Modeling number of bacteria per food unit in comparison to bacterial concentration in quantitative risk assessment: Impact on risk estimates

The efficacy of nisin against Listeria monocytogenes on cold-smoked salmon at natural contamination levels is concentration-dependent and varies by serotype

Cold-smoked salmon is a ready-to-eat food product capable of supporting Listeria monocytogenes growth at refrigeration temperatures. While the FDA-approved antimicrobial nisin can be used to mitigate L. monocytogenes contamination, stresses associated with cold-smoked salmon and the associated processing environments may reduce nisin efficacy. A previous study in our laboratory showed that, at high inoculation levels, pre-exposure of L. monocytogenes to sublethal concentrations of quaternary ammonium compounds had an overall detrimental effect on nisin efficacy. The objective of this study was to investigate the impact of nisin concentration and storage temperature on nisin efficacy against L. monocytogenes inoculated on salmon at natural contamination levels. Three L. monocytogenes strains were pre-grown in the presence of sublethal levels of benzalkonium chloride prior to inoculation at ~10² CFU/g on salmon slices that were pre-treated with either 0, 25, or 250 ppm nisin, followed by vacuum-packing and incubation at 4 or 7°C for up to 30 days. L. monocytogenes was enumerated on days 1, 15, and 30 using direct plating and/or most probable number methods. A hurdle model was constructed to describe the odds of complete elimination of L. monocytogenes on salmon and the level of L. monocytogenes when complete elimination was not achieved. Our data showed that (i) nisin efficacy (defined as L. monocytogenes reduction relative to the untreated control) was concentration-dependent with increased efficacy at 250 ppm nisin, and that (ii) 250 ppm nisin treatments led to a reduction in L. monocytogenes prevalence, independent of storage temperature and serotype; this effect of nisin could only be identified since low inoculation levels were used. While lower storage temperatures (i.e., 4°C) yielded lowered absolute L. monocytogenes counts on days 15 and 30 (as compared to 7°C), nisin efficacy did not differ between these two temperatures. Finally, the serotype 1/2b strain was found to be more susceptible to nisin compared with serotype 1/2a and 4b strains on samples incubated at 7°C or treated with 25 ppm nisin. This variation of nisin susceptibility across serotypes, which is affected by both the storage temperature and nisin concentration, needs to be considered while evaluating the efficacy of nisin.

A Quantitative Risk Assessment of Human Salmonellosis from Consumption of Walnuts in the United States

We assessed the risk of human salmonellosis from consumption of shelled walnuts in the United States and the impact of 0- to 5-log reduction treatments for Salmonella during processing. We established a baseline model with Salmonella contamination data from 2010 to 2013 surveys of walnuts from California operations to estimate baseline prevalence and levels of Salmonella during preshelling storage and typical walnut processing stages, considered U.S. consumption data, and applied an adapted dose-response model from the Food and Agriculture Organization and the World Health Organization to evaluate risk of illness per serving and per year. Our baseline model predicted 1 case of salmonellosis per 100 million servings (95% confidence interval [CI], 1 case per 3 million to 1 case per 2 billion servings) of walnuts untreated during processing and uncooked by consumers, resulting in an estimated 6 cases of salmonellosis per year (95% CI, <1 to 278 cases) in the United States. A minimum 3-log reduction treatment for Salmonella during processing of walnuts eaten alone or as an uncooked ingredient resulted in a mean risk of <1 case per year. We modeled the impact on risk per serving of three atypical situations in which the Salmonella levels were increased by 0.5 to 1.5 log CFU per unit pretreatment during processing at the float tank or during preshelling storage or posttreatment during partitioning into consumer packages. No change in risk was associated with the small increase in levels of Salmonella at the float tank, whereas an increase in risk was estimated for each of the other two atypical events. In a fourth scenario, we estimated the risk per serving associated with consumption of walnuts with Salmonella prevalence and levels from a 2014 to 2015 U.S. retail survey. Risk per serving estimates were two orders of magnitude larger than those of the baseline model without treatment. Further research is needed to determine whether this finding reflects variability in Salmonella contamination across the supply or a rare event affecting a portion of the supply.

