Quantitative risk assessment model to investigate the public health impact of varying Listeria monocytogenes allowable levels in different food commodities: A retrospective analysis

Invasive listeriosis is a potentially fatal foodborne disease that according to this study may affect up to 32.9 % of the US population considered as increased risk and including people with underlying conditions and co-morbidities. Listeria monocytogenes has been scrutinized in research and surveillance programs worldwide in Ready-to-Eat (RTE) food commodities (RTE salads, deli meats, soft/semi-soft cheese, seafood) and frozen vegetables in the last 30 years with an estimated overall prevalence of 1.4-9.9 % worldwide (WD) and 0.5-3.8 % in the United States (US). Current L. monocytogenes control efforts have led to a prevalence reduction in the last 5 years of 4.9-62.9 % (WD) and 12.4-92.7 % (US). A quantitative risk assessment model was developed, estimating the probability of infection in the US susceptible population to be 10-10,000× higher than general population and the total number of estimated cases in the US was 1044 and 2089 cases by using the FAO/WHO and Pouillot dose-response models. Most cases were attributed to deli meats (>90 % of cases) followed by RTE salads (3.9-4.5 %), soft and semi-soft cheese and RTE seafood (0.5-1.0 %) and frozen vegetables (0.2-0.3 %). Cases attributed to the increased risk population corresponded to 96.6-98.0 % of the total cases with the highly susceptible population responsible for 46.9-80.1 % of the cases. Removing product lots with a concentration higher than 1 CFU/g reduced the prevalence of contamination by 15.7-88.3 % and number of cases by 55.9-100 %. Introducing lot-by-lot testing and defining allowable quantitative regulatory limits for low-risk RTE commodities may reduce the public health impact of L. monocytogenes and improve the availability of enumeration data.