Quantitative microbial risk assessment of Salmonella in fresh chicken patties.

Quantitative microbial risk assessment (QMRA) has witnessed rapid development within the context of food safety in recent years. As a means of contributing to these advancements, a QMRA for Salmonella spp. in fresh chicken patties for the general European Union (EU) population was developed. A two-dimensional (Second Order) Monte-Carlo simulation method was used for separating variability and uncertainty of model's parameters. The stages of industrial processing, retail storage, domestic storage, and cooking in the domestic environment were considered in the exposure assessment. For hazard characterization, a dose-response model was developed by combining 8 published dose-response models using a Pert distribution for describing uncertainty. The QMRA model predicted a mean probability of illness of 1.19*10-4 (5.28*10-5 - 3.57*10-4 95 % C.I.), and a mean annual number of illnesses per 100,000 people of 2.13 (0.96 - 6.59 95 % C.I.). Moreover, sensitivity analysis was performed, and variability in cooking preferences was found to be the most influential model parameter (r = -0.39), followed by dose-response related variability (r = 0.22), and variability in the concentration of Salmonella spp. at the time of introduction at the processing facility (r = 0.11). Various mitigation strategy scenarios were tested, from which, "increasing the internal temperature of cooking" and "decreasing shelf life" were estimated to be the most effective in reducing the predicted risk of illness. Salmonella-related illnesses exhibit particularly high severity, making them some of the most prominent zoonotic diseases in the EU. Regular monitoring of this hazard in order to further highlight its related parameters and causes is a necessary procedure. This study not only provides an updated assessment of Salmonella spp. risk associated with chicken patties, but also facilitates the identification of crucial targets for scientific investigation and implementation of real-world intervention strategies.

Practical Preventive Considerations for Reducing the Public Health Burden of Poultry-Related Salmonellosis.

With poultry products as one of the leading reservoirs for the pathogen, in a typical year in the United States, it is estimated that over one million individuals contract non-typhoidal Salmonella infections. Foodborne outbreaks associated with Salmonella infections in poultry, thus, continue to remain a significant risk to public health. Moreover, the further emergence of antimicrobial resistance among various serovars of Salmonella is an additional public health concern. Feeding-based strategies (such as use of prebiotics, probiotics, and/or phytobiotics as well as essential oils), non-feeding-based strategies (such as use of bacteriophages, vaccinations, and in ovo strategies), omics tools and surveillance for identifying antibiotic-resistance genes, post-harvest application of antimicrobials, and biosecurity measures at poultry facilities are practical interventions that could reduce the public health burden of salmonellosis and antibiotic resistance associated with poultry products. With the escalating consumption of poultry products around the globe, the fate, prevalence, and transmission of Salmonella in agricultural settings and various poultry-processing facilities are major public health challenges demanding integrated control measures throughout the food chain. Implementation of practical preventive measures discussed in the current study could appreciably reduce the public health burden of foodborne salmonellosis associated with poultry products.

Salmonella assessment along the Spanish food chain: Likelihood of Salmonella occurrence in poultry and pig products is maintained across the food chain stages.

Salmonellosis is one of the most important foodborne diseases worldwide, including the European Union. Despite the One Health approach measures for risk assessment and risk management implemented by the European Union, the occurrence of disease and disease outbreaks remains high (e.g. 694 outbreaks were reported in 2020), highlighting the need of new assessment methods. Herein we applied machine learning using the random forests method to evaluate and identify key points regarding the occurrence of Salmonella sp. along the Spanish food chain during 2015-2020, using data provided by the Spanish Agency for Food Safety and Nutrition. We compared the role of the three categorical variables [product (20 categories), region (18 categories) and stage (11 categories)]. Salmonella presence was influenced by the three explanatory variables considered: first by product, followed by region and stage. The most determinant product for Salmonella probability was 'meat', while the most important stage was 'slaughterhouse'. Specifically, the highest values were found in pig and poultry meats. In these products, the Salmonella probability was high at the early and final stages of the food chain, although not at intermediate stages. The presence of Salmonella in the final stages (retail) of the food chain is of concern, as it can cause human cases of salmonellosis, including outbreaks. This study demonstrates the utility of the random forest method to identify key points and evaluate the control efforts. We recommend improving the surveillance and control measures, especially in the product and stages pointed out by our analysis, and enhancing the data collection harmonization among the different autonomous communities.

