Listeria monocytogenes: low levels equal low risk.

Because of the public health significance of L. monocytogenes, U.S. regulatory agencies established a policy whereby ready-to-eat foods contaminated with the organism at a detectable level are deemed adulterated. This "zero tolerance" policy, however, makes no distinction between foods contaminated at high and low levels. We have reported elsewhere that a survey of over 31,000 ready-to-eat retail food samples, representing eight product categories, showed an overall prevalence rate of 1.82% for these foods. In this study, we used the food survey data in combination with concurrent data regarding illness in the population consuming the foods, together with other variable factors, to derive a dose-response model. The confidence interval for prevalence was 1.68 to 1.97%. L. monocytogenes levels, which ranged from -2 to 6 log CFU/g, were adequately described by the distribution beta (0.29, 2.68, -1.69, 6.1). An exponential dose-response model was obtained, with an R value (essentially the probability of a single cell causing illness) of 1.76 x 10(-10) for the population at the highest risk. A microbial risk assessment based on the model shows that an alternative to the zero tolerance strategy has a greater risk reduction potential and suggests that a management strategy focusing on the concentration of L. monocytogenes rather than its presence alone may have a greater impact on the improvement of public health by facilitating the development of control measures to limit the maximum levels of L. monocytogenes in foods.