title: Estimating the Relative Role of Various Subcategories of Food, Water, and Animal Contact Transmission of 28 Enteric Diseases in Canada.
abstract: OBJECTIVE
  Enteric illness represents a significant burden of illness in Canada and internationally. Building on previous research, an expert elicitation was undertaken to explore the routes of transmission for 28 pathogens involved in enteric illness in Canada. This article considers the subcategories of foodborne, waterborne, and animal contact transmission.
  
  
  METHODS
  As part of an expert elicitation, 31 experts were asked to provide estimates of source attribution for subcategories of foodborne (n = 15), waterborne (n = 10), and animal contact (n = 3) transmission. The results from an online survey were combined using triangular probability distributions, and median and 90% credible intervals were produced. The total proportion and estimated number of cases of enteric illness attributable to each type of food commodity, water source, and animal exposure route were calculated using results from the larger elicitation survey and from a recent Canadian foodborne burden of illness study (Thomas et al., 2013).
  
  
  RESULTS
  Thirty experts provided foodborne subcategory estimates for 15/28 pathogens, waterborne subcategory estimates for 14/28 pathogens and animal contact subcategory estimates for 5/28. The elicitation identified raw produce, recreational water, and farm animal contact as important risk factors for enteric illness. These results also highlighted the complexity of transmission, with greater uncertainty for certain pathogens and routes of transmission.
  
  
  CONCLUSIONS
  This study is the first of its kind to explore subcategories of foodborne, waterborne, and animal contact transmission across such a range of enteric pathogens. Despite inherent uncertainty, these estimates present an important quantitative synthesis of the roles of foodborne commodities, water sources, and pathways of animal contact in the transmission of enteric illness in Canada.
authors: Centre for Foodborne, Environmental, and Zoonotic Infectious Diseases, Public Health Agency of Canada , Ottawa, Canada .
authors: Ainslie J
authors: AJ
authors: Butler
authors: Centre for Foodborne, Environmental, and Zoonotic Infectious Diseases, Public Health Agency of Canada , Ottawa, Canada .
authors: Katarina D M
authors: KD
authors: Pintar
authors: Centre for Foodborne, Environmental, and Zoonotic Infectious Diseases, Public Health Agency of Canada , Ottawa, Canada .
authors: M Kate
authors: MK
authors: Thomas
mesh_terms: D000818:Animals; D000829:Animals, Domestic / Q000382:microbiology / Q000469:parasitology; D002170:Canada / Q000453:epidemiology; D004199:Disease Vectors / Q000145:classification; D005502:Food / Q000009:adverse effects; D005516:Food Microbiology; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000382:microbiology / Q000469:parasitology; D006801:Humans; D066256:Raw Foods / Q000009:adverse effects / Q000382:microbiology / Q000469:parasitology; D014871:Water Microbiology; D000069578:Waterborne Diseases / Q000453:epidemiology* / Q000382:microbiology / Q000469:parasitology / Q000635:transmission