Risk Assessment of Salmonellosis from Consumption of Alfalfa Sprouts and Evaluation of the Public Health Impact of Sprout Seed Treatment and Spent Irrigation Water Testing

We developed a risk assessment of human salmonellosis associated with consumption of alfalfa sprouts in the United States to evaluate the public health impact of applying treatments to seeds (0-5-log₁₀ reduction in Salmonella) and testing spent irrigation water (SIW) during production. The risk model considered variability and uncertainty in Salmonella contamination in seeds, Salmonella growth and spread during sprout production, sprout consumption, and Salmonella dose response. Based on an estimated prevalence of 2.35% for 6.8 kg seed batches and without interventions, the model predicted 76,600 (95% confidence interval (CI) 15,400-248,000) cases/year. Risk reduction (by 5- to 7-fold) predicted from a 1-log₁₀ seed treatment alone was comparable to SIW testing alone, and each additional 1-log₁₀ seed treatment was predicted to provide a greater risk reduction than SIW testing. A 3-log₁₀ or a 5-log₁₀ seed treatment reduced the predicted cases/year to 139 (95% CI 33-448) or 1.4 (95% CI <1-4.5), respectively. Combined with SIW testing, a 3-log₁₀ or 5-log₁₀ seed treatment reduced the cases/year to 45 (95% CI 10-146) or <1 (95% CI <1-1.5), respectively. If the SIW coverage was less complete (i.e., less representative), a smaller risk reduction was predicted, e.g., a combined 3-log₁₀ seed treatment and SIW testing with 20% coverage resulted in an estimated 92 (95% CI 22-298) cases/year. Analysis of alternative scenarios using different assumptions for key model inputs showed that the predicted relative risk reductions are robust. This risk assessment provides a comprehensive approach for evaluating the public health impact of various interventions in a sprout production system.

A Quantitative Risk Assessment of Human Salmonellosis from Consumption of Pistachios in the United States

We developed a quantitative risk assessment model to assess the risk of human nontyphoidal salmonellosis from consumption of pistachios in the United States and to evaluate the impact of Salmonella treatments (1- to 5-log reductions). The exposure model estimating prevalence and contamination levels of Salmonella at consumption included steps in pistachio processing such as transport from grower to huller, removal of the hull through wet abrasion, separation of pistachio floaters (immature, smaller nuts) and sinkers (mature, larger nuts) in a flotation tank, drying, storage, and partitioning. The risks of illness per serving and per year were evaluated by including a Salmonella dose-response model and U.S. consumption data. The spread of Salmonella through float tank water, delay in drying resulting in growth, increased Salmonella levels through pest infestation during storage (pre- and posttreatment), and a simulation of the 2016 U.S. salmonellosis outbreak linked to consumption of pistachios were the modeled atypical situations. The baseline model predicted one case of salmonellosis per 2 million servings (95% CI: one case per 5 million to 800,000 servings) for sinker pistachios and one case per 200,000 servings (95% CI: one case per 400,000 to 40,000 servings) for floater pistachios when no Salmonella treatment was applied and pistachios were consumed as a core product (>80% pistachio) uncooked at home. Assuming 90% of the pistachio supply is sinkers and 10% is floaters, the model estimated 419 salmonellosis cases per year (95% CI: 200 to 1,083 cases) when no Salmonella treatment was applied. A mean risk of illness of less than one case per year was estimated when a minimum 4-log reduction treatment was applied to the U.S. pistachio supply, similar to the results of the Salmonella risk assessment for almonds. This analysis revealed that the predicted risk of illness per serving is higher for all atypical situations modeled compared with the baseline, and delay in drying had the greatest impact on consumer risk.

Transfer and Redistribution of Salmonella Typhimurium LT2 and Escherichia coli O157:H7 during Pilot-Scale Processing of Baby Spinach, Cilantro, and Romaine Lettuce

Several outbreaks of foodborne illness traced to leafy greens and culinary herbs have been hypothesized to involve cross-contamination during washing and processing. This study aimed to assess the redistribution of Salmonella Typhimurium LT2 during pilot-scale production of baby spinach and cilantro and redistribution of Escherichia coli O157:H7 during pilot-scale production of romaine lettuce. Four inoculated surrogate:uninoculated product weight ratios (10:100, 5:100, 1:100, and 0.5:100) and three inoculation levels (103, 101, and 10-1 CFU/g) were used for the three commodities. For each of three trials per condition, 5-kg batches containing uninoculated product and spot-inoculated surrogate products at each ratio and inoculation level were washed for 90 s in a 3.6-m-long flume tank through which 890 L of sanitizer-free, filtered tap water was circulated. After washing and removing the inoculated surrogate products, washed product (∼23, 225-g samples per trial) was analyzed for presence or absence of Salmonella Typhimurium or E. coli O157:H7 by using the GeneQuence Assay. For baby spinach, cilantro, and romaine lettuce, no significant differences ( P > 0.05) in the percentage of positive samples were observed at the same inoculation level and inoculated:uninoculated weight ratio. For each pathogen product evaluated (triplicate trials), inoculation level had a significant impact on the percentage of positive samples after processing, with the percentage of positive samples decreasing, as the initial surrogate inoculation level decreased. The weight ratio of contaminated:noncontaminated product plays an important role: positive samples ranged from 0% to 11.6% ± 2.05% and from 68.1% ± 33.6% to 100% among the four ratios at inoculation of 10-1 and 101 CFU/g, respectively. To our knowledge, this study is the first to assess the redistribution of low levels of pathogens from incoming product to leafy greens during processing and should provide important data for microbial risk assessments and other types of food safety analyses related to fresh-cut leafy greens.

