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We developed a risk assessment of human salmonellosis associated with consumption of alfalfa sprouts in the United States to evaluate the public health impact of applying treatments to seeds (0–5‐log 10  reduction in  Salmonella ) and testing spent irrigation water (SIW) during production. The risk model considered variability and uncertainty in  Salmonella  contamination in seeds,  Salmonella  growth and spread during sprout production, sprout consumption, and  Salmonella  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 – 248,000) cases/year. Risk reduction (by 5 ‐  to 7‐fold) predicted from a 1‐log 10  seed treatment alone was comparable to SIW testing alone, and each additional 1‐log 10  seed treatment was predicted to provide a greater risk reduction than SIW testing. A 3‐log 10  or a 5‐log 10  seed treatment reduced the predicted cases/year to 139 (95% CI 33 – 448) or 1.4 (95% CI <1 – 4.5), respectively. Combined with SIW testing, a 3‐log 10  or 5‐log 10  seed treatment reduced the cases/year to 45 (95% CI 10–146) or <1 (95% CI <1 – 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‐log 10  seed treatment and SIW testing with 20% coverage resulted in an estimated 92 (95% CI 22 – 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.

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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