Quantitative Risk Assessment of Rabies Entering Great Britain from North America via Cats and Dogs

Great Britain has been rabies-free since 1922, which is often considered to be in part due to the strict laws requiring that imported cats and dogs be vaccinated and quarantined for 6 months immediately on entry into the country. Except for two isolated incidents, this quarantine policy has contributed to ensuring that Great Britain has remained free of rabies. In 2000, amendments to the UK quarantine laws were made and the Pet Travel Scheme (PETS) was launched for companion animals traveling from European Union countries and rabies-free islands. Since its introduction, it has been proposed that other countries including North America should be included within the UK scheme. A quantitative risk assessment was developed to assist in the policy decision to amend the long-standing quarantine laws for dogs and cats from North America. It was determined that the risk of rabies entry is very low and is dependent on the level of compliance (i.e., legally conforming to all of the required regulations) with PETS and the number of pets imported. Assuming 100% compliance with PETS and the current level of importation of cats and dogs from North America, the annual probability of importing rabies is lower for animals traveling via PETS (7.22 x 10(-6), 95th percentile) than quarantine (1.01 x 10(-5), 95th percentile). These results, and other scientific evidence, directly informed the decision to expand the PETS scheme to North America as of December 2002.     

Quantitative Assessment of the Risk of Release of Foot‐and‐Mouth Disease Virus via Export of Bull Semen from Israel

Various foot‐and‐mouth disease (FMD) virus strains circulate in the Middle East, causing frequent episodes of FMD outbreaks among Israeli livestock. Since the virus is highly resistant in semen, artificial insemination with contaminated bull semen may lead to the infection of the receiver cow. As a non‐FMD‐free country with vaccination, Israel is currently engaged in trading bull semen only with countries of the same status. The purpose of this study was to assess the risk of release of FMD virus through export of bull semen in order to estimate the risk for FMD‐free countries considering purchasing Israeli bull semen. A stochastic risk assessment model was used to estimate this risk, defined as the annual likelihood of exporting at least one ejaculate of bull semen contaminated with viable FMD virus. A total of 45 scenarios were assessed to account for uncertainty and variability around specific parameter estimates and to evaluate the effect of various mitigation measures, such as performing a preexport test on semen ejaculates. Under the most plausible scenario, the annual likelihood of exporting bull semen contaminated with FMD virus had a median of 1.3 * 10^?7 for an export of 100 ejaculates per year. This corresponds to one infected ejaculate exported every 7 million years. Under the worst‐case scenario, the median of the risk rose to 7.9 * 10^?5, which is equivalent to the export of one infected ejaculate every 12,000 years. Sensitivity analysis indicated that the most influential parameter is the probability of viral excretion in infected bulls.     

Assessing the export trade risk of bluetongue virus serotypes 4 and 8 in France

Bluetongue (BT) causes an economic loss of $3 billion every year in the world. After two serious occurrences of BT (bluetongue virus [BTV] occurrence in 2006 and 2015), France has been controlling for decades, but it has not been eradicated. As the largest live cattle export market in the world, France is also one of the major exporters of breeding animals and genetic materials in the world. The biosafety of its exported cattle and products has always been a concern. The scenario tree quantitative model was used to analyze the risk of BTV release from French exported live cattle and bovine semen. The results showed that with the increase in vaccination coverage rates, the risk decreased. If the vaccine coverage is 0%, the areas with the highest average risk probability of BTV-4 and BTV-8 release from exported live cattle were Haute-Savoie and Puy-de-Dôme, and the risk was 2.96 × 10^–4 and 4.25 × 10^–4, respectively. When the vaccine coverage was 90%, the risk probability of BTV-4 and BTV-8 release from exported live cattle was 2.96 × 10^–5 and 4.24 × 10^–5, respectively. The average probability of BTV-8 release from bovine semen was 1.09 × 10^–10. Sensitivity analysis showed that the probability of false negative polymerase chain reaction (PCR) test and the probability of BT infection in the bull breeding station had an impact on the model. The identification of high-risk areas and the discovery of key control measures provide a reference for decision makers to assess the risk of French exports of live cattle and bovine semen.     

