Volume 27, Number 1—January 2021
Research
Attribution of Illnesses Transmitted by Food and Water to Comprehensive Transmission Pathways Using Structured Expert Judgment, United States
Elizabeth Beshearse
, Beau B. Bruce, Gabriela F. Nane, Roger M. Cooke, Willy Aspinall, Tine Hald, Stacy M. Crim, Patricia M. Griffin, Kathleen E. Fullerton, Sarah A. Collier, Katharine M. Benedict, Michael J. Beach, Aron J. Hall, and Arie H. Havelaar
, Beau B. Bruce, Gabriela F. Nane, Roger M. Cooke, Willy Aspinall, Tine Hald, Stacy M. Crim, Patricia M. Griffin, Kathleen E. Fullerton, Sarah A. Collier, Katharine M. Benedict, Michael J. Beach, Aron J. Hall, and Arie H. Havelaar
Table 4
Source attribution results for major transmission pathways, structured expert judgment, United States, 2017*
| Pathogen name |
Mean % (95% uncertainty interval) |
||||
|---|---|---|---|---|---|
| Foodborne |
Waterborne |
Person-to-person |
Animal contact |
Environmental |
|
| Bacteria | |||||
| Brucella spp. | 45 (13–77) | 10 (0–42) | Blocked | 36 (10–73) | 9 (0–32) |
| Campylobacter spp. | 57 (30–80) | 13 (1–31) | 7 (0–23) | 16 (3–35) | 7 (0–30) |
| Enterotoxigenic Escherichia coli | 69 (37– 91) | 9 (0–38) | 7 (0–38) | Blocked | 15 (2–33) |
| STEC O157 | 60 (40–77) | 5 (1–13) | 16 (4–33) | 12 (3–25) | 7 (1–17) |
| STEC non-O157 | 50 (26–75) | 6 (0–17) | 15 (2–34) | 21 (2–46) | 8 (0–24) |
| E. coli, other diarrheagenic | 55 (27–80) | 9 (0–30) | 16 (2–39) | 9 (0–33) | 12 (0–33) |
| Legionella spp. | Blocked | 97 (67–100) | 0 (0–1) | Blocked | 2 (0–28) |
| Mycobacterium bovis | 75 (36–98) | 1 (0–9) | 9 (0–39) | 13 (0–50) | 2 (0–12) |
| Nontuberculous Mycobacterium spp. | Blocked | 72 (39–94) | 4 (0–21) | 2 (0–35) | 22 (0–49) |
| Pseudomonas spp., otitis externa | Blocked | 81 (67–95) | 3 (0–13) | 1 (0–4) | 15 (1–,25) |
| Pseudomonas spp., septicemia | Blocked | 22 (3–53) | 2 (0–19) | 2 (0–11) | 74 (41–94) |
| Pseudomonas spp., pneumonia | Blocked | 51 (14–80) | 4 (1–32) | 0 (0–2) | 45 (15–80) |
| Salmonella enterica, nontyphoidal | 66 (48–81) | 6 (0–22) | 7 (0–16) | 11 (3–24) | 9 (2–21) |
| S. enterica, nontyphoidal, age <5 y | 46 (20–66) | 7 (0–26) | 18 (6–35) | 13 (2–30) | 16 (2–36) |
| S. enterica serotype Enteritidis | 80 (63–92) | 4 (0–11) | 7 (1–16) | 5 (0–19) | 4 (1–14) |
| S. enterica serotype I 4,[5],12:i:- | 66 (40–82) | 6 (1–15) | 8 (1–17) | 12 (2–27) | 7 (0–20) |
| S. enterica serotype Javiana | 56 (29–76) | 7 (1–20) | 9 (2–22) | 14 (3–33) | 14 (2–29) |
| S. enterica serotype Newport | 74 (50–86) | 2 (0–9) | 7 (1–16) | 8 (1–19) | 8 (2–18) |
| S. enterica serotype Typhimurium | 59 (27–78) | 7 (1–18) | 8 (2–19) | 14 (3–29) | 13 (2–30) |
