Search

Qualitative frameworks are widely employed to tackle urgent animal or public health issues when data are scarce and/or urgent decisions need to be made. In qualitative models, the degree of belief regarding the probabilities of the events occurring along the risk pathway(s) and the outcomes is described in nonnumerical terms, typically using words such as Low, Medium, or High. The main methodological challenge, intrinsic in qualitative models, relates to performing mathematical operations and adherence to the rule of probabilities when probabilities are nonnumerical. Although methods to obtain the qualitative probability from the conditional realization of n events are well-established and consistent with the multiplication rule of probabilities, there is a lack of accepted methods for addressing situations where the probability of an event occurring can increase, and the rule of probability P(AUB) = P(A) + P(B) - P(A∩B) should apply. In this work, we propose a method based on the pairwise summation to fill this methodological gap. Our method was tested on two qualitative models and compared by means of scenario analysis to other approaches found in literature. The qualitative nature of the models prevented formal validation; however, when using the pairwise summation, results consistently appeared more coherent with probability rules. Even if the final qualitative estimate can only represent an approximation of the actual probability of the event occurring, qualitative models have proven to be effective in providing scientific-based evidence to support decision-making. The method proposed in this study contributes to reducing the subjectivity that characterizes qualitative models, improving transparency and reproducibility., (© 2024 The Authors. Risk Analysis published by Wiley Periodicals LLC on behalf of Society for Risk Analysis.)

In accordance with the EFSA Strategy 2027 outlining the need for fit-for-purpose protocols for EFSA generic scientific assessments, the EFSA Panel on Plant Health (PLH Panel) developed standard protocols to harmonise the problem formulation process and outputs for mandates addressing recurrent scientific questions. Three types of recurring EFSA plant health mandates require generic scientific assessments: (i) pest categorisation; (ii) commodity risk assessment for the purpose of derogation to provisions of the EU plant health law and (iii) quantitative pest risk assessment. The three standard protocols are tailored to the appropriate level of detail and build on the existing guidance documents laying out the methods for conducting risk assessment in the plant health domain. To develop a standard protocol for pest categorisation, the PLH Panel adapted the latest version of the standard template reporting the evidence needs and the assessment questions to conclude whether a pest fulfils the criteria for being considered a potential quarantine pest for the EU. To develop a standard protocol for commodity risk assessment, the PLH Panel adapted the procedure and standard templates used for commodity risk assessment of high risk plants. To develop a standard protocol for quantitative pest risk assessments (qPRA), the Panel reviewed the existing guidance document on qPRA and the qPRAs published by the PLH Panel. The hierarchy of assessment questions and sub-questions used were identified and extracted. Based on this, a hierarchically organised IT-tool was formulated as protocol for the planning and documentation of future qPRAs., Competing Interests: If you wish to access the declaration of interests of any expert contributing to an EFSA scientific assessment, please contact interestmanagement@efsa.europa.eu., (© 2024 European Food Safety Authority. EFSA Journal published by Wiley‐VCH GmbH on behalf of European Food Safety Authority.)

