Microbial Risk Analysis最新文献

{"title":"Assessing the Risk of Salmonellosis from Consumption of Conventionally and Alternatively Produced Broiler Meat Prepared In-Home in the United States","authors":"Chase E. Golden,&nbsp;Abhinav Mishra","doi":"10.1016/j.mran.2021.100160","DOIUrl":"10.1016/j.mran.2021.100160","url":null,"abstract":"<div><p><em>Salmonella</em> has long presented a major problem for the food safety of broiler meat. As the popularity of alternatively produced (e.g. organic) broiler meat increases, an understanding of the food safety risks associated with these types of products is needed. The purpose of this study was to develop a retail-to-consumption quantitative microbial risk assessment model that could be used to estimate the differences in risk of salmonellosis acquired from the consumption of conventionally and alternatively produced broiler meat in the United States annually. Data were extracted and used to define distributions that could be used to estimate <em>Salmonella</em> growth during retail storage, transportation, and home storage, as well as concentration changes during preparation and due to cross-contamination. A Monte Carlo simulation with 100,000 iterations was performed to estimate the risk of infection per serving and total number of infections in the United States annually from both meat types. Sensitivity analyses were performed to determine the factors that were highly correlated with increased risk of salmonellosis. Conventionally produced chicken meat was estimated to have a median risk of infection per serving of 6.4 <span><math><mo>×</mo></math></span> 10⁻⁸ and cause an average of approximately 3,880,000 infections annually compared with a median risk of infection per serving of 7.7 <span><math><mo>×</mo></math></span> 10⁻⁸ and average of approximately 641,000 estimated infections for alternatively produced chicken. The sensitivity analysis identified cross-contamination of hands during meal preparation as the most important factor linked to risk. The ‘what-if’ scenario analysis estimated that using antimicrobial soap during hand washing after handling raw chicken can reduce the risk considerably. The developed risk assessment model provides information on the public health risk of conventionally and alternatively produced broiler meat. These results will be useful in determining the key intervention strategies to mitigate the food safety risks associated with the consumption of contaminated chicken products.</p></div>","PeriodicalId":48593,"journal":{"name":"Microbial Risk Analysis","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.mran.2021.100160","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45599402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A semi-quantitative model for ranking the risk of incursion of exotic animal pathogens into a European Union Member State","authors":"Roberto Condoleo ,&nbsp;Rachel A. Taylor ,&nbsp;Robin R.L. Simons ,&nbsp;Paul Gale ,&nbsp;Ziad Mezher ,&nbsp;Helen Roberts","doi":"10.1016/j.mran.2021.100175","DOIUrl":"10.1016/j.mran.2021.100175","url":null,"abstract":"<div><p>Risk ranking tools to prioritize the impact of exotic animal diseases in a country or area are useful to assist risk managers in optimizing the allocation of available resources for the prevention and control of infectious diseases. Although several such tools have already been developed, few focus on the probability of entry of an exotic pathogen into a territory and even fewer are able to rank multiple pathogens at the same time. We developed a semi-quantitative multi-criteria model to estimate the probability of incursion of an exotic pathogen into a European country and use Italy as a case study. We consider the import of 37 animal diseases of importance to Italy, based on OIE notification guidelines, and determine a disease status around the world based on current country-level reporting to the OIE. We identify seven possible pathways for the introduction of a pathogen and for each of them we determine a scoring system to assess for each disease the probability of introduction via each pathway. These scores, alongside the disease status, are used to calculate an overall risk score for each pathogen. The results indicate that the risk of incursion of <em>Echinococcus multilocularis</em>, African swine fever virus, <em>Trichinella</em> spp., lumpy skin disease and foot and mouth disease virus are ranked the highest. Additional analyses identified that the disease ranking is sensitive to the relative importance of the pathways of entry and also the impact of potential mitigation measures. The model is designed to be periodically updated with new data as they become available, e.g. global disease prevalence and trade volume. Therefore, it can be used by official authorities on a regular basis to obtain up-to-date results and consequentially strengthen surveillance towards those pathogens with the highest probability of entry.