Quantitative Risk Assessment of Salmonella in Ground Beef Products and the Resulting Impact of Risk Mitigation Strategies on Public Health.

Salmonellosis incidence rates have not declined over the last 15 years in the US despite a significant Salmonella prevalence reduction in meat and poultry products. Ground beef is currently regulated using only qualitative Salmonella criteria, and Salmonella enumeration values have been proposed as an alternative for implementing risk-based mitigation strategies to prevent illnesses. The purpose of this study was to develop a quantitative microbial risk assessment (QMRA) model to estimate the annual number of salmonellosis cases attributable to the consumption of ground beef contaminated with Salmonella and investigate the impact of risk management strategies on public health. Model results estimated 8,980 (6,222-14,215, 90% CI) annual illnesses attributable to ground beef consumption in the US. The removal or diversion of highly contaminated ground beef production lots containing levels above 10 MPN/g (0.4%) and 1 MPN/g (2.4%) would result in a 13.6% (5,369-12,280, 90% CI) and 36.7% (3,939-8,990, 90% CI) reduction of annual salmonellosis illnesses, respectively. Frozen ground beef cooked at home was the consumption scenario of the highest risk for acquiring salmonellosis. Highly virulent serotypes accounted for 96.7% of annual illnesses despite only being present in 13.7% of ground beef samples. The removal of MDR Salmonella would result in decreased burden of disease with a 45% reduction in acute DALY annually. Focusing salmonellosis reduction efforts on removing highly contaminated ground beef lots, highly virulent Salmonella serotypes, and MDR Salmonella from not-ready-to-eat (NRTE) products were predicted to be effective risk prevention strategies.

Poultry Food Assess Risk Model for Salmonella and Chicken Gizzards: I. Initial Contamination.

The Poultry Food Assess Risk Model (PFARM) project was initiated in 1995 to develop data collection and modeling methods for simulating the risk of salmonellosis from poultry food produced by individual production chains. In the present study, the Initial Contamination (IC) step of PFARM for Salmonella and chicken gizzards (CG) was conducted as a case study. Salmonella prevalence (Pr), number (N), and serotype/zoonotic potential (ZP) data (n = 100) for one sample size (56 g) of CG were collected at meal preparation (MP), and then Monte Carlo simulation (MCS) was used to obtain data for other sample sizes (112, 168, 224, 280 g). The PFARM was developed in Excel and was simulated with @Risk. Data were simulated using a moving window of 60 samples to determine how Salmonella Pr, N, and ZP changed over time in the production chain. The ability of Salmonella to survive, grow, and spread in the production chain and food, and then cause disease in humans was ZP, which was based on U. S. Centers for Disease Control and Prevention data for salmonellosis. Of 100 CG samples tested, 35 were contaminated with Salmonella with N from 0 to 0.809 (median) to 2.788 log per 56 g. Salmonella serotype Pr per 56 g was 16% for Kentucky (ZPmode = 1.1), 9% for Infantis (ZPmode = 4.4), 6% for Enteritidis (ZPmode = 5.0), 3% for Typhimurium (ZPmode = 4.9), and 1% for Thompson (ZPmode = 3.7). Results from MCS indicated that Salmonella Pr, N, and ZP among portions of CG at MP changed (P ≤ 0.05) over time in the production chain. Notably, the main serotype changed from Kentucky (low ZP) to Infantis (high ZP). However, the pattern of change for Salmonella Pr, N, and ZP differed over time in the production chain and by the statistic used to characterize it. Thus, a performance standard (PS) based on Salmonella Pr, N, or ZP at testing or MP will likely not be a good indicator of poultry food safety or risk of salmonellosis.

Quantitative microbiological risk assessment of nontyphoidal Salmonella in ground pork in households in Chengdu, China.

