Exposure Assessment to Salmonella by Consumption of Informally Marketed Milk and Gouda Cheese in Musanze Town, Rwanda

Olivier Kamana , Liesbeth Jacxsens , Anastase Kimonyo , Mieke Uyttendaele
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Abstract

This study assesses the exposure to Salmonella by consumption of boiled milk and Gouda cheese in Musanze town, Rwanda. A consumer survey (n = 90) revealed that among milk buyers in milk shops, 40.0% were also buying boiled milk for their families resulting in consumption by 136 consumers, mainly adults aging between 19-29 years (32.3%). Among those interviewed consumers in households, 66.7% were re-boiling the milk and 33.3% were storing it refrigerated before consumption. Gouda cheese is usually sold in supermarkets belonging to the formal market. A cheese portion with a weight of 62.5 g is mainly consumed (80.0%, n=370), and the weekly consumption frequency is most in practice (38.1%). A probabilistic exposure model was built up by taking into account prevalence data of Salmonella contamination in boiled milk and Gouda cheese in Rwanda, assumed concentration data of Salmonella, information of the milk chain gathered by observation, and collected consumption data and consumer behavior information. Finally, the risk of infection per day and per year were calculated for different categories of consumers. It appears that even though Salmonella is eliminated by milk boiling, the risk of infection still persists due to post-contamination in the milk shops (8.4% of consumers infected per year), but is decreased by additional boiling in households to 4.9% (children) and 4.6% (adults) per year. For cheese consumption, the risk of infection was lowered by multiple food safety interventions for cheese producers such as trainings on food hygiene and provision of modern equipments improving thus the situation from before to after 2012 by 30.0%% per year in case of adults. Those calculations demonstrate clearly that the additional efforts to reduce the occurrence of Salmonella in the Rwandan dairy chain will benefit the Rwandan population and decrease the burden of food borne disease.

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通过食用卢旺达穆桑泽镇非正规销售的牛奶和豪达奶酪对沙门氏菌的暴露评估
本研究评估了卢旺达Musanze镇通过食用煮牛奶和豪达奶酪暴露于沙门氏菌的情况。一项消费者调查(n = 90)显示,在牛奶店购买牛奶的消费者中,40.0%的人也会为家人购买煮熟的牛奶,共有136名消费者消费,主要是19-29岁的成年人(32.3%)。在以家庭为单位的受访消费者中,66.7%的人会将牛奶重新煮开,33.3%的人会将牛奶冷藏后再饮用。豪达奶酪通常在属于正规市场的超市出售。主要食用62.5 g奶酪分量(80.0%,n=370),实践中每周食用频率最高(38.1%)。考虑卢旺达煮牛奶和豪达奶酪中沙门氏菌污染的流行率数据,假设沙门氏菌浓度数据,通过观察收集到的牛奶链信息,以及收集到的消费数据和消费者行为信息,建立了概率暴露模型。最后,计算了不同类别消费者每天和每年的感染风险。尽管通过煮牛奶可以消除沙门氏菌,但由于牛奶店的污染,感染的风险仍然存在(每年有8.4%的消费者感染),但通过在家庭中额外煮牛奶,感染的风险降低到每年4.9%(儿童)和4.6%(成人)。对于奶酪消费,通过对奶酪生产商进行食品卫生培训和提供现代化设备等多种食品安全干预措施,降低了感染风险,因此从2012年之前到之后,成年人的感染风险每年提高30.0%。这些计算清楚地表明,为减少卢旺达乳制品链中沙门氏菌的发生而作出的额外努力将使卢旺达人民受益,并减少食源性疾病的负担。
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