Hanne Rosenquist

Quantitative risk assessment of human campylobacteriosis associated with thermophilic Campylobacter species in chickens

A quantitative risk assessment comprising the elements hazard identification, hazard characterization, exposure assessment, and risk characterization has been prepared to assess the effect of different mitigation strategies on the number of human cases in Denmark associated with thermophilic Campylobacter spp. in chickens. To estimate the human exposure to Campylobacter from a chicken meal and the number of human cases associated with this exposure, a mathematical risk model was developed. The model details the spread and transfer of Campylobacter in chickens from slaughter to consumption and the relationship between ingested dose and the probability of developing campylobacteriosis. Human exposure was estimated in two successive mathematical modules. Module 1 addresses changes in prevalence and numbers of Campylobacter on chicken carcasses throughout the processing steps of a slaughterhouse. Module 2 covers the transfer of Campylobacter during food handling in private kitchens. The age and sex of consumers were included in this module to introduce variable hygiene levels during food preparation and variable sizes and compositions of meals. Finally, the outcome of the exposure assessment modules was integrated with a Beta-Poisson dose-response model to provide a risk estimate. Simulations designed to predict the effect of different mitigation strategies showed that the incidence of campylobacteriosis associated with consumption of chicken meals could be reduced 30 times by introducing a 2 log reduction of the number of Campylobacter on the chicken carcasses. To obtain a similar reduction of the incidence, the flock prevalence should be reduced approximately 30 times or the kitchen hygiene improved approximately 30 times. Cross-contamination from positive to negative flocks during slaughter had almost no effect on the human Campylobacter incidence, which indicates that implementation of logistic slaughter will only have a minor influence on the risk. Finally, the simulations showed that people in the age of 18-29 years had the highest risk of developing campylobacteriosis.

A comparison of risk assessments on Campylobacter in broiler meat.

In recent years, several quantitative risk assessments for Campylobacter in broiler meat have been developed to support risk managers in controlling this pathogen. The models encompass some or all of the consecutive stages in the broiler meat production chain: primary production, industrial processing, consumer food preparation, and the dose-response relationship. The modelling approaches vary between the models, and this has supported the progress of risk assessment as a research discipline. The risk assessments are not only used to assess the human incidence of campylobacteriosis due to contaminated broiler meat, but more importantly for analyses of the effects of control measures at different stages in the broiler meat production chain. This review paper provides a comparative overview of models developed in the United Kingdom, Denmark, the Netherlands and Germany, and aims to identify differences and similarities of these existing models. Risk assessments developed for FAO/WHO and in New Zealand are also briefly discussed. Although the dynamics of the existing models may differ substantially, there are some similar conclusions shared between all models. The continuous introduction of Campylobacter in flocks implies that monitoring for Campylobacter at the farm up to one week before slaughter may result in flocks that are falsely tested negative: once Campylobacter is established at the farm, the within-flock prevalence increases dramatically within a week. Consequently, at the point of slaughter, the prevalence is most likely to be either very low (<5%) or very high (>95%). In evaluating control strategies, all models find a negligible effect of logistic slaughter, the separate processing of positive and negative flocks. Also, all risk assessments conclude that the most effective intervention measures aim at reducing the Campylobacter concentration, rather than reducing the prevalence. During the stage where the consumer handles the food, cross-contamination is generally considered to be more relevant than undercooking. An important finding, shared by all, is that the tails of the distributions describing the variability in Campylobacter concentrations between meat products and meals determine the risks, not the mean values of those distributions. Although a unified model for risk assessment of Campylobacter in the broiler meat production would be desirable in order to promote a European harmonized approach, it is neither feasible nor desirable to merge the different models into one generic risk assessment model. The purpose of such a generic model has yet to be defined at a European level and the large variety in practices between countries, especially related to consumer food preparation and consumption, complicates a unified approach.

Chemical decontamination of Campylobacter jejuni on chicken skin and meat.

This study evaluated the effectiveness of 11 chemical compounds to reduce Campylobacter jejuni on chicken skin and meat samples dipped in chemical solutions. Treatment of skin samples for 1 min using tartaric acid (2%) and caprylic acid sodium salt (5%) caused reductions of C. jejuni NCTC11168, which were not significantly different from the reduction obtained by sterile water (0.95 log). Statistically larger reductions (1.57 to 3.81 log) were caused by formic acid (2%), lactic acid (2.5%), trisodium phosphate (10%), capric acid sodium salt (5%), grapefruit seed extract (1.6%), and chlorhexidine diacetate salt hydrate (1%). The most effective compounds were cetylpyridinium chloride (0.5%) and benzalkonium chloride (1%) (>4.2 log). However, when these treated samples were stored for 24 h at 5 degrees C, cetylpyridinium chloride, benzalkonium chloride, and grapefruit seed extract were less effective, indicating that some cells may recover after a 1-min treatment with these chemicals. An increase in treatment time to 15 min resulted in higher effectiveness of trisodium phosphate and formic acid. Interestingly, when reduction of the C. jejuni population was compared on chicken skin and meat, sterile water and lactic acid caused considerably larger reductions on skin than on meat, whereas the opposite was seen for caprylic acid sodium salt. In conclusion, this study has identified chemicals with substantial reduction effects on C. jejuni. The analysis has further emphasized that treatment time and food matrix affect the outcome in an unpredictable manner and, therefore, detailed studies are needed to evaluate the reduction effectiveness of chemicals.

