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Gume B, Berhanu L, Kassa T, Bediru H, Fikre AG, Dadi LS, Mereta ST. Bacterial hazard identification and exposure assessment of raw milk consumption in Jimma zone, South West Ethiopia. BMC Microbiol 2023; 23:166. [PMID: 37312070 DOI: 10.1186/s12866-023-02910-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/25/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Raw milk may contain pathogenic microorganism that can sometimes fatally affect the health of consumers. However, risks related to raw milk consumption in Southwest Ethiopia are not well studied. The aim of this study was to evaluate the presence of five target pathogenic bacteria including Escherichia coli O157:H7, Salmonella enterica Typhimurium, Staphylococcus aureus, Listeria monocytogenes, and Campylobacter jejuni in raw milk and to assess exposure associated with the consumption of raw milk. METHOD A cross-sectional study was carried out between November 2019 and June 2020 to in Jimma zone, Southwest Ethiopia. Laboratory analysis was conducted on milk samples collected from Seven Woreda towns, including, Agaro, Yebu, Sekoru, Serbo, Shebe, Seka, Sheki and Jimma town administration. Semi-structured interview questions were administered to collect data on the amount and frequency of consumption. Descriptive statistics were used to summarize laboratory results and questionnaire survey data. RESULT Among 150 total raw milk samples, about 61.3% were found contaminated by one or more types of pathogens along the dairy value chain. The highest and the least bacterial counts recorded were 4.88 log10cfu/ml and 3.45 log10cfu/ml from E. coli and L. monocytogenes respectively. The mean concentrations of pathogens demonstrated significant statistical difference (p < 0.05) using 95% confidence interval where the prevalence percentage of isolates increased as the milk was transported from farms to the retail outlets. Except for C. jejuni; all other pathogens were detected in the range of unsatisfactory level of milk microbiological quality along the chain. The estimated mean annual risk of acquiring intoxication of E. coli across retailer outlets is 100% whereas salmonellosis, S. aureus intoxication, and listeriosis are 84%, 65% and 63% respectively. CONCLUSION The study highlights the significant health risks associated with the consumption of raw milk due to its unacceptable microbiological quality. The traditional production and consumption patterns of raw milk are the primary reasons for the high annual probability of infection. Therefore, regular monitoring and implementation of hazard identification and critical control point principles are necessary from raw milk production to retail points to ensure the safety of consumers.
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Affiliation(s)
- Beje Gume
- Department of Environmental Health Science and Technology, Jimma University, P.O. Box 378, Jimma, Ethiopia.
| | - Leykun Berhanu
- Department of Environmental Health Science, Wollo University, P.O. Box 1145, Dessie, Ethiopia
| | - Tesfaye Kassa
- School of Medical Laboratory Science, Jimma University, P.O. Box 788, Jimma, Ethiopia
| | - Habib Bediru
- Jimma Town Livestock and Fishery Development Office, P.O. Box 378, Jimma, Ethiopia
| | | | - Lelisa Sena Dadi
- Department of Epidemiology, Jimma University, P.O. Box 378, Jimma, Ethiopia
| | - Seid Tiku Mereta
- Department of Environmental Health Science and Technology, Jimma University, P.O. Box 378, Jimma, Ethiopia
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Knipper AD, Göhlich S, Stingl K, Ghoreishi N, Fischer-Tenhagen C, Bandick N, Tenhagen BA, Crease T. Longitudinal Study for the Detection and Quantification of Campylobacter spp. in Dairy Cows during Milking and in the Dairy Farm Environment. Foods 2023; 12:foods12081639. [PMID: 37107434 PMCID: PMC10137412 DOI: 10.3390/foods12081639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
Campylobacteriosis outbreaks have repeatedly been associated with the consumption of raw milk. This study aimed to explore the variation in the prevalence and concentration of Campylobacter spp. in cows' milk and feces, the farm environment and on the teat skin over an entire year at a small German dairy farm. Bi-weekly samples were collected from the environment (boot socks), teats, raw milk, milk filters, milking clusters and feces collected from the recta of dairy cows. Samples were analyzed for Campylobacter spp., E. coli, the total aerobic plate count and for Pseudomonas spp. The prevalence of Campylobacter spp. was found to be the highest in feces (77.1%), completely absent in milking equipment and low in raw milk (0.4%). The mean concentration of Campylobacter spp. was 2.43 log10 colony-forming units (CFU)/g in feces and 1.26 log10 CFU/teat swab. Only a single milk filter at the end of the milk pipeline and one individual cow's raw milk sample were positive on the same day, with a concentration of 2.74 log10 CFU/filter and 2.37 log10 CFU/mL for the raw milk. On the same day, nine teat swab samples tested positive for Campylobacter spp. This study highlights the persistence of Campylobacter spp. for at least one year in the intestine of individual cows and within the general farm environment and demonstrates that fecal cross-contamination of the teats can occur even when the contamination of raw milk is a rare event.
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Affiliation(s)
- Anna-Delia Knipper
- Department of Biological Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
| | - Steven Göhlich
- Department of Biological Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
| | - Kerstin Stingl
- Department of Biological Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
| | - Narges Ghoreishi
- Department Exposure, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
| | - Carola Fischer-Tenhagen
- Center for Protection of Experimental Animals, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
| | - Niels Bandick
- Department of Biological Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
| | - Bernd-Alois Tenhagen
- Department of Biological Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
| | - Tasja Crease
- Department of Biological Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
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Knipper AD, Ghoreishi N, Crease T. Prevalence and concentration of Campylobacter in faeces of dairy cows: A systematic review and meta-analysis. PLoS One 2022; 17:e0276018. [PMID: 36240215 PMCID: PMC9565387 DOI: 10.1371/journal.pone.0276018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/28/2022] [Indexed: 11/26/2022] Open
Abstract
The consumption of raw milk from dairy cows has caused multiple food-borne outbreaks of campylobacteriosis in the European Union (EU) since 2011. Cross-contamination of raw milk through faeces is an important vehicle for transmission of Campylobacter to consumers. This systematic review and meta-analysis, aimed to summarize data on the prevalence and concentration of Campylobacter in faeces of dairy cows. Suitable scientific articles published up to July 2021 were identified through a systematic literature search and subjected to screening and quality assessment. Fifty-three out of 1338 identified studies were eligible for data extraction and 44 were further eligible for meta-analysis. The pooled prevalence was calculated in two different meta-analytic models: a simple model based on one average prevalence estimate per study and a multilevel meta-analytic model that included all prevalence outcomes reported in each study (including different subgroups of e.g. health status and age of dairy cows). The results of the two models were significantly different with a pooled prevalence estimate of 29%, 95% CI [23-36%] and 51%, 95% CI [44-57%], respectively. The effect of sub-groups on prevalence were analyzed with a multilevel mixed-effect model which showed a significant effect of the faecal collection methods and Campylobacter species on the prevalence. A meta-analysis on concentration data could not be performed due to the limited availability of data. This systematic review highlights important data gaps and limitations in current studies and variation of prevalence outcomes between available studies. The included studies used a variety of methods for sampling, data collection and analysis of Campylobacter that added uncertainty to the pooled prevalence estimates. Nevertheless, the performed meta-analysis improved our understanding of Campylobacter prevalence in faeces of dairy cows and is considered a valuable basis for the further development of quantitative microbiological risk assessment models for Campylobacter in (raw) milk and food products thereof.