Following a request from the European Commission, the EFSA Panel on Plant Health performed a quantitative risk assessment for the EU of Phlyctinus callosus (Coleoptera: Curculionidae), a polyphagous pest occurring in Australia, New Zealand and South Africa. The current risk assessment focused on potential pathways for entry, the climatic conditions allowing establishment, the expected spread capacity and the impact considering a time horizon of 10 years (2023-2032). The Panel identified the import of apples, cut flowers and table grapes as the most relevant entry pathways. Over the next 10 years, an annual median estimate of approximately 49.5 (90% certainty range, CR, ranging from 4.0 to 881.2) potential P. callosus founder populations are expected. When the probability of establishment is considered and climatic indicators are used to define the areas in the EU where establishment is possible, the model estimated a median of 1 founder population every 1.3 years (90% CR: 1 every 30.8 years to 23.3 per year) in the scenario where the areas are defined by the union of all the climatic indicators and 1 founder population every 11.9 years (90% CR: 1 every 256.6 years to 2.5 per year) in the scenario where establishment is possible only in the areas defined by the climatic indicator of minimum soil temperature. The estimated number of founder populations per year is mostly driven by the probability of establishment in the rural areas, infestation rate in table grapes and the probability of transfer to a suitable host in the rural area. The risk of entry for cut flowers and apples is substantially lower than the risk from the table grapes. If such founder populations were to establish, P. callosus is estimated to spread by natural dispersal and common agricultural practices at a rate of 15.5 m/year (90% CR 5.1-46.8 m/year) after a lag phase of 4.0 years (90% CR 1.3-8.7 years). The impact, expressed as percentage loss of the production directly attributable to P. callosus in the areas where establishment is possible and assuming farmers do not apply specific control measures was estimated at 0.5% (90% CR 0.01%-2.8%) for cut flowers/foliage, 5.2% (90% CR 2.2%-11.7%) for apples and 2% (90% CR 1.3%-5.2%) for table grapes. Options for risk reduction are discussed, but their effectiveness is not quantified., Competing Interests: If you wish to access the declaration of interests of any expert contributing to an EFSA scientific assessment, please contact interestmanagement@efsa.europa.eu., (© 2024 European Food Safety Authority. EFSA Journal published by Wiley‐VCH GmbH on behalf of European Food Safety Authority.)

Nontyphoidal Salmonella is one of the major causes of self-limiting diarrheal disease and the most common foodborne pathogen worldwide. It is an important contributor to the burden of foodborne illness in South America, including Peru, where chicken and pork are important vehicles for Salmonella infection. Salmonella infections are underreported, particularly in low- and middle-income countries where concerted action tackling Salmonella along the chicken and pork chains, from primary production to retail, is urgently needed. To support and inform the implementation of new strategies to reduce Salmonella contamination of chicken and pork, this study describes the frequency and distribution of foodborne outbreaks attributed to Salmonella in Peru and evaluates the level of Salmonella in chicken and pork meat sold in markets of three regions of Peru. To that end, we analyzed historical reports of foodborne outbreaks, levels of Salmonella in chicken and pork sold in markets, and the number of mesophiles in the collected meat samples. As a result, the microbiological analysis reveals a widespread contamination of chicken (77.1%) and pork (26.8%) with Salmonella. It also pinpoints Salmonella as the causative agent in nearly half of the outbreaks (47.0%) where the potential origin is identified over a 11-year period with chicken, mayonnaise, and pork being the most likely food vehicles. These results suggest that Salmonella is a major contributor to foodborne illness in Peru and that the monitoring of mesophiles could be a good strategy for surveillance, generating data to support source attribution studies and ultimately evidence-informed policies.

Following a request from the European Commission, the EFSA Panel on Plant Health performed a quantitative risk assessment for the EU of Retithrips syriacus (Mayet) (Thysanoptera: Thripidae), a polyphagous thrips, regarded as a tropical/subtropical pest occurring in several countries of Africa, South America, Asia and in the EU in Cyprus. The current risk assessment focused on potential pathways for entry, the climatic conditions allowing establishment, the expected spread capacity and the impact considering a time horizon of 10 years (2023-2032). The Panel identified the import of cut roses, persimmons, table grapes, as well as plants for planting of the genera Acalypha and Terminalia from third countries and those of Persea americana (avocado) from Israel as the most relevant entry pathways to consider. Over the next 10 years, an annual median estimate of 95 (90% Certainty Range, CR, ranging from 13 to 1832) potential R. syriacus founder populations per year are expected to successfully transfer to a suitable host in the EU NUTS2 regions where the climatic conditions are predicted as suitable for establishment; this value drops to a median of 4.6 founder populations per year (90% CR: 1 every 1.9 years - 85.6 per year) after considering the actual probability of establishment of a potential founder population. The estimated number of founder population per year is mostly driven by the import of cut roses and plants for planting. If such founder populations were to establish, R. syriacus is estimated to spread at a median rate of 0.05 km/year (90% CR 0.02-2.30 km/year) after a median lag phase of 1.1 years (90% CR 0.3-3.3 years). The overall impact on yield (expressed as % of the total agricultural production) directly attributable to R. syriacus when considering: (i) the main R. syriacus hosts in the EU, (ii) the areas of the EU where establishment is possible, (iii) the current agricultural practices and (iv) the evidence of impact from the countries where the pest is established for a long time, was estimated at 0.065% as the median value of the uncertainty distribution (90% CR 0.001%-0.571%). Options for risk reduction are discussed, but the effectiveness was not quantified., Competing Interests: If you wish to access the declaration of interests of any expert contributing to an EFSA scientific assessment, please contact interestmanagement@efsa.europa.eu., (© 2024 European Food Safety Authority. EFSA Journal published by Wiley‐VCH GmbH on behalf of European Food Safety Authority.)

