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The risk model considered variability and uncertainty in <jats:italic>Salmonella<\/jats:italic> contamination in seeds, <jats:italic>Salmonella<\/jats:italic> growth and spread during sprout production, sprout consumption, and <jats:italic>Salmonella<\/jats:italic> dose response. Based on an estimated prevalence of 2.35% for 6.8 kg seed batches and without interventions, the model predicted 76,600 (95% confidence interval (CI) 15,400<jats:bold>\u2013<\/jats:bold>248,000) cases\/year. Risk reduction (by 5<jats:bold>\u2010<\/jats:bold> to 7\u2010fold) predicted from a 1\u2010log<jats:sub>10<\/jats:sub> seed treatment alone was comparable to SIW testing alone, and each additional 1\u2010log<jats:sub>10<\/jats:sub> seed treatment was predicted to provide a greater risk reduction than SIW testing. A 3\u2010log<jats:sub>10<\/jats:sub> or a 5\u2010log<jats:sub>10<\/jats:sub> seed treatment reduced the predicted cases\/year to 139 (95% CI 33<jats:bold>\u2013<\/jats:bold>448) or 1.4 (95% CI &lt;1<jats:bold>\u2013<\/jats:bold>4.5), respectively. Combined with SIW testing, a 3\u2010log<jats:sub>10<\/jats:sub> or 5\u2010log<jats:sub>10<\/jats:sub> seed treatment reduced the cases\/year to 45 (95% CI 10\u2013146) or &lt;1 (95% CI &lt;1<jats:bold>\u2013<\/jats:bold>1.5), respectively. If the SIW coverage was less complete (i.e., less representative), a smaller risk reduction was predicted, e.g., a combined 3\u2010log<jats:sub>10<\/jats:sub> seed treatment and SIW testing with 20% coverage resulted in an estimated 92 (95% CI 22<jats:bold>\u2013<\/jats:bold>298) cases\/year. Analysis of alternative scenarios using different assumptions for key model inputs showed that the predicted relative risk reductions are robust. This risk assessment provides a comprehensive approach for evaluating the public health impact of various interventions in a sprout production system.<\/jats:p>","DOI":"10.1111\/risa.12964","type":"journal-article","created":{"date-parts":[[2018,1,16]],"date-time":"2018-01-16T22:19:01Z","timestamp":1516141141000},"page":"1738-1757","source":"Crossref","is-referenced-by-count":13,"title":["Risk Assessment of Salmonellosis from Consumption of Alfalfa Sprouts and Evaluation of the Public Health Impact of Sprout Seed Treatment and Spent Irrigation Water Testing"],"prefix":"10.1111","volume":"38","author":[{"given":"Yuhuan","family":"Chen","sequence":"first","affiliation":[{"name":"Center for Food Safety and Applied Nutrition U.S. Food and Drug Administration  College Park MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R\u00e9gis","family":"Pouillot","sequence":"additional","affiliation":[{"name":"Center for Food Safety and Applied Nutrition U.S. Food and Drug Administration  College Park MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofia M.","family":"Santillana Farakos","sequence":"additional","affiliation":[{"name":"Center for Food Safety and Applied Nutrition U.S. Food and Drug Administration  College Park MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Duret","sequence":"additional","affiliation":[{"name":"Center for Food Safety and Applied Nutrition U.S. Food and Drug Administration  College Park MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith","family":"Spungen","sequence":"additional","affiliation":[{"name":"Center for Food Safety and Applied Nutrition U.S. Food and Drug Administration  College Park MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tong\u2010Jen","family":"Fu","sequence":"additional","affiliation":[{"name":"Center for Food Safety and Applied Nutrition U.S. Food and Drug Administration  Bedford Park IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fazila","family":"Shakir","sequence":"additional","affiliation":[{"name":"Center for Food Safety and Applied Nutrition U.S. Food and Drug Administration  College Park MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia A.","family":"Homola","sequence":"additional","affiliation":[{"name":"Center for Food Safety and Applied Nutrition U.S. Food and Drug Administration  College Park MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherri","family":"Dennis","sequence":"additional","affiliation":[{"name":"Center for Food Safety and Applied Nutrition U.S. Food and Drug Administration  College Park MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane M.","family":"Van Doren","sequence":"additional","affiliation":[{"name":"Center for Food Safety and Applied Nutrition U.S. Food and Drug Administration  College Park MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,1,16]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/fpd.2013.1705"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-1605(99)00135-X"},{"key":"e_1_2_7_4_1","unstructured":"U.S. Food and Drug Administration.FDA Investigates Multistate Outbreak ofSalmonellaInfections Linked to Alfalfa Sprouts 2016. 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