Abstract：
Over 20% of E. coli O157 illnesses and over 5% of Salmonella illnesses are estimated to be attributable to beef consumption in the United States. Irradiating ground beef is one possible method to reduce disease burden. We simulated the effect of ground beef irradiation on illnesses, hospitalizations, deaths, and direct healthcare costs from ground beef-associated E. coli O157 and Salmonella illnesses in the United States. To estimate the fraction of illnesses, hospitalizations, deaths, and direct healthcare costs preventable by ground beef irradiation, we multiplied the disease burden attributable to ground beef; the estimated percentage of ground beef sold that is not currently irradiated; the percentage of unirradiated ground beef that would be irradiated; and the percentage reduction in risk of illness after irradiation. We multiplied this fraction by estimates of burden and direct healthcare costs to calculate the numbers or amounts averted. Model inputs were obtained from the literature and expert opinion. We used Monte Carlo simulation to incorporate uncertainty in inputs into model estimates. Simulation outcomes were summarized with means and 95% uncertainty intervals (UI). Irradiating 50% of the currently unirradiated ground beef supply would avert 3,285 (95% UI: 624-9,977) E. coli O157 illnesses, 135 (95% UI: 24-397) hospitalizations, 197 (95% UI: 34-631) hemolytic uremic syndrome cases, 2 (95% UI: 0-16) deaths, and $2,972,656 (95% UI: $254,708-$14,496,916) in direct healthcare costs annually. For Salmonella, irradiation would avert 20,308 (95% UI: 9,858-38,903) illnesses, 400 (95% UI: 158-834) hospitalizations, 6 (95% UI: 0-18) deaths, and $7,318,632 (95% UI: $1,436,141-$26,439,493) in direct healthcare costs. Increasing ground beef irradiation could reduce E. coli O157 and Salmonella burden in the United States. Additional studies should assess whether targeted irradiation of higher-risk ground beef products could prevent similar numbers of illnesses with less total product irradiated.
摘要：
据估计，在美国，超过20％的大肠杆菌O157疾病和超过5％的沙门氏菌疾病归因于牛肉消费。辐照碎牛肉是减轻疾病负担的一种可能方法。我们模拟了碎牛肉辐照对疾病的影响，住院治疗,死亡,以及美国与碎牛肉相关的大肠杆菌O157和沙门氏菌疾病的直接医疗费用。为了估计疾病的比例，住院治疗,死亡,和直接的医疗保健成本可以通过碎牛肉辐照来预防，我们增加了可归因于碎牛肉的疾病负担;目前未辐照的已售出碎牛肉的估计百分比;未辐照的碎牛肉将被辐照的百分比;以及辐照后患病风险降低的百分比。我们将这一比例乘以负担和直接医疗保健成本的估计，以计算避免的数量或金额。模型输入来自文献和专家意见。我们使用蒙特卡罗模拟将输入的不确定性纳入模型估计。模拟结果用平均值和95%不确定度区间(UI)进行总结。辐照目前未辐照的50％的碎牛肉供应将避免3,285（95％UI：624-9,977）大肠杆菌O157疾病，135（95％UI：24-397）住院，197例（95%UI：34-631）溶血性尿毒综合征，2（95％UI：0-16）死亡，每年的直接医疗费用为$2,972,656（95%UI：$254,708-$14,496,916）。对于沙门氏菌,辐照将避免20,308（95％UI：9,858-38,903）疾病，400（95％UI：158-834）住院，6（95％UI：0-18）死亡，和7,318,632美元（95%UI：1,436,141-26,439,493美元）的直接医疗费用。在美国，增加碎牛肉辐照可以减少大肠杆菌O157和沙门氏菌的负担。其他研究应评估对高风险碎牛肉产品的靶向辐照是否可以预防类似数量的疾病，而辐照的产品总量较少。
