title: A Comparative Exposure Assessment of Campylobacter in Ontario, Canada.
abstract: To inform source attribution efforts, a comparative exposure assessment was developed to estimate the relative exposure to Campylobacter, the leading bacterial gastrointestinal disease in Canada, for 13 different transmission routes within Ontario, Canada, during the summer. Exposure was quantified with stochastic models at the population level, which incorporated measures of frequency, quantity ingested, prevalence, and concentration, using data from FoodNet Canada surveillance, the peer-reviewed and gray literature, other Ontario data, and data that were specifically collected for this study. Models were run with @Risk software using Monte Carlo simulations. The mean number of cells of Campylobacter ingested per Ontarian per day during the summer, ranked from highest to lowest is as follows: household pets, chicken, living on a farm, raw milk, visiting a farm, recreational water, beef, drinking water, pork, vegetables, seafood, petting zoos, and fruits. The study results identify knowledge gaps for some transmission routes, and indicate that some transmission routes for Campylobacter are underestimated in the current literature, such as household pets and raw milk. Many data gaps were identified for future data collection consideration, especially for the concentration of Campylobacter in all transmission routes.
authors.affiliation: Centre for Foodborne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada.
authors.forename: Katarina D M
authors.initials: KDM
authors.lastname: Pintar
authors.affiliation: Centre for Foodborne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada.
authors.forename: Kate M
authors.initials: KM
authors.lastname: Thomas
authors.affiliation: Centre for Foodborne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada.
authors.forename: Tanya
authors.initials: T
authors.lastname: Christidis
authors.affiliation: National Microbiology Laboratory, Public Health Agency of Canada.
authors.forename: Ainsley
authors.initials: A
authors.lastname: Otten
authors.affiliation: Centre for Foodborne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada.
authors.forename: Andrea
authors.initials: A
authors.lastname: Nesbitt
authors.affiliation: Centre for Foodborne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada.
authors.forename: Barbara
authors.initials: B
authors.lastname: Marshall
authors.affiliation: Centre for Foodborne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada.
authors.forename: Frank
authors.initials: F
authors.lastname: Pollari
authors.affiliation: Centre for Foodborne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada.
authors.forename: Matt
authors.initials: M
authors.lastname: Hurst
authors.affiliation: Université de Montréal, Montreal, Canada.
authors.forename: Andre
authors.initials: A
authors.lastname: Ravel
mesh_terms: D002167:Campylobacter; D002169:Campylobacter Infections / Q000453:epidemiology*; D003198:Computer Simulation; D005506:Food Contamination; D005516:Food Microbiology; D005638:Fruit; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D009010:Monte Carlo Method; D009864:Ontario / Q000453:epidemiology; D015995:Prevalence; D018570:Risk Assessment; D014675:Vegetables; D014871:Water Microbiology
keywords: Campylobacter; comparative risk assessment; enteric illness; source attribution; zoonoses