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Affiliation(s)
- Anna-Delia Knipper
- German Federal Institute for Risk Assessment (BfR), Department Biological Safety, Junior Research Group Supply Chain Models, Berlin, Germany
| | - Narges Ghoreishi
- German Federal Institute for Risk Assessment (BfR), Department Exposure, Unit of Epidemiology, Statistics and Exposure Modelling, Berlin, Germany
| | - Tasja Crease
- German Federal Institute for Risk Assessment (BfR), Department Biological Safety, Junior Research Group Supply Chain Models, Berlin, Germany
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4
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Microbial risk assessment of Escherichia coli shiga-toxin producers (STEC) in raw sheep's milk cheeses in Italy. Food Control 2022. [DOI: 10.1016/j.foodcont.2022.108951] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Feliciano R, Boué G, Mohssin F, Hussaini MM, Membré JM. Probabilistic modelling of Escherichia coli concentration in raw milk under hot weather conditions. Food Res Int 2021; 149:110679. [PMID: 34600681 DOI: 10.1016/j.foodres.2021.110679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 11/19/2022]
Abstract
Climate change is one of the threats to the dairy supply chain as it may affect the microbiological quality of raw milk. In this context, a probabilistic model was developed to quantify the concentration of Escherichia coli in raw milk and explore what may happen to France under climate change conditions. It included four modules: initial contamination, packaging, retailing, and consumer refrigeration. The model was built in R using the 2nd order Monte Carlo mc2d package to propagate the uncertainty and analysed its impact independently of the variability. The initial microbial counts were obtained from a dairy farm located in Saudi Arabia to reflect the impact of hot weather conditions. This country was taken as representative of what might happen in Europe and therefore in France in the future due to climate change. A large dataset containing 622 data points was analysed. They were fitted by a Normal probability distribution using the fitdistrplus package. The microbial growth was determined across various scenarios of time and temperature storage reflecting the raw milk supply-chain in France. Existing growth rate data from literature and ComBase were analysed by the Ratkowsky secondary model. Results were interpreted using the nlstools package. The mean E. coli initial concentration in raw milk was estimated to be 1.31 [1.27; 1.35] log CFU/ mL and was found to increase at the end of the supply chain as a function of various time and temperature conditions. The estimations varied from 1.73 [1.42; 2.28] log CFU/mL after 12 h, 2.11 [1.46; 3.22] log CFU/mL after 36 h, and 2.41 [1.69;3.86] log CFU/mL after 60 h of consumer storage. The number of milk packages exceeding the 2-log French hygiene criterion for E. coli increased from 10% [8;12%] to 53% [27;77%] during consumer storage. In addition, the most significant factors contributing to the uncertainty of the model outputs were identified by running a sensitivity analysis. The results showed that the uncertainty around the Ratkowsky model parameters contributed the most to the uncertainty of E. coli concentration estimates. Overall, the model and its outputs provide an insight on the possible microbial raw milk quality in the future in France due to higher temperatures conditions driven by climate change.
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Fusco V, Chieffi D, Fanelli F, Logrieco AF, Cho G, Kabisch J, Böhnlein C, Franz CMAP. Microbial quality and safety of milk and milk products in the 21st century. Compr Rev Food Sci Food Saf 2020; 19:2013-2049. [DOI: 10.1111/1541-4337.12568] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 04/03/2020] [Accepted: 04/03/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Vincenzina Fusco
- Institute of Sciences of Food Production National Research Council of Italy (CNR‐ISPA) Bari Italy
| | - Daniele Chieffi
- Institute of Sciences of Food Production National Research Council of Italy (CNR‐ISPA) Bari Italy
| | - Francesca Fanelli
- Institute of Sciences of Food Production National Research Council of Italy (CNR‐ISPA) Bari Italy
| | - Antonio F. Logrieco
- Institute of Sciences of Food Production National Research Council of Italy (CNR‐ISPA) Bari Italy
| | - Gyu‐Sung Cho
- Department of Microbiology and BiotechnologyMax‐Rubner Institut Kiel Germany
| | - Jan Kabisch
- Department of Microbiology and BiotechnologyMax‐Rubner Institut Kiel Germany
| | - Christina Böhnlein
- Department of Microbiology and BiotechnologyMax‐Rubner Institut Kiel Germany
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Serraino A, Bonilauri P, Kerekes K, Farkas Z, Giacometti F, Canever A, Zambrini AV, Ambrus Á. Occurrence of Aflatoxin M1 in Raw Milk Marketed in Italy: Exposure Assessment and Risk Characterization. Front Microbiol 2019; 10:2516. [PMID: 31787941 PMCID: PMC6856139 DOI: 10.3389/fmicb.2019.02516] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 10/18/2019] [Indexed: 11/13/2022] Open
Abstract
The current study is based on the AFM1 contamination of milk determined from April 2013 to December 2018 in the framework of a self-control plan of six milk processing plants in Italy. These data - together with the consumption data of milk consumers - were evaluated and used for the calculation of the Estimated Daily Intake (EDI), the Hazard Index (HI), and the fraction of hepatocarcinoma cases (HCC) due to AFM1 exposure in different population groups. Altogether a total of 31,702 milk samples were analyzed, representing 556,413 tons of milk, which is an outstanding amount compared to published studies. The results indicate the monthly fluctuation of AFM1 levels through a period of nearly 6 years. The EDI of AFM1 in different population groups was in the range of 0.025-0.328 ng kg-1 body weight (bw) per day, based on the average consumption levels and weighted mean contamination of the milk in the study period. Considering average consumptions, in the groups of infants and toddlers, the HI calculation resulted in 1.64 and 1.4, respectively, while for older age groups, it was <1. The estimated fractions of HCC incidences attributable to the AFM1 intakes were 0.005 and 0.004 cases per 100,000 individuals in the 0-0.9 and 1-2.9-year age groups, respectively, and below 0.004 cases in the other age categories. The monthly average AFM1 contamination of tested milk consignments ranged between 7.19 and 22.53 ng kg-1. Although the results of this extensive investigation showed a low risk of HCC, the variability of climatic conditions throughout years that influence AFB1 contamination of feed and consequently AFM1 contamination of milk justifies their continuous monitoring and update of the risk assessment.