</p></div>","PeriodicalId":48593,"journal":{"name":"Microbial Risk Analysis","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.mran.2021.100175","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45984878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative microbial risk assessment to estimate the public health risk from exposure to enterotoxigenic E. coli in drinking water in the rural area of Villapinzon, Colombia","authors":"J.L. Moncada Barragán ,&nbsp;Lucumí D.I. Cuesta ,&nbsp;M.S. Rodriguez Susa","doi":"10.1016/j.mran.2021.100173","DOIUrl":"10.1016/j.mran.2021.100173","url":null,"abstract":"<div><p>The consumption of contaminated water is a major cause of acute diarrheal disease (ADD), particularly in rural areas where treatment and control are limited. The aim of this study was to characterize the epidemiological situation and microbiological risk linked to water consumption in the rural area near the capital of Colombia. A cross-sectional study was carried out using secondary data analysis about water quality records and survey information. We described the epidemiological situation of ADD in the municipality and we estimated the risk of ADD by enterotoxigenic <em>E. coli</em> (ETEC) from drinking water in that region using Quantitative Microbial Risk Assessment (QMRA). During the study period, 1318 cases of ADD were reported, with 33% in children under 5. For all zones evaluated the risk exceeds commonly used acceptable risk levels. Inadequate protocols for thermal treatment and subsequent storage increase the risk of illness. The study highlights the need to strengthen intersectoral work, improve water infrastructure, and implement protocols and education about the management of drinking water to reduce health risks.</p></div>","PeriodicalId":48593,"journal":{"name":"Microbial Risk Analysis","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.mran.2021.100173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49637040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection, molecular characterization, and antimicrobial susceptibility, of Campylobacter spp. isolated from shellfish","authors":"Antonio Lozano-León ,&nbsp;Rafael R. Rodríguez-Souto ,&nbsp;Narjol González-Escalona ,&nbsp;José Llovo-Taboada ,&nbsp;José Iglesias-Canle ,&nbsp;Ana Álvarez-Castro ,&nbsp;Alejandro Garrido-Maestu","doi":"10.1016/j.mran.2021.100176","DOIUrl":"10.1016/j.mran.2021.100176","url":null,"abstract":"<div><p>Campylobacteriosis is one of the most important reported zoonosis worldwide. Besides poultry other sources of infection have been described. In the current study, the incidence of <em>Campylobacter</em> spp. was assessed over a five-month period in mussel samples harvested from one of the most important producing areas (Galicia, NW Spain) in Europe. Out of 91 samples screened, 8% were positive and identified as <em>C. lari</em> by MALDI-TOF and whole genome sequencing. All were detected during the colder months (February and March). The antimicrobial resistance and virulence genes analysis indicated that all were multi-resistant to at least 4 antimicrobials. They were negative for the presence of 5 virulence-related genes. This is the first report of this zoonotic pathogen in mussels from one of the most important shellfish producing regions in Europe. The genomes of these 7 <em>C. lari</em> isolates were released to the genome public database at NCBI.</p></div>","PeriodicalId":48593,"journal":{"name":"Microbial Risk Analysis","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.mran.2021.100176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45909812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for sporadic giardiasis: a systematic review and meta-analysis","authors":"Anne Thébault ,&nbsp;Loic Favennec ,&nbsp;Pauline Kooh ,&nbsp;Vasco Cadavez ,&nbsp;Ursula Gonzales-Barron ,&nbsp;Isabelle Villena","doi":"10.1016/j.mran.2020.100158","DOIUrl":"10.1016/j.mran.2020.100158","url":null,"abstract":"<div><p><em>Giardia duodenalis</em> is an important source of gastroenteritis worldwide. Endemic cases have been described in developing and industrialized countries. We analyzed risk factors for sporadic giardiasis by a systematic review and a meta-analysis of the literature. From 72 studies, contact with an infected person, lack of personal hygiene, and attending a child daycare center were identified as risk factors in children and adults.</p><p>Feco-oral transmission was significantly associated with exposure to human sewage/waste water, untreated drinking water and recreational waters. Travel abroad was a risk factor in industrialized countries. No handwashing before eating or preparing food, eating unwashed vegetables, or composite food were significant risk factors. Breastfeeding was a protective factor in developing countries. Interestingly, contact with pets was found as a significant risk factor in children in this meta-analysis. This could be explored in future studies with the comparison of the <em>Giardia</em> assemblage isolated from humans and pets. In the future, it would be interesting to investigate more precisely the type of water, vegetable, and whenever possible the method of preparation/treatment. Environmental and epidemiological investigations of specific risk factors by assemblages and types of <em>Giardia</em> spp. should be further studied. Finally, host factors in relationship with the severity and sequelae of giardiasis deserve future research.