title: Quantitative farm-to-fork risk assessment model for norovirus and hepatitis A virus in European leafy green vegetable and berry fruit supply chains.
abstract: Fresh produce that is contaminated with viruses may lead to infection and viral gastroenteritis or hepatitis when consumed raw. It is thus important to reduce virus numbers on these foods. Prevention of virus contamination in fresh produce production and processing may be more effective than treatment, as sufficient virus removal or inactivation by post-harvest treatment requires high doses that may adversely affect food quality. To date knowledge of the contribution of various potential contamination routes is lacking. A risk assessment model was developed for human norovirus, hepatitis A virus and human adenovirus in raspberry and salad vegetable supply chains to quantify contributions of potential contamination sources to the contamination of produce at retail. These models were used to estimate public health risks. Model parameterization was based on monitoring data from European supply chains and literature data. No human pathogenic viruses were found in the soft fruit supply chains; human adenovirus (hAdV) was detected, which was additionally monitored as an indicator of fecal pollution to assess the contribution of potential contamination points. Estimated risks per serving of lettuce based on the models were 3×10(-4) (6×10(-6)-5×10(-3)) for NoV infection and 3×10(-8) (7×10(-10)-3×10(-6)) for hepatitis A jaundice. The contribution to virus contamination of hand-contact was larger as compared with the contribution of irrigation, the conveyor belt or the water used for produce rinsing. In conclusion, viral contamination in the lettuce and soft fruit supply chains occurred and estimated health risks were generally low. Nevertheless, the 97.5% upper limit for the estimated NoV contamination of lettuce suggested that infection risks up to 50% per serving might occur. Our study suggests that attention to full compliance for hand hygiene will improve fresh produce safety related to virus risks most as compared to the other examined sources, given the monitoring results. This effect will be further aided by compliance with other hygiene and water quality regulations in production and processing facilities.
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands. Electronic address: martijn.bouwknegt@rivm.nl.
authors.forename: Martijn
authors.initials: M
authors.lastname: Bouwknegt
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands; Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
authors.forename: Katharina
authors.initials: K
authors.lastname: Verhaelen
authors.affiliation: Department of Food and Environmental Virology, National Veterinary Research Institute, Puławy, Poland.
authors.forename: Artur
authors.initials: A
authors.lastname: Rzeżutka
authors.affiliation: Department of Food and Environmental Virology, National Veterinary Research Institute, Puławy, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Kozyra
authors.affiliation: Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
authors.forename: Leena
authors.initials: L
authors.lastname: Maunula
authors.affiliation: Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
authors.forename: Carl-Henrik
authors.initials: CH
authors.lastname: von Bonsdorff
authors.affiliation: Department of Public Health, Medical School, University of Patras, Patras, Greece.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Vantarakis
authors.affiliation: Department of Public Health, Medical School, University of Patras, Patras, Greece.
authors.forename: Petros
authors.initials: P
authors.lastname: Kokkinos
authors.affiliation: Virology Department, Scientific Veterinary Institute "Novi Sad", Novi Sad, Serbia.
authors.forename: Tamas
authors.initials: T
authors.lastname: Petrovic
authors.affiliation: Virology Department, Scientific Veterinary Institute "Novi Sad", Novi Sad, Serbia.
authors.forename: Sava
authors.initials: S
authors.lastname: Lazic
authors.affiliation: Veterinary Research Institute, Brno, Czech Republic.
authors.forename: Ivo
authors.initials: I
authors.lastname: Pavlik
authors.affiliation: Veterinary Research Institute, Brno, Czech Republic.
authors.forename: Petra
authors.initials: P
authors.lastname: Vasickova
authors.affiliation: Department of Microbial and Molecular Systems, KU Leuven University, Leuven, Belgium.
authors.forename: Kris A
authors.initials: KA
authors.lastname: Willems
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands; Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
authors.forename: Arie H
authors.initials: AH
authors.lastname: Havelaar
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: Saskia A
authors.initials: SA
authors.lastname: Rutjes
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands; Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: de Roda Husman
mesh_terms: D000260:Adenoviruses, Human / Q000302:isolation & purification / Q000502:physiology; D017250:Caliciviridae Infections / Q000517:prevention & control; D005638:Fruit / Q000821:virology*; D063373:Hand Hygiene; D006506:Hepatitis A / Q000517:prevention & control; D030041:Hepatitis A virus / Q000302:isolation & purification / Q000502:physiology*; D006801:Humans; D018545:Lactuca / Q000821:virology*; D008962:Models, Theoretical; D029322:Norovirus / Q000302:isolation & purification / Q000502:physiology*; D018570:Risk Assessment; D060753:Water Quality
keywords: Intervention; Lettuce; QMRA; Raspberries; Strawberries; Viruses