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Affiliation(s)
- Andrea Serraino
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Paolo Bonilauri
- Experimental Zooprophylactic Institute of Lombardy and Emilia-Romagna, Reggio Emilia, Italy
| | - Kata Kerekes
- Department of Food Safety Planning and Monitoring, System Management and Supervision Directorate, National Food Chain Safety Office, Budapest, Hungary
| | - Zsuzsa Farkas
- Department of Food Safety Planning and Monitoring, System Management and Supervision Directorate, National Food Chain Safety Office, Budapest, Hungary
| | - Federica Giacometti
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Alessandra Canever
- Department of Quality, Innovation, Safety, Environment, Granarolo S.p.A., Bologna, Italy
| | | | - Árpád Ambrus
- Doctoral School of Nutrition and Food Sciences, University of Debrecen, Debrecen, Hungary
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8
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Brouwer AF, Masters NB, Eisenberg JNS. Quantitative Microbial Risk Assessment and Infectious Disease Transmission Modeling of Waterborne Enteric Pathogens. Curr Environ Health Rep 2019; 5:293-304. [PMID: 29679300 DOI: 10.1007/s40572-018-0196-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW Waterborne enteric pathogens remain a global health threat. Increasingly, quantitative microbial risk assessment (QMRA) and infectious disease transmission modeling (IDTM) are used to assess waterborne pathogen risks and evaluate mitigation. These modeling efforts, however, have largely been conducted independently for different purposes and in different settings. In this review, we examine the settings where each modeling strategy is employed. RECENT FINDINGS QMRA research has focused on food contamination and recreational water in high-income countries (HICs) and drinking water and wastewater in low- and middle-income countries (LMICs). IDTM research has focused on large outbreaks (predominately LMICs) and vaccine-preventable diseases (LMICs and HICs). Human ecology determines the niches that pathogens exploit, leading researchers to focus on different risk assessment research strategies in different settings. To enhance risk modeling, QMRA and IDTM approaches should be integrated to include dynamics of pathogens in the environment and pathogen transmission through populations.
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Affiliation(s)
- Andrew F Brouwer
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Nina B Masters
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, 48109, USA
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9
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Mahgoub SA. Fermented Food in Egypt: A Sustainable Bio-preservation to Improve the Safety of Food. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/698_2018_245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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10
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Ntuli V, Njage PMK, Bonilauri P, Serraino A, Buys EM. Quantitative Risk Assessment of Hemolytic Uremic Syndrome Associated with Consumption of Bulk Milk Sold Directly from Producer to Consumer in South Africa. J Food Prot 2018; 81:472-481. [PMID: 29474148 DOI: 10.4315/0362-028x.jfp-17-199] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 10/31/2017] [Indexed: 11/11/2022]
Abstract
This study was conducted to estimate the hemolytic uremic syndrome (HUS) risk associated with consumption of producer-distributor bulk milk (PDBM) contaminated with Shiga toxin-producing Escherichia coli (STEC) in South Africa. Data were obtained from recently completed studies in South Africa taking into account prior collected prevalence data of STEC in raw and pasteurized PDBM and survey information from producer-distributor outlets and households. Inputs for the models were complemented with data from published and unpublished literature. A probabilistic exposure model was developed with Monte Carlo simulation in Excel add-in software using @Risk software. Hazard characterization was based on an exponential dose-response model to calculate the probability of illness from STEC infection in individuals 5 years and younger and individuals older than 5 years. The estimated mean STEC level was 0.12 CFU/mL (95% confidence interval [CI]: 0 to 1.2; σ = 0.34) for raw PDBM and 0.08 CFU/mL (95% CI: 0 to 1; σ = 0.27) for pasteurized PDBM. A higher risk of HUS cases per year was recorded in raw than in pasteurized PDBM and also in individuals younger than 5 years of age. For every 100,000 servings consumed, the expected median numbers of HUS cases per year from raw PDBM were 52 for 5 years and younger and 3.2 for older than 5 years. The median numbers of cases per year for pasteurized PDBM were 47 for 5 years and younger and 2.9 for older than 5 years. Sensitivity analysis revealed that serving volume and time taken to sell PDBM at producer-distributor outlets were the factors with the greatest impact on probability of illness. The models developed in this study are an example of risk assessments for milk produced and marketed from similar scenarios across the globe.
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Affiliation(s)
- Victor Ntuli
- Department of Food Science, University of Pretoria, Private Bag X20, Hatfield, Pretoria 0028, South Africa (ORCID: http://orcid.org/0000-0002-1392-9797 [V.N.])
| | - Patrick M K Njage
- Department of Food Science, University of Pretoria, Private Bag X20, Hatfield, Pretoria 0028, South Africa (ORCID: http://orcid.org/0000-0002-1392-9797 [V.N.]).,Division for Epidemiology and Microbial Genomics, National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Paolo Bonilauri
- Experimental Institute for Zooprophylaxis in Lombardy and Emilia Romagna, Via Bianchi 7/9, 25124 Brescia, Italy
| | - Andrea Serraino
- Department of Veterinary Medical Sciences, University of Bologna, Via Tolara di Sopra 50, 40064 Ozzano Emilia, Bologna, Italy
| | - Elna M Buys
- Department of Food Science, University of Pretoria, Private Bag X20, Hatfield, Pretoria 0028, South Africa (ORCID: http://orcid.org/0000-0002-1392-9797 [V.N.])
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Faggiano G, Chieffi D, Logrieco AF, Fusco V. Effect of refrigeration and probiotic adjunct on pathogenic and spoilage microorganisms in raw milk for direct human consumption. J FOOD PROCESS PRES 2017. [DOI: 10.1111/jfpp.13499] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Giusy Faggiano
- National Research Council of Italy, Institute of Sciences of Food Production (CNR‐ISPA)Bari Italy
| | - Daniele Chieffi
- National Research Council of Italy, Institute of Sciences of Food Production (CNR‐ISPA)Bari Italy
| | - Antonio F. Logrieco
- National Research Council of Italy, Institute of Sciences of Food Production (CNR‐ISPA)Bari Italy
| | - Vincenzina Fusco
- National Research Council of Italy, Institute of Sciences of Food Production (CNR‐ISPA)Bari Italy
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Pérez‐Rodríguez F, Carrasco E, Bover‐Cid S, Jofré A, Valero A. Closing gaps for performing a risk assessment on Listeria monocytogenes in ready‐to‐eat (RTE) foods: activity 2, a quantitative risk characterization on L. monocytogenes in RTE foods; starting from the retail stage. ACTA ACUST UNITED AC 2017. [DOI: 10.2903/sp.efsa.2017.en-1252] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
| | | | - Sara Bover‐Cid
- Institut de Recerca i Tecnologia Agroalimentàries (IRTA) Food Safety Programme Spain
| | - Anna Jofré
- Institut de Recerca i Tecnologia Agroalimentàries (IRTA) Food Safety Programme Spain
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14
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Giacometti F, Bonilauri P, Piva S, Scavia G, Amatiste S, Bianchi DM, Losio MN, Bilei S, Cascone G, Comin D, Daminelli P, Decastelli L, Merialdi G, Mioni R, Peli A, Petruzzelli A, Tonucci F, Liuzzo G, Serraino A. Paediatric HUS Cases Related to the Consumption of Raw Milk Sold by Vending Machines in Italy: Quantitative Risk Assessment Based on Escherichia coli O157 Official Controls over 7 years. Zoonoses Public Health 2016; 64:505-516. [PMID: 27991739 DOI: 10.1111/zph.12331] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Indexed: 12/12/2022]
Abstract
A quantitative risk assessment (RA) was developed to estimate haemolytic-uremic syndrome (HUS) cases in paediatric population associated with the consumption of raw milk sold in vending machines in Italy. The historical national evolution of raw milk consumption phenomenon since 2008, when consumer interest started to grow, and after 7 years of marketing adjustment, is outlined. Exposure assessment was based on the official Shiga toxin-producing Escherichia coli O157:H7 (STEC) microbiological records of raw milk samples from vending machines monitored by the regional Veterinary Authorities from 2008 to 2014, microbial growth during storage, consumption frequency of raw milk, serving size, consumption preference and age of consumers. The differential risk considered milk handled under regulation conditions (4°C throughout all phases) and the worst time-temperature field handling conditions detected. In case of boiling milk before consumption, we assumed that the risk of HUS is fixed at zero. The model estimates clearly show that the public health significance of HUS cases due to raw milk STEC contamination depends on the current variability surrounding the risk profile of the food and the consumer behaviour has more impact than milk storage scenario. The estimated HUS cases predicted by our model are roughly in line with the effective STEC O157-associated HUS cases notified in Italy only when the proportion of consumers not boiling milk before consumption is assumed to be 1%. Raw milk consumption remains a source of E. coli O157:H7 for humans, but its overall relevance is likely to have subsided and significant caution should be exerted for temporal, geographical and consumers behaviour analysis. Health education programmes and regulatory actions are required to educate people, primarily children, on other STEC sources.
