The resilience of the Dutch pork supply chain to Toxoplasma gondii.

Toxoplasma gondii (T. gondii) is a parasite leading to a substantial disease burden. An important source of toxoplasmosis is raw or undercooked pork. Our aim is to develop a model that can assess the resilience of the Dutch pork supply chain to T. gondii shocks, measured in Disability adjusted life years (DALYs), and the cost-effectiveness ratio (CER) of control measures that improve the resilience of the supply chain. We developed a farm-to-fork model to simulate T. gondii through the pork supply chain. We modelled two shocks: 1) young cats on the farm, a long-term shock, and 2) feeding pigs a batch of contaminated goat whey, a short-term shock, and two control measures: 1) sterilising cats at farm level, and 2) freezing meat at processing level. When facing shock 1, all control measures can be considered cost-effective with a CER between k€3 and k€24 per DALY in the first year and between k€1 and k€13 per DALY in subsequent years. When facing shock 2, freezing unheated meat, or freezing unheated meat and large pork cuts, or freezing all pork products led to a CER of respectively k€21, k€10, and k€46 per DALY in the first year. However, in subsequent years, the CER ranged from k€162 to k€820 per DALY, which cannot be considered cost-effective anymore. Control measures are more cost-effective in case of a long-term shock than in case of an isolated short-term shock. In the latter case, a control measure can be cost-effective if applied only for a limited time after the shock has been detected. The developed model can be used by decision makers to select effective control measures against toxoplasmosis caused by pork consumption.