Foodborne disease caused by nontyphoidal Salmonella (NTS) is one of the most important food safety issues worldwide. The objectives of this study were to carry out microbial monitoring on the prevalence of NTS in commercial ground pork, investigate consumption patterns, and conduct a quantitative microbiological risk assessment (QMRA) that considers cross-contamination to determine the risk caused by consuming ground pork and ready-to-eat food contaminated during food handling in the kitchen in Chengdu, China. The food pathway of ground pork was simplified and assumed to be several units according to the actual situation and our survey data, which were collected from our research or references and substituted into the QMRA model for simulation. The results showed that the prevalence of NTS in ground pork purchased in Chengdu was 69.64% (95% confidence interval [CI], 60.2-78.0), with a mean contamination level of -0.164 log CFU/g. After general cooking, NTS in ground pork could be eliminated (contamination level of zero). The estimated probability of causing salmonellosis per day was 9.43E-06 (95% CI: 8.82E-06-1.00E-05), while the estimated salmonellosis cases per million people per year were 3442 (95% CI: 3218-3666). According to the sensitivity analysis, the occurrence of cross-contamination was the most important factor affecting the probability of salmonellosis. To reduce the risk of salmonellosis caused by NTS through ground pork consumption, reasonable hygiene prevention and control measures should be adopted during food preparation to reduce cross-contamination. This study provides valuable information for household cooking and food safety management in China.

[Establishment of multi-sector collaborative mechanism and surveillance network for Salmonella infection outbreak response and control].

Salmonellosis is one of the common food-borne diseases, local and cross-region outbreaks are not rare. The risk of cross-border transmission of Salmonella is increasing with the high frequency of global economic trades. The recently occurred multi-country outbreaks of Salmonella Typhimurium infection associated with chocolate products have highlighted the importance of improving capability of surveillance and warning of foodborne-disease, especially salmonellosis, in China. It is essential to strengthen the collaboration among clinical medicine, disease control and food safety institutions, improve the capability of whole-genome sequencing of Salmonella for the disease surveillance and tracing, and facilitate the information sharing and collaboration among the food safety related sectors for the timely detection, prevention and control of outbreaks of Salmonella infection in China.

Salmonella spp. in low water activity food: Occurrence, survival mechanisms, and thermoresistance.

The occurrence of disease outbreaks involving low-water-activity (aw ) foods has gained increased prominence due in part to the fact that reducing free water in these foods is normally a measure that controls the growth and multiplication of pathogenic microorganisms. Salmonella, one of the main bacteria involved in these outbreaks, represents a major public health problem worldwide and in Brazil, which highlights the importance of good manufacturing and handling practices for food quality. The virulence of this pathogen, associated with its high ability to persist in the environment, makes Salmonella one of the main challenges for the food industry. The objectives of this article are to present the general characteristics, virulence, thermoresistance, control, and relevance of Salmonella in foodborne diseases, and describe the so-called low-water-activity foods and the salmonellosis outbreaks involving them.

Refrigeration of eggs influences the virulence of Salmonella Typhimurium.

Salmonella Typhimurium is a human pathogen associated with eggs and egg-derived products. In Australia, it is recommended that eggs should be refrigerated to prevent condensation that can enhance bacterial penetration across the eggshell. Except for the United States, the guidelines on egg refrigeration are not prescriptive. In the current study, in-vitro and in-vivo experiments were conducted to understand the role of egg storage temperatures (refrigerated vs ambient) on bacterial load and the virulence genes expression of Salmonella Typhimurium. The in-vitro egg study showed that the load of Salmonella Typhimurium significantly increased in yolk and albumen stored at 25 °C. The gene expression study showed that ompR, misL, pefA, spvA, shdA, bapA, and csgB were significantly up-regulated in the egg yolk stored at 5 °C and 25 °C for 96 h; however, an in-vivo study revealed that mice infected with egg yolk stored at 25 °C, developed salmonellosis from day 3 post-infection (p.i.). Mice fed with inoculated egg yolk, albumen, or eggshell wash stored at refrigerated temperature did not show signs of salmonellosis during the period of the experiment. Data obtained in this study highlighted the importance of egg refrigeration in terms of improving product safety.

