Department of Gastrointestinal, Emerging and Zoonotic Infections, Health Protection Agency Centre for Infections, London, United Kingdom.
Foodborne Pathog Dis. 2010 Jul;7(7):749-56. doi: 10.1089/fpd.2009.0439.
Human listeriosis is a rare but serious foodborne disease, with high morbidity and mortality in vulnerable populations (e.g., pregnant women, the elderly, and the immunocompromised). The disease is predominantly caused by the consumption of contaminated ready-to-eat foods. Since 2001, an increase in the number of listeriosis cases has been observed in several European Union countries, including England and Wales, predominantly in the over-60s population. The cause of this selective increased incidence is unknown. The Hald Salmonella Bayesian source attribution model was adapted to determine the potential of this approach to quantify the contribution of different food sources to the burden of human listeriosis in England and Wales from 2004 to 2007. The most important food sources for the overall population were multicomponent foods (sandwiches and prepacked mixed salad vegetables) (23.1%), finfish (16.8%), and beef (15.3%). Attribution of major sources of infection was similar for the elderly population (>or=60 years old, multicomponent foods [22.0%], finfish [14.7%], and beef [13.6%]). For pregnancy-associated cases, beef (12.3%), milk and milk products (11.8%), and finfish (11.2%) were more important sources of infection. The adapted model also showed that the serotype 4b was associated with relatively more human infections than that of other serotypes; further, the subtype 4b amplified fragment-length polymorphism V was associated with more pregnancy-associated cases than other subtypes of 4b. This approach of quantifying the contribution of various food sources to human listeriosis provides a useful tool in food safety risk analysis, and underlines the need for further emphasis to be given to the reduction of Listeria monocytogenes in high-risk foods, such as multicomponent foods, which are consumed without any further treatment. The need for targeted dietary advice for the elderly population is also highlighted.
人李斯特菌病是一种罕见但严重的食源性疾病，在脆弱人群（如孕妇、老年人和免疫功能低下者）中的发病率和死亡率较高。该病主要由食用受污染的即食食品引起。自 2001 年以来，包括英国和威尔士在内的几个欧盟国家的李斯特菌病病例数量有所增加，主要发生在 60 岁以上人群中。这种选择性发病率增加的原因尚不清楚。我们对 Hald 沙门氏菌贝叶斯源归因模型进行了调整，以确定该方法定量确定不同食物来源对英格兰和威尔士 2004 年至 2007 年期间人类李斯特菌病负担的贡献的潜力。对总人口而言，最重要的食物来源是多成分食品（三明治和预包装混合沙拉蔬菜）（23.1%）、鱼（16.8%）和牛肉（15.3%）。对老年人群（>=60 岁）而言，主要感染源的归因也类似，多成分食品（22.0%）、鱼（14.7%）和牛肉（13.6%）。对于与妊娠相关的病例，牛肉（12.3%）、牛奶和奶制品（11.8%）和鱼（11.2%）是更重要的感染源。调整后的模型还表明，血清型 4b 与相对更多的人类感染有关，而其他血清型则较少；此外，4b 亚型扩增片段长度多态性 V 与更多的妊娠相关病例有关，而其他 4b 亚型则较少。这种定量评估各种食物来源对人类李斯特菌病贡献的方法为食品安全风险分析提供了一种有用的工具，并强调需要进一步重视减少高危食品（如多成分食品）中的李斯特菌单核细胞增生李斯特菌，这些食品无需进一步处理即可食用。还强调了针对老年人的有针对性饮食建议的必要性。
