Arie H Havelaar

Arie H Havelaar
University of Florida | UF · Emerging Pathogens Institute

PhD

About

517
Publications
142,172
Reads
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24,498
Citations
Additional affiliations
January 1996 - September 2014
National Institute for Public Health and the Environment
Position
  • Principal Investigator
July 2007 - present
EFSA European Food Safety Authority
March 2007 - present
Utrecht University

Publications

Publications (517)
Article
Full-text available
Background Campylobacter is associated with environmental enteric dysfunction (EED) and malnutrition in children. Campylobacter infection could be a linchpin between livestock fecal exposure and health outcomes in low-resource smallholder settings. Methods We followed a birth cohort of 106 infants in rural smallholder households in eastern Ethiopi...
Article
Full-text available
Introduction Enteric pathogens are a leading causes of diarrheal deaths in low-and middle-income countries. The Exposure Assessment of Campylobacter Infections in Rural Ethiopia (EXCAM) project, aims to identify potential sources of bacteria in the genus Campylobacter and, more generally, fecal contamination of infants during the first 1.5 years of...
Article
Full-text available
Increasing attention has focused on health outcomes of Campylobacter infections among children younger than 5 years in low-resource settings. Recent evidence suggests that colonization by Campylobacter species contributes to environmental enteric dysfunction, malnutrition, and growth faltering in young children. Campylobacter species are zoonotic,...
Preprint
Full-text available
Background Campylobacter jejuni and C. coli are the most common causes of bacterial enteritis worldwide whereas symptomatic and asymptomatic infections are associated with stunting in children in low- and middle-income countries. Little is known about their sources and transmission pathways in low- and middle-income countries, and particularly for...
Preprint
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Background Campylobacter infections pose a significant challenge in low- and middle-income countries, contributing to child mortality. Campylobacter is linked to acute gastrointestinal illness and severe long-term consequences, including environmental enteric dysfunction (EED) and stunting. In 2018, our cross-sectional study in Ethiopia detected Ca...
Preprint
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In low- and middle-income countries (LMICs), enteric infections pose a significant threat to children's health. However, understanding the specifics of when, where, and how young children in LMICs are exposed to enteric pathogens and the roles of animal reservoirs, environmental media, and human hosts play during exposure remains limited. This stud...
Preprint
Full-text available
Enteric pathogens are a leading causes of diarrheal deaths in low- and middle-income countries. The Exposure Assessment of Campylobacter Infections in Rural Ethiopia (EXCAM) project, aims to identify potential sources of bacteria in the genus Campylobacter and, more generally, fecal contamination of infants during the first 1.5 years of life using...
Preprint
Full-text available
Increasing attention has focused on health outcomes of Campylobacter infections among children under five years in low-resource settings. Recent evidence suggests colonization of Campylobacter species contributes to environmental enteric dysfunction, malnutrition, and growth faltering in young children. Campylobacter species are zoonotic, and facto...
Preprint
Full-text available
Background: Campylobacter is associated with environmental enteric dysfunction (EED) and malnutrition in children. Campylobacter infection could be a critical link between determinants of livestock fecal exposure and health outcomes in low-resource smallholder settings. Methods: We followed a birth cohort of 106 infants in a community of rural smal...
Article
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Drying is one of the oldest methods of food preservation, involving the addition of salt and removal of water to generate a shelf-stable and nutrient-dense product. Pathogens have demonstrated the ability to adapt during a slow drying process, making them more resistant to dehydration and heat treatment. In Ethiopia, an inconsistent electrical grid...
Preprint
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In eastern Ethiopia, production of khat has increased in recent years, with significant implications for women in khat production and sale. Women have long been engaged in agricultural production in the region, yet the implications of the shift from food crop production to khat/cash crop production on degree and manner of women's engagement in agri...
Article
The prevalence of Campylobacter infection is generally high among children in low- and middle-income countries (LMIC), but the dynamics of its acquisition and clearance are understudied. We aim to quantify this process among children under two years old in eight LMIC using a statistical modeling approach, leveraging enzyme-immunoassay-based Campylo...
Article
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Chagas disease (ChD), caused by infection with the flagellated protozoan, Trypanosoma cruzi, has a complicated transmission cycle with many infection routes. These include vector-borne (via the triatomine (reduviid bug) vector defecating into a skin abrasion, usually following a blood meal), transplacental transmission, blood transfusion, organ tra...
Article
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Introduction Foodborne diseases (FBD) are a significant problem in low- and middle-income countries, especially in Africa. Country-specific estimates of the economic costs related to FBD caused by different hazards in different food products can inform decision makers about this problem’s magnitude. This aids policy makers in prioritising actions t...