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Affiliation(s)
- F Giacometti
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - P Bonilauri
- Experimental Institute for Zooprophylaxis in Lombardy and Emilia Romagna, Reggo Emilia, Italy
| | - S Piva
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - G Scavia
- Istituto Superiore di Sanità, Rome, Italy
| | - S Amatiste
- Experimental Institute for Zooprophylaxis in Lazio and Tuscany, Rome, Italy
| | - D M Bianchi
- Experimental Institute for Zooprophylaxis in Piedmont, Liguria and Valle D'Aosta, Torino, Italy
| | - M N Losio
- Experimental Institute for Zooprophylaxis in Lombardy and Emilia Romagna, Brescia, Italy
| | - S Bilei
- Experimental Institute for Zooprophylaxis in Lazio and Tuscany, Rome, Italy
| | - G Cascone
- Experimental Institute for Zooprophylaxis in Sicily, Palermo, Italy
| | - D Comin
- Experimental Institute for Zooprophylaxis in Venezie, San Donà di Piave, Italy
| | - P Daminelli
- Experimental Institute for Zooprophylaxis in Lombardy and Emilia Romagna, Brescia, Italy
| | - L Decastelli
- Experimental Institute for Zooprophylaxis in Piedmont, Liguria and Valle D'Aosta, Torino, Italy
| | - G Merialdi
- Experimental Institute for Zooprophylaxis in Lombardy and Emilia Romagna, Bologna, Italy
| | - R Mioni
- Experimental Institute for Zooprophylaxis in Venezie, San Donà di Piave, Italy
| | - A Peli
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - A Petruzzelli
- Experimental Institute for Zooprophylaxis in Umbria and Marche, Pesaro, Italy
| | - F Tonucci
- Experimental Institute for Zooprophylaxis in Umbria and Marche, Pesaro, Italy
| | - G Liuzzo
- Modena Health Trust, Carpi District, Modena, Italy
| | - A Serraino
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
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Di Giannatale E, Garofolo G, Alessiani A, Di Donato G, Candeloro L, Vencia W, Decastelli L, Marotta F. Tracing Back Clinical Campylobacter jejuni in the Northwest of Italy and Assessing Their Potential Source. Front Microbiol 2016; 7:887. [PMID: 27379033 PMCID: PMC4904018 DOI: 10.3389/fmicb.2016.00887] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 05/25/2016] [Indexed: 12/03/2022] Open
Abstract
Food-borne campylobacteriosis is caused mainly by the handling or consumption of undercooked chicken meat or by the ingestion of contaminated raw milk. Knowledge about the contributions of different food sources to gastrointestinal disease is fundamental to prioritize food safety interventions and to establish proper control strategies. Assessing the genetic diversity among Campylobacter species is essential to our understanding of their epidemiology and population structure. We molecularly characterized 56 Campylobacter jejuni isolates (31 from patients hospitalized with gastroenteritis, 17 from raw milk samples, and 8 from chicken samples) using multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) in order to trace the source of the disease. We also used a population genetic approach to investigate the source of the human cases from six different reservoirs of infection. MLST identified 25 different sequence types and 11 clonal complexes (CCs) (21, 658, 206, 353, 443, 48, 61, 257, 1332, 354, 574) and these included several alleles not cited previously in the PubMLST international database. The most prevalent CCs were 21, 206, and 354. PFGE showed 34 pulsotypes divided between 28 different clusters. At the fine scale, by means of PFGE and MLST, only two human cases were linked to raw milk, while one case was linked to chicken meat. The investigation revealed the presence of several genotypes among the human isolates, which probably suggests multiple foci for the infections. Finally, the source attribution model we used revealed that most cases were attributed to chicken (69.75%) as the main reservoir in Italy, followed to a lesser extent by the following sources: cattle (8.25%); environment (6.28%); wild bird (7.37%); small ruminant (5.35%), and pork (2.98%). This study confirms the importance of correlating epidemiological investigations with molecular epidemiological data to better understand the dynamics of infection.
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Affiliation(s)
- Elisabetta Di Giannatale
- National Reference Laboratory for Campylobacter, Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G.Caporale”Teramo, Italy
| | - Giuliano Garofolo
- National Reference Laboratory for Campylobacter, Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G.Caporale”Teramo, Italy
| | - Alessandra Alessiani
- National Reference Laboratory for Campylobacter, Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G.Caporale”Teramo, Italy
| | - Guido Di Donato
- National Reference Laboratory for Campylobacter, Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G.Caporale”Teramo, Italy
| | - Luca Candeloro
- Department of Statistics and GIS, Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G.Caporale”Teramo, Italy
| | - Walter Vencia
- Food Hygiene and Safety Department, Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d’AostaTorino, Italy
| | - Lucia Decastelli
- Food Hygiene and Safety Department, Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d’AostaTorino, Italy
| | - Francesca Marotta
- National Reference Laboratory for Campylobacter, Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G.Caporale”Teramo, Italy
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16
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Crotta M, Rizzi R, Varisco G, Daminelli P, Cunico EC, Luini M, Graber HU, Paterlini F, Guitian J. Multiple-Strain Approach and Probabilistic Modeling of Consumer Habits in Quantitative Microbial Risk Assessment: A Quantitative Assessment of Exposure to Staphylococcal Enterotoxin A in Raw Milk. J Food Prot 2016; 79:432-41. [PMID: 26939653 DOI: 10.4315/0362-028x.jfp-15-235] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Quantitative microbial risk assessment (QMRA) models are extensively applied to inform management of a broad range of food safety risks. Inevitably, QMRA modeling involves an element of simplification of the biological process of interest. Two features that are frequently simplified or disregarded are the pathogenicity of multiple strains of a single pathogen and consumer behavior at the household level. In this study, we developed a QMRA model with a multiple-strain approach and a consumer phase module (CPM) based on uncertainty distributions fitted from field data. We modeled exposure to staphylococcal enterotoxin A in raw milk in Lombardy; a specific enterotoxin production module was thus included. The model is adaptable and could be used to assess the risk related to other pathogens in raw milk as well as other staphylococcal enterotoxins. The multiplestrain approach, implemented as a multinomial process, allowed the inclusion of variability and uncertainty with regard to pathogenicity at the bacterial level. Data from 301 questionnaires submitted to raw milk consumers were used to obtain uncertainty distributions for the CPM. The distributions were modeled to be easily updatable with further data or evidence. The sources of uncertainty due to the multiple-strain approach and the CPM were identified, and their impact on the output was assessed by comparing specific scenarios to the baseline. When the distributions reflecting the uncertainty in consumer behavior were fixed to the 95th percentile, the risk of exposure increased up to 160 times. This reflects the importance of taking into consideration the diversity of consumers' habits at the household level and the impact that the lack of knowledge about variables in the CPM can have on the final QMRA estimates. The multiple-strain approach lends itself to use in other food matrices besides raw milk and allows the model to better capture the complexity of the real world and to be capable of geographical specificity.
