Using expert elicitation to link foodborne illnesses in the United States to foods

U.S. foodborne illness risk analysis would benefit greatly from better information on the relationship between the incidence of foodborne illness and exposure to foodborne pathogens. In this study, expert elicitation was used to attribute U.S. foodborne illnesses caused by the nine FoodNet pathogens, Toxoplasma gondii, and noroviruses to consumption of foods in 11 broad categories. Forty-two nationally recognized food safety experts responded to a formal written expert elicitation survey. For each pathogen, respondents gave their best estimate of the distribution of foodborne illnesses associated with each of the food categories and the 90% confidence bounds on each of their estimates. Based on the work of Paul Mead and his coauthors, food attribution percentage estimates from this study were used to attribute case, hospitalization, and death incidence estimates to foods according to pathogen. These attribution estimates indicate that 15 food-pathogen pairs account for 90% of the illnesses, 25 pairs account for 90% of hospitalizations, and 21 pairs account for 90% of deaths.