Article
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Agriculture, and particularly livestock and animal source foods, has been closely linked to improvements in human nutrition. Production, income, and women’s empowerment improve household food security and child nutritional outcomes in interacting ways. Khat production in Eastern Ethiopia is changing the economic and livelihood landscape for communi...
Article
Full-text available
In our previous cross-sectional study, multiple species of Campylobacter were detected (88%) in stool samples from children (12 to 14 months of age) in rural eastern Ethiopia. This study assessed the temporal fecal carriage of Campylobacter in infants and identified putative reservoirs associated with these infections in infants from the same regio...
Article
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The majority of emerging infectious diseases are zoonoses, most of which are classified as "neglected". By affecting both humans and animals, zoonoses pose a dual burden. The disability-adjusted life year (DALY) metric quantifies human health burden since it combines mortality and morbidity. This review aims to describe and analyze the current stat...
Article
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Background The Girinka program in Rwanda has contributed to an increase in milk production, as well as to reduced malnutrition and increased incomes. But dairy products can be hazardous to health, potentially transmitting diseases such as bovine brucellosis, tuberculosis, and cause diarrhea. We analyzed the burden of foodborne disease due to consum...
Article
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Objective To assess the feasibility and potential benefits of personalized biomarker-based text messages in prolonging lactation among parents of critically ill infants. Study Design Thirty-six participants were randomized to receive either daily texts with Mother’s Own Milk (MOM) sodium levels or standard care. Surveys at months 1 and 3 assessed...
Preprint
Full-text available
Background: The burden of Campylobacter infection is high in children under five years of age in low- and middle-income countries (LMIC), but its acquisition and clearance process is understudied due to scarcity of longitudinal data. We aim to quantify this process using a statistical modeling approach, leveraging data from a multi-nation study. Me...
Poster
Full-text available
Campylobacter was detected in all households selected in this study (n=106). A total of 71% (1,939/2,718) of field samples were positive for Campylobacter at the genus level Campylobacter was detected in 61% (657/1,074) of infant stools at the genus level (Fig. 1)-Campylobacter prevalence in the infant stools significantly increased over time; 29%...
Article
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Background Estimates by the World Health Organization indicate that over 800,000 global neonatal deaths each year are attributed to deviations from recommended best practices in infant feeding. Identifying factors promoting ideal breastfeeding practices may facilitate efforts to decrease neonatal and infant death rates and progress towards achievin...
Article
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Background Globally, foodborne diseases result in a significant disease burden with low- and middle-income countries disproportionately affected. Estimates of healthcare costs related to foodborne disease can aid decision makers to take action to mitigate risks and prevent illness. However, only limited data on the African continent are available,...
Article
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Foodborne disease is a significant global health problem, with low- and middle-income countries disproportionately affected. Given that most fresh animal and vegetable foods in LMICs are bought in informal food systems, much the burden of foodborne disease in LMIC is also linked to informal markets. Developing estimates of the national burden of fo...
Article
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Nontyphoidal salmonellosis is the leading reported foodborne illness in Florida. Although the diversity of Salmonella serotypes circulating in Florida has been identified, the geographical characteristics of the major serotypes are poorly described. Here we examined the geospatial patterns of 803 whole-genome sequenced Salmonella isolates within se...
Article
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Introduction Undernutrition is an underlying cause of mortality in children under five (CU5) years of age. Animal-source foods have been shown to decrease malnutrition in CU5. Livestock are important reservoirs for Campylobacter bacteria, which are recognised as risk factors for child malnutrition. Increasing livestock production may be beneficial...
Article
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Background According to the World Health Organization, 600 million cases of foodborne disease occurred in 2010. To inform risk management strategies aimed at reducing this burden, attribution to specific foods is necessary. Objective We present attribution estimates for foodborne pathogens (Campylobacter spp., enterotoxigenic Escherichia coli (ETE...
Preprint
Full-text available
Objective : To assess the feasibility and potential benefits of personalized biomarker-based text messages in prolonging lactation among parents of critically ill infants. Study Design: Thirty-six participants were randomized to receive either daily texts with Mother’s Own Milk (MOM) sodium levels or standard care. Surveys at months 1 and 3 assesse...
Article
Background: For 60 y, it has been known that aflatoxin B1 (AFB1), a mycotoxin produced by Aspergillus fungi in certain food and feed crops, causes hepatocellular carcinoma (liver cancer; HCC) in humans. The annual global burden of AFB1-related HCC has been estimated. However, much less is known about the potential carcinogenic impact of a metaboli...
