Advancing the protection of subpopulations vulnerable to microbial pathogen risks

Populations worldwide are routinely at risk due to emerging and recurring infectious diseases, many of which cross borders via international trade or air and water transmission. Some people are especially vulnerable to microbial pathogens because of their inherent or acquired traits for susceptibility. The World Health Organization, other international organizations and various nations have published guidelines for assessing microbial pathogen risks, but little attention to date has been focused on developing methods for characterizing microbial pathogen risks to susceptible subpopulations. The work described in this presentation is based on a systematic, worldwide examination of government-sponsored microbial risk assessments (MRA) of pathogens in foods (raw to highly processed foods), water (drinking, recreational and wastewater), biosolids, indoor air, and of microbes used intentionally for cleanup and other purposes. All MRAs studied were published since 1995; most were conducted in the past 5 years. The fundamental frameworks, principles, methods and limitations of these MRAs were identified and evaluated. Key issues in conceptualizing and modeling susceptibility throughout MRA emerged from this critical analysis. Both scientific and policy needs were recognized, providing the foundation for recommending improvements in MRA to more effectively characterize and meet the needs of susceptible subpopulations. This presentation focuses on how susceptibility is and could be better assessed throughout MRA, and how improved assessments could advance public health strategies for protecting susceptible subpopulations exposed to microbial pathogens, especially those transmitted in food and water.