Critical review of methods for risk ranking of food-related hazards, based on risks for human health.

This study aimed to critically review methods for ranking risks related to food safety and dietary hazards on the basis of their anticipated human health impacts. A literature review was performed to identify and characterize methods for risk ranking from the fields of food, environmental science and socio-economic sciences. The review used a predefined search protocol, and covered the bibliographic databases Scopus, CAB Abstracts, Web of Sciences, and PubMed over the period 1993-2013. All references deemed relevant, on the basis of predefined evaluation criteria, were included in the review, and the risk ranking method characterized. The methods were then clustered-based on their characteristics-into eleven method categories. These categories included: risk assessment, comparative risk assessment, risk ratio method, scoring method, cost of illness, health adjusted life years (HALY), multi-criteria decision analysis, risk matrix, flow charts/decision trees, stated preference techniques and expert synthesis. Method categories were described by their characteristics, weaknesses and strengths, data resources, and fields of applications. It was concluded there is no single best method for risk ranking. The method to be used should be selected on the basis of risk manager/assessor requirements, data availability, and the characteristics of the method. Recommendations for future use and application are provided.

Community incidence of pathogen-specific gastroenteritis: reconstructing the surveillance pyramid for seven pathogens in seven European Union member states.

By building reconstruction models for a case of gastroenteritis in the general population moving through different steps of the surveillance pyramid we estimated that millions of illnesses occur annually in the European population, leading to thousands of hospitalizations. We used data on the healthcare system in seven European Union member states in relation to pathogen characteristics that influence healthcare seeking. Data on healthcare usage were obtained by harmonized cross-sectional surveys. The degree of under-diagnosis and underreporting varied by pathogen and country. Overall, underreporting and under-diagnosis were estimated to be lowest for Germany and Sweden, followed by Denmark, The Netherlands, UK, Italy and Poland. Across all countries, the incidence rate was highest for Campylobacter spp. and Salmonella spp. Incidence estimates resulting from the pyramid reconstruction approach are adjusted for biases due to different surveillance systems and are therefore a better basis for international comparisons than reported data.

Burden of acute gastrointestinal illness in Denmark 2009: a population-based telephone survey.

A cross-sectional telephone survey was conducted in Denmark throughout 2009 to determine the incidence of acute gastrointestinal illness (AGI). Using the Danish population register, a random population sample stratified by gender and age groups was selected and mobile or landline phone numbers found. Representative numbers of interviews were performed by gender, age group and month. A recently proposed international case definition of AGI, including cases with diarrhoea and/or vomiting in a 4-week recall period, was used. A total of 1853 individuals were included and 206 (11·1%) fulfilled the case definition; 78% reported diarrhoea. This corresponds to an overall standardized incidence rate of 1·4 (95% CI 1·2-1·6) episodes of AGI per person-year. The incidence rate was generally higher in the younger age groups; only being 2·3, 1·9 and 0·80 per person-year in the 0-9, 10-39 and ≥40 years age groups, respectively. The incidence rate estimates were considerably higher when calculated from shorter recall periods.

Zoonoses in the European Union: origin, distribution and dynamics - the EFSA-ECDC summary report 2009.

We present a summary of the main findings of the latest report of the European Food Safety Authority and European Centre for Disease Prevention and Control on zoonoses, zoonotic agents and food-borne outbreaks in the European Union (EU), based on data from 2009. Zoonoses are prevalent and widely distributed across several countries in the EU. The most important highlight of this report was the continuous decrease of human salmonellosis since 2005, probably due to effective control programmes in livestock.

Zoonotic infections in Europe in 2007: a summary of the EFSA-ECDC annual report.

The European Food Safety Authority and the European Centre for Disease Prevention and Control have just published their Community Zoonoses Report for 2007, analysing the occurrence of infectious diseases transmittable from animals to humans. Campylobacter infections still topped the list of zoonotic diseases in the European Union and the number of Salmonella infections in humans decreased for the fourth year in a row. Cases of listeriosis remained at the same level as in 2006, but due to the severity of the disease, more studies on transmission routes are warranted. The report highlights the importance of continued co-operation between veterinarians and public health specialists, both at the EU level and within Member States.

Cross and co resistance among Danish porcine E. coli isolates.

Cross and co-resistance to antimicrobials are presented for 765 Danish Escherichia coli isolates of porcine origin from 2009 to 2013. All isolates and data originate from the DANMAP surveillance but have not previously been used to describe the occurrence of cross and co- resistance. Data presented here clearly indicate the ability of low classified antimicrobials as ampicillin to uphold resistance to critical important antimicrobials for human treatment.

The effects, costs and benefits of Salmonella control in the Danish table-egg sector.

A public plan for eradicating Salmonella in Danish table-egg production was implemented in 1996. During 2002, the poultry industry took over the responsibility of the programme. The proportion of infected layer flocks was reduced from 13.4% in 1998 to 0.4% in 2006. The public-health impact of the plan has been quite marked. In 1997, 55-65% of the 5015 cases of human salmonellosis were estimated to be associated with eggs. In 2006, these figures were reduced to 1658 and 5-7%, respectively. Based on an assessment of the number of human cases attributable to table eggs, we used probabilistic modelling to estimate the avoided societal costs (health care and lost labour), and compared these with the public costs of control. The probable avoided societal costs during 1998-2002 were estimated to be 23.3 million euros (95% CI 16.3-34.9), and the results showed a continuous decreasing cost-benefit ratio reaching well below 1 in 2002. Further reductions in the primary production based on effective surveillance and control are required to ensure continued success.