Article
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Poultry litter is a widely used biological soil amendment in the production of fresh produce. However, poultry litter may contain human pathogens, such as Salmonella , which introduces the risk of preharvest produce contamination in agricultural fields.
Article
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Livestock production may improve nutritional outcomes of pregnant women and children by increasing household income, availability of nutrient-dense foods, and women's empowerment. Nevertheless, the relationship is complex, and the nutritional status of children may be impaired by presence of or proximity to livestock and their pathogens. In this pa...
Article
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Investments in animal health and Veterinary Services can have a measurable impact on the health of people and the environment. These investments require a baseline metric that describes the burden of animal health and welfare in order to justify and prioritise resource allocation and from which to measure the impact of interventions. This paper is...
Article
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Pond irrigation water comprises a major pathway of pathogenic bacteria to fresh produce. Current regulatory methods have been shown to be ineffective assessing this risk when variability of bacterial concentrations is large. This paper proposes using mechanistic modeling of bacterial transport as a way to identify improved strategies for mitigating...
Article
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The state of Florida reports a high burden of non-typhoidal Salmonella enterica with approximately two times higher than the national incidence. We retrospectively analyzed the population structure and molecular epidemiology of 1,709 clinical isolates from 2017 and 2018. We found 115 different serotypes. Rarefaction suggested that the serotype rich...
Chapter
A recent ample Structured Expert Judgment (SEJ) study quantified the source attribution of 33 distinct pathogens in the United States. The source attribution for five transmission pathways: food, water, animal contact, person-to-person, and environment has been considered. This chapter will detail how SEJ has been applied to answer questions of int...
Article
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Livestock farming provides a possible mechanism by which smallholder farmers can meet their household need for animal source foods (ASF), which may reduce the risk of stunting. However, direct/indirect contacts with domestic animals may increase colonization by Campylobacter spp., which has been associated with Environmental Enteric Dysfunction (EE...
Article
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Non-typhoidal Salmonella enterica infections cause a high disease burden in the United States with an estimated 1.2 million illnesses annually. The state of Florida consistently has a relatively high incidence compared to other states in the United States. Nevertheless, studies regarding the epidemiology of nontyphoidal salmonellosis and its spatia...
Article
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Illnesses transmitted by food and water cause a major disease burden in the United States despite advancements in food safety, water treatment, and sanitation. We report estimates from a structured expert judgment study using 48 experts who applied Cooke’s classical model of the proportion of disease attributable to 5 major transmission pathways (f...
Article
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Provision of safe drinking water in the United States is a great public health achievement. However, new waterborne disease challenges have emerged (e.g., aging infrastructure, chlorine-tolerant and biofilm-related pathogens, increased recreational water use). Comprehensive estimates of the health burden for all water exposure routes (ingestion, co...
Chapter
Toxoplasma gondii is an important zoonotic parasite with a worldwide distribution. Felids are the definitive hosts and, upon primary infection, they shed millions of oocysts into the environment. These oocysts are infectious to a wide range of warm-blooded animals, and these intermediate hosts develop tissue cysts. Humans can be infected through oo...
Article
Dairy production is rapidly increasing in developing countries and making significant contributions to health, nutrition, environments, and livelihoods, with the potential for still greater contributions. However, dairy products can also contribute to human disease in many ways, with dairyborne disease likely being the most important. Health risks...
Article
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Background According to the Internal Displacement Monitoring Centre report on global human displacement, Ethiopia has the highest number of newly displaced people forced to flee their homes. Displaced people have arrived in other regions, sometimes leading to conflict. Several regions in Ethiopia experience on-going ethnic tensions and violence bet...
Article
Foodborne disease poses several major threats toward attaining sustainable improvements in food and nutrition security (FNS), on a global scale. These threats have numerous rippling effects on public health, economic growth, and country development. This article—based on a review of literature and experience from the United States Agency for Intern...
Article
The Florida Complaint and Outbreak Reporting System (FL-CORS) database is used by the Florida Department of Health's Food and Waterborne Disease Program as one of the tools to detect foodborne disease outbreaks (FBOs). We present a descriptive and spatial network analysis of FL-CORS data collected during 2015 to 2018. We also quantified FBOs that w...
Preprint
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Background According to data from the Internal Displacement Monitoring Centre’s Global Report on Internal Displacement 2019, Ethiopia had the highest number of people newly displaced within their own country due to violence. Several regions in the country experience on-going ethnic tensions and violent tribal conflict, which leaves smallholder farm...