Bayesian model for tracing Salmonella contamination in the pig feed chain

Salmonella infections in pigs are in most cases asymptomatic, posing a risk of salmonellosis for pork consumers. Salmonella can transmit to pigs from various sources, including contaminated feed. We present an approach for quantifying the risk to pigs from contaminations in the feed chain, based on a Bayesian model. The model relies on Salmonella surveillance data and other information from surveys, reports, registries, statistics, legislation and literature regarding feed production and pig farming. Uncertainties were probabilistically quantified by synthesizing evidence from the available information over a categorically structured flow chain of ingredients mixed for feeds served to pigs. Model based probability for infection from feeds together with Salmonella subtyping data, were used to estimate the proportion of Salmonella infections in pigs attributable to feed. The results can be further used in assessments considering the human health risk linked to animal feed via livestock. The presented methods can be used to predict the effect of changes in the feed chain, and they are generally applicable to other animals and pathogens.

A Quantitative Assessment of the Risk of Human Salmonellosis Arising from the Consumption of Pecans in the United States

A quantitative risk assessment was conducted to assess the risk of human salmonellosis acquired from consumption of pecans in the United States. The model considered the potential for Salmonella survival, growth, and recontamination of pecans from the sheller to the consumer, including steps such as immersion in water, drying, conditioning, cracking, partitioning, and storage. Five theoretical microbial reduction treatment levels (1 to 5 log CFU) were modeled. Data from the 2010 to 2013 surveys by the National Pecan Shellers Association were used for initial prevalence and contamination levels. The impacts of atypical situations in the pecan production system were also evaluated. Higher initial contamination levels, recontamination during processing, and a delay in drying postconditioning were the modeled atypical situations. The baseline model predicted a mean risk of salmonellosis in the United States from consumption of in-shell and shelled pecans processed by cold conditioning with no microbial reduction treatment and no further home cooking as 1 case per 775,193 servings (95% confidence interval [CI]: 1 case per 1,915,709 to 178,253 servings). This predicted risk per serving was estimated as a mean of 529 cases of salmonellosis per year (95% CI: 213 to 2,295 cases). Hot conditioning for shelled pecans and microbial reduction treatment of both shelled and in-shell pecans had a significant impact on the predicted mean risk of illness. Assuming 77% of the shelled pecans sold at retail (i.e., 80% of the retail supply) received hot conditioning, the mean estimated salmonellosis cases per year from consumption of in-shell and shelled pecans uncooked at home was 203 (95% CI: 81 to 882 cases) if no additional microbial reduction treatment were applied. The predicted risk of illness per serving was higher for all atypical situations modeled compared with the baseline model, and delay in drying had the greatest impact on risk.

A Quantitative Assessment of the Risk of Human Salmonellosis Arising from the Consumption of Almonds in the United States: The Impact of Preventive Treatment Levels

The presence of Salmonella on almonds continues to result in product-related outbreaks and recalls in the United States. In this study, the impact of microbial reduction treatment levels (1 to 5 log CFU) on the risk of human salmonellosis from the consumption of almond kernels in the United States was evaluated. An exposure model, including major steps in almond processing, was used to estimate prevalence and levels of contamination of Salmonella on almonds at the point of consumption. A Salmonella dose-response model and consumption data for almonds in the United States were used to assess risk of illness per serving and per year, quantifying variability and uncertainty separately. A 3-log reduction treatment resulted in a predicted mean risk of illness of two cases per year for almonds consumed as a core product not cooked at home (95% confidence interval [CI], one to four cases), one case per year for almonds consumed as an ingredient not cooked at home (95% CI, one to two cases), and less than one case per year for almonds consumed as an ingredient cooked at home (95% CI, 7 × 10-7 to 3 × 10-6 cases). A minimum 4-log reduction treatment resulted in an estimated mean risk of illness below one case per year in the United States. This study also includes an assessment of the risk of human salmonellosis as a result of an exceptional situation, which results in higher risk estimates compared with the baseline model. The exceptional situations modeled posttreatment resulted in estimates of mean risk that were not significantly affected by treatment level. Sensitivity analysis results showed initial Salmonella contamination level to be the factor with the most impact on risk per serving estimates, given a certain treatment level. The risk assessment also includes a simulation of the events that occurred in 2001. Treatment levels with a minimum 4-log microbial reduction would have been sufficient to prevent the outbreak cases. The uncertainty range in the estimates indicates that additional information is needed to make more precise predictions of this specific outbreak event.