A Quantitative Release Assessment for the Noncommercial Movement of Companion Animals: Risk of Rabies Reintroduction to the United Kingdom

In 2004, the European Union (EU) implemented a pet movement policy (referred to here as the EUPMP) under EU regulation 998/2003. The United Kingdom (UK) was granted a temporary derogation from the policy until December 2011 and instead has in place its own Pet Movement Policy (Pet Travel Scheme (PETS)). A quantitative risk assessment (QRA) was developed to estimate the risk of rabies introduction to the UK under both schemes to quantify any change in the risk of rabies introduction should the UK harmonize with the EU policy. Assuming 100 % compliance with the regulations, moving to the EUPMP was predicted to increase the annual risk of rabies introduction to the UK by approximately 60‐fold, from 7.79 × 10^?5 (5.90 × 10^?5, 1.06 × 10^?4) under the current scheme to 4.79 × 10^?3 (4.05 × 10^?3, 5.65 × 10^?3) under the EUPMP. This corresponds to a decrease from 13,272 (9,408, 16,940) to 211 (177, 247) years between rabies introductions. The risks associated with both the schemes were predicted to increase when less than 100 % compliance was assumed, with the current scheme of PETS and quarantine being shown to be particularly sensitive to noncompliance. The results of this risk assessment, along with other evidence, formed a scientific evidence base to inform policy decision with respect to companion animal movement.     

Sensitivity Analysis to Evaluate the Impact of Uncertain Factors in a Scenario Tree Model for Classical Swine Fever Introduction

Introduction of classical swine fever virus (CSFV) is a continuing threat to the pig production sector in the European Union. A scenario tree model was developed to obtain more insight into the main risk factors determining the probability of CSFV introduction (P(CSFV)). As this model contains many uncertain input parameters, sensitivity analysis was used to indicate which of these parameters influence model results most. Group screening combined with the statistical techniques of design of experiments and meta-modeling was applied to detect the most important uncertain input parameters among a total of 257 parameters. The response variable chosen was the annual P(CSFV) into the Netherlands. Only 128 scenario calculations were needed to specify the final meta-model. A consecutive one-at-a-time sensitivity analysis was performed with the main effects of this meta-model to explore their impact on the ranking of risk factors contributing most to the annual P(CSFV). The results indicated that model outcome is most sensitive to the uncertain input parameters concerning the expected number of classical swine fever epidemics in Germany, Belgium, and the United Kingdom and the probability that CSFV survives in an empty livestock truck traveling over a distance of 0-900 km.     

Quantitative Microbial Risk Assessment of Cryptosporidiosis and Giardiasis from Very Small Private Water Supplies

This article reports a quantitative microbial risk assessment of the risk of Giardia and Cryptosporidium in very small private water supplies. Both pathogens have been implicated in causing outbreaks of waterborne disease associated with such supplies, though the risk of endemic disease is not known. For exposure assessments, we used existing data to derive regression equations describing the relationships between the concentration of these pathogens and Escherichia coli in private water supplies. Pathogen concentrations were then estimated using national surveillance data of E. coli in private water supplies in England and France. The estimated risk of infection was very high with the median annual risk being of the order of 25–28% for Cryptosporidium and 0.4% to 0.7% for Giardia, though, in the poorer quality supplies the risk could be much higher. These risks are substantially greater than for public water supplies and well above the risk considered tolerable. The observation that observed infection rates are generally much lower may indicate increased immunity in people regularly consuming water from private supplies. However, this increased immunity is presumed to derive from increased disease risk in young children, the group most at risk from severe disease.     