Following a request from the European Commission, the EFSA Panel on Plant Health performed a quantitative pest risk assessment to assess whether the import of cut roses provides a pathway for the introduction of Thaumatotibia leucotreta (Lepidoptera: Tortricidae) into the EU. The assessment was limited to the entry and establishment steps. A pathway model was used to assess how many T. leucotreta individuals would survive and emerge as adults from commercial or household wastes in an EU NUTS2 region climatically suitable in a specific season. This pathway model for entry consisted of three components: a cut roses distribution model, a T. leucotreta developmental model and a waste model. Four scenarios of timing from initial disposal of the cut roses until waste treatment (3, 7, 14 and 28 days) were considered. The estimated median number of adults escaping per year from imported cut roses in all the climatically suitable NUTS2 regions of the EU varied from 49,867 (90% uncertainty between 5,298 and 234,393) up to 143,689 (90% uncertainty between 21,126 and 401,458) for the 3- and 28-day scenarios. Assuming that, on average, a successful mating will happen for every 435 escaping moths, the estimated median number of T. leucotreta mated females per year from imported cut roses in all the climatically suitable NUTS2 regions of the EU would vary from 115 (90% uncertainty between 12 and 538) up to 330 (90% uncertainty between 49 and 923) for the 3- and 28-day scenarios. Due to the extreme polyphagia of T. leucotreta , host availability will not be a limiting factor for establishment. Climatic suitability assessment, using a physiologically based demographic modelling approach, identified the coastline extending from the northwest of the Iberian Peninsula through the Mediterranean as area suitable for establishment of T. leucotreta . This assessment indicates that cut roses provide a pathway for the introduction of T. leucotreta into the EU., (© 2023 European Food Safety Authority. EFSA Journal published by Wiley‐VCH GmbH on behalf of European Food Safety Authority.)

Johne's disease (JD) is a chronic disease of ruminants endemic in the UK and other countries and responsible for large economic losses for the dairy sector. JD is caused by Mycobacterium avium subspecies paratuberculosis (MAP), which typically infects calves that remain latently infected during a long period, making early detection of infection challenging. Cow to calf transmission can occur in-utero, via milk/colostrum or faecal-orally. Understanding of the different transmission routes to calves is important in informing control recommendations. Our aim in this longitudinal study was to measure the association between the transmission routes via the dam and the environment on a calf subsequently testing serologically positive for MAP. The study population comprised of 439 UK dairy calves from 6 herds enrolled between 2012 and 2013. These calves were followed up from birth until 2023. At birth individual calf data was captured. During follow-up, individuals entering the milking herd were quarterly tested for the presence of MAP antibodies using milk ELISA. Cox regression models were used to measure the association between exposure from the dam (in-utero and/or colostrum) or from the environment (long time in dirty yard) and time to first detection of MAP infection. An association between calves born to positive dams and probability of having a MAP positive test result remained after excluding potential MAP transmission via colostrum (Hazard ratio: 2.24; 95% CI: 1.14 - 4.41). Calves unlikely to be infected with MAP via the in-utero or colostrum route, had 3.68 (95% CI: 3.68 1.45-9.33) higher hazard of a positive test result when they stayed longer in a dirty calving area. The effect of the dam infection status on transmission to calves precedes the dam's seroconversion and persists after excluding the potential role of transmission via colostrum. The association between time spent in a dirty calving area and probability of a MAP positive test result highlights the role of environmental contamination as a source of infection in addition to the dam., Competing Interests: Declaration of Competing Interest All authors declare that they have no conflicts of interest., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Shiga toxin-producing Escherichia coli (STEC) O157:H7 is a food and waterborne pathogen with severe public health implications. We report the first-time isolation of this pathogen in the Central Highlands of Peru through standardized culture procedures and polymerase chain reaction (PCR). Escherichia coli strains were cultured from rectal-anal swabs from dairy calves and beef from food markets. The latex agglutination test was used to detect O157 and H7 antigens, and multiplex real-time PCR was carried out to detect virulence-related genes. The STEC O157:H7 strains were isolated from 3.5% (1/28) of beef samples and from 6.0% (3/50) of dairy calves that also carried both eaeA and stx1 genes. Therefore, this pathogen is a potential cause of food/waterborne disease in the region, and its surveillance in both livestock and their products should be improved to characterize the impact of its zoonotic transmission. From 2010 to 2020, E. coli was suspected in 10 outbreaks reported to the Peruvian Ministry of Health. Isolates from future outbreaks should be characterized to assess the burden posed by STEC O157:H7 in Peru.