</p></div>","PeriodicalId":48593,"journal":{"name":"Microbial Risk Analysis","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.mran.2020.100158","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41653480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for sporadic toxoplasmosis: A systematic review and meta-analysis","authors":"Anne Thebault ,&nbsp;Pauline Kooh ,&nbsp;Vasco Cadavez ,&nbsp;Ursula Gonzales-Barron ,&nbsp;Isabelle Villena","doi":"10.1016/j.mran.2020.100133","DOIUrl":"10.1016/j.mran.2020.100133","url":null,"abstract":"<div><p><span>Toxoplasmosis<span> is considered as the most prevalent parasitic zoonotic infection worldwide. The parasitic cycle is mostly known, but the relative contribution of different sources and pathways of transmission was not previously studied by a meta-analysis. A systematic review and a meta-analysis of case-control, cohort, and cross-sectional studies were performed to determine the main risk factors associated with sporadic </span></span><span><em>Toxoplasma</em></span> infection. Suitable scientific articles were identified through a systematic literature search and subjected to a methodological quality assessment. Mixed-effects meta-analysis models were adjusted by population type – children, mixed population, and pregnant women – to appropriate data partitions. 187 primary studies passed the quality assessment stage, investigating risk factors for sporadic infection with <span><em>Toxoplasma gondii</em></span><span> conducted between 1983 and 2016. Cases were defined by serology.</span></p><p>The meta-analysis of <em>Toxoplasma</em><span> sporadic infections revealed the significance of transmission by environmental factors such as contact with soil and contact with animals, in particular cats. The consumption of raw or undercooked meat and unwashed vegetables significantly increased the odds of acquiring the disease. Shellfish and raw milk were identified as significant sources of toxoplasmosis. Almost all meat categories were identified as risk factors: pork, poultry, beef, processed meat, lamb, and game meat. Contaminated drinking water may play a role in the acquisition of infection. Moreover, the lack of hygiene in preparing food was identified as a risk factor. A significant risk factor for pregnant women is traveling abroad. Lastly, blood transfusion (in pregnant women) and immunocompromised conditions were found associated with positive serology. The broad definition of exposures and the use of serology for the case definition are the main limitations for the interpretation of the results of this meta-analysis. The transmission pathways require further investigations using longitudinal studies and subtyping approaches.</span></p></div>","PeriodicalId":48593,"journal":{"name":"Microbial Risk Analysis","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.mran.2020.100133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45296798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for sporadic cryptosporidiosis: A systematic review and meta-analysis","authors":"Pauline Kooh ,&nbsp;Anne Thébault ,&nbsp;Vasco Cadavez ,&nbsp;Ursula Gonzales-Barron ,&nbsp;Isabelle Villena","doi":"10.1016/j.mran.2020.100116","DOIUrl":"10.1016/j.mran.2020.100116","url":null,"abstract":"<div><p><span><em>Cryptosporidium</em></span> spp. is an important cause of gastrointestinal disease worldwide, responsible for 69 million cases of illness in 2016. Information on the sources and transmission pathways of human cryptosporidiosis results mainly from outbreak investigations.</p><p>A systematic review and a meta-analysis of case-control and cohort studies were performed to determine the main risk factors associated with sporadic cryptosporidiosis. Suitable scientific articles were identified through a systematic literature search and subjected to a methodological quality assessment. From each study, odds ratio (OR) measures were extracted or calculated, as well as study characteristics such as population type, design, type of model and risk factor hierarchy. Mixed-effects meta-analysis models were adjusted by population type to appropriate data partitions.</p><p>From 1985 identified references, the quality assessment stage was passed by 57 cohort and case-control studies focusing on sporadic cryptosporidiosis. The eligible studies were conducted between 1983 and 2016 and provided 568 OR categorized for meta-analysis.