| S. enterica, all other serotypes group 1 | 60 (29–79) | 6 (1–18) | 9 (2–21) | 12 (2–29) | 12 (3–,29) |
| S. enterica, all other serotypes group 2 | 40 (10–65) | 7 (1–24) | 10 (2–26) | 17 (1–40) | 26 (6–51) |
| Shigella spp. | 8 (1–36) | 4 (1–21) | 81 (48–93) | Blocked | 6 (0–26) |
| Staphylococcus aureus | Blocked | 75 (23–98) | 18 (1–71) | 1 (0–5) | 5 (0–37) |
| Streptococcus spp., group A | 4 (0–33) | 1 (0–6) | 92 (55–99) | 1 (0–12) | 2 (0–19) |
| Vibrio alginolyticus | 60 (24–84) | 37 (13–71) | 0 (0–1) | 1 (0–4) | 2 (0–11) |
| V. alginolyticus, non-AGI | 2 (0–17) | 97 (79–100) | 0 (0–1) | 0 (0–2) | 0 (0–2) |
| V. cholerae nontoxigenic | 92 (61–100) | 6 (0–30) | 1 (0–3) | 0 (0–4) | 0 (0–3) |
| V. cholerae nontoxigenic, non-AGI | 33 (8–59) | 65 (39–90) | 0 (0–1) | 0 (0–1) | 2 (0–13) |
| V. parahaemolyticus | 74 (59–91) | 24 (7–38) | 0 (0–2) | 0 (0–2) | 1 (0 –5) |
| V. parahaemolyticus, non-AGI | 8 (2–39) | 90 (57–97) | 0 (0–1) | 0 (0–1) | 2 (0–8) |
| V. vulnificus† | 20 (7–54) | 77 (40–91) | 0 (0–3) | 1 (0–9) | 2 (0–12) |
| V. vulnificus, non-AGI | 20 (9–34) | 78 (58–89) | 0 (0–1) | 1 (0–16) | 2 (0–9) |
| Vibrio spp., other AGI | 96 (69–100) | 2 (0–23) | 0 (0–1) | 0 (0–2) | 1 (0–8) |
| Vibrio spp, other non-AGI | 95 (58–100) | 3 (0–27) | 0 (0–1) | 0 (0–2) | 2 (0–15) |
| Yersinia enterocolitica |
77 (44–100) |
9 (0–37) |
3 (0–17) |
4 (0–16) |
8 (0–33) |
| Protozoa | |||||
| Acanthamoeba spp. | Blocked | 82 (46–100) | Blocked | 0 (0–0) | 18 (0–54) |
| Balamuthia mandrillaris | Blocked | 54 (5–95) | Blocked | 0 (0–0) | 46 (5–95) |
| Cryptosporidium spp. | 7 (0–25) | 43 (17–73) | 20 (2–49) | 21 (4–48) | 8 (0–34) |
| Cyclospora cayetanensis | 83 (59–99) | 6 (0–25) | 3 (0–14) | 1 (0–9) | 7 (0–28) |
| Giardia spp. | 10 (0–35) | 44 (16–78) | 27 (3–59) | 10 (0–38) | 8 (0–37) |
| Naegleria fowleri | Blocked | 88 (61–100) | Blocked | Blocked | 12 (0–38) |
| Toxoplasma gondii |
28 (4–60) |
5 (0–27) |
Blocked |
58 (24–86) |
9 (0–29) |
| Viruses | |||||
| Astrovirus | 15 (1–38) | 6 (0–25) | 73 (44–94) | Blocked | 6 (0–18) |
| Hepatitis A virus | 42 (9–78) | 8 (0–33) | 41 (8–77) | Blocked | 8 (0–34) |
| Norovirus | 19 (6–37) | 6 (0–25) | 70 (46–88) | Blocked | 5 (0–18) |
| Rotavirus | 5 (0–20) | 7 (0–28) | 81 (57–98) | Blocked | 5 (0–21) |
| Sapovirus | 13 (0–34) | 8 (0–30) | 75 (49–94) | Blocked | 4 (0–16) |
*Blocked indicates pathways blocked by study administrators. AGI, acute gastrointestinal disease; STEC, Shiga toxin–producing Escherichia coli. †Clinical manifestations of interest for initial elicitation were bacteremia and wound infections.
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