Following a request from the European Commission, the EFSA Panel on Plant Health performed a risk assessment of the citrus fruit midge Resseliella citrifrugis (Diptera: Cecidomyiidae), an oligophagous species, which feeds on fruits of Citrus spp., and is reported from China. The pest was temporarily regulated in October 2022 (Regulation (EU) 2022/1941, under Art. 30 (2016/2031)). The entry risk assessment focused on the citrus fruit pathway. Three scenarios were considered: A0 (current practice, i.e. regulated pest for the EU), A1 (deregulation) and A2 (A0 with additional stand-alone post-harvest cold treatment). Based on the outputs of the entry model, under scenario A0, slightly less than 40 potential founder populations per year are expected (median; 90%-uncertainty interval between about one per 30 years and about 3,000 per year). Under scenario A1, the risk of entry increases by about three times and reaches about 120 potential founder populations per year (median; 90%-uncertainty interval between about one per 10 years and about 9,000 per year). Compared to scenario A0, the risk of entry is orders of magnitude lower for scenario A2 (median = about one potential founder population per 120 years; 90%-uncertainty interval between one per about 600 million years and about two per year). The main uncertainties in the entry assessment are the probability of transfer, the RRO effectiveness (for scenario A2) and the disaggregation of consignments (transport of citrus fruit in boxes or lots to different locations). For all scenarios, the number of established populations is only slightly lower than the number of potential founder populations. Establishment is thus not expected to be a major constraint for this pest to then spread and cause impacts, despite the uncertainty about the pest thermal requirements. The median lag period between establishment and spread is estimated to be about 18 months (90%-uncertainty interval between about 7 and 54 months). After the lag period, the median rate of spread by flying and due to transport of harvested citrus fruit from orchards to packinghouses is estimated at about 100 km/year (90%-range between about 40 and 500 km/year). The main uncertainties in the spread assessment include the level of susceptibility of cultivars of different citrus species in the EU, the spread rate in China and the climate suitability of the initial spread focus in the EU. The median impact of R. citrifrugis in the EU citrus-growing area (proportion of infested citrus fruit out of harvested citrus fruit) is estimated at about 10% (90%-uncertainty interval between about 2% and 25%). Uncertainties affecting the impact assessment include the susceptibility of different citrus cultivars and the effect of the citrus fruit-harvesting season in the EU (mainly winter, the less suitable season for the pest)., (© 2023 European Food Safety Authority. EFSA Journal published by Wiley‐VCH GmbH on behalf of European Food Safety Authority.)