Quantitative Assessment of Building Fire Risk to Life Safety

This article presents a quantitative risk assessment framework for evaluating fire risk to life safety. Fire risk is divided into two parts: probability and corresponding consequence of every fire scenario. The time-dependent event tree technique is used to analyze probable fire scenarios based on the effect of fire protection systems on fire spread and smoke movement. To obtain the variation of occurrence probability with time, Markov chain is combined with a time-dependent event tree for stochastic analysis on the occurrence probability of fire scenarios. To obtain consequences of every fire scenario, some uncertainties are considered in the risk analysis process. When calculating the onset time to untenable conditions, a range of fires are designed based on different fire growth rates, after which uncertainty of onset time to untenable conditions can be characterized by probability distribution. When calculating occupant evacuation time, occupant premovement time is considered as a probability distribution. Consequences of a fire scenario can be evaluated according to probability distribution of evacuation time and onset time of untenable conditions. Then, fire risk to life safety can be evaluated based on occurrence probability and consequences of every fire scenario. To express the risk assessment method in detail, a commercial building is presented as a case study. A discussion compares the assessment result of the case study with fire statistics.     

Development and application of a dose–response model for Elizabethkingia spp

Elizabethkingia spp. are common environmental pathogens responsible for infections in more vulnerable populations. Although the exposure routes of concern are not well understood, some hospital-associated outbreaks have indicated possible waterborne transmission. In order to facilitate quantitative microbial risk assessment (QMRA) for Elizabethkingia spp., this study fit dose–response models to frog and mice datasets that evaluated intramuscular and intraperitoneal exposure to Elizabethkingia spp. The frog datasets could be pooled, and the exact beta-Poisson model was the best fitting model with optimized parameters α  = 0.52 and β = 86,351. Using the exact beta-Poisson model, the dose of Elizabethkingia miricola resulting in a 50% morbidity response (LD₅₀) was estimated to be approximately 237,000 CFU. The model developed herein was used to estimate the probability of infection for a hospital patient under a modeled exposure scenario involving a contaminated medical device and reported Elizabethkingia spp. concentrations isolated from hospital sinks after an outbreak. The median exposure dose was approximately 3 CFU/insertion event, and the corresponding median risk of infection was 3.4E-05. The median risk estimated in this case study was lower than the 3% attack rate observed in a previous outbreak, however, there are noted gaps pertaining to the possible concentrations of Elizabethkingia spp. in tap water and the most likely exposure routes. This is the first dose–response model developed for Elizabethkingia spp. thus enabling future risk assessments to help determine levels of risk and potential effective risk management strategies.     

Scenario Tree Modeling to Analyze the Probability of Classical Swine Fever Virus Introduction into Member States of the European Union

The introduction of classical swine fever virus (CSFV) into a country free of disease without vaccination may have huge consequences in terms of both disease spread and economic losses. More quantitative insight into the main factors determining the probability of CSFV introduction (PCSFV) is needed to optimally use resources for the prevention of CSFV introduction. For this purpose a spreadsheet model was constructed that calculates the annual PCSFV into member states of the European Union (EU). The scenario pathway approach was used as most probabilities in the model are very small. Probability distributions were used to take into account inherent variability of input parameters. The model contained pathways of CSFV introduction including the import of pigs and pork products, returning livestock trucks, and contacts with wild boar. All EU member states were included as possible sources of CSFV. Default results for the Netherlands showed a mean overall annual PCSFV of approximately 0.06, indicating that the Netherlands can expect CSFV introduction on average once every 18 years from the pathways and countries included in the model. Almost 65% of this probability could be attributed to the pathway of returning livestock trucks. The most likely sources of CSFV introduction were Germany, Belgium, and the United Kingdom. Although the calculated probabilities were rather low when compared with expert estimates and recent history, the most likely causes of CSFV introduction indicated by the model were considered to be realistic. It was therefore concluded that the model is a useful tool to structure and analyze information for decision making concerning the prevention of CSFV introduction.     

Annual Burden of Occupationally‐Acquired Influenza Infections in Hospitals and Emergency Departments in the United States

