Risk Assessment of Norovirus Illness from Consumption of Raw Oysters in the United States and in Canada.

Human norovirus (NoV) is the leading cause of foodborne illness in the United States and Canada. Bivalve molluscan shellfish is one commodity commonly identified as being a vector of NoV. Bivalve molluscan shellfish are grown in waters that may be affected by contamination events, tend to bioaccumulate viruses, and are frequently eaten raw. In an effort to better assess the elements that contribute to potential risk of NoV infection and illness from consumption of bivalve molluscan shellfish, the U.S. Department of Health and Human Services/Food and Drug Administration (FDA), Health Canada (HC), the Canadian Food Inspection Agency (CFIA), and Environment and Climate Change Canada (ECCC) collaborated to conduct a quantitative risk assessment for NoV in bivalve molluscan shellfish, notably oysters. This study describes the model and scenarios developed and results obtained to assess the risk of NoV infection and illness from consumption of raw oysters harvested from a quasi-steady-state situation. Among the many factors that influence the risk of NoV illness for raw oyster consumers, the concentrations of NoV in the influent (raw, untreated) and effluent (treated) of wastewater treatment plants (WWTP) were identified to be the most important. Thus, mitigation and control strategies that limit the influence from human waste (WWTP outfalls) in oyster growing areas have a major influence on the risk of illness from consumption of those oysters.

Outbreaks of Escherichia coli O157:H7 Infections Linked to Romaine Lettuce in Canada from 2008 to 2018: An Analysis of Food Safety Context.

ABSTRACT: Foodborne diseases are a major cause of illness in Canada. One of the main pathogens causing cases and outbreaks of foodborne illness in Canada is Escherichia coli O157:H7. From 2008 to 2018, 11 outbreaks of E. coli O157:H7 infection in Canada were linked to leafy greens, including 7 (63.6%) linked to romaine lettuce, 2 (18.2%) linked to iceberg lettuce, and 2 (18.2%) linked to other or unspecified types of leafy greens. The consumption of lettuce in Canada, the behavior of E. coli O157:H7 on lettuce leaves, and the production practices used for romaine and iceberg lettuce do not seem to explain why a higher number of outbreaks of E. coli O157:H7 infection were linked to romaine than to iceberg lettuce. However, the difference in the shape of iceberg and romaine lettuce heads could be an important factor. Among the seven outbreaks linked to romaine lettuce in Canada between 2008 and 2018, an eastern distribution of cases was observed. Cases from western provinces were reported only twice. The consumption of romaine and iceberg lettuce by the Canadian population does not seem to explain the eastern distribution of cases observed, but the commercial distribution, travel distances, and the storage practices used for lettuce may be important factors. In the past 10 years, the majority of the outbreaks of E. coli O157:H7 infection linked to romaine lettuce occurred during the spring (March to June) and fall (September to December). The timing of these outbreaks may be explained by the availability of lettuce in Canada, the growing region transition periods in the United States, and the seasonality in the prevalence of E. coli O157:H7. The consumption of romaine lettuce by the Canadian population does not explain the timing of the outbreaks observed.

Expert Elicitation to Estimate the Relative Risk of Food Safety Criteria Included in the Establishment-Based Risk Assessment Model for Canadian Hatcheries.

The Canadian Food Inspection Agency is developing an Establishment-based Risk Assessment model for Hatcheries to allocate inspection resources according to the food safety risk associated with each hatchery falling under its jurisdiction. In a previous study, 29 factors contributing to the food safety risk of hatcheries were identified and grouped into three clusters (inherent risk, risk mitigation, and compliance) and assessment criteria were defined. The objective of the current study was to estimate the relative risk (RR) of these criteria. Two rounds of expert elicitations were conducted to allow 13 Canadian experts to estimate the RR of each criterion (n = 96) based on its potential impact on human health, with a specific focus on Salmonella spp. This process also aimed to estimate the maximum increase or decrease in the overall food safety risk of a hatchery when considering multiple criteria belonging to a specific cluster and to assess the risk attribution of Salmonella spp. at the hatchery and bird-type levels. Results showed that the respondent profile had no influence on the importance given to a majority of criteria. Uniformity of answers among experts improved from the first to the second round. Overall, 62.5%, 32.3%, and 5.2% of the criteria were attributed to an RR that was less than 2, between 2 and 3, and greater than 3, respectively. Mixing eggs from different supply flocks when placed into the same hatching unit, hatching multiple species, and importing eggs with unknown quality status were identified as having the highest contribution to a hatchery's inherent risk. Requiring information on the foodborne pathogen status of supplying flocks and the occurrence of regulatory enforcement actions were the most impactful risk mitigation and compliance factors, respectively. The median RR value assigned to each criterion and cluster will be used to build this new model.

