Hald Tine, Vose David, Wegener Henrik C, Koupeev Timour
Danish Institute of Food and Veterinary Research, Mørkhøj Bygade, Søberg, Denmark.
Risk Anal. 2004 Feb;24(1):255-69. doi: 10.1111/j.0272-4332.2004.00427.x.
Based on the data from the integrated Danish Salmonella surveillance in 1999, we developed a mathematical model for quantifying the contribution of each of the major animal-food sources to human salmonellosis. The model was set up to calculate the number of domestic and sporadic cases caused by different Salmonella sero and phage types as a function of the prevalence of these Salmonella types in the animal-food sources and the amount of food source consumed. A multiparameter prior accounting for the presumed but unknown differences between serotypes and food sources with respect to causing human salmonellosis was also included. The joint posterior distribution was estimated by fitting the model to the reported number of domestic and sporadic cases per Salmonella type in a Bayesian framework using Markov Chain Monte Carlo simulation. The number of domestic and sporadic cases was obtained by subtracting the estimated number of travel- and outbreak-associated cases from the total number of reported cases, i.e., the observed data. The most important food sources were found to be table eggs and domestically produced pork comprising 47.1% (95% credibility interval, CI: 43.3-50.8%) and 9% (95% CI: 7.8-10.4%) of the cases, respectively. Taken together, imported foods were estimated to account for 11.8% (95% CI: 5.0-19.0%) of the cases. Other food sources considered had only a minor impact, whereas 25% of the cases could not be associated with any source. This approach of quantifying the contribution of the various sources to human salmonellosis has proved to be a valuable tool in risk management in Denmark and provides an example of how to integrate quantitative risk assessment and zoonotic disease surveillance.
基于1999年丹麦沙门氏菌综合监测数据，我们开发了一个数学模型，用于量化每种主要动物源性食品对人类沙门氏菌病的贡献。该模型用于计算由不同沙门氏菌血清型和噬菌体类型引起的本地病例和散发病例数量，作为这些沙门氏菌类型在动物源性食品中的流行率以及所消费食品源数量的函数。还纳入了一个多参数先验，以考虑血清型和食品源在导致人类沙门氏菌病方面假定但未知的差异。通过在贝叶斯框架下使用马尔可夫链蒙特卡罗模拟将模型拟合到每种沙门氏菌类型报告的本地病例和散发病例数量，估计联合后验分布。本地病例和散发病例数量通过从报告病例总数（即观察数据）中减去估计的与旅行和暴发相关的病例数量获得。发现最重要的食品源是食用鸡蛋和国产猪肉，分别占病例的47.1%（95%可信区间，CI：43.3 - 50.8%）和9%（95%CI：7.8 - 10.4%）。综合来看，估计进口食品占病例的11.8%（95%CI：5.0 - 19.0%）。其他考虑的食品源影响较小，而25%的病例无法与任何来源相关联。这种量化各种来源对人类沙门氏菌病贡献的方法已被证明是丹麦风险管理中的一个有价值工具，并提供了一个如何整合定量风险评估和人畜共患病监测的示例。