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Affiliation(s)
- Matteo Crotta
- Department DIVET, Università degli Studi di Milano, Via Celoria 10, 20133 Milan, Italy
| | - Rita Rizzi
- Department DIVET, Università degli Studi di Milano, Via Celoria 10, 20133 Milan, Italy
| | - Giorgio Varisco
- Lombardy and Emilia Romagna Experimental Zooprophylactic Institute, Via Bianchi 79, 25124 Brescia, Italy
| | - Paolo Daminelli
- Lombardy and Emilia Romagna Experimental Zooprophylactic Institute, Via Bianchi 79, 25124 Brescia, Italy
| | - Elena Cosciani Cunico
- Lombardy and Emilia Romagna Experimental Zooprophylactic Institute, Via Bianchi 79, 25124 Brescia, Italy
| | - Mario Luini
- Lombardy and Emilia Romagna Experimental Zooprophylactic Institute, Via Einstein, 26900 Lodi, Italy
| | - Hans Ulrich Graber
- Agroscope, Institute for Food Sciences IFS, Schwarzenburgstrasse 161, 3003 Berne, Switzerland
| | - Franco Paterlini
- Lombardy and Emilia Romagna Experimental Zooprophylactic Institute, Via Rovelli 53, 24100 Bergamo, Italy
| | - Javier Guitian
- Veterinary Epidemiology, Economics and Public Health Group, The Royal Veterinary College, Hawkshead Lane, North Mymms, AL9 7TA, Hatfield, UK
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17
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Crotta M, Paterlini F, Rizzi R, Guitian J. Consumers' behavior in quantitative microbial risk assessment for pathogens in raw milk: Incorporation of the likelihood of consumption as a function of storage time and temperature. J Dairy Sci 2015; 99:1029-1038. [PMID: 26686719 DOI: 10.3168/jds.2015-10175] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 10/14/2015] [Indexed: 11/19/2022]
Abstract
Foodborne disease as a result of raw milk consumption is an increasing concern in Western countries. Quantitative microbial risk assessment models have been used to estimate the risk of illness due to different pathogens in raw milk. In these models, the duration and temperature of storage before consumption have a critical influence in the final outcome of the simulations and are usually described and modeled as independent distributions in the consumer phase module. We hypothesize that this assumption can result in the computation, during simulations, of extreme scenarios that ultimately lead to an overestimation of the risk. In this study, a sensorial analysis was conducted to replicate consumers' behavior. The results of the analysis were used to establish, by means of a logistic model, the relationship between time-temperature combinations and the probability that a serving of raw milk is actually consumed. To assess our hypothesis, 2 recently published quantitative microbial risk assessment models quantifying the risks of listeriosis and salmonellosis related to the consumption of raw milk were implemented. First, the default settings described in the publications were kept; second, the likelihood of consumption as a function of the length and temperature of storage was included. When results were compared, the density of computed extreme scenarios decreased significantly in the modified model; consequently, the probability of illness and the expected number of cases per year also decreased. Reductions of 11.6 and 12.7% in the proportion of computed scenarios in which a contaminated milk serving was consumed were observed for the first and the second study, respectively. Our results confirm that overlooking the time-temperature dependency may yield to an important overestimation of the risk. Furthermore, we provide estimates of this dependency that could easily be implemented in future quantitative microbial risk assessment models of raw milk pathogens.
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Affiliation(s)
- Matteo Crotta
- Department of Veterinary Science and Public Health, Università degli Studi di Milano, Via Celoria 10, 20133 Milan, Italy.
| | - Franco Paterlini
- Lombardy and Emilia Romagna Experimental Zooprophylactic Institute, Via Rovelli 53, 24100 Bergamo, Italy
| | - Rita Rizzi
- Department of Veterinary Science and Public Health, Università degli Studi di Milano, Via Celoria 10, 20133 Milan, Italy
| | - Javier Guitian
- Veterinary Epidemiology, Economics and Pubic Health Group, The Royal Veterinary College, Hawkshead Lane, North Mymms, AL9 7TA, Hatfield, United Kingdom
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18
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Kashoma IP, Kassem II, John J, Kessy BM, Gebreyes W, Kazwala RR, Rajashekara G. Prevalence and Antimicrobial Resistance of Campylobacter Isolated from Dressed Beef Carcasses and Raw Milk in Tanzania. Microb Drug Resist 2015; 22:40-52. [PMID: 26153978 DOI: 10.1089/mdr.2015.0079] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Campylobacter species are commonly transmitted to humans through consumption of contaminated foods such as milk and meat. The aim of this study was to investigate the prevalence, antimicrobial resistance, and genetic determinants of resistance of Campylobacter isolated from raw milk and beef carcasses in Tanzania. The antimicrobial resistance genes tested included blaOXA-61 (ampicillin), aph-3-1 (aminoglycoside), tet(O) (tetracycline), and cmeB (multi-drug efflux pump). The prevalence of Campylobacter was 9.5% in beef carcasses and 13.4% in raw milk, respectively. Using multiplex-polymerase chain reaction (PCR), we identified 58.1% of the isolates as Campylobacter jejuni, 30.7% as Campylobacter coli, and 9.7% as other Campylobacter spp. One isolate (1.6%) was positive for both C. jejuni and C. coli specific PCR. Antimicrobial susceptibility testing using the disk diffusion assay and the broth microdilution method showed resistance to: ampicillin (63% and 94.1%), ciprofloxacin (9.3% and 11.8%), erythromycin (53.7% and 70.6%), gentamicin (0% and 15.7%), streptomycin (35.2% and 84.3%), and tetracycline (18.5% and 17.7%), respectively. Resistance to azithromycin (42.6%), nalidixic acid (64.8%), and chloramphenicol (13%) was determined using the disk diffusion assay only, while resistance to tylosin (90.2%) was quantified using the broth microdilution method. The blaOXA-61 (52.6% and 28.1%), cmeB (26.3% and 31.3%), tet(O) (26.3% and 31.3%), and aph-3-1 (5.3% and 3.0%) were detected in C. coli and C. jejuni. These findings highlight the extent of antimicrobial resistance in Campylobacter occurring in important foods in Tanzania. The potential risks to consumers emphasize the need for adequate control approaches, including the prudent use of antimicrobials to minimize the spread of antimicrobial-resistant Campylobacter.