Identification and selection of food safety-related risk factors to be included in the Canadian Food Inspection Agency's Establishment-based Risk Assessment model for Hatcheries.

Towards the continuous improvement of its inspection system, the Canadian Food Inspection Agency (CFIA) is developing an Establishment-based Risk Assessment model for Hatcheries to allocate inspection resources based on the food safety risk associated with the Canadian hatcheries falling under its jurisdiction. The objectives of the current study were to identify and select critical food safety-related risk factors that would be included in this model, with a main focus on Salmonella. A literature review was used to develop a comprehensive list of risk factors that could potentially contribute to the food safety risk attributed to Canadian hatcheries operating in all production streams (breeders, layers, broilers, turkeys, waterfowl and game birds). The development of this list used a selection process that was conducted according to the availability of data sources, the clarity of definition and the measurability of the selected risk factors. A panel of experts reviewed and adjusted the identified risk factors. A final list of 29 risk factors was generated; 20 originated from the scientific literature and nine from the expert panel. Risk factors were grouped in three clusters according to whether they pertained to the inherent risk (nine factors identified), risk mitigation (nine factors identified) or compliance of a hatchery with its preventive control plan and regulatory requirements (11 factors identified). Criteria for assessing each risk factor were defined based on common practices used in the Canadian hatchery industry. This comprehensive list of risk factors and criteria represents useful information to support the design and implementation of a Canadian risk assessment model for hatcheries, but could also be used by like-minded food safety authorities.

Enumerative Analysis of Salmonella in Outbreak-Associated Breaded and Frozen Comminuted Raw Chicken Products.

A significant data gap exists with respect to the levels of pathogens in foods implicated in foodborne outbreaks. These data are essential for the quantification of pathogen exposure via the ingestion of contaminated food. Here we report the levels of the foodborne pathogen Salmonella in comminuted raw chicken products that had been breaded and then frozen. The products investigated were collected during four food safety investigations of foodborne outbreaks that occurred in Canada from 2014 to 2016. Most-probable-number (MPN) distribution analysis of the food samples revealed Salmonella levels of 0.0018 to 3 MPN/g, which is equivalent to 1 MPN per 0.33 to 556 g of product. These data suggest low levels of Salmonella may be associated with foodborne outbreaks.

Meta-Analysis of the Reduction of Norovirus and Male-Specific Coliphage Concentrations in Wastewater Treatment Plants.

