborne, waterborne, animal contact, person-to-person, and other) at the point of consumption. The elicitation consisted of a (snowball) recruitment phase; administration of a pre-survey to collect background information, an introductory webinar, an elicitation survey, a 1-day discussion, survey readministration, and a feedback exercise, and surveys were administered online. Experts were prompted to quantify changes in contamination at the point of entry into the kitchen versus point of consumption. Estimates were combined via triangular probability distributions, and medians and 90% credible-interval estimates were produced. Transmission was attributed primarily to food for Bacillus cereus, Clostridium perfringens, Cyclospora cayetanensis, Trichinella spp., all three Vibrio spp. categories explored, and Yersinia enterocolitica. Multisource pathogens (e.g., transmitted commonly through both water and food) such as Campylobacter spp., four Escherichia coli categories, Listeria monocytogenes, Salmonella spp., and Staphylococcus aureus were also estimated as mostly foodborne. Water was the primary pathway for Giardia spp. and Cryptosporidium spp., and person-to-person transmission dominated for six enteric viruses and Shigella spp. Consideration of the point of attribution highlighted the importance of food handling and cross-contamination in the transmission pathway. This study provides source attribution estimates of enteric illness for Canada, considering all possible transmission routes. Further research is necessary to improve our understanding of poorly characterized pathogens such as sapovirus and E. coli subgroups in Canada.

Authors+Show Affiliations

Centre for Foodborne , Environmental, and Zoonotic Infectious Diseases, Public Health Agency of Canada, Ottawa, Ontario, Canada .No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25835810

Citation

Butler, Ainslie J., et al. "Expert Elicitation as a Means to Attribute 28 Enteric Pathogens to Foodborne, Waterborne, Animal Contact, and Person-to-person Transmission Routes in Canada." Foodborne Pathogens and Disease, vol. 12, no. 4, 2015, pp. 335-44.
Butler AJ, Thomas MK, Pintar KD. Expert elicitation as a means to attribute 28 enteric pathogens to foodborne, waterborne, animal contact, and person-to-person transmission routes in Canada. Foodborne Pathog Dis. 2015;12(4):335-44.
Butler, A. J., Thomas, M. K., & Pintar, K. D. (2015). Expert elicitation as a means to attribute 28 enteric pathogens to foodborne, waterborne, animal contact, and person-to-person transmission routes in Canada. Foodborne Pathogens and Disease, 12(4), 335-44. https://doi.org/10.1089/fpd.2014.1856
Butler AJ, Thomas MK, Pintar KD. Expert Elicitation as a Means to Attribute 28 Enteric Pathogens to Foodborne, Waterborne, Animal Contact, and Person-to-person Transmission Routes in Canada. Foodborne Pathog Dis. 2015;12(4):335-44. PubMed PMID: 25835810.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Expert elicitation as a means to attribute 28 enteric pathogens to foodborne, waterborne, animal contact, and person-to-person transmission routes in Canada. AU - Butler,Ainslie J, AU - Thomas,M Kate, AU - Pintar,Katarina D M, PY - 2015/4/4/entrez PY - 2015/4/4/pubmed PY - 2015/12/19/medline SP - 335 EP - 44 JF - Foodborne pathogens and disease JO - Foodborne Pathog Dis VL - 12 IS - 4 N2 - Enteric illness contributes to a significant burden of illness in Canada and globally. Understanding its sources is a critical step in identifying and preventing health risks. Expert elicitation is a powerful tool, used previously, to obtain information about enteric illness source attribution where information is difficult or expensive to obtain. Thirty-one experts estimated transmission of 28 pathogens via major transmission routes (foodborne, waterborne, animal contact, person-to-person, and other) at the point of consumption. The elicitation consisted of a (snowball) recruitment phase; administration of a pre-survey to collect background information, an introductory webinar, an elicitation survey, a 1-day discussion, survey readministration, and a feedback exercise, and surveys were administered online. Experts were prompted to quantify changes in contamination at the point of entry into the kitchen versus point of consumption. Estimates were combined via triangular probability distributions, and medians and 90% credible-interval estimates were produced. Transmission was attributed primarily to food for Bacillus cereus, Clostridium perfringens, Cyclospora cayetanensis, Trichinella spp., all three Vibrio spp. categories explored, and Yersinia enterocolitica. Multisource pathogens (e.g., transmitted commonly through both water and food) such as Campylobacter spp., four Escherichia coli categories, Listeria monocytogenes, Salmonella spp., and Staphylococcus aureus were also estimated as mostly foodborne. Water was the primary pathway for Giardia spp. and Cryptosporidium spp., and person-to-person transmission dominated for six enteric viruses and Shigella spp. Consideration of the point of attribution highlighted the importance of food handling and cross-contamination in the transmission pathway. This study provides source attribution estimates of enteric illness for Canada, considering all possible transmission routes. Further research is necessary to improve our understanding of poorly characterized pathogens such as sapovirus and E. coli subgroups in Canada. SN - 1556-7125 UR - https://www.unboundmedicine.com/medline/citation/25835810/Expert_elicitation_as_a_means_to_attribute_28_enteric_pathogens_to_foodborne_waterborne_animal_contact_and_person_to_person_transmission_routes_in_Canada_ DB - PRIME DP - Unbound Medicine ER -