Occurrence of natural Bacillus thuringiensis contaminants and residues of Bacillus thuringiensis-based insecticides on fresh fruits and vegetables

ABSTRACT A total of 128 Bacillus cereus-like strains isolated from fresh fruits and vegetables for sale in retail shops in Denmark were characterized. Of these strains, 39% (50/128) were classified as Bacillus thuringiensis on the basis of their content of cry genes determined by PCR or crystal proteins visualized by microscopy. Random amplified polymorphic DNA analysis and plasmid profiling indicated that 23 of the 50 B. thuringiensis strains were of the same subtype as B. thuringiensis strains used as commercial bioinsecticides. Fourteen isolates were indistinguishable from B. thuringiensis subsp. kurstaki HD1 present in the products Dipel, Biobit, and Foray, and nine isolates grouped with B. thuringiensis subsp. aizawai present in Turex. The commercial strains were primarily isolated from samples of tomatoes, cucumbers, and peppers. A multiplex PCR method was developed to simultaneously detect all three genes in the enterotoxin hemolysin BL (HBL) and the nonhemolytic enterotoxin (NHE), respectively. This revealed that the frequency of these enterotoxin genes was higher among the strains indistinguishable from the commercial strains than among the other B. thuringiensis and B. cereus-like strains isolated from fruits and vegetables. The same was seen for a third enterotoxin, CytK. In conclusion, the present study strongly indicates that residues of B. thuringiensis-based insecticides can be found on fresh fruits and vegetables and that these are potentially enterotoxigenic.

Reduction of Thermotolerant Campylobacter Species on Broiler Carcasses following Physical Decontamination at Slaughter

To reduce the incidences of human Campylobacter infections, a number of countries are investigating methods for reducing human exposure to Campylobacter from broiler meat. In addition to implementing biosecurity measures at the farm, Campylobacter may be controlled by reducing Campylobacter counts through physical decontamination of the meat. The current study was conducted to compare the Campylobacter-reducing ability of three physical decontamination techniques, forced air chilling, crust freezing, and steam-ultrasound, performed in the plant with naturally contaminated broiler chickens. The effects of all three techniques were evaluated and compared with the effect of freezing. Mean reductions obtained were 0.44 log CFU per carcass, 0.42 log CFU per sample, and > or = 2.51 log CFU per carcass, respectively. All techniques resulted in significant reductions of the Campylobacter concentration on the carcasses (P < 0.05). However, none of the techniques were as effective as freezing based on reductions in Campylobacter counts and on adverse effects. The increase in Campylobacter counts on carcasses following visceral rupture during the evisceration operation also was examined. Visceral rupture resulted in an increase of 0.9 log CFU per carcass, suggesting that Campylobacter counts also may be reduced by optimizing the hygienic design of equipment or by physical removal of fecal contamination.

Danish strategies to control Campylobacter in broilers and broiler meat: facts and effects.

Thermotolerant Campylobacter spp. have been the most common bacterial cause of human gastrointestinal disease in Denmark since 1999. In 2003, the Danish voluntary strategy to control Campylobacter was intensified. The focus was on biosecurity, allocation of meat from Campylobacter-negative broilers to the production of chilled products, and consumer information campaigns. From 2002 to 2007, the percentage of Campylobacter-positive broiler flocks at slaughter decreased from 43% to 27%. After processing, Campylobacter-positive samples of chilled broiler meat fell from 18% in 2004 to 8% in 2007. Furthermore, the number of registered human Campylobacter cases decreased by 12%; from 4379 cases in 2002 to 3865 cases in 2007. We believe that the observed decrease in the occurrence of Campylobacter in broilers and broiler meat and the coincidental fall in the number of registered human cases is, in part, a result of the implemented control strategy.

Characterization of Campylobacter phages including analysis of host range by selected Campylobacter Penner serotypes

