Quantitative risk assessment for Listeria monocytogenes in smoked or gravad salmon and rainbow trout in Sweden.

The objective of the present work was to develop a quantitative risk assessment model in which the exposure and risk of acquiring listeriosis from consumption of packaged smoked or gravad salmon and rainbow trout were estimated. An Excel spreadsheet model was constructed in which variables were represented by distributions based on surveys of L. monocytogenes in these food products, and on demographic and consumption data. Growth or inactivation was not included in the model. The model was run through Monte Carlo simulations using the @Risk software (Palisade Corporation). The probability of illness per serving was calculated using two dose-response models from the literature. The first was an exponential model in which the species specific constant R, that helps define the dose-response curve, previously has been estimated to be 1.18 x 10(-10) based on German data (GR). In this study, R was estimated to 5.6 x 10(-10) based on Swedish data. The second model was a flexible Weibull-Gamma model (WG), with different coefficients for high- and low-risk groups. The exponential model (GR), although conservative and generally overestimating the risk, still predicted a lower probability of illness than the WG-model. The estimated mean risk per serving was 2.8 x 10(-5) (GR, high-risk group), 2.0 x 10(-3) (WG, low-risk group) and 0.016 (WG, high-risk group), respectively. The average number of reported listeriosis cases in Sweden is 37 per year. In comparison, the mean number of annual cases predicted by the risk assessment model was 168 (range 47 to 2800, GR, high-risk group), and 95 000 (range 34 000 to 1.6 x 10(6), WG high-risk group), respectively. If 1 to 10% (uniform distribution) of strains, instead of all, were considered virulent, the mean number of predicted cases would decrease to nine (GR) and 5200 (WG), respectively. The mean annual cumulative individual risk in the high-risk group based on a monthly exposure was estimated to be 4.0 x 10(-4) (range 8.0 x 10(-8) to 5.4 x 10(-3), GR). This risk increased to 1.5 x 10(-3) (range 1.7 x 10(-5) to 9.2 x 10(-3), GR) based on a weekly exposure. The risk assessment model was most sensitive to the input distribution describing the level of contamination and to a lesser degree on the prevalence of L. monocytogenes, the proportion of virulent strains, and serving sizes. A lack of data on the prevalence and concentration of L. monocytogenes in these products, dose-response data and quantitative information on the proportion of virulent strains were identified.