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Affiliation(s)
- Isaac P Kashoma
- 1 Faculty of Veterinary Medicine, Sokoine University of Agriculture , Morogoro, Tanzania .,2 VPH-Biotec Global Consortium , Columbus, Ohio
| | - Issmat I Kassem
- 3 Food Animal Health Research Program, Ohio Agricultural Research and Development Center, The Ohio State University , Wooster, Ohio
| | - Julius John
- 1 Faculty of Veterinary Medicine, Sokoine University of Agriculture , Morogoro, Tanzania .,2 VPH-Biotec Global Consortium , Columbus, Ohio
| | - Beda M Kessy
- 1 Faculty of Veterinary Medicine, Sokoine University of Agriculture , Morogoro, Tanzania
| | - Wondwossen Gebreyes
- 2 VPH-Biotec Global Consortium , Columbus, Ohio.,4 Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University , Columbus, Ohio
| | - Rudovick R Kazwala
- 1 Faculty of Veterinary Medicine, Sokoine University of Agriculture , Morogoro, Tanzania .,2 VPH-Biotec Global Consortium , Columbus, Ohio
| | - Gireesh Rajashekara
- 1 Faculty of Veterinary Medicine, Sokoine University of Agriculture , Morogoro, Tanzania .,2 VPH-Biotec Global Consortium , Columbus, Ohio.,3 Food Animal Health Research Program, Ohio Agricultural Research and Development Center, The Ohio State University , Wooster, Ohio
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19
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Giacometti F, Bonilauri P, Amatiste S, Arrigoni N, Bianchi M, Losio MN, Bilei S, Cascone G, Comin D, Daminelli P, Decastelli L, Merialdi G, Mioni R, Peli A, Petruzzelli A, Tonucci F, Piva S, Serraino A. Human campylobacteriosis related to the consumption of raw milk sold by vending machines in Italy: Quantitative risk assessment based on official controls over four years. Prev Vet Med 2015; 121:151-8. [PMID: 26142145 DOI: 10.1016/j.prevetmed.2015.06.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 05/19/2015] [Accepted: 06/14/2015] [Indexed: 10/23/2022]
Abstract
A quantitative risk assessment (RA) model was developed to describe the risk of campylobacteriosis linked to consumption of raw milk sold in vending machines in Italy. Exposure assessment was based on the official microbiological records of raw milk samples from vending machines monitored by the regional Veterinary Authorities from 2008 to 2011, microbial growth during storage, destruction experiments, consumption frequency of raw milk, serving size, consumption preference and age of consumers. The differential risk considered milk handled under regulation conditions (4°C throughout all phases) and the worst time-temperature field handling conditions detected. Two separate RA models were developed, one for the consumption of boiled milk and the other for the consumption of raw milk, and two different dose-response (D-R) relationships were considered. The RA model predicted no human campylobacteriosis cases per year either in the best (4°C) storage conditions or in the case of thermal abuse in case of boiling raw milk, whereas in case of raw milk consumption the annual estimated campylobacteriosis cases depend on the dose-response relationships used in the model (D-R I or D-R II), the milk time-temperature storage conditions, consumer behaviour and age of consumers, namely young (with two cut-off values of ≤5 or ≤6 years old for the sensitive population) versus adult consumers. The annual estimated cases for young consumers using D-R II for the sensitive population (≤5 years old) ranged between 1013.7/100,000 population and 8110.3/100,000 population and for adult consumers using D-R I between 79.4/100,000 population and 333.1/100,000 population. Quantification of the risks associated with raw milk consumption is necessary from a public health perspective and the proposed RA model represents a useful and flexible tool to perform future RAs based on local consumer habits to support decision-making on safety policies. Further educational programmes for raw milk consumers or potential raw milk consumers are required to encourage consumers to boil milk to reduce the associated risk of illness.
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Affiliation(s)
- Federica Giacometti
- University of Bologna, Department of Veterinary Medical Sciences, Via Tolara di Sopra, 50, Bologna, 40064 Ozzano Emilia, Italy
| | - Paolo Bonilauri
- Experimental Institute for Zooprophylaxis in Lombardy and Emilia Romagna, Via Pitagora 2, 42100 Reggio Emilia, Italy
| | - Simonetta Amatiste
- Experimental Institute for Zooprophylaxis in Lazio and Tuscany, Via Appia Nuova 1411, 00187 Rome, Italy
| | - Norma Arrigoni
- Experimental Institute for Zooprophylaxis in Lombardy and Emilia Romagna, Strada della Faggiola 1, 29027 Gariga di Podenzano, Italy
| | - Manila Bianchi
- Experimental Institute for Zooprophylaxis in Piedmont, Liguria and Valle D'Aosta, Via Bologna, 148, 10154 Turin, Italy
| | - Marina Nadia Losio
- Experimental Institute for Zooprophylaxis in Lombardy and Emilia Romagna, Via Bianchi 7/9, 25124 Brescia, Italy
| | - Stefano Bilei
- Experimental Institute for Zooprophylaxis in Lazio and Tuscany, Via Appia Nuova 1411, 00187 Rome, Italy
| | - Giuseppe Cascone
- Experimental Institute for Zooprophylaxis in Sicily, Via G. Marinuzzi, 3, 90129, Palermo, Italy
| | - Damiano Comin
- Experimental Institute for Zooprophylaxis in Veneto, Viale dell'Università, 10, Padua,35020 Legnaro, Italy
| | - Paolo Daminelli
- Experimental Institute for Zooprophylaxis in Lombardy and Emilia Romagna, Via Bianchi 7/9, 25124 Brescia, Italy
| | - Lucia Decastelli
- Experimental Institute for Zooprophylaxis in Piedmont, Liguria and Valle D'Aosta, Via Bologna, 148, 10154 Turin, Italy
| | - Giuseppe Merialdi
- Experimental Institute for Zooprophylaxis in Lombardy and Emilia Romagna, Via P. Fiorini, 5, 40127 Bologna, Italy
| | - Renzo Mioni
- Experimental Institute for Zooprophylaxis in Veneto, Viale dell'Università, 10, Padua,35020 Legnaro, Italy
| | - Angelo Peli
- University of Bologna, Department of Veterinary Medical Sciences, Via Tolara di Sopra, 50, Bologna, 40064 Ozzano Emilia, Italy
| | - Annalisa Petruzzelli
- Experimental Institute for Zooprophylaxis in Umbria and Marche, Via G. Salvemini, 1, 06162, Perugia, Italy
| | - Franco Tonucci
- Experimental Institute for Zooprophylaxis in Umbria and Marche, Via G. Salvemini, 1, 06162, Perugia, Italy
| | - Silvia Piva
- University of Bologna, Department of Veterinary Medical Sciences, Via Tolara di Sopra, 50, Bologna, 40064 Ozzano Emilia, Italy
| | - Andrea Serraino
- University of Bologna, Department of Veterinary Medical Sciences, Via Tolara di Sopra, 50, Bologna, 40064 Ozzano Emilia, Italy.