Infections among health‐care personnel (HCP) occur as a result of providing care to patients with infectious diseases, but surveillance is limited to a few diseases. The objective of this study is to determine the annual number of influenza infections acquired by HCP as a result of occupational exposures to influenza patients in hospitals and emergency departments (EDs) in the United States. A risk analysis approach was taken. A compartmental model was used to estimate the influenza dose received in a single exposure, and a dose–response function applied to calculate the probability of infection. A three‐step algorithm tabulated the total number of influenza infections based on: the total number of occupational exposures (tabulated in previous work), the total number of HCP with occupational exposures, and the probability of infection in an occupational exposure. Estimated influenza infections were highly dependent upon the dose–response function. Given current compliance with infection control precautions, we estimated 151,300 and 34,150 influenza infections annually with two dose–response functions (annual incidence proportions of 9.3% and 2.1%, respectively). Greater reductions in infectious were achieved by full compliance with vaccination and IC precautions than with patient isolation. The burden of occupationally‐acquired influenza among HCP in hospitals and EDs in the United States is not trivial, and can be reduced through improved compliance with vaccination and preventive measures, including engineering and administrative controls.     

Risk assessment of banknotes as a fomite of SARS-CoV-2 in cash payment transactions

The COVID 19 pandemic has triggered concerns and assumptions globally about transmission of the SARS-CoV-2 virus via cash transactions. This paper assesses the risk of contracting COVID-19 through exposure to SARS-CoV-2 via cash acting as a fomite in payment transactions. A quantitative microbial risk assessment was conducted for a scenario assuming an infectious person at the onset of symptoms, when virion concentrations in coughed droplets are at their highest. This person then contaminates a banknote by coughing on it and immediately hands it over to another person, who might then be infected by transferring the virions with a finger from the contaminated banknote to a facial mucous membrane. The scenario considered transfer efficiency of virions on the banknote to fingertips when droplets were still wet and after having dried up and subsequently being touched by finger printing or rubbing the object. Accounting for the likelihood of the scenario to occur by considering (1) a local prevalence of 100 COVID-19 cases/100,000 persons, (2) a maximum of about one-fifth of infected persons transmit high virus loads, and (3) the numbers of cash transactions/person/day, the risk of contracting COVID-19 via person-to-person cash transactions was estimated to be much lower than once per 39,000 days (107 years) for a single person. In the general populace, there will be a maximum of 2.6 expected cases/100,000 persons/day. The risk for a cashier at an average point of sale was estimated to be much less than once per 430 working days (21 months). The depicted scenario is a rare event, therefore, for a single person, the risk of contracting COVID-19 via person-to-person cash transactions is very low. At a point of sale, the risk to the cashier proportionally increases but it is still low.     

Rate of Foot-and-Mouth Disease Virus Transmission by Carriers Quantified from Experimental Data

Upon infection with foot-and-mouth disease virus (FMDV) a considerable number of animals become carriers of the virus. These carriers are considered to be a risk for new outbreaks, but the rate at which these animals can transmit the infection has not been quantified. An analysis was carried out using data from previously published experiments in order to quantify the transmission rate parameter β of FMDV infection from carriers to susceptible animals. The parameter β was estimated at 0.0256 (likelihood-based confidence interval: 0.008–0.059) infections per carrier per month. Moreover, analysis of published experimental data indicates that the proportion of FMDV carriers decreases at a rate of 0.115 per month. Both parameters obtained from this study are useful for quantitative risk analyses of the trade of animals from FMDV-infected areas or the lifting of vaccination programs.     

Foot-and-Mouth Disease Entrance Assessment Model Through Air Passenger Violations

This article aims to construct a risk model for the prediction of foot-and-mouth disease (FMD) entrance caused by passengers who illegally carry meat products of cloven-hoofed animals through international airports into a country. The risk that meat contaminated with the FMD virus is formulated as the probabilities of FMD factor events (the prevalence of FMD), the commodity factor event (the transportation, storage, and distribution (TSD) factor event), and the passenger event. Data used for analysis were records of illegal meat product carriers from areas A and B intercepted at an international airport in Taiwan. A risk model was proposed to simulate the probability distributions in disease prevalence, probability of FMD virus existing in the meat products after meat processing, and estimation of survival of virus and time period for TSD. The probability of the passenger event was hypothesized with the odds of intercepted passengers and estimated via logistic regression. The results showed that the odds of passengers being intercepted by beagles were higher than those intercepted by Customs. By conducting Monte Carlo simulations, the probability of FMD virus risk caused by FMD factors from area A was 149 times lower than that from area B. The probability of FMD virus risk caused by the passenger event from area A was four times lower than the corresponding probability from area B. The model provides a contribution to FMD prevention and can be a reference for developing models of other diseases.     