Those who work in the area of surveillance and prevention of emerging infectious diseases (EIDs) face a challenge in accurately predicting where infection will occur and who (or what) it will affect. Establishing surveillance and control programmes for EIDs requires substantial and long-term commitment of resources that are limited in nature. This contrasts with the unquantifiable number of possible zoonotic and non-zoonotic infectious diseases that may emerge, even when the focus is restricted to diseases involving livestock. Such diseases may emerge from many combinations of, and changes in, host species, production systems, environments/habitats and pathogen types. Given these multiple elements, risk prioritisation frameworks should be used more widely to support decision-making and resource allocation for surveillance. In this paper, the authors use recent examples of EID events in livestock to review surveillance approaches for the early detection of EIDs, and highlight the need for surveillance programmes to be informed and prioritised by regularly updated risk assessment frameworks. They conclude by discussing some unmet needs in risk assessment practices for EIDs, and the need for improved coordination in global infectious disease surveillance.

Invasive Alien Species (IAS), i.e. species introduced by humans outside their natural geographic range, may act as host or vectors of pathogens of both human and animal health relevance. Although it has been recognized that IAS should deserve more attention from a public and animal health perspective, data on the pathogens hosted by these species are not systematically collected and this prevents accurate assessments of IAS-specific risks of disease transmission. To support the future development of disease risk assessments, we systematically reviewed the scientific literature related to the pathogens of the eleven mammal species included in the European list of IAS of concern to gain insight in the amount and quality of data available. Data were analyzed to assess the current knowledge on the pathogens harbored by mammal IAS in natural conditions, through the identification of the main factors associated with research intensity on IAS pathogens and with the IAS observed pathogen species richness, the estimation of the true pathogen species richness for each IAS, and a meta-analysis of prevalence for the pathogens of health relevance. While the review confirmed that mammal IAS harbor pathogens of human and animal health relevance such as rabies virus, West Nile Virus, Borrelia burgdorferi and Mycobacterium bovis, results also highlighted strong information gaps and biases in research on IAS pathogens. In addition, the analyses showed an underestimation of the number of pathogens harbored by these species and the existence of high levels of uncertainty in the prevalence of the pathogens of health significance identified. These results highlight the need towards more efforts in making the available information on IAS pathogens accessible and systematically collected in order to provide data for future investigations and risk assessments, as well as the need of relying on alternative sources of information to assess IAS disease risk, like expert opinions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The authors received no specific funding for this work., (Copyright © 2022 Elsevier B.V. All rights reserved.)

High-pressure processing (HPP) is a non-thermal treatment in which, for microbial inactivation, foods are subjected to isostatic pressures (P) of 400-600 MPa with common holding times (t) from 1.5 to 6 min. The main factors that influence the efficacy (log 10 reduction of vegetative microorganisms) of HPP when applied to foodstuffs are intrinsic (e.g. water activity and pH), extrinsic (P and t) and microorganism-related (type, taxonomic unit, strain and physiological state). It was concluded that HPP of food will not present any additional microbial or chemical food safety concerns when compared to other routinely applied treatments (e.g. pasteurisation). Pathogen reductions in milk/colostrum caused by the current HPP conditions applied by the industry are lower than those achieved by the legal requirements for thermal pasteurisation. However, HPP minimum requirements (P/t combinations) could be identified to achieve specific log 10 reductions of relevant hazards based on performance criteria (PC) proposed by international standard agencies (5-8 log 10 reductions). The most stringent HPP conditions used industrially (600 MPa, 6 min) would achieve the above-mentioned PC, except for Staphylococcus aureus . Alkaline phosphatase (ALP), the endogenous milk enzyme that is widely used to verify adequate thermal pasteurisation of cows' milk, is relatively pressure resistant and its use would be limited to that of an overprocessing indicator. Current data are not robust enough to support the proposal of an appropriate indicator to verify the efficacy of HPP under the current HPP conditions applied by the industry. Minimum HPP requirements to reduce Listeria monocytogenes levels by specific log 10 reductions could be identified when HPP is applied to ready-to-eat (RTE) cooked meat products, but not for other types of RTE foods. These identified minimum requirements would result in the inactivation of other relevant pathogens ( Salmonella and Escherichia coli ) in these RTE foods to a similar or higher extent., (© 2022 Wiley‐VCH Verlag GmbH & Co. KgaA on behalf of the European Food Safety Authority.)