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20
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Scientific Opinion on the public health risks related to the consumption of raw drinking milk. EFSA J 2015. [DOI: 10.2903/j.efsa.2015.3940] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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21
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Giacometti F, Bonilauri P, Albonetti S, Amatiste S, Arrigoni N, Bianchi M, Bertasi B, Bilei S, Bolzoni G, Cascone G, Comin D, Daminelli P, Decastelli L, Merialdi G, Mioni R, Peli A, Petruzzelli A, Tonucci F, Bonerba E, Serraino A. Quantitative risk assessment of human salmonellosis and listeriosis related to the consumption of raw milk in Italy. J Food Prot 2015; 78:13-21. [PMID: 25581173 DOI: 10.4315/0362-028x.jfp-14-171] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Two quantitative risk assessment (RA) models were developed to describe the risk of salmonellosis and listeriosis linked to consumption of raw milk sold in vending machines in Italy. Exposure assessment considered the official microbiological records monitoring raw milk samples from vending machines performed by the regional veterinary authorities from 2008 to 2011, microbial growth during storage, destruction experiments, consumption frequency of raw milk, serving size, and consumption preference. Two separate RA models were developed: one for the consumption of boiled milk and the other for the consumption of raw milk. The RA models predicted no human listeriosis cases per year either in the best or worst storage conditions and with or without boiling raw milk, whereas the annual estimated cases of salmonellosis depend on the dose-response relationships used in the model, the milk storage conditions, and consumer behavior in relation to boiling raw milk or not. For example, the estimated salmonellosis cases ranged from no expected cases, assuming that the entire population boiled milk before consumption, to a maximum of 980,128 cases, assuming that the entire population drank raw milk without boiling, in the worst milk storage conditions, and with the lowest dose-response model. The findings of this study clearly show how consumer behavior could affect the probability and number of salmonellosis cases and in general, the risk of illness. Hence, the proposed RA models emphasize yet again that boiling milk before drinking is a simple yet effective tool to protect consumers against the risk of illness inherent in the consumption of raw milk. The models may also offer risk managers a useful tool to identify or implement appropriate measures to control the risk of acquiring foodborne pathogens. Quantification of the risks associated with raw milk consumption is necessary from a public health perspective.
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Affiliation(s)
- Federica Giacometti
- Department of Veterinary Medical Sciences, University of Bologna, Via Tolara di Sopra, 50-40064 Ozzano Emilia, Bologna, Italy
| | - Paolo Bonilauri
- Experimental Institute for Zooprophylaxis in Lombardy and Emilia Romagna, Via Pitagora, 2-42100 Reggio Emilia, Italy
| | - Sabrina Albonetti
- Department of Veterinary Medical Sciences, University of Bologna, Via Tolara di Sopra, 50-40064 Ozzano Emilia, Bologna, Italy
| | - Simonetta Amatiste
- Experimental Institute for Zooprophylaxis in Lazio and Tuscany, Via Appia Nuova, 1411-00187 Rome (Campanelle), Italy
| | - Norma Arrigoni
- Experimental Institute for Zooprophylaxis in Lombardy and Emilia Romagna, Strada della Faggiola, 1-29027 Gariga di Podenzano (PC), Italy
| | - Manila Bianchi
- Experimental Institute for Zooprophylaxis in Piedmont, Liguria and Valle D'Aosta, Via Bologna, 148-10154 Turin, Italy
| | - Barbara Bertasi
- Experimental Institute for Zooprophylaxis in Lombardy and Emilia Romagna, Via Bianchi, 7/9-25124 Brescia, Italy
| | - Stefano Bilei
- Experimental Institute for Zooprophylaxis in Lazio and Tuscany, Via Appia Nuova, 1411-00187 Rome (Campanelle), Italy
| | - Giuseppe Bolzoni
- National Reference Centre for Cattle Milk Quality, Experimental Institute for Zooprophylaxis in Lombardy and Emilia Romagna, 7/9-25124 Brescia, Italy
| | - Giuseppe Cascone
- Experimental Institute for Zooprophylaxis in Sicily, Via G. Marinuzzi, 3-90129, Palermo, Italy
| | - Damiano Comin
- Experimental Institute for Zooprophylaxis in Venice, Viale dell'Università, 10-35020 Legnaro, Padua, Italy
| | - Paolo Daminelli
- Experimental Institute for Zooprophylaxis in Lombardy and Emilia Romagna, Via Bianchi, 7/9-25124 Brescia, Italy
| | - Lucia Decastelli
- Experimental Institute for Zooprophylaxis in Piedmont, Liguria and Valle D'Aosta, Via Bologna, 148-10154 Turin, Italy
| | - Giuseppe Merialdi
- Experimental Institute for Zooprophylaxis in Lombardy and Emilia Romagna, Via P. Fiorini, 5-40127 Bologna, Italy
| | - Renzo Mioni
- Experimental Institute for Zooprophylaxis in Venice, Viale dell'Università, 10-35020 Legnaro, Padua, Italy
| | - Angelo Peli
- Department of Veterinary Medical Sciences, University of Bologna, Via Tolara di Sopra, 50-40064 Ozzano Emilia, Bologna, Italy
| | - Annalisa Petruzzelli
- Experimental Institute for Zooprophylaxis in Umbria and Marche, Via G. Salvemini, 1-06162 Perugia, Italy
| | - Franco Tonucci
- Experimental Institute for Zooprophylaxis in Lombardy and Emilia Romagna, Via P. Fiorini, 5-40127 Bologna, Italy
| | - Elisabetta Bonerba
- Department of Veterinary Medicine, University of Bari, Strada Provinciale per Casamassima, km 3, 70010 (BA), Italy
| | - Andrea Serraino
- Department of Veterinary Medical Sciences, University of Bologna, Via Tolara di Sopra, 50-40064 Ozzano Emilia, Bologna, Italy.
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22
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Serraino A, Bonilauri P, Arrigoni N, Ostanello F, Ricchi M, Marchetti G, Bonfante E, Albonetti S, Giacometti F. Quantitative risk assessment of Mycobacterium avium subsp. paratuberculosis survival in pasteurized milk in three dairy plants in Italy. Food Control 2014. [DOI: 10.1016/j.foodcont.2014.04.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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23
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Merialdi G, Bardasi L, Stancampiano L, Taddei R, Delogu M, Di Francesco A, Guarniero I, Grilli E, Fustini M, Bonfante E, Giacometti F, Serraino A. Temporal Variation of Faecal Shedding of Escherichia coli 0157:H7 in A Dairy Herd Producing Raw Milk for Direct Human Consumption. Ital J Food Saf 2014; 3:2297. [PMID: 27800362 PMCID: PMC5076729 DOI: 10.4081/ijfs.2014.2297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 03/06/2014] [Accepted: 03/22/2014] [Indexed: 11/23/2022] Open
Abstract
The objective of this study was to analyse over time the evolution of E. coli O157:H7 faecal shedding in a dairy herd producing raw milk for direct human consumption. The study was performed between October 2012 and September 2013 in an average size Italian dairy farm where animals are housed inside the barn all over the year. The farm housed about 140 animals during the study – 70 cows and 70 calves and heifers. Twenty-six animals were randomly selected from both the cows and young animals group, and faecal sampling was performed rectally six times two months apart in each animal. Eleven animals were culled during the study and a total of 285 faecal samples were collected. At each faecal sampling, three trough water samples and two trough feed samples were also collected for a total of 36 water samples and 24 feed samples. Samples were analysed by real time polymerase chain reaction (RT-PCR) and culture. Overall, 16 (5.6%) faecal samples were positive for E. coli O157 by RT-PCR. Cultural examination found 9 (3.1%) samples positive for E. coli O157; all the isolates were positive for stx1, stx 2 and eae genes. One (4.1%) feed sample was positive for E. coli O157 by RT-PCR; none of the water samples was positive for E. coli O157. The model highlighted a general significant reduction of the number of positive samples observed during the study from the first to the sixth sampling (P=0.000) and a positive relation between the presence of positive samples and average environmental temperature (P=0.003). The results of the study showed that in an Italian dairy farm housing animals all year, faecal shedding of E. coli O157 followed the same temporal trend reported for other types of farming. The enhanced faecal shedding during warmer months may have a significant impact on environmental contamination and the safety of raw milk and its byproducts.
