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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 3

Transmission subpathway definitions, structured expert judgment, United States, 2017

Subpathway
 Description
Foodborne subpathway
Food handler–related
 When food processed or prepared for others is contaminated by an infected person.
Waterborne subpathways
Recreational water, treated or untreated Water that is used for recreational activities, such as in an aquatic facility or natural body of water. Can be treated or untreated. Treated water has undergone a systematic disinfection process (e.g., chlorination and filtration) with the goal of maintaining good microbiologic quality for recreation; untreated water has not undergone a disinfection or treatment process to maintain good microbiological quality for recreation (e.g., lakes, rivers, oceans, and reservoirs).
Drinking water Water that is used primarily for drinking but including other domestic uses, such as washing or showering; can come from a public water system, a private well, or commercially bottled sources.
Nonrecreational, nondrinking water
 Water that is used for purposes other than recreation or drinking (e.g., for agriculture, industry, medical treatment, backcountry streams or flood waters). Agricultural water includes water that is used to grow fresh produce and sustain livestock. Industrial water includes water used during manufacturing or in cooling equipment. Medical water includes any water used within medical devices or water used for washing surgical tools and equipment, and water used for hydrotherapy. This subcategory does not include transmission that can be accounted for by another major pathway, such as food or animals
Environmental subpathways
Presumed animal contact associated When a person becomes ill from exposure to soil, mud, or surfaces contaminated by an animal without direct contact or simultaneous presence with the animal, or when an infection is suspected to be animal associated because of previous knowledge about the pathogen.
Presumed person-to-person associated When a person becomes ill from an exposure indirectly associated with an ill person.

Main Article

Page created: October 14, 2020
Page updated: January 27, 2021
Page reviewed: January 27, 2021
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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