Modeling exotic highly pathogenic avian influenza virus entrance risk through air passenger violations

The highly pathogenic avian influenza virus (HPAIV) is able to survive in poultry products and could be carried into a country by air travelers. An assessment model was constructed to estimate the probability of the exotic viable HPAIV entering Taiwan from two neighboring areas through poultry products carried illegally by air passengers at Taiwan's main airports. The entrance risk was evaluated based on HPAIV-related factors (the prevalence and the incubation period of HPAIV; the manufacturing process of poultry products; and the distribution-storage-transportation factor event) and the passenger event. Distribution functions were adopted to simulate the probabilities of each HPAIV factor. The odds of passengers being intercepted with illegal poultry products were estimated by logistic regression. The Monte Carlo simulation established that the risk caused by HPAIV-related factors from area A was lower than area B, whereas the entrance risk by the passenger event from area A was similar to area B. Sensitivity analysis showed that the incubation period of HPAIV and the interception of passenger violations were major determinants. Although the result showed viable HPAIV was unlikely to enter Taiwan through meat illegally carried by air passengers, this low probability could be caused by incomplete animal disease data and modeling uncertainties. Considering the negative socioeconomic impacts of HPAIV outbreaks, strengthening airport quarantine measures is still necessary. This assessment provides a profile of HPAIV entrance risk through air travelers arriving from endemic areas and a feasible direction for quarantine and public health measures.     

Quantitative Assessment of the Health Risk for Livestock When Animal Viruses Are Applied in Human Oncolytic Therapy: A Case Study for Seneca Valley Virus

Some viruses cause tumor regression and can be used to treat cancer patients; these viruses are called oncolytic viruses. To assess whether oncolytic viruses from animal origin excreted by patients pose a health risk for livestock, a quantitative risk assessment (QRA) was performed to estimate the risk for the Dutch pig industry after environmental release of Seneca Valley virus (SVV). The QRA assumed SVV excretion in stool by one cancer patient on Day 1 in the Netherlands, discharge of SVV with treated wastewater into the river Meuse, downstream intake of river water for drinking water production, and consumption of this drinking water by pigs. Dose–response curves for SVV infection and clinical disease in pigs were constructed from experimental data. In the worst scenario (four log₁₀ virus reduction by drinking water treatment and a farm with 10,000 pigs), the infection risk is less than 1% with 95% certainty. The risk of clinical disease is almost seven orders of magnitude lower. Risks may increase proportionally with the numbers of treated patients and days of virus excretion. These data indicate that application of wild‐type oncolytic animal viruses may infect susceptible livestock. A QRA regarding the use of oncolytic animal virus is, therefore, highly recommended. For this, data on excretion by patients, and dose–response parameters for infection and clinical disease in livestock, should be studied.     

Assessing Climate Change Impacts on Wildfire Exposure in Mediterranean Areas

We used simulation modeling to assess potential climate change impacts on wildfire exposure in Italy and Corsica (France). Weather data were obtained from a regional climate model for the period 1981–2070 using the IPCC A1B emissions scenario. Wildfire simulations were performed with the minimum travel time fire spread algorithm using predicted fuel moisture, wind speed, and wind direction to simulate expected changes in weather for three climatic periods (1981–2010, 2011–2040, and 2041–2070). Overall, the wildfire simulations showed very slight changes in flame length, while other outputs such as burn probability and fire size increased significantly in the second future period (2041–2070), especially in the southern portion of the study area. The projected changes fuel moisture could result in a lengthening of the fire season for the entire study area. This work represents the first application in Europe of a methodology based on high resolution (250 m) landscape wildfire modeling to assess potential impacts of climate changes on wildfire exposure at a national scale. The findings can provide information and support in wildfire management planning and fire risk mitigation activities.     