Modeling Salmonella spp. inactivation in chicken meat subjected to isothermal and non-isothermal temperature profiles.

Salmonella genus has foodborne pathogen species commonly involved in many outbreaks related to the consumption of chicken meat. Many studies have aimed to model bacterial inactivation as a function of the temperature. Due to the large heterogeneity of the results, a unified description of Salmonella spp. inactivation behavior is hard to establish. In the current study, by evaluating the root mean square errors, mean absolute deviation, and Akaike and Bayesian information criteria, the double Weibull model was considered the most accurate primary model to fit 61 datasets of Salmonella inactivation in chicken meat. Results can be interpreted as if the bacterial population is divided into two subpopulations consisting of one more resistant (2.3% of the total population) and one more sensitive to thermal stress (97.7% of the total population). The thermal sensitivity of the bacteria depends on the fat content of the chicken meat. From an adapted version of the Bigelow secondary model including both temperature and fat content, 90% of the Salmonella population can be inactivated after heating at 60 °C of chicken breast, thigh muscles, wings, and skin during approximately 2.5, 5.0, 9.5, and 57.4 min, respectively. The resulting model was applied to four different non-isothermal temperature profiles regarding Salmonella growth in chicken meat. Model performance for the non-isothermal profiles was evaluated by the acceptable prediction zone concept. Results showed that >80% of the predictions fell in the acceptable prediction zone when the temperature changes smoothly at temperature rates lower than 20 °C/min. Results obtained can be used in risk assessment models regarding contamination with Salmonella spp. in chicken parts with different fat contents.

Retail fresh vegetables as a potential source of Salmonella infection in the Mekong Delta, Vietnam.

From July 2017 to Jan 2019, a total of 572 retail fresh vegetables were collected to clarify the contamination of Salmonella in the Mekong Delta, Vietnam. Salmonella was isolated from 74 (12.9%) of 572 samples. The isolation rate of Salmonella from retail fresh vegetables in the rainy season (15.3%) was significantly higher than that in the dry season (7.6%) (P < 0.05). Of 74 Salmonella isolates, Salmonella Weltevreden was the most predominant serovar (35.1%) identified from retail fresh vegetables in all of the wet markets. All S. Weltevreden isolates (100%) were susceptible to nine antibiotics examined. Thus, retail fresh vegetables were considered as an important potential vehicle of Salmonella transmission to humans in the Mekong Delta. These results provide important data for preventing and controlling human salmonellosis in this area.

Fluorothiazinon, a small-molecular inhibitor of T3SS, suppresses salmonella oral infection in mice.

Therapeutic strategies that target bacterial virulence have received considerable attention. The type III secretion system (T3SS) is important for bacterial virulence and represents an attractive therapeutic target. Recently, we developed a new small-molecule inhibitor belonging to a class 2,4-disubstituted-4H-[1,3,4]-thiadiazine-5-ones, Fluorothiazinon (FT-previously called CL-55). FT effectively suppressed T3SS of Chlamydia spp., Pseudomonas aeruginosa, and Salmonella without affecting bacterial growth in vitro. FT was previously characterized by low toxicity, stability, and therapeutic efficacy in animal models. Salmonella T3SS inhibition by FT was studied using in vitro assays for effector proteins detection and estimation of salmonella replication in peritoneal macrophages. The antibacterial effect of FT in vivo was investigated in murine models of salmonella chronic systemic and acute infection. Oral administration of the virulent strain of Salmonella enterica serovar Typhimurium to mice-induced chronic systemic infection with the pathogen persistence in different lymphoid organs such as spleens, Peyer's plaques, and mesenteric lymph nodes. We found that FT suppressed orally induced salmonella infection both with therapeutic and prophylactic administration. Treatment by FT at a dose of 50 mg/kg for 4 days starting from day 7 post-infection (therapy) as well as for 4 days before infection (prevention) led to practically complete eradication of salmonella in mice. FT shows a strong potential for antibacterial therapy and could be used as a substance in the design of antibacterial drugs for pharmaceutical intervention including therapy of antibiotic-resistant infections.