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Affiliation(s)
- Giuseppe Merialdi
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna , Bologna
| | - Lia Bardasi
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna , Bologna
| | - Laura Stancampiano
- Dipartimento di Scienze Mediche Veterinarie, Università di Bologna , Ozzano dell'Emilia (BO), Italy
| | - Roberta Taddei
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna , Bologna
| | - Mauro Delogu
- Dipartimento di Scienze Mediche Veterinarie, Università di Bologna , Ozzano dell'Emilia (BO), Italy
| | - Antonietta Di Francesco
- Dipartimento di Scienze Mediche Veterinarie, Università di Bologna , Ozzano dell'Emilia (BO), Italy
| | - Ilaria Guarniero
- Dipartimento di Scienze Mediche Veterinarie, Università di Bologna , Ozzano dell'Emilia (BO), Italy
| | - Ester Grilli
- Dipartimento di Scienze Mediche Veterinarie, Università di Bologna , Ozzano dell'Emilia (BO), Italy
| | - Mattia Fustini
- Dipartimento di Scienze Mediche Veterinarie, Università di Bologna , Ozzano dell'Emilia (BO), Italy
| | - Elena Bonfante
- Dipartimento di Scienze Mediche Veterinarie, Università di Bologna , Ozzano dell'Emilia (BO), Italy
| | - Federica Giacometti
- Dipartimento di Scienze Mediche Veterinarie, Università di Bologna , Ozzano dell'Emilia (BO), Italy
| | - Andrea Serraino
- Dipartimento di Scienze Mediche Veterinarie, Università di Bologna , Ozzano dell'Emilia (BO), Italy
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Giacometti F, Serraino A, Pasquali F, De Cesare A, Bonerba E, Rosmini R. Behavior ofArcobacter butzleriandArcobacter cryaerophilusin Ultrahigh-Temperature, Pasteurized, and Raw Cow's Milk Under Different Temperature Conditions. Foodborne Pathog Dis 2014; 11:15-20. [DOI: 10.1089/fpd.2013.1597] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Federica Giacometti
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Andrea Serraino
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | | | | | | | - Roberto Rosmini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
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Giacometti F, Bonilauri P, Serraino A, Peli A, Amatiste S, Arrigoni N, Bianchi M, Bilei S, Cascone G, Comin D, Daminelli P, Decastelli L, Fustini M, Mion R, Petruzzelli A, Rosmini R, Rugna G, Tamba M, Tonucci F, Bolzoni G. Four-year monitoring of foodborne pathogens in raw milk sold by vending machines in Italy. J Food Prot 2013; 76:1902-7. [PMID: 24215694 DOI: 10.4315/0362-028x.jfp-13-213] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Prevalence data were collected from official microbiological records monitoring four selected foodborne pathogens (Salmonella, Listeria monocytogenes, Escherichia coli O157:H7, and Campylobacter jejuni) in raw milk sold by self-service vending machines in seven Italian regions (60,907 samples from 1,239 vending machines) from 2008 to 2011. Data from samples analyzed by both culture-based and real-time PCR methods were collected in one region. One hundred raw milk consumers in four regions were interviewed while purchasing raw milk from vending machines. One hundred seventy-eight of 60,907 samples were positive for one of the four foodborne pathogens investigated: 18 samples were positive for Salmonella, 83 for L. monocytogenes, 24 for E. coli O157:H7, and 53 for C. jejuni in the seven regions investigated. No significant differences in prevalence were found among regions, but a significant increase in C. jejuni prevalence was observed over the years of the study. A comparison of the two analysis methods revealed that real-time PCR was 2.71 to 9.40 times more sensitive than the culture-based method. Data on consumer habits revealed that some behaviors may enhance the risk of infection linked to raw milk consumption: 37% of consumers did not boil milk before consumption, 93% never used an insulated bag to transport raw milk home, and raw milk was consumed by children younger than 5 years of age. These results emphasize that end-product controls alone are not sufficient to guarantee an adequate level of consumer protection. The beta distribution of positive samples in this study and the data on raw milk consumer habits will be useful for the development of a national quantitative risk assessment of Salmonella, L. monocytogenes, E. coli O157, and C. jejuni infection associated with raw milk consumption.
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Affiliation(s)
- Federica Giacometti
- Department of Veterinary Medical Sciences, University of Bologna, Via Tolara di Sopra 50, 40064 Ozzano Emilia, Bologna, Italy
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Serraino A, Florio D, Giacometti F, Piva S, Mion D, Zanoni RG. Presence of Campylobacter and Arcobacter species in in-line milk filters of farms authorized to produce and sell raw milk and of a water buffalo dairy farm in Italy. J Dairy Sci 2013; 96:2801-7. [PMID: 23453517 DOI: 10.3168/jds.2012-6249] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 01/07/2013] [Indexed: 01/28/2023]
Abstract
The objectives of this study were to investigate the presence of Campylobacter spp. and Arcobacter spp. in dairy herds authorized for the production and sale of raw milk and in a water buffalo dairy farm, and to test the antimicrobial susceptibility of the isolates. A total of 196 in-line milk filters were collected from 14 dairy farms (13 bovine and 1 water buffalo) for detection of Campylobacter spp. and Arcobacter spp. by microbiological culture. For each farm investigated, 1 isolate for each Campylobacter and Arcobacter species isolated was tested using the Etest method (AB Biodisk, Solna, Sweden) to evaluate the susceptibility to ciprofloxacin, tetracycline, chloramphenicol, ampicillin, erythromycin, and gentamicin. A total of 52 isolates were detected in 49 milk filters in 12 farms (85.7%) out of 14 and the isolates were identified as Campylobacter jejuni (6), Campylobacter hyointestinalis ssp. hyointestinalis (8), Campylobacter concisus (1), Campylobacter fetus ssp. fetus (1), Arcobacter butzleri (22), and Arcobacter cryaerophilus (14). The small number of isolates tested for antimicrobial susceptibility precludes any epidemiological consideration but highlights that all Campylobacter isolates were susceptible to macrolides, which are the first-choice drugs for the treatment of campylobacteriosis, and that resistance to fluoroquinolones and tetracycline was detected; for Arcobacter isolates, resistance to ampicillin and chloramphenicol was detected. The sale of raw milk for human consumption by self-service automatic vending machines has been allowed in Italy since 2004 and the presence of C. jejuni in in-line milk filters confirms that raw milk consumption is a significant risk factor for human infection. The high occurrence of emerging Campylobacter spp. and Arcobacter spp. discovered in dairy farms authorized for production and sale of raw milk represents an emerging hazard for human health.
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Affiliation(s)
- A Serraino
- Department of Veterinary Medical Sciences, via Tolara di Sopra 50, 40064 Ozzano Emilia, Bologna, Italy.
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