Human norovirus (NoV) is the leading cause of foodborne illness in the United States and Canada. Wastewater treatment plant (WWTP) effluents impacting bivalve mollusk-growing areas are potential sources of NoV contamination. We have developed a meta-analysis that evaluates WWTP influent concentrations and log10 reductions of NoV genotype I (NoV GI; in numbers of genome copies per liter [gc/liter]), NoV genotype II (NoV GII; in gc/liter), and male-specific coliphage (MSC; in number of PFU per liter), a proposed viral surrogate for NoV. The meta-analysis included relevant data (2,943 measurements) reported in the scientific literature through September 2013 and previously unpublished surveillance data from the United States and Canada. Model results indicated that the mean WWTP influent concentration of NoV GII (3.9 log10 gc/liter; 95% credible interval [CI], 3.5, 4.3 log10 gc/liter) is larger than the value for NoV GI (1.5 log10 gc/liter; 95% CI, 0.4, 2.4 log10 gc/liter), with large variations occurring from one WWTP to another. For WWTPs with mechanical systems and chlorine disinfection, mean log10 reductions were -2.4 log10 gc/liter (95% CI, -3.9, -1.1 log10 gc/liter) for NoV GI, -2.7 log10 gc/liter (95% CI, -3.6, -1.9 log10 gc/liter) for NoV GII, and -2.9 log10 PFU per liter (95% CI, -3.4, -2.4 log10 PFU per liter) for MSCs. Comparable values for WWTPs with lagoon systems and chlorine disinfection were -1.4 log10 gc/liter (95% CI, -3.3, 0.5 log10 gc/liter) for NoV GI, -1.7 log10 gc/liter (95% CI, -3.1, -0.3 log10 gc/liter) for NoV GII, and -3.6 log10 PFU per liter (95% CI, -4.8, -2.4 PFU per liter) for MSCs. Within WWTPs, correlations exist between mean NoV GI and NoV GII influent concentrations and between the mean log10 reduction in NoV GII and the mean log10 reduction in MSCs.

Escherichia coli O157:H7 Outbreak Associated with the Consumption of Beef and Veal Tartares in the Province of Quebec, Canada, in 2013.

OBJECTIVES: An Escherichia coli O157:H7 outbreak occurred in 2013 that was associated with the consumption of beef and veal tartares in the province of Quebec. This report describes the results of the ensuing investigation. MATERIALS AND METHODS: As the outbreak was identified, all individuals in the province of Quebec affected with the same strain of E. coli O157:H7 as defined by pulsed-field gel electrophoresis were interviewed using a standardized questionnaire. Cases reported from other provinces in Canada were interviewed by their public health authorities and the results were reported to the Quebec public health authorities. Microbiological and environmental investigations were conducted by the Sous-ministériat à la santé animale et à l'inspection des aliments du Ministère de l'Agriculture, des Pêcheries et de l'Alimentation du Québec, by the Ville de Montréal's Food Inspection Branch, and by the Canadian Food Inspection Agency at the restaurants, suppliers, and slaughterhouses identified. RESULTS: In total, seven individuals in three different Canadian provinces became ill following infection with the same outbreak strain of E. coli O157:H7. Two cases were hospitalized and one had severe hemolytic uremic syndrome. No deaths were reported. Two restaurant locations serving different tartare meals including, beef, veal, salmon, tuna, and duck were identified as potential sources of the outbreak. No deficiencies at the restaurant locations were observed during inspections by food inspectors. CONCLUSIONS: The risk of consuming tartare can be lowered when basic hygienic rules are followed, temperature is strictly controlled, and fresh meat is used. However, even if handling, chopping, and temperature control during storage of the meat are considered adequate, tartare is a raw product and the risk of contamination is present. Consumers should be advised that consuming this product can lead to serious illness.

Expert elicitation for the judgment of prion disease risk uncertainties.

There is a high level of uncertainty surrounding the potential for iatrogenic prion transmission through transplantation, medical instrument reuse, blood transfusion, and blood product use due to a lack of evidence-based research on this important risk issue. A group of specialists was enlisted to evaluate some of the knowledge gaps in this area using the "Classical Model," a structured elicitation procedure for weighting and pooling expert judgment. The elicitation exercise was undertaken in March 2009 with 11 transmissible spongiform encephalopathy (TSE) experts who were first calibrated using a series of seed questions for which the answers are known; they were then asked to answer a number of target questions that are important for risk assessment purposes, but for which there remains high uncertainty at this time. The target questions focused on variant Creutzfeldt-Jakob disease (vCJD) prevalence, incubation times for vCJD, genetic susceptibility to prion disease, blood infectivity, prion reduction of blood and blood products, surgical instrument risks, and interspecies transmission of TSEs. The experts were also asked to perform pairwise risk rankings for 12 different potential routes of infection. Dura mater transplantation was seen as having the highest risk, while dental tissue grafts were viewed as presenting the lowest risk of iatrogenic transmission. The structured elicitation procedure provides a rational, auditable, and repeatable basis for obtaining useful information on prion disease risk issues, for which data are sparse.