Development and characterization of a carvacrol nanoemulsion and evaluation of its antimicrobial activity against selected food-related pathogens.

Carvacrol has been recognized as an efficient growth inhibitor of food pathogens. However, carvacrol oil is poorly water-soluble and can be oxidized, decomposed or evaporated when exposed to the air, light, or heat. To overcome these limitations, a carvacrol nanoemulsion was developed and its antimicrobial activity against food pathogens evaluated in this study. The nanoemulsion containing 3% carvacrol oil, 9% surfactants (HLB 11) and 88% water, presented good stability over a period of 90 days. In general, the carvacrol nanoemulsion (MIC: 256 µg ml-1 for E. coli and Salmonella spp., 128 µg ml-1 for Staphylococcus aureus and Pseudomonas aeruginosa) exhibited improved antimicrobial activity compared to the free oil. The carvacrol nanoemulsion additionally displayed bactericidal activity against Escherichia coli, P. aeruginosa and Salmonella spp. Therefore, the results of this study indicated that carvacrol oil nanoemulsions can potentially be incorporated into food formulations, wherein their efficacy for the prevention and control of microbial growth could be evaluated.

A broad-spectrum phage controls multidrug-resistant Salmonella in liquid eggs.

Salmonella is a foodborne pathogen constantly threating public health. The widespread use of antibiotics and globalization of the food industry result in rapid growth of drug-resistance. Eggs contaminated by multidrug-resistant (MDR) Salmonella are one of the riskiest factors of salmonellosis, which are frequently associated with outbreaks worldwide. Thus, there are increasing needs for the development of new technologies in controlling MDR pathogens and for the confirmation of their practical efficiency in target food matrices. In this study, 43 Salmonella phages were isolated from environmental resources and among them, phage D1-2 was selected since it exhibited the most potent lytic ability and the broadest host spectrum against tested Salmonella strains. Further study demonstrated that D1-2 shows high pH and thermal tolerances and a short latent period, together with a low frequency of emergence of phage resistance. D1-2 effectively inhibited the growth of two MDR Salmonella strains in liquid egg white and egg yolk at both 4 °C and 25 °C. Morphology and phylogeny indicated that D1-2 belongs to the Myoviridae family. Genome analysis of D1-2 revealed a linear dsDNA sequence with no homology to virulence or antibiotic-resistance associated genes, presenting D1-2 is a promising candidate for the biocontrol of MDR Salmonella in highly risky foods.

Source Attribution of Salmonella in Macadamia Nuts to Animal and Environmental Reservoirs in Queensland, Australia.

Salmonella enterica is a common contaminant of macadamia nut kernels in the subtropical state of Queensland (QLD), Australia. We hypothesized that nonhuman sources in the plantation environment contaminate macadamia nuts. We applied a modified Hald source attribution model to attribute Salmonella serovars and phage types detected on macadamia nuts from 1998 to 2017 to specific animal and environmental sources. Potential sources were represented by Salmonella types isolated from avian, companion animal, biosolids-soil-compost, equine, porcine, poultry, reptile, ruminant, and wildlife samples by the QLD Health reference laboratory. Two attribution models were applied: model 1 merged data across 1998-2017, whereas model 2 pooled data into 5-year time intervals. Model 1 attributed 47% (credible interval, CrI: 33.6-60.8) of all Salmonella detections on macadamia nuts to biosolids-soil-compost. Wildlife and companion animals were found to be the second and third most important contamination sources, respectively. Results from model 2 showed that the importance of the different sources varied between the different time periods; for example, Salmonella contamination from biosolids-soil-compost varied from 4.4% (CrI: 0.2-11.7) in 1998-2002 to 19.3% (CrI: 4.6-39.4) in 2003-2007, and the proportion attributed to poultry varied from 4.8% (CrI: 1-11) in 2008-2012 to 24% (CrI: 11.3-40.7) in 2013-2017. Findings suggest that macadamia nuts were contaminated by direct transmission from animals with access to the plantations (e.g., wildlife and companion animals) or from indirect transmission from animal reservoirs through biosolids-soil-compost. The findings from this study can be used to guide environmental and wildlife sampling and analysis to further investigate routes of Salmonella contamination of macadamia nuts and propose control options to reduce potential risk of human salmonellosis.

