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The growing burden of foodborne outbreaks due to contaminated fresh produce: risks and opportunities

  • M. F. LYNCH (a1), R. V. TAUXE (a1) and C. W. HEDBERG (a2)

Foodborne outbreaks from contaminated fresh produce have been increasingly recognized in many parts of the world. This reflects a convergence of increasing consumption of fresh produce, changes in production and distribution, and a growing awareness of the problem on the part of public health officials. The complex biology of pathogen contamination and survival on plant materials is beginning to be explained. Adhesion of pathogens to surfaces and internalization of pathogens limits the usefulness of conventional processing and chemical sanitizing methods in preventing transmission from contaminated produce. Better methods of preventing contamination on the farm, or during packing or processing, or use of a terminal control such as irradiation could reduce the burden of disease transmission from fresh produce. Outbreak investigations represent important opportunities to evaluate contamination at the farm level and along the farm-to-fork continuum. More complete and timely environmental assessments of these events and more research into the biology and ecology of pathogen-produce interactions are needed to identify better prevention strategies.

Corresponding author
*Author for correspondence: M. F. Lynch, MD, MPH, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-22, Atlanta, GA 30341, USA. (Email:
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4.  JP Nuorti , A widespread outbreak of Yersinia pseudotuberculosis O:3 infection from iceberg lettuce. Journal of Infectious Diseases 2004; 189: 766774.

9.  L Pezzoli , Packed with Salmonella – investigation of an international outbreak of Salmonella Senftenberg infection linked to contamination of prepacked basil in 2007. Foodborne Pathogens and Disease 2008; 5: 661668.

16.  AL Reingold . Outbreak investigations – a perspective. Emerging Infectious Diseases 1998; 4: 2127.

18.  CW Hedberg , Outbreaks of salmonellosis associated with eating uncooked tomatoes: implications for public health. Epidemiology and Infection 1999; 122: 385393.

19. Anonymous. Eggs and Salmonella infections. British Medical Journal 1944; 2: 760761.

21.  ME St Louis , The emergence of grade A eggs as a major source of Salmonella enteritidis infections. New implications for the control of salmonellosis. Journal of the American Medical Association 1988; 259: 21032107.

22.  RK Gast . Detection of Salmonella enteritidis in experimentally infected laying hens by culturing pools of egg contents. Poultry Science 1993; 72: 267274.

23.  LW Riley , Hemorrhagic colitis associated with a rare Escherichia coli serotype. New England Journal of Medicine 1983; 308: 681685.

24.  JM Rangel , Epidemiology of Escherichia coli O157:H7 outbreaks, United States, 1982–2002. Emerging Infectious Diseases 2005; 11: 603609.

28.  AY Ho , Outbreak of cyclosporiasis associated with imported raspberries, Philadelphia, Pennsylvania, 2000. Emerging Infectious Diseases 2002; 8: 783788.

29.  C Wheeler , An outbreak of hepatitis A associated with green onions. New England Journal of Medicine 2005; 353: 890897.

32.  B Swaminathan , Building PulseNet International: an interconnected system of laboratory networks to facilitate timely public health recognition and response to foodborne disease outbreaks and emerging foodborne diseases. Foodborne Pathogens and Disease 2006; 3: 3650.

33.  MA Widdowson , Norovirus and foodborne disease, United States, 1991–2000. Emerging Infectious Diseases 2005; 11: 95102.

34.  SL Burnett , LR Beuchat . Human pathogens associated with raw produce and unpasteurized juices, and difficulties in decontamination. Journal of Industrial Microbiology and Biotechnology 2001; 27: 104110.

35.  HL Tyler , EW Triplett . Plants as a habitat for beneficial and/or human pathogenic bacteria. Annual Review of Phytopathology 2008; 46: 5373.

36.  MT Brandl , RE Mandrell . Fitness of Salmonella enterica serovar Thompson in the cilantro phyllosphere. Applied Environmental Microbiology 2002; 68: 36143621.

38.  MT Brandl , Comparison of survival of Campylobacter jejuni in the phyllosphere with that in the rhizosphere of spinach and radish plants. Applied Environmental Microbiology 2004; 70: 11821189.

41.  SL Burnett , J Chen , LR Beuchat . Attachment of Escherichia coli O157:H7 to the surfaces and internal structures of apples as detected by confocal scanning laser microscopy. Applied Environmental Microbiology 2000; 66: 46794687.

44.  AO Charkowski , Differences in growth of Salmonella enterica and Escherichia coli O157:H7 on alfalfa sprouts. Applied Environmental Microbiology 2002; 68: 31143120.

45.  X Guo , Survival of salmonellae on and in tomato plants from the time of inoculation at flowering and early stages of fruit development through fruit ripening. Applied Environmental Microbiology 2001; 67: 47604764.

47.  AE Fiore . Hepatitis A transmitted by food. Clinical Infectious Diseases 2004; 38: 705715.

48.  M Cooley , Incidence and tracking of Escherichia coli O157:H7 in a major produce production region in California. PLoS ONE 2007; 2(11): e1159. Published online: 14 November 2007. doi:10.1371/journal.pone.0001159.

49.  MT Jay , Escherichia coli O157:H7 in feral swine near spinach fields and cattle, central California coast. Emerging Infectious Diseases 2007; 13(12) ( Accessed 28 Nov 2008.

51.  S Sivapalasingam , A multistate outbreak of Salmonella enterica Serotype Newport infection linked to mango consumption: impact of water-dip disinfestation technology. Clinical Infectious Diseases 2003; 37: 15851590.

55.  P Srikantiah , Web-based investigation of multistate salmonellosis outbreak. Emerging Infectious Diseases 2005; 11: 610612.

64.  GA Mumma , Egg quality assurance programs and egg-associated Salmonella enteritidis infections, United States. Emerging Infectious Diseases 2004; 10: 17821789.

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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
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