Seroprevalence data for Toxoplasma gondii and Hepatitis E virus (HEV) in wild boar (Sus scrofa), roe deer (Capreolus capreolus), red deer (Cervus elaphus), mouflon (Ovis aries/musimon) and chamois (Rupicapra rupicapra) hunted/culled in northern Italy were used to fit seroprevalence distributions describing the exposure and co-exposure of the species to the two pathogens. The higher proportion of T. gondii and HEV seropositive animals was observed in wild boars with point estimate seroprevalence of 49% (N = 331) and 15% (N = 326) respectively. Data allowed comparisons by area (pre-Alpine Vs Alpine environment) for roe deer, red deer and mouflons. Contrasts between the distributions describing the uncertainty in seroprevalence suggest roe deer, red deer and mouflons have higher probability of being seropositive to T. gondii in pre-Alps. When considering HEV, few seropositive animals were detected and contrasts were symmetrically centred to zero for roe deer and red deer; mouflons shown higher probability of being seropositive in Alpine environment. HEV seropositive animals also included chamois (P = 5.1%, N = 97) in the Alpine districts, confirming circulation of HEV in remote areas. Evidence of HEV and T. gondii co-exposure was limited except for wild boars where it was observed in 30 samples representing 60% of the overall HEV-positive samples. Seroprevalence data of single infection and co-infection are extremely useful to investigate circulation of zoonotic pathogens in wild animals and estimate the foodborne risk of human exposure, however, these type of data do not directly translate into the presence/absence of the pathogen in seropositive and seronegative animals. At benefit of future development of quantitative risk assessments aiming at estimating the risk of human infection/co-infection via consumption of game meat, we developed and made available an online application that allows estimating the probability of the pathogen(s) being present as a function of seroprevalence data., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Competing Interests: The authors have declared that no competing interests exist.

The 2011 EFSA opinion on Campylobacter was updated using more recent scientific data. The relative risk reduction in EU human campylobacteriosis attributable to broiler meat was estimated for on-farm control options using Population Attributable Fractions (PAF) for interventions that reduce Campylobacter flock prevalence, updating the modelling approach for interventions that reduce caecal concentrations and reviewing scientific literature. According to the PAF analyses calculated for six control options, the mean relative risk reductions that could be achieved by adoption of each of these six control options individually are estimated to be substantial but the width of the confidence intervals of all control options indicates a high degree of uncertainty in the specific risk reduction potentials. The updated model resulted in lower estimates of impact than the model used in the previous opinion. A 3-log 10 reduction in broiler caecal concentrations was estimated to reduce the relative EU risk of human campylobacteriosis attributable to broiler meat by 58% compared to an estimate larger than 90% in the previous opinion. Expert Knowledge Elicitation was used to rank control options, for weighting and integrating different evidence streams and assess uncertainties. Medians of the relative risk reductions of selected control options had largely overlapping probability intervals, so the rank order was uncertain: vaccination 27% (90% probability interval (PI) 4-74%); feed and water additives 24% (90% PI 4-60%); discontinued thinning 18% (90% PI 5-65%); employing few and well-trained staff 16% (90% PI 5-45%); avoiding drinkers that allow standing water 15% (90% PI 4-53%); addition of disinfectants to drinking water 14% (90% PI 3-36%); hygienic anterooms 12% (90% PI 3-50%); designated tools per broiler house 7% (90% PI 1-18%). It is not possible to quantify the effects of combined control activities because the evidence-derived estimates are inter-dependent and there is a high level of uncertainty associated with each., (© 2020 European Food Safety Authority. EFSA Journal published by John Wiley and Sons Ltd on behalf of European Food Safety Authority.)

