IAFP 2009 Program Book and Abstract Book - AB19

S12 Attribution of Foodborne Illness/Disease Different approaches are used to prioritize efforts to control foodborne diseases. Generally, the efforts are aimed at the pathogens most commonly associated with human disease, those associated with the largest numbers of outbreaks, or those causing the greatest burden to public health. A more recent approach is directed toward the food sources/vehicles most commonly associated with human disease. Attribution analysis is the science that estimates the relative contribution of different commodities to the burden of foodborne disease. This symposium will begin with the newest estimates of the burden of foodborne illness in the United States and continue with an introduction to the concept of attribution analysis with examples United States and abroad. Burden of Foodborne Illness in the United States FREDERICK J. ANGULO, Enteric Diseases Epidemiology Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA The first comprehensive assessment of the burden of foodborne illness in the United States was published in 1999. Since then, the Centers for Disease Control and Prevention has been developing an approach that uses refined methods and recent data to estimate the human health burden of disease due to contaminated food consumed within the United States. Much of these data are provided from the Foodborne Diseases Active Surveillance Network (FoodNet). The new estimates will likely be published in 2009. The new estimates should facilitate future research to attribute the burden of foodborne illness to specific venues and food commodities, estimate the economic burden, and direct policy to reduce the substantial burden resulting from consuming contaminated food in the United States. Attributing Foodborne Illness to Specific Sources – The Danish Experience SARA M. PIRES, National Food Institute, Technical University of Denmark, Søborg, Denmark Many efforts have been made in the last decades to control foodborne diseases. However, information on the impact of these interventions is limited. To identify and prioritize successful food safety interventions, it is important to attribute the burden of human illness to the specific sources. A variety of general methods to attribute foodborne diseases to specific sources has been developed, including microbiological approaches, epidemiological approaches, intervention studies, and expert elicitation approaches. Each method presents advantages and limitations, and their usefulness depends on the public health questions being addressed. Additionally, attribution approaches attribute human illness at different points of the farm-to-fork continuum, depending on the type of data utilized. Because pathogens may enter the food distribution chain at different points, attribution to specific sources may vary, depending on the point along the food chain the approach focuses on. In recent years, different source attribution approaches have been applied in Denmark to attribute reported human salmonellosis to specific sources. The microbial subtyping approach (Salmonella Source Account) has been routinely applied and has proved to be a valuable tool for focusing food safety interventions to the appropriate animal reservoir. With the objectives of complementing these results and assessing the usefulness of other approaches for source attribution, human salmonellosis was attributed to the responsible sources using (1) a comparative exposure assessment approach, (2) a systematic review and meta-analysis of case-control studies of sporadic disease, and (3) an analysis of data from outbreak investigations. Results, strengths and limitations of each method are presented and discussed. Attribution of Foodborne Illnesses, Hospitalizations, and Deaths to Food Commodities in the United States Using Outbreak Data John A. Painter, Christopher R. Braden, TRACY AYERS, Robert M. Hoekstra, Frederick J. Angulo, Robert V. Tauxe and Patricia M. Griffin, Division of Foodborne, Bacterial and Mycotic Diseases, National Center for Zoonotic, Vectorborne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA An estimated 14 million cases of foodborne illness in the United States are attributed to known pathogens. Attributing the health burden of foodborne illnesses to specific food commodity groups can help guide prevention efforts to high risk commodities. However, a comprehensive attribution of these illnesses to specific foods is lacking. A standardized method for attributing illnesses to foods would be useful for the prioritization of food safety intervention strategies. We reviewed all reported foodborne outbreaks from 1998 through 2004 with an implicated food vehicle and a single etiologic agent. We assigned each implicated food to one or more of twelve mutually exclusive major categories of food commodities according to the ingredients. We calculated the crude percentage of outbreak illnesses attributed to each commodity for each pathogen. To estimate the attribution of foodborne illness, hospitalizations, and deaths, we weighted the crude percents by the estimated annual number of illnesses, hospitalizations, and deaths for each pathogen. Between 1998 and 2004, nearly 9,000 outbreaks were reported to CDC. Of those, about 35% had an identified etiology and vehicle reported. A model was developed to incorporate illnesses from complex food items to present an overall attribution of illnesses to food commodities. The model estimated the contribution of specific foods to foodborne illness. This model may be modified in the future to incorporate revised burden of illness estimates and additional outbreak data. Attribution data can be used by public health officials and regulatory agencies to prioritize and monitor food safety interventions. Abstract Book — 19 ILSI Symposia

IAFP 2009 Program Book and Abstract Book

Table of Contents for the Digital Edition of IAFP 2009 Program Book and Abstract Book