Raw grated beetroot linked to several outbreaks of sudden-onset gastrointestinal illness, Finland 2010

SUMMARY In 2010, 7/44 (16%) reported foodborne outbreaks in Finland were linked with raw beetroot consumption. We reviewed data from the national outbreak registry in order to hypothesize the aetiology of illness and to prevent further outbreaks. In the seven outbreaks, 124 cases among 623 respondents were identified. Consumption of raw beetroot was strongly associated with gastrointestinal illness (relative risk 8·99, 95% confidence interval 6·06–13·35). The illness was characterized by sudden onset of gastrointestinal symptoms; the median incubation time was 40 min and duration of illness 5 h. No common foodborne pathogens or toxins were found in either clinical or beetroot samples, but all tested beetroot samples were of poor quality according to total bacterial counts. Beta-haemolytic Pseudomonas fluorescens was detected in several beetroot samples but its effect on human health is unknown. No outbreaks were reported after the Finnish Food Safety Authority Evira advised against serving raw beetroot in institutional canteens.

[1]  Sylviane Dragacci,et al.  Staphylococcus aureus and its food poisoning toxins: characterization and outbreak investigation. , 2012, FEMS microbiology reviews.

[2]  N. A. Logan,et al.  Bacillus and relatives in foodborne illness , 2012, Journal of applied microbiology.

[3]  M. Wiedmann,et al.  When cheese gets the blues: Pseudomonas fluorescens as the causative agent of cheese spoilage. , 2011, Journal of dairy science.

[4]  Jonathan Fulford,et al.  Dietary nitrate supplementation reduces the O2 cost of walking and running: a placebo-controlled study. , 2011, Journal of applied physiology.

[5]  I. Stulova,et al.  Microbiological quality of raw milk produced in Estonia , 2010, Letters in applied microbiology.

[6]  Robert B. Gramacy,et al.  amei: An R Package for the Adaptive Management of Epidemiological Interventions , 2010 .

[7]  Wolfgang Viechtbauer,et al.  Conducting Meta-Analyses in R with the metafor Package , 2010 .

[8]  L. Rodrigues,et al.  Prevalence and characteristics of asymptomatic norovirus infection in the community in England , 2010, Epidemiology and Infection.

[9]  Hua-lei Wang,et al.  Identification and characterization of a virulence-associated protease from a pathogenic Pseudomonas fluorescens strain. , 2009, Veterinary microbiology.

[10]  N. Bryan,et al.  Food sources of nitrates and nitrites: the physiologic context for potential health benefits. , 2009, The American journal of clinical nutrition.

[11]  Nicholas A Ratamess,et al.  Effect of betaine supplementation on power performance and fatigue , 2009, Journal of the International Society of Sports Nutrition.

[12]  A. Siitonen,et al.  Yersinia pseudotuberculosis O:1 Traced to Raw Carrots, Finland , 2008, Emerging infectious diseases.

[13]  A. Siitonen,et al.  Yersinia pseudotuberculosis causing a large outbreak associated with carrots in Finland, 2006 , 2008, Epidemiology and Infection.

[14]  Raghu Kacker,et al.  Random-effects model for meta-analysis of clinical trials: an update. , 2007, Contemporary clinical trials.

[15]  A. Siitonen,et al.  An outbreak of gastrointestinal illness and erythema nodosum from grated carrots contaminated with Yersinia pseudotuberculosis. , 2006, The Journal of infectious diseases.

[16]  J. Giroux,et al.  Mysterious outbreaks of gastrointestinal illness associated with burritos supplied through school lunch programs. , 2006, Journal of food protection.

[17]  Joseph A. Baur,et al.  Therapeutic potential of resveratrol: the in vivo evidence , 2006, Nature Reviews Drug Discovery.

[18]  A. Siitonen,et al.  Multiple Outbreaks of Yersinia pseudotuberculosis Infections in Finland , 2004, Journal of Clinical Microbiology.

[19]  J. Kanner,et al.  Betalains--a new class of dietary cationized antioxidants. , 2001, Journal of agricultural and food chemistry.

[20]  S. Becker,et al.  A comparison of maximum likelihood and jewell's estimator of the odds ratio and relative risk in single 2 × 2 tables , 1989 .

[21]  N. Laird,et al.  Meta-analysis in clinical trials. , 1986, Controlled clinical trials.

[22]  N P Jewell,et al.  Small-sample bias of point estimators of the odds ratio from matched sets. , 1984, Biometrics.

[23]  Multiple outbreaks of gastrointestinal illness among school children associated with consumption of flour tortillas--Massachusetts, 2003-2004. , 2006, MMWR. Morbidity and mortality weekly report.

[24]  N. Jewell A comparison of maximum likelihood and Jewell's estimator of the odds ratio and relative risk in single 2 x 2 tables. , 1991, Statistics in medicine.