Background: Taenia saginata cysticercus is the larval stage of the zoonotic parasite Taenia saginata, with a life-cycle involving both cattle and humans. The public health impact is considered low. The current surveillance system, based on post-mortem inspection of carcasses has low sensitivity and leads to considerable economic burden. Therefore, in the interests of public health and food production efficiency, this study aims to explore the potential of risk-based and cost-effective meat inspection activities for the detection and control of T. saginata cysticercus in low prevalence settings., Methods: Building on the findings of a study on risk factors for T. saginata cysticercus infection in cattle in Great Britain, we simulated scenarios using a stochastic scenario tree model, where animals are allocated to different risk categories based on their age, sex and movement history. These animals underwent different types of meat inspection (alternative or current) depending on their risk category. Expert elicitation was conducted to assess feasibility of scenarios and provide data for economic analysis. The cost-effectiveness of these scenarios was calculated as an incremental cost-effectiveness ratio, using the number of infected carcasses detected as the technical outcome., Results: Targeting the high-risk population with more incisions into the heart while abandoning incisions into the masseter muscles was found to reduce the total number of inspections and cost, while simultaneously increasing the number of infected carcasses found., Conclusions: The results suggest that, under reasonable assumptions regarding potential improvements to current inspection methods, a more efficient and sensitive meat inspection system could be used on animals categorised according to their risk of harbouring T. saginata cysticercus at slaughter. Such a system could reduce associated cost to the beef industry and lower microbial contamination of beef products, improving public health outcomes.

Quantitative microbial risk assessment (QMRA) models are extensively applied to inform management of a broad range of food safety risks. Inevitably, QMRA modeling involves an element of simplification of the biological process of interest. Two features that are frequently simplified or disregarded are the pathogenicity of multiple strains of a single pathogen and consumer behavior at the household level. In this study, we developed a QMRA model with a multiple-strain approach and a consumer phase module (CPM) based on uncertainty distributions fitted from field data. We modeled exposure to staphylococcal enterotoxin A in raw milk in Lombardy; a specific enterotoxin production module was thus included. The model is adaptable and could be used to assess the risk related to other pathogens in raw milk as well as other staphylococcal enterotoxins. The multiplestrain approach, implemented as a multinomial process, allowed the inclusion of variability and uncertainty with regard to pathogenicity at the bacterial level. Data from 301 questionnaires submitted to raw milk consumers were used to obtain uncertainty distributions for the CPM. The distributions were modeled to be easily updatable with further data or evidence. The sources of uncertainty due to the multiple-strain approach and the CPM were identified, and their impact on the output was assessed by comparing specific scenarios to the baseline. When the distributions reflecting the uncertainty in consumer behavior were fixed to the 95th percentile, the risk of exposure increased up to 160 times. This reflects the importance of taking into consideration the diversity of consumers' habits at the household level and the impact that the lack of knowledge about variables in the CPM can have on the final QMRA estimates. The multiple-strain approach lends itself to use in other food matrices besides raw milk and allows the model to better capture the complexity of the real world and to be capable of geographical specificity.

Foodborne disease as a result of raw milk consumption is an increasing concern in Western countries. Quantitative microbial risk assessment models have been used to estimate the risk of illness due to different pathogens in raw milk. In these models, the duration and temperature of storage before consumption have a critical influence in the final outcome of the simulations and are usually described and modeled as independent distributions in the consumer phase module. We hypothesize that this assumption can result in the computation, during simulations, of extreme scenarios that ultimately lead to an overestimation of the risk. In this study, a sensorial analysis was conducted to replicate consumers' behavior. The results of the analysis were used to establish, by means of a logistic model, the relationship between time-temperature combinations and the probability that a serving of raw milk is actually consumed. To assess our hypothesis, 2 recently published quantitative microbial risk assessment models quantifying the risks of listeriosis and salmonellosis related to the consumption of raw milk were implemented. First, the default settings described in the publications were kept; second, the likelihood of consumption as a function of the length and temperature of storage was included. When results were compared, the density of computed extreme scenarios decreased significantly in the modified model; consequently, the probability of illness and the expected number of cases per year also decreased. Reductions of 11.6 and 12.7% in the proportion of computed scenarios in which a contaminated milk serving was consumed were observed for the first and the second study, respectively. Our results confirm that overlooking the time-temperature dependency may yield to an important overestimation of the risk. Furthermore, we provide estimates of this dependency that could easily be implemented in future quantitative microbial risk assessment models of raw milk pathogens., (Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)