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    Het volksgezondheidsrisico van directe dier-mens overdracht van pathogene bacterien: epidemiologie en blootstelling

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    Authors
    Evers EG
    Horneman ML
    Doorduyn YD
    Series/Report no.
    RIVM rapport 330080002
    Type
    Report
    Language
    nl
    
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    Title
    Het volksgezondheidsrisico van directe dier-mens overdracht van pathogene bacterien: epidemiologie en blootstelling
    Translated Title
    The public health risk of direct animal-human transfer of pathogenic bacteria: epidemiology and exposure
    Publiekssamenvatting
    Het is veelal niet mogelijk om betrouwbare uitspraken te doen over het risico voor de volksgezondheid van direct contact tussen dier en mens. Gegeven deze onzekerheid zijn er meerdere aanwijzingen dat overdracht van Campylobacter door honden van belang is. Het is belangrijk om de kans op ziekte via voedsel-, water- en direct contact-routes tegen elkaar af te wegen, zodat de overheid voor de meest effectieve maatregelen kan kiezen. De pathogenen Campylobacter, Salmonella en Shiga toxine-producerende Escherichia coli O157 (STEC O157) en de transmissieroutes hond, kat en kinderboerderij werden onderzocht met de methoden van epidemiologische analyse en blootstellingsschatting. Epidemiologisch literatuuronderzoek toont aan dat overdracht van STEC O157 op kinderboerderijen plaatsvindt, maar de omvang is onbekend. Campylobacter-infecties worden in veel onderzoeken in verband gebracht met honden en veel minder vaak met katten. Toch blijkt 3-6 % van de humane gevallen toe te schrijven aan contact met honden en 4-7 % aan contact met katten. Voor de overige pathogeen-route combinaties is overdracht onvoldoende bewezen of niet beschreven. Anderzijds blijkt volgens de methode van blootstellingsschattingen dat de gemiddelde blootstelling voor Nederlanders duidelijk het hoogste is voor de pathogeen-transmissieroute combinatie Campylobacter - hond. De blootstelling aan STEC O157 via de drie routes en aan Salmonella via honden en de kinderboerderij is relatief laag. De overige pathogeen-route combinaties vertonen een intermediaire blootstelling. Er is een aanvang gemaakt om de aansluiting tussen beide methoden te verbeteren, gericht op het omrekenen van blootstellingsschattingen in epidemiologische associatiematen.
    It is usually not possible to make reliable statements on the risk for public health of direct contact between animals and humans. Given this uncertainty, there are several indications that transfer of Campylobacter by dogs is important. It is important to weigh the probability of disease via food, water and direct contact routes, so that the government can choose the most effective measures. The pathogens Campylobacter, Salmonella and Shiga toxin-producing Escherichia coli O157 (STEC O157) and the transmission routes dog, cat and petting zoo were investigated using the methods of epidemiological analysis and exposure estimation. Epidemiological literature research shows that transfer of STEC O157 at petting zoos does occur, but the extent is unknown. Campylobacter infections are in many investigations associated with dogs and much less often with cats. Still, 3-6 % of human cases can be ascribed to contact with dogs and 4-7 % can be ascribed to contact with cats. For the other pathogen-route combinations transfer is insufficiently proven or not described. On the other hand, according to the method of exposure estimation, the mean exposure for the Dutch population is clearly highest for the pathogen - transmission route combination Campylobacter-dog. The exposure to STEC O157 via the three routes and to Salmonella via dogs and petting zoos is relatively small. The other pathogen-route combinations show an intermediate exposure. Work was commenced to improve the connection between both methods, aimed at converting exposure estimates to epidemiological measures of association.
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    URI
    http://hdl.handle.net/10029/258245
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