Evaluating the Risk of Salmonellosis from Dry Roasted Sunflower Seeds.

Outbreaks and recalls related to nuts and seeds in the United States have increased recently, and 80% of these recalls are due to Salmonella. The U.S. Food and Drug Administration's Food Safety Modernization Act requires food manufacturers to implement risk-based preventive controls based on scientific and technical evidence. Data are limited on the inactivation of Salmonella during processing of saltwater brined in-shell sunflower seeds. The goal of this research was to validate the adequacy of roasting in controlling Salmonella during the production of sunflower seeds and to assess the resulting risk. Four Salmonella strains were inoculated onto sunflower seeds and processed to simulate commercial manufacturing. Seeds were tumbled and roasted at 225°F (107.2°C) and 275°F (135°C) for roasting times from 5 to 45 min. Regression models for Salmonella inactivation and water activity change were developed. The inactivation model predicted a 5-log reduction in Salmonella when sunflower seeds were roasted at 135°C for 19.2 min, with a corresponding water activity of ∼0.61. Roasted sunflower seeds are typically not saleable at water activities >0.6 due to quality issues. Saleable water activities (0.03 to 0.04) were only achieved when the sunflower seeds were roasted for 45 min at 135°C, which resulted in a >7-log reduction in Salmonella. A quantitative microbial risk assessment based on literature values, expert opinion, and the above-mentioned models was used to predict risk of salmonellosis from sunflower seeds. The quantitative microbial risk assessment model predicted an arithmetic mean probability of illness of 1.45E-07 per 28-g serving based on roasting at 135°C for 20 min and an arithmetic mean probability of illness of 5.46E-10 per serving based on roasting at 135°C for >45 min (i.e., saleable product process parameters). This study demonstrates that sunflower seeds roasted to saleable parameters should not represent a public health risk from potential presence of Salmonella.

Reduced Susceptibility of Salmonella Typhimurium Strains to Oregano Essential Oil and Enrofloxacin: An In Vitro Assay.

Several European animal nutrition companies have incorporated essential oils (EOs) into animal feed as a result of the prohibition of antibiotics to promote animal growth. Previous studies of EOs have highlighted the absence of bacterial resistance for these substances, although most of the published works focus on studying their tolerance to subinhibitory doses. For this study, oregano essential oil (OEO) was chosen for its proven inhibitory and bactericidal activity. This study is an in vitro assay of the possible induction of Salmonella enterica serovar Typhimurium strains with reduced susceptibility to OEO by mutation, seeking to calculate the mutant prevention concentration (MPC) since this is an important measurement for the control Salmonella's resistance to fluoroquinolones such as enrofloxacin (ENR), the treatment of choice for this infection. To establish the MPC, we used a bacterial inoculum ≥109 colony-forming unit (CFU)/mL and examined the bases for points of resistance to ENR and mutations of target genes of the quinolone resistance determining region (QRDR). The three strains of Salmonella Typhimurium used in this study showed an MPC of four times the minimum inhibitory concentration (MIC) for ENR. In all cases, strains with reduced susceptibility to ENR were obtained, although none reached the point of resistance. The QRDR characterization region was in all cases of wild type (wt). Two of the strains tested with OEO grew at a concentration of 1 × MIC, which could be strains with reduced susceptibility, associated with mutation or not. In this case, the MPC was 2 × MIC. Once isolated and identified as Salmonella Typhimurium, the MIC against OEO of all strains obtained in the induction test indicated a possible reduction in susceptibility. However, the result obtained for both strains coincided with MIC of the original strains, rejecting a priori such a reduced susceptibility of Salmonella Typhimurium to OEO.

A Successful Technique for the Surface Decontamination of Salmonella enterica Serovar Typhimurium Externally Contaminated Whole Shell Eggs Using Common Commercial Kitchen Equipment.

