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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 BeshearseComments to Author , 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
Author affiliations: University of Florida, Gainesville, Florida, USA (E. Beshearse, A.H. Havelaar); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (B.B. Bruce, S.M. Crim, P.M. Griffin, K.E. Fullerton, S.A. Collier, K.M. Benedict, M.J. Beach, A.J. Hall); Delft University of Technology, Delft, the Netherlands (G.F. Nane); Resources for the Future, Washington, DC, USA (R. Cooke); Aspinall & Associates, Tisbury, UK (W. Aspinall); University of Bristol, Bristol, UK (W. Aspinall); Technical University of Denmark, Lyngby, Denmark (T. Hald)

Main Article

Table 6

Source attribution results for waterborne transmission subpathways (means and 95 uncertainty interval), structured expert judgment, United States, 2017*

Pathogen name
 Mean % (95% uncertainty interval)
Recreational water
 Drinking water
 Nonrecreational, nondrinking water
Bacteria
Brucella spp. 45 (0–100) 8 (0–97) 47 (0–100)
Campylobacter spp. 32 (0–97) 44 (0–99) 24 (0–99)
Enterotoxigenic Escherichia coli 31 (3–85) 57 (8–94) 12 (0–58)
STEC O157 69 (33–94) 26 (3–60) 5 (0–28)
STEC non-O157 51 (18–77) 12 (0–43) 38 (12–69)
E. coli, other diarrheagenic 20 (2–53) 70 (34–92) 10 (0–38)
Legionella spp. 9 (2–35) 52 (19–78) 39 (13–69)
Mycobacterium bovis 21 (0–100) 14 (0–100) 65 (0–100)
Nontuberculous Mycobacterium spp. 13 (0–43) 67 (33–93) 20 (0–51)
Pseudomonas spp., otitis externa 95 (75–100) 3 (0–21) 2 (0–11)
Pseudomonas spp., septicemia 7 (2–37) 16 (1–50) 77 (37–94)
Pseudomonas spp., pneumonia 48 (17–74) 6 (1–33) 46 (18–76)
Salmonella enterica, nontyphoidal 18 (2–53) 75 (37–93) 7 (0–26)
S. enterica, nontyphoidal, <5 y 19 (3–49) 69 (38–91) 12 (1–30)
S. enterica serotype Enteritidis 20 (3–49) 71 (38–92) 9 (1–27)
S. enterica serotype I 4,[5],12:i:- 18 (2–49) 74 (38–93) 9 (0–35)
S. enterica serotype Javiana 21 (3–53) 67 (29–90) 12 (0–42)
S. enterica serotype Newport 17 (2–48) 74 (40–94) 9 (0–39)
S. enterica serotype Typhimurium 19 (3–51) 73 (39–93) 8 (1–29)
S. enterica, all other serotypes group 1 19 (3–51) 72 (36–93) 9 (0–39)
S. enterica, all other serotypes group 2 19 (2–50) 69 (36–91) 12 (1–40)
Shigella spp. 77 (41–95) 3 (0–25) 20 (3–50)
Staphylococcus aureus 91 (50–100) 5 (0–29) 4 (0–43)
Streptococcus spp., group A 73 (0–100) 10 (0–95) 18 (0–100)
Vibrio alginolyticus AGI 97 (66–100) 1 (0–6) 2 (0–21)
V. alginolyticus, non-AGI 96 (49–100) 2 (0–36) 3 (0–47)
V. cholerae nontoxigenic AGI 96 (56–100) 2 (0–11) 2 (0–22)
V. cholerae nontoxigenic, non-AGI 96 (50–100) 2 (0–14) 3 (0–43)
V. parahaemolyticus 98 (62–100) 1 (0–10) 1 (0–13)
V. parahaemolyticus, non-AGI 97 (50–100) 2 (0–35) 2 (0–37)
V. vulnificus† 98 (66–100) 1 (0–9) 2 (0–24)
V. vulnificus, non-AGI 96 (49–100) 2 (0–37) 2 (0–43)
Vibrio spp., other AGI 69 (0–100) 4 (0–69) 27 (0–100)
Vibrio spp, other non-AGI 70 (0–100) 4 (0–69) 26 (0–100)
Yersinia enterocolitica
 51 (6–100)
 28 (0–83)
 21 (0–79)
Protozoa
Acanthamoeba spp. 52 (8–88) 15 (0–51) 33 (3–76)
Balamuthia mandrillaris 48 (6–88) 4 (0–26) 48 (7–89)
Cryptosporidium spp. 66 (21–96) 24 (0–68) 11 (0–41)
Cyclospora cayetanensis 39 (0–99) 32 (0–97) 29 (0–100)
Giardia spp. 49 (9–93) 33 (2–82) 18 (0–67)
Naegleria fowleri 85 (51–98) 3 (0–27) 12 (1–45)
Toxoplasma gondii
 37 (0–100)
 27 (0–100)
 36 (0–100)
Viruses
Astrovirus 39 (0–99) 47 (0–100) 13 (0–92)
Hepatitis A virus 35 (0–100) 44 (0–100) 21 (0–97)
Norovirus 47 (8–90) 45 (6–86) 8 (0–42)
Rotavirus 41 (7–84) 50 (8–86) 9 (0–41)
Sapovirus 55 (11–97) 37 (0–84) 8 (0–41)

*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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Page created: October 14, 2020
Page updated: January 27, 2021
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