</p><p>This meta-analysis identified travel, immunocompromising conditions, contact with infected humans, waterborne transmission (contact with recreational waters, wastewater, and consumption of untreated drinking water), contact with animals and food consumption as the relevant risk factors for sporadic cryptosporidiosis. With regards to food exposures, consumption of meat, dairy products (raw milk) and dishes consumed outside home were found significantly associated with cryptosporidiosis. The consumption of poorly washed fruits and vegetables significantly increases ORs. This meta-analysis reveals that some potential sources of <em>Cryptosporidium</em> such as shellfish or vegetables are under-investigated.</p><p>Future case-control studies for sporadic cryptosporidiosis should include population at risk, and investigate other potential sources in relation to the genotype and the subtype of <em>Cryptosporidium</em> spp.</p></div>","PeriodicalId":48593,"journal":{"name":"Microbial Risk Analysis","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.mran.2020.100116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44212804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategy for systematic review of observational studies and meta-analysis modelling of risk factors for sporadic foodborne diseases","authors":"Ursula Gonzales-Barron ,&nbsp;Anne Thébault ,&nbsp;Pauline Kooh ,&nbsp;Laurence Watier ,&nbsp;Moez Sanaa ,&nbsp;Vasco Cadavez","doi":"10.1016/j.mran.2019.07.003","DOIUrl":"10.1016/j.mran.2019.07.003","url":null,"abstract":"<div><p><span>In order to design effective public health strategies, and, in particular, effective food safety interventions to reduce the burden of foodborne disease, the most important sources of enteric illnesses should be identified. Both case-control and cohort observational studies have for long been powerful approaches among epidemiologists to investigate the association of exposure and illness. In the literature, there are numerous case-control and cohort studies reporting results on risk factors and routes of transmission of sporadic foodborne infections. The objective of this article is to describe, in depth, the strategies implemented for systematic review and meta-analysis of the associations between multiple risk factors and eleven food and waterborne diseases, namely, non-typhoidal salmonellosis, campylobacteriosis, Shiga-toxin </span><em>E. coli</em><span><span> infection, listeriosis, yersiniosis, </span>toxoplasmosis<span>, norovirus infection, hepatitis A, hepatitis E, cryptosporidiosis and giardiasis. First, this article describes the procedures of systematic searches in five bibliographic engines, screening of relevance and assessment of methodological quality according to pre-set criteria. It proceeds with the explanation of a broad data categorisation scheme established to hierarchically group the risk factors into travel, host-specific factors and pathways of exposure (i.e., person-to-person, animal, environment and food routes), with views to harmonising and supporting the integration of outcomes from studies investigating a variety of potential determinants of disease. Next, the article describes the four meta-analysis models that were devised in order to calculate: (i) overall odds-ratios of acquiring the disease due to a specific risk factor by geographical region; (ii) overall odds-ratios of acquiring the disease from the different risk factors; (iii) overall risks of disease from consumption of ready-to-eat and barbecued foods; and (iv) overall effects of food handling (i.e., consuming food in raw, undercooked or unwashed state) and food preparation setting (i.e., eating food prepared outside the home) on risk of disease. The procedures for sensitivity analysis and removal of any influential and potentially-biased odds-ratio; and two methods for publication bias assessment are outlined. Finally, details are given on deviations from the standard risk categorisation scheme for specific foodborne hazards.</span></span></p></div>","PeriodicalId":48593,"journal":{"name":"Microbial Risk Analysis","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.mran.2019.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44686555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for sporadic Yersinia enterocolitica infections: a systematic review and meta-analysis","authors":"Laurent Guillier ,&nbsp;Philippe Fravalo ,&nbsp;Alexandre Leclercq ,&nbsp;Anne Thébault ,&nbsp;Pauline Kooh ,&nbsp;Vasco Cadavez ,&nbsp;Ursula Gonzales-Barron","doi":"10.1016/j.mran.2020.100141","DOIUrl":"10.1016/j.mran.2020.100141","url":null,"abstract":"<div><p><span><em>Yersinia</em><em> enterocolotica</em></span> is an important causative agent of diarrheal illness. A systematic review and meta-analysis of case-control studies were performed to determine the main risk factors associated with sporadic <em>Y. enterocolitica</em> infections. Suitable scientific articles published between 1987 and 2017 were identified through a systematic literature search and subject to methodological quality assessment. From each study, odds ratios (OR) were extracted or calculated, as well as study characteristics such as population type, design, type of model used and risk factor categorization. Mixed-effects meta-analytical models were adjusted by population type to appropriate data partitions. From 807 identified references, the quality assessment stage was passed by 14 case-control studies focusing on sporadic <em>Y. enterocolitica</em> infections which provided 165 ORs for meta-analysis. All studies considered <em>Y. enterocolitica</em> as the cause of sporadic infections and are mainly located in Europe.