title: Risk ranking of pathogens in ready-to-eat unprocessed foods of non-animal origin (FoNAO) in the EU: initial evaluation using outbreak data (2007-2011).
abstract: Foods of non-animal origin (FoNAO) are consumed in a variety of forms, being a major component of almost all meals. These food types have the potential to be associated with large outbreaks as seen in 2011 associated with VTEC O104. In order to identify and rank specific food/pathogen combinations most often linked to human cases originating from FoNAO in the EU, a semi-quantitative model was developed using seven criteria: strength of associations between food and pathogen based on the foodborne outbreak data from EU Zoonoses Monitoring (2007-2011), incidence of illness, burden of disease, dose-response relationship, consumption, prevalence of contamination and pathogen growth potential during shelf life. The top ranking food/pathogen combination was Salmonella spp. and leafy greens eaten raw followed by (in equal rank) Salmonella spp. and bulb and stem vegetables, Salmonella spp. and tomatoes, Salmonella spp. and melons, and pathogenic Escherichia coli and fresh pods, legumes or grains. Despite the inherent assumptions and limitations, this risk model is considered a tool for risk managers, as it allows ranking of food/pathogen combinations most often linked to foodborne human cases originating from FoNAO in the EU. Efforts to collect additional data even in the absence of reported outbreaks as well as to enhance the quality of the EU-specific data, which was used as input for all the model criteria, will allow the improvement of the model outputs. Furthermore, it is recommended that harmonised terminology be applied to the categorisation of foods collected for different reasons, e.g. monitoring, surveillance, outbreak investigation and consumption. In addition, to assist future microbiological risk assessments, consideration should be given to the collection of additional information on how food has been processed, stored and prepared as part of the above data collection exercises.
authors.affiliation: European Food Safety Authority, Via Carlo Magno 1A, 43126 Parma, Italy. Electronic address: mariateresa.dasilvafelicio@efsa.europa.eu.
authors.forename: M T
authors.initials: MT
authors.lastname: Da Silva Felício
authors.affiliation: Technical University of Denmark, National Food Institute, Mørkhøj Bygade 19, Building C, 2860 Søborg, Denmark.
authors.forename: T
authors.initials: T
authors.lastname: Hald
authors.affiliation: European Food Safety Authority, Via Carlo Magno 1A, 43126 Parma, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Liebana
authors.affiliation: Department of Food Science and Technology, CEBAS-CSIC, P.O. Box 164, Espinardo, Murcia E-30100, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Allende
authors.affiliation: European Food Safety Authority, Via Carlo Magno 1A, 43126 Parma, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Hugas
authors.affiliation: INRA, UMR408, F-84914 Avignon, France; Univ-Avignon, UMR408, F-84000 Avignon, France.
authors.forename: C
authors.initials: C
authors.lastname: Nguyen-The
authors.affiliation: Norwegian Veterinary Institute, Section for Bacteriology - Food and GMO, Pb 750 Sentrum, N-0106 Oslo, Norway.
authors.forename: G Skoien
authors.initials: GS
authors.lastname: Johannessen
authors.affiliation: European Centre for Disease Prevention and Control, Unit of Surveillance and Response Support, Food- and Waterborne Diseases and Zoonoses Programme, Tomtebodavägen 11a, 171 83 Stockholm, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Niskanen
authors.affiliation: Laboratory of Food Microbiology and Food Preservation, Department of Food Safety and Food Quality, Faculty of Bioscience Engineering, Ghent University, Block B, 4th Floor, Room B4.022, Coupure Links 653, B-9000 Ghent, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Uyttendaele
authors.affiliation: Public Health England, 61 Colindale Avenue, London NW9 5EQ, United Kingdom; University of Liverpool, Institute of Infection and Global Health, L69 3GL, United Kingdom.
authors.forename: J
authors.initials: J
authors.lastname: McLauchlin
mesh_terms: D018407:Bacterial Physiological Phenomena; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D005516:Food Microbiology; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D006801:Humans; D008962:Models, Theoretical; D018570:Risk Assessment; D018406:Virus Physiological Phenomena
keywords: Food/pathogen combination; Foodborne pathogens; Outbreaks; Semi-quantitative model