Preprint
Full-text available
Background: According to the Internal Displacement Monitoring Centre report on global human displacement, Ethiopia has the highest number of newly displaced people forced to flee their homes. Displaced people have arrived in other regions, sometimes leading to conflict. Several regions in Ethiopia experience on-going ethnic tensions and violence be...
Preprint
Full-text available
Background According to the Internal Displacement Monitoring Centre report on global human displacement, Ethiopia has the highest number of newly displaced people forced to flee their homes. Displaced people have arrived in other regions, sometimes leading to conflict. Several regions in Ethiopia experience on-going ethnic tensions and violence bet...
Article
Full-text available
High Campylobacter prevalence during early childhood has been associated with stunting and environmental enteric dysfunction (EED), especially in low resource settings. This study assessed the prevalence, diversity, abundance, and co-occurrence of Campylobacter spp. in stools from children in a rural area of eastern Ethiopia and their association w...
Article
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Background Childhood stunting and malnutrition condemn millions of people globally to a life of disadvantage and cognitive and physical impairment. Though increasing egg consumption is often seen as an important solution for low and middle income countries (including Ethiopia), emerging evidence suggests that greater exposure to poultry feces may a...
Article
The notion that consuming animal-source food (ASF; milk, meat, fish and eggs) is incompatible with sustainable development is flawed. Negative perceptions of livestock consumption in many sustainability debates arise from a focus on overconsumption of ASF, particularly in middle to high-income countries, and a narrow interpretation of sustainabilit...
Article
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Objectives Animal-sourced foods (ASFs), such as meat, provide nutrients that are beneficial for physical and cognitive development, especially in developing countries. Despite Ethiopia containing Africa’s largest inventory of livestock, market structure and inefficiencies in livestock and meat industries contribute to low-per capita consumption of...
Article
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Globally, two billion people suffer from micronutrient deficiencies, 151 million children under five suffer from stunting, and millions more have impaired cognitive development related to poor nutrition. This is partly due to insufficient consumption of animal-sourced foods (ASF), which supply multiple bioavailable nutrients that are lacking in the...
Article
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Animal source foods (ASF) such as dairy, eggs, fish and meat are an important source of high-quality nutrients. Lack of ASF in diets can result in developmental disorders including stunting, anemia, poor cognitive and motor development. ASF are more effective in preventing stunting than other foods and promoting ASF consumption in low- and middle-i...
Article
The One Health concept proposes that there is a connection between human, animal and environmental health. Plants and their health are not explicitly included. In this review, we broaden the One Health concept to include soil, plant, animal and ecosystem health. We argue that the health conditions of all organisms in an ecosystem are interconnected...
Chapter
Disease burden estimates provide the foundation for evidence-informed policy making and are critical to public health priority setting around food safety. Several efforts have recently been undertaken to better quantify the burden of foodborne disease, but there is still much work to be done. While burden estimates are crucial to raising awareness...
Article
Several produce-borne outbreaks have been associated with the use of contaminated water during preharvest applications. Salmonella has been implicated in a number of these outbreaks. The purpose of this study was to evaluate the microbial quality of agricultural surface water used in preharvest production on the Eastern Shore of Virginia in accorda...
Article
Microbial contamination of fresh produce (fresh fruits and vegetables) poses serious public health concerns worldwide. This study was conducted as a comprehensive analysis of biological hazards in the global fresh produce chain. Data about produce-related outbreaks and illness were collected from the annual reports and databases of foodborne outbre...
Article
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Background and aims: The Burden of Communicable Diseases in Europe (BCoDE) study aimed to calculate disability-adjusted life years (DALYs) for 31 selected diseases in the European Union (EU) and European Economic Area (EEA). Methods: DALYs were estimated using an incidence-based and pathogen-based approach. Incidence was estimated through assessme...
Article
As participants at the Ecosystem Inception Meeting convened by the Global Dairy Platform and held in Chicago in June 2016, we have identified some concepts as central to the study of food systems science. Following the definition developed by the Food and Agriculture Organization for sustainable diets, the food supply needs to provide foods that ar...
Chapter
Burden and risk assessment play an increasingly important and accepted role in defining control policies for foodborne parasites (FBPs). Burden assessment is a top-down approach, starting from available epidemiological data, while risk assessment is a bottom-up or predictive approach, starting from exposure and dose-response data. Both methods howe...
Chapter
Foodborne illness is typically associated with acute gastroenteritis, caused by intestinal infection by bacteria, viruses, or parasites. The actual scope of foodborne disease is however much broader than this. Intestinal infections with common pathogens such as Campylobacter or Salmonella may result in disabling complications, long-term health outc...