基于HHM-RFRM的船舶航行风险评估方法研究

船舶航行风险是由各种风险因素交互作用产生。综合 HHM-RFRM 理论，构建船舶航行多维风险情景危险度测度模型，以风险因素耦合视角探讨船舶航行风险管理问题。在船舶航行多维风险情景危险度测度模型中结合贝叶斯定理，对船舶航行风险情景进行了定性与定量化过滤、评级。最后以大连港某从事商务活动的货船为例，验证了所提出方法的可行性。传统的风险评估方法只能评估单个风险因素对系统的影响，此评估方法克服了这一局限性，为船舶航行风险管理提供新的视角。     

A Framework for Understanding Uncertainty in Seismic Risk Assessment

A better understanding of the uncertainty that exists in models used for seismic risk assessment is critical to improving risk-based decisions pertaining to earthquake safety. Current models estimating the probability of collapse of a building do not consider comprehensively the nature and impact of uncertainty. This article presents a model framework to enhance seismic risk assessment and thus gives decisionmakers a fuller understanding of the nature and limitations of the estimates. This can help ensure that risks are not over- or underestimated and the value of acquiring accurate data is appreciated fully. The methodology presented provides a novel treatment of uncertainties in input variables, their propagation through the model, and their effect on the results. The study presents ranges of possible annual collapse probabilities for different case studies on buildings in different parts of the world, exposed to different levels of seismicity, and with different vulnerabilities. A global sensitivity analysis was conducted to determine the significance of uncertain variables. Two key outcomes are (1) that the uncertainty in ground-motion conversion equations has the largest effect on the uncertainty in the calculation of annual collapse probability; and (2) the vulnerability of a building appears to have an effect on the range of annual collapse probabilities produced, i.e., the level of uncertainty in the estimate of annual collapse probability, with less vulnerable buildings having a smaller uncertainty.     

Evaluating Risk Communication: Examining Target Audience Perceptions About Four Presentation Formats for Fish Consumption Health Advisory Information

Information format can influence the extent to which target audiences understand and respond to risk-related information. This study examined four elements of risk information presentation format. Using printed materials, we examined target audience perceptions about: (a) reading level; (b) use of diagrams vs. text; (c) commanding versus cajoling tone; and (d) use of qualitative vs. quantitative information presented in a risk ladder. We used the risk communication topic of human health concerns related to eating noncommercial Great Lakes fish affected by chemical contaminants. Results from the comparisons of specific communication formats indicated that multiple formats are required to meet the needs of a significant percent of anglers for three of the four format types examined. Advisory text should be reviewed to ensure the reading level is geared to abilities of the target audience. For many audiences, a combination of qualitative and quantitative information, and a combination of diagrams and text may be most effective. For most audiences, a cajoling rather than commanding tone better provides them with the information they need to make a decision about fish consumption. Segmenting audiences regarding information needs and communication formats may help clarify which approaches to take with each audience.     

A Quantitative Assessment of the Risk for Highly Pathogenic Avian Influenza Introduction into Spain via Legal Trade of Live Poultry

Highly pathogenic avian influenza (HPAI) is considered one of the most important diseases of poultry. During the last 9 years, HPAI epidemics have been reported in Asia, the Americas, Africa, and in 18 countries of the European Union (EU). For that reason, it is possible that the risk for HPAI virus (HPAIV) introduction into Spain may have recently increased. Because of the EU free‐trade policy and because legal trade of live poultry was considered an important route for HPAI spread in certain regions of the world, there are fears that Spain may become HPAIV‐infected as a consequence of the legal introduction of live poultry. However, no quantitative assessment of the risk for HPAIV introduction into Spain or into any other EU member state via the trade of poultry has been published in the peer‐reviewed literature. This article presents the results of the first quantitative assessment of the risk for HPAIV introduction into a free country via legal trade of live poultry, along with estimates of the geographical variation of the risk and of the relative contribution of exporting countries and susceptible poultry species to the risk. The annual mean risk for HPAI introduction into Spain was estimated to be as low as 1.36 × 10⁻³, suggesting that under prevailing conditions, introduction of HPAIV into Spain through the trade of live poultry is unlikely to occur. Moreover, these results support the hypothesis that legal trade of live poultry does not impose a significant risk for the spread of HPAI into EU member states.