BackgroundThe predominant food borne pathogen in the western world today is Campylobacter. Campylobacter specific bacteriophages (phages) have been proposed as an alternative agent for reducing the burden of Campylobacter in broilers. One concern in relation to phage biocontrol is the narrow host range often displayed by phages. To identify the potential of phages as a Campylobacter reducing agent we needed to determine their infectivity on a panel of isolates representing the Campylobacter strains found in broilers as well as humans.ResultsIn this study, Campylobacter phages were isolated from the intestines of broilers and ducks and from abattoir sewage. Twelve phages were investigated to determine their ability to infect the Campylobacter Penner serotypes commonly present in Danish poultry and patients with campylobacteriosis. A total of 89% of the Campylobacter jejuni strains and 14% of the Campylobacter coli strains could be infected by at least one of the bacteriophages. The majority of the phages infected the most common serotypes in Danish broilers (O:1,44; O:2; O:4-complex), but showed limited ability to infect 21 of the less frequent Campylobacter serotypes. Pulse field gel electrophoresis (PFGE) and restriction endonuclease analysis (REA) were used to characterize the phage genomes. Three categories of bacteriophages were observed. I: a genome size of ~194 kb and refractory to digestion with HhaI; II: a genome size of ~140 kb and digestible by HhaI; and III: a genome size undeterminable in PFGE. The categorization of the phages correlated with the host range patterns displayed by the phages. Six phages were subjected to transmission electron microscopy (TEM). They all belonged to the family of Myoviridae.ConclusionWe have characterized and identified the host range of 12 Danish Campylobacter phages. Due to their ability to infect the majority of the common serotypes in Denmark we suggest the phages can become an effective agent in the effort to reduce the incidence of campylobacteriosis in Denmark. This study provides the basis for future experiments in Campylobacter phages and knowledge for the selection of Campylobacter phages for biocontrol in broilers.

Effect of organic acids and marination ingredients on the survival of Campylobacter jejuni on meat.

The aim of this study was to determine whether marination of chicken meat in different food ingredients can be used to reduce populations of Campylobacter jejuni. C. jejuni strains were exposed to different organic acids (tartaric, acetic, lactic, malic, and citric acids) and food marinating ingredients at 4 degrees C in broth and on chicken meat. The organic acids (0.5%) reduced populations of C. jejuni in broth (chicken juice and brain heart infusion broth) by 4 to 6 log units (after 24 h); tartaric acid was the most efficient treatment. Large strain variation was observed among 14 C. jejuni isolates inoculated in brain heart infusion broth containing 0.3% tartaric acid. On chicken meat medallions, reductions of C. jejuni were 0.5 to 2 log units when tartaric acid solutions (2, 4, 6, and 10%) were spread onto the meat. Analysis of acidic food ingredient (e.g., vinegar, lemon juice, pomegranate syrup, and soya sauce) revealed that such ingredients reduced counts of C. jejuni by at least 0.8 log units on meat medallions. Three low pH marinades (pH < 3) based on pomegranate syrup, lemon juice, and white wine vinegar were prepared. When applied to whole filets, these marinades resulted in a reduction of approximately 1.2 log units after 3 days of storage. Taste evaluations of chicken meat that had been marinated and then fried were graded positively for flavor and texture. Thus, success was achieved in creating a marinade with an acceptable taste that reduced the counts of C. jejuni.

A Model of Hygiene Practices and Consumption Patterns in the Consumer Phase

A mathematical model is presented, which addresses individual hygiene practices during food preparation and consumption patterns in private homes. Further, the model links food preparers and consumers based on their relationship to household types. For different age and gender groups, the model estimates (i) the probability of ingesting a meal where precautions have not been taken to avoid the transfer of microorganisms from raw food to final meal (a risk meal), exemplified by the event that the cutting board was not washed during food preparation, and (ii) the probability of ingesting a risk meal in a private home, where chicken was the prepared food item (a chicken risk meal). Chicken was included in the model, as chickens are believed to be the major source of human exposure to the foodborne pathogen Campylobacter. Monte Carlo simulations showed that the probability of ingesting a risk meal was highest for young males (aged 18-29 years) and lowest for the elderly above 60 years of age. Children aged 0-4 years had a higher probability of ingesting a risk meal than children aged 5-17 years. This difference between age and gender groups was ascribed to the variations in the hygiene levels of food preparers. By including the probability of ingesting a chicken meal at home, simulations revealed that all age groups, except the group above 60 years of age, had approximately the same probability of ingesting a chicken risk meal, the probability of females being slightly higher than that of males. The simulated results show that the probability of ingesting a chicken risk meal at home does not only depend on the hygiene practices of the persons preparing the food, but also on the consumption patterns of consumers, and the relationship between people preparing and ingesting food. This finding supports the need of including information on consumer behavior and preparation hygiene in the consumer phase of exposure assessments.

Source attribution of human campylobacteriosis in Denmark

SUMMARY This study assesses the contribution of different sources of human campylobacteriosis in Denmark using two different source-attribution approaches. In total, 794 non-human isolates and 406 isolates from human cases (domestic, travel related, and cases with unknown travel history) were collected. Isolates were characterized by multilocus sequence typing, flaA typing and susceptibility to antibiotics. Both models used indicate that the major burden of human campylobacteriosis in Denmark originates from the domestic broiler chicken reservoir. The second most important reservoir was found to be cattle. The Asymmetric Island model attributed 52% [95% credibility interval (CrI) 37-67] to Danish chicken, 17% (95% CrI 3-33) to imported chicken, and 17% (95% CrI 7-28) to cattle. Similarly, the Campylobacter source-attribution model apportioned 38% (95% CrI 28-47) to Danish chicken, 14% (95% CrI 10-18) to imported chicken, and 16% (95% CrI 7-25) to cattle. The addition of flaA type as an extra discriminatory typing parameter did not change the attribution of cases markedly.