Eggs are a highly nutritious food source used in a wide range of food products. In Australia, eggs are a frequent source of foodborne salmonellosis outbreaks, associated with eggshell contamination with Salmonella enterica serovar Typhimurium (ST). Despite their potentially hazardous nature, raw eggs are often used and consumed in mayonnaise, mousse, ice cream and eggnog. The aim of this study was to develop a shell egg decontamination method that removed ST contamination from the outside of an egg without impacting its usability. The decontamination method was developed by the adaptation of a temperature-controlled water bath (commonly present in kitchens and associated with the sous-vide technique) for the surface decontamination of eggs. The outside of whole eggs was artificially inoculated with two ST strains. The eggs were decontaminated by placing in a sous-vide cooker with the water heated to 57°C. The remaining viable ST present on the whole shell egg, crushed shells, internal egg contents and sous-vide water were enumerated over time by culturing onto XLD agar. The quality of the uncontaminated heat-treated eggs was determined by measuring the Haugh unit, yolk index, albumen pH, thermocoagulation, and stability of foam. A blind control study was conducted to assess the acceptability and usability of the treated eggs by chefs and food handlers for the preparation of mayonnaise. Complete decontamination of ST was achieved by treating eggs for 9 min in the sous-vide cooker (57°C). No statistically significant difference was observed in the quality of treated eggs compared with nontreated eggs using the quality measurements and acceptability score from chefs. This method provides a simple approach that can be adopted by chefs and food handlers to obtain safe eggs before the preparation of raw egg products.

An outbreak of monophasic Salmonella Typhimurium associated with raw pork sausage and other pork products, Denmark 2018-19.

In Denmark, outbreaks of salmonella with more than 20 cases have become rare. In November 2018, an outbreak of monophasic Salmonella Typhimurium was detected and an investigation initiated with the aim of identifying the source and controlling the outbreak. Outbreak cases were defined based on core genome multilocus sequence types. We conducted hypothesis-generating interviews, a matched case-control study, food sampling and trace-back investigations. We identified 49 cases distributed across Denmark. In univariable analyses a traditional form of raw Danish pork sausage (medister sausage), pork chops and ground veal/pork showed matched odds ratio of 26 (95% CI 3-207), 4 (95% CI 1-13) and 4 (95% CI 1-10), respectively. In a multivariable analysis, only medister sausage remained significant. Several patients described tasting or eating the sausage raw or undercooked. Samples of medister sausage analysed were negative for salmonella and investigations at the production site did not reveal the mechanism of contamination. In conclusion, in spite of having eliminated salmonella in the egg and broiler industry, Denmark is still at risk of major salmonella outbreaks. We identified a raw pork sausage as a particular risk product that needs to be thoroughly cooked before consumption. Tasting raw meat or eating undercooked pork should be discouraged.

Ceftiofur-resistant Salmonella enterica serovar Heidelberg of poultry origin - a risk profile using the Codex framework.

Codex published the 'Guidelines for Risk Analysis of Foodborne Antimicrobial Resistance' to standardise the approach for evaluating risk posed by foodborne antimicrobial-resistant bacteria. One of the first steps in the guidelines is to compile a risk profile, which provides the current state of knowledge regarding a food safety issue, describes risk management options and recommends next steps. In Canada, ceftiofur/ceftriaxone-resistant Salmonella enterica subsp. enterica serovar Heidelberg from poultry was identified as an antimicrobial resistance (AMR) food safety issue. The first objective of this article was to contextualise this food safety issue, using the risk profile format of the Codex Guidelines. A second objective was to evaluate the applicability of the Codex Guidelines. This risk profile indicated that ceftiofur/ceftriaxone-resistant S. Heidelberg (CSH) was commonly isolated from poultry and was associated with severe disease in humans. Ceftiofur use in poultry hatcheries temporally mirrored the prevalence of CSH from poultry meat at retail and from people with salmonellosis. The evidence was sufficient to indicate the need for risk management options, such as restricting the use of ceftiofur in poultry. The Codex Guidelines provided a useful approach to summarise data for decision-makers to evaluate an AMR food safety issue.