Reported foodborne outbreaks due to fresh produce in the United States and European Union: trends and causes.

The consumption of fruit and vegetables continues to rise in the United States and European Union due to healthy lifestyle recommendations. Meanwhile, the rate of foodborne illness caused by the consumption of these products remains high in both regions, representing a significant public health and financial issue. This study addresses the occurrence of reported foodborne outbreaks associated with fresh fruits and vegetables consumption in the United States and European Union during the period 2004-2012, where data are available. Special attention is paid to those pathogens responsible for these outbreaks, the mechanisms of contamination, and the fresh produce vehicles involved. Norovirus is shown to be responsible for most of the produce-related outbreaks, followed by Salmonella. Norovirus is mainly linked with the consumption of salad in the United States and of berries in the European Union, as demonstrated by the Multiple Correspondence Analysis (MCA). Salmonella was the leading cause of multistate produce outbreaks in the United States and was the pathogen involved in the majority of sprouts-associated outbreaks. As is reflected in the MCA, the pattern of fresh produce outbreaks differed in the United States and European Union by the type of microorganism and the food vehicle involved.

[1]  J. Farber,et al.  Foodborne outbreaks in Canada linked to produce. , 2001, Journal of food protection.

[2]  G. Sánchez,et al.  Effects of sanitation, freezing and frozen storage on enteric viruses in berries and herbs. , 2008, International journal of food microbiology.

[3]  R. Tauxe,et al.  Fresh produce: a growing cause of outbreaks of foodborne illness in the United States, 1973 through 1997. , 2004, Journal of food protection.

[4]  R. Stephan,et al.  Bacteriological survey of ready-to-eat lettuce, fresh-cut fruit, and sprouts collected from the Swiss market. , 2012, Journal of food protection.

[5]  P. Feng,et al.  Microbial quality of bagged baby spinach and romaine lettuce: effects of top versus bottom sampling. , 2012, Journal of food protection.

[6]  S. O'Brien,et al.  Surveillance of foodborne outbreaks of infectious intestinal disease in England and Wales 1992-1999: contributing to evidence-based food policy? , 2002, Public health.

[7]  F. M. Ghazali,et al.  The scenario of norovirus contamination in food and food handlers. , 2010, Journal of microbiology and biotechnology.

[8]  P. Hand,et al.  Fresh fruit and vegetables as vehicles for the transmission of human pathogens. , 2010, Environmental microbiology.

[9]  R. Baines,et al.  Escherichia coli O104:H4 outbreak from sprouted seeds. , 2013, International journal of hygiene and environmental health.

[10]  J. Farber,et al.  Foodborne outbreaks in Canada linked to produce: 2001 through 2009. , 2013, Journal of food protection.

[11]  J. Blanco,et al.  Characteristics of the Shiga-toxin-producing enteroaggregative Escherichia coli O104:H4 German outbreak strain and of STEC strains isolated in Spain. , 2011, International microbiology : the official journal of the Spanish Society for Microbiology.

[12]  D. Nyachuba Foodborne illness: is it on the rise? , 2010, Nutrition reviews.

[13]  R. Clarke,et al.  Theory and Applications of Correspondence Analysis , 1985 .

[14]  D. D'Souza,et al.  Simple and Rapid Detection of Human Norovirus from Produce Using SYBR Green I-based Real-time RT-PCR , 2011, Food and Environmental Virology.

[15]  E. Belausov,et al.  Salmonella Typhimurium internalization is variable in leafy vegetables and fresh herbs. , 2011, International journal of food microbiology.

[16]  P. Feng,et al.  Decontamination of Salmonella, Shigella, and Escherichia coli O157:H7 from leafy green vegetables using edible plant extracts. , 2013, Journal of food science.

[17]  D Harmsen,et al.  EUREGIO MRSA-net Twente/Münsterland--a Dutch-German cross-border network for the prevention and control of infections caused by methicillin-resistant Staphylococcus aureus. , 2008, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[18]  E. H. Garrett,et al.  Outbreaks Associated with Fresh Produce: Incidence, Growth, and Survival of Pathogens in Fresh and Fresh‐Cut Produce , 2001 .

[19]  Hilde Kruse,et al.  Food-borne diseases — The challenges of 20 years ago still persist while new ones continue to emerge , 2010, International Journal of Food Microbiology.

[20]  J. Rello,et al.  E. coli O104:H4 outbreak and haemolytic-uraemic syndrome. , 2012, Medicina intensiva.

[21]  S. Arendt,et al.  Reporting of Foodborne Illness by U.S. Consumers and Healthcare Professionals , 2013, International journal of environmental research and public health.

[22]  R. Holley,et al.  Factors influencing the microbial safety of fresh produce: a review. , 2012, Food microbiology.

[23]  L. Beuchat,et al.  Recent Trends in Microbiological Safety of Fruits and Vegetables , 2003 .

[24]  Matthias Greiner,et al.  German outbreak of Escherichia coli O104:H4 associated with sprouts. , 2011, The New England journal of medicine.

[25]  H. Hirt,et al.  The Dark Side of the Salad: Salmonella typhimurium Overcomes the Innate Immune Response of Arabidopsis thaliana and Shows an Endopathogenic Lifestyle , 2008, PloS one.

[26]  J. D. Greig,et al.  Analysis of foodborne outbreak data reported internationally for source attribution. , 2009, International journal of food microbiology.

[27]  L. Mauer,et al.  Examination of the internalization of Salmonella serovar Typhimurium in peanut, Arachis hypogaea, using immunocytochemical techniques , 2012 .

[28]  J. Ibrahim,et al.  A summary of health outcomes: multistate foodborne disease outbreaks in the U.S., 1998-2007. , 2012, Journal of environmental health.

[29]  K. Jones,et al.  Microbial contamination of fruit and vegetables and the behaviour of enteropathogens in the phyllosphere: a review , 2008, Journal of applied microbiology.

[30]  C W Hedberg,et al.  The growing burden of foodborne outbreaks due to contaminated fresh produce: risks and opportunities , 2009, Epidemiology and Infection.

[31]  W. van Pelt,et al.  An international outbreak of Shiga toxin-producing Escherichia coli O157 infection due to lettuce, September-October 2007. , 2008, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.