Falk L E, Fader K A, Cui D S, Totton S C, Fazil A M, Lammerding A M, Smith B A
Public Health Agency of Canada,Guelph,Ontario,Canada.
Epidemiol Infect. 2016 Oct;144(13):2743-58. doi: 10.1017/S0950268816000327. Epub 2016 Mar 28.
Although infection by the pathogenic bacterium Listeria monocytogenes is relatively rare, consequences can be severe, with a high case-fatality rate in vulnerable populations. A quantitative, probabilistic risk assessment tool was developed to compare estimates of the number of invasive listeriosis cases in vulnerable Canadian subpopulations given consumption of contaminated ready-to-eat delicatessen meats and hot dogs, under various user-defined scenarios. The model incorporates variability and uncertainty through Monte Carlo simulation. Processes considered within the model include cross-contamination, growth, risk factor prevalence, subpopulation susceptibilities, and thermal inactivation. Hypothetical contamination events were simulated. Results demonstrated varying risk depending on the consumer risk factors and implicated product (turkey delicatessen meat without growth inhibitors ranked highest for this scenario). The majority (80%) of listeriosis cases were predicted in at-risk subpopulations comprising only 20% of the total Canadian population, with the greatest number of predicted cases in the subpopulation with dialysis and/or liver disease. This tool can be used to simulate conditions and outcomes under different scenarios, such as a contamination event and/or outbreak, to inform public health interventions.
尽管致病性细菌单核细胞增生李斯特菌的感染相对罕见，但后果可能很严重，在易感人群中的病死率很高。开发了一种定量概率风险评估工具，用于比较在各种用户定义的情景下，食用受污染的即食熟食肉类和热狗后，加拿大易感亚人群中侵袭性李斯特菌病病例数的估计值。该模型通过蒙特卡洛模拟纳入了变异性和不确定性。模型中考虑的过程包括交叉污染、生长、风险因素流行率、亚人群易感性和热灭活。模拟了假设的污染事件。结果表明，风险因消费者风险因素和相关产品而异（在此情景下，不含生长抑制剂的火鸡熟食肉类风险最高）。预测的李斯特菌病病例中，大多数（80%）发生在仅占加拿大总人口20%的高危亚人群中，透析和/或肝病亚人群中的预测病例数最多。该工具可用于模拟不同情景下的情况和结果，如污染事件和/或疫情爆发，为公共卫生干预提供信息。