</p><p>The meta-analysis identified host-specifics factors, animal and food exposures as significant risk factors. The meta-analysis confirms the predominant role of the pig reservoir. The occupational contact with pigs and the consumption of pork meat are significantly associated with sporadic <em>Y. enterocolitica</em> infections occurrence. The consumption of raw or undercooked pork meat is also a very important risk factor. Untreated drinking water was also identified as risk factor. Further studies with other enteropathogenic <em>Yersinia</em> species, especially <em>Y. pseudotuberculosis</em>, and/or from other continents would help to refine conclusions of the meta-analysis of the risk factors of yersiniosis.</p></div>","PeriodicalId":48593,"journal":{"name":"Microbial Risk Analysis","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.mran.2020.100141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47590009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for sporadic hepatitis E infection: a systematic review and meta-analysis","authors":"Nicole Pavio ,&nbsp;Pauline Kooh ,&nbsp;Vasco Cadavez ,&nbsp;Ursula Gonzales-Barron ,&nbsp;Anne Thébault","doi":"10.1016/j.mran.2020.100129","DOIUrl":"10.1016/j.mran.2020.100129","url":null,"abstract":"<div><p>Hepatitis E virus (HEV) is one of the main causes of viral hepatitis infection worldwide. Sources of contamination can vary greatly according to geographical regions and HEV genotypes. HEV is endemic and responsible for large waterborne epidemics involving human HEV-1 or HEV-2 genotypes in regions with limited sanitation, in contrast to industrialized countries, where HEV is mainly a foodborne zoonosis involving HEV-3 and HEV-4 zoonotic genotypes. Limited data on HEV source attribution are available, and all possible sources and transmission pathways of HEV are not fully identified.</p><p>A systematic review and a meta-analysis of case-control and cohort studies (including transversal studies) were performed to determine the main risk factors associated with sporadic hepatitis E infection. Suitable scientific articles were identified through a systematic literature search and subjected to a methodological quality assessment. From each study, odds-ratio (OR) measures were extracted/calculated, as well as study characteristics such as population type, design, and risk factor hierarchy. Mixed-effects meta-analyses models were adjusted by population type to appropriate data partitions.</p><p>Seventy-seven cohort and case-control studies conducted between 1986 and 2016 and investigating risk factors in mixed population, susceptible population, and pregnant women, were included in this meta-analysis. Hepatitis E cases were defined with serological exams and differentiated whenever the serological exam is associated or not with symptoms.</p><p>This meta-analysis identified the parenteral pathway (blood transfusion, tattooing or IV injection, dialysis or hemodialysis), and routes of infection related to contaminated water, animal contact (occupational exposure) and consumption of foods as relevant risk factors for hepatitis E infection.</p><p>With regards to the role of food, as suspected and sometimes proven in several studies, pig meat, pork sausages, and game meat are identified as significant risk factors for HEV, in particular undercooked pig meat, or meat preparations containing pig liver. In addition, consumption of shellfish (oysters and mussels), in which HEV can accumulate when water is environmentally contaminated (from animal or human origin), is also associated with the detection of anti-HEV antibodies.</p><p>The results of this meta-analysis show that symptomatic and infected cases share the most explainable risk factors, and are in agreement with recent studies conducted in Europe. This meta-analysis reveals that some sources such as consumption of insufficiently treated water, shellfish, or vegetables are under-investigated. Future case-control studies should include population at risk but under-investigated, such as transplant recipients, pregnant women and children, and investigate other potential sources of HEV.</p></div>","PeriodicalId":48593,"journal":{"name":"Microbial Risk Analysis","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.mran.2020.100129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43527966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}