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用于评估旨在预防人类感染大肠杆菌O157:H7疾病的收获前干预措施使用情况的简化分析。

Streamlined analysis for evaluating the use of preharvest interventions intended to prevent Escherichia coli O157:H7 illness in humans.

作者信息

Withee James, Williams Michael, Disney Terry, Schlosser Wayne, Bauer Nate, Ebel Eric

机构信息

Risk Assessment and Residue Division, Office of Public Health Science, Food Safety Inspection Service, U.S. Department of Agriculture, Fort Collins, Colorado 80526, USA.

出版信息

Foodborne Pathog Dis. 2009 Sep;6(7):817-25. doi: 10.1089/fpd.2008.0255.

DOI:10.1089/fpd.2008.0255
PMID:19737060
Abstract

The U.S. Department of Agriculture Food Safety Inspection Service is responsible for ensuring the safety of meat, poultry, and egg products consumed in the United States. Here we describe a risk assessment method that provides quantitative criteria for decision makers tasked with developing food safety policies. To demonstrate the utility of this method, we apply it to a hypothetical case study on the use of an Escherichia coli O157:H7 cattle vaccine to prevent human illness caused by consuming beef. A combination of quantitative risk assessment methods and marginal economic analysis are used to describe the maximum cost per unit that would still allow the vaccine to be a cost-effective intervention as well as the minimum effectiveness it could have at a fixed cost. We create two economic production functions where the input is number of vaccinated cattle and the output is human illnesses prevented. The production functions are then used for marginal economic analysis to assess the cost/benefit ratio of using the vaccine to prevent foodborne illness. In our case study, it was determined that vaccinating the entire U.S. herd at a cost of between $2.29 and $9.14 per unit (depending on overall effectiveness of the vaccine) would be a cost-effective intervention for preventing E. coli O157:H7 illness in humans. In addition, we determined that vaccinating only a given fraction of the herd would be cost effective for vaccines that are less effective or more costly. For example, a vaccine costing $9.00 per unit that had a 100% efficacy but required 100% herd coverage for immunity would be cost effective for use in about 500,000 cattle each year-equating to an estimated 750 human illnesses prevented per annum. We believe this approach could be useful for public health policy development in a wide range of applications.

摘要

美国农业部食品安全检验局负责确保在美国消费的肉类、家禽和蛋类产品的安全。在此,我们描述一种风险评估方法,该方法为负责制定食品安全政策的决策者提供定量标准。为证明此方法的实用性,我们将其应用于一个关于使用大肠杆菌O157:H7牛疫苗预防食用牛肉导致人类疾病的假设案例研究。结合定量风险评估方法和边际经济分析来描述每单位仍能使疫苗成为具有成本效益干预措施的最高成本,以及在固定成本下它可能具有的最低有效性。我们创建两个经济生产函数,其中输入是接种疫苗的牛的数量,输出是预防的人类疾病数量。然后将生产函数用于边际经济分析,以评估使用疫苗预防食源性疾病的成本/效益比。在我们的案例研究中,确定以每单位2.29美元至9.14美元的成本(取决于疫苗的总体有效性)为美国所有牛群接种疫苗,对于预防人类大肠杆菌O157:H7疾病将是一种具有成本效益的干预措施。此外,我们确定对于有效性较低或成本较高的疫苗,仅对给定比例的牛群进行接种将具有成本效益。例如,一种每单位成本为9.00美元、具有100%效力但需要100%牛群覆盖率才能产生免疫力的疫苗,每年用于约500,000头牛将具有成本效益——相当于每年估计预防750例人类疾病。我们相信这种方法在广泛的应用中可能对公共卫生政策制定有用。

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