title: Effectiveness and efficiency of controlling Campylobacter on broiler chicken meat.
abstract: Campylobacter bacteria are an important cause of foodborne infections. We estimated the potential costs and benefits of a large number of possible interventions to decrease human exposure to Campylobacter by consumption of chicken meat, which accounts for 20-40% of all cases of human campylobacteriosis in the Netherlands. For this purpose, a farm-to-fork risk assessment model was combined with economic analysis and epidemiological data. Reduction of contamination at broiler farms could be efficient in theory. However, it is unclear which hygienic measures need to be taken and the costs can be very high. The experimental treatment of colonized broiler flocks with bacteriophages has proven to be effective and could also be cost efficient, if confirmed in practice. Since a major decrease of infections at the broiler farm is not expected in the short term, additional measures in the processing plant were also considered. At this moment, guaranteed Campylobacter-free chicken meat at the retail level is not realistic. The most promising interventions in the processing plant are limiting fecal leakage during processing and separation of contaminated and noncontaminated flocks (scheduling), followed by decontamination of the contaminated flock. New (faster and more sensitive) test methods to detect Campylobacter colonization in broilers flocks are a prerequisite for successful scheduling scenarios. Other methods to decrease the contamination of meat of colonized flocks such as freezing and heat treatment are more expensive and/or less effective than chemical decontamination.
authors.affiliation: National Institute for Public Health and the Environment, 3720 BA, Bilthoven, The Netherlands. arie.havelaar@rivm.nl
authors.forename: Arie H
authors.initials: AH
authors.lastname: Havelaar
authors.forename: Marie-Josee J
authors.initials: MJ
authors.lastname: Mangen
authors.forename: Aline A
authors.initials: AA
authors.lastname: de Koeijer
authors.forename: Marc-Jeroen
authors.initials: MJ
authors.lastname: Bogaardt
authors.forename: Eric G
authors.initials: EG
authors.lastname: Evers
authors.forename: Wilma F
authors.initials: WF
authors.lastname: Jacobs-Reitsma
authors.forename: Wilfrid
authors.initials: W
authors.lastname: van Pelt
authors.forename: Jaap A
authors.initials: JA
authors.lastname: Wagenaar
authors.forename: G Ardine
authors.initials: GA
authors.lastname: de Wit
authors.forename: Henk
authors.initials: H
authors.lastname: van der Zee
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Nauta
mesh_terms: D000818:Animals; D000829:Animals, Domestic; D002167:Campylobacter / Q000302:isolation & purification*; D002645:Chickens / Q000382:microbiology*; D005511:Food Handling / Q000191:economics; D005516:Food Microbiology; D006801:Humans; D008460:Meat / Q000191:economics* / Q000382:microbiology*; D008954:Models, Biological; D011336:Probability; D018570:Risk Assessment / Q000191:economics; D012680:Sensitivity and Specificity