Quantitative Microbial Risk Assessment of Hemolytic Uremic Syndrome due to Beef Consumption: Impact of Interventions to Reduce the Presence of Shiga Toxin-Producing Escherichia coli

Abstract

In the last decades, several Quantitative Microbial Risk Assessment (QMRA) of Hemolytic Uremic Syndrome (HUS) from beef consumption have been conducted. In general, all models reported a similar probability of illness from consumption of a single serving of beef contaminated with Shiga Toxin-Producing Escherichia coli (STEC). However, differences in the probabilities estimated by the different models worldwide reflect the local conditions of food production, distribution, storage, and preparation. In general terms, most of the QMRA published to date agree on the importance of the main factors identified in the transmission of the disease. The sensitivity analysis on ground beef showed that the risk of infection and HUS-probability were linked to the following variables: no application of Hazard Analysis and Critical Control Point (HACCP) for STEC in abattoirs; no application of Sanitation Standard Operating Procedures (SSOP) in butcher shops; no application of Good Manufacture Practices (GMP) and Good Hygiene Practices (GHP) in butcher shops; application of GMP and GHP at home and cooking preference. Knowledge of the impact of the variables identified in the sensitivity analysis allows optimizing resources, and time to direct actions with greater certainty, as well as to avoid taking measures that will not have an impact on the risk of HUS-STEC. Among the interventions under controlled experimental conditions evaluated to control STEC in beef products, gamma irradiation was the most effective one. The second most effective intervention was high pressure processing (HPP). Respect interventions against STEC on beef carcasses in commercial abattoirs, the inclusion of intervention treatments in HACCP programs should help achieve significant reductions in pathogenic bacteria on carcasses. The following interventions applied on carcasses in abattoirs will be briefly described: organic acids, hot water, steam vacuum, electrolytically generated hypochlorous acid (EGHA), ozone (aqueous and gaseous), and combined interventions. However, a single intervention at one stage of the production chain is not enough to eliminate pathogens reliably and entirely from beef surfaces. Undoubtedly, it is necessary to consolidate the epidemiological surveillance of HUS and generate information on each of the STEC transmission routes. In this way, new QMRA could be carried out, risk variables identified, and new scenario analysis performed so that health authorities can take targeted measures and actions to mitigate all STEC-caused diseases.