Fresh produce is an important part of a healthy diet. During the last three decades, the number of outbreaks caused by foodborne pathogens associated with fresh produce consumption reported to the Centers for Disease Control and Prevention has increased. To identify trends, we analyzed data for 1973 through 1997 from the Foodborne Outbreak Surveillance System. We defined a produce-associated outbreak as the occurrence of two or more cases of the same illness in which epidemiologic investigation implicated the same uncooked fruit, vegetable, salad, or juice. A total of 190 produce-associated outbreaks were reported, associated with 16,058 illnesses, 598 hospitalizations, and eight deaths. Produce-associated outbreaks accounted for an increasing proportion of all reported foodborne outbreaks with a known food item, rising from 0.7% in the 1970s to 6% in the 1990s. Among produce-associated outbreaks, the food items most frequently implicated included salad, lettuce, juice, melon, sprouts, and berries. Among 103 (54%) produce-associated outbreaks with a known pathogen, 62 (60%) were caused by bacterial pathogens, of which 30 (48%) were caused by Salmonella. During the study period, Cyclospora and Escherichia coli O157:H7 were newly recognized as causes of foodborne illness. Foodborne outbreaks associated with fresh produce in the United States have increased in absolute numbers and as a proportion of all reported foodborne outbreaks. Fruit and vegetables are major components of a healthy diet, but eating fresh uncooked produce is not risk free. Further efforts are needed to better understand the complex interactions between microbes and produce and the mechanisms by which contamination occurs from farm to table.
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Research Article|
October 01 2004
Fresh Produce: A Growing Cause of Outbreaks of Foodborne Illness in the United States, 1973 through 1997
SUMATHI SIVAPALASINGAM;
SUMATHI SIVAPALASINGAM
*
1Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, 1600 Clifton Road, Atlanta, Georgia 30333, USA
2Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, Georgia 30333, USA
* Author for correspondence. Present address: New York University Medical Center, Department of Medicine, Division of Infectious Diseases, 550 First Avenue, C&D Building, Room 558, New York, NY 10016. Tel: 212-263-0766; Fax: 212-263-8264; E-mail: sumathi.sivapalasingam@med.nyu.edu.
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CINDY R. FRIEDMAN;
CINDY R. FRIEDMAN
1Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, 1600 Clifton Road, Atlanta, Georgia 30333, USA
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LINDA COHEN;
LINDA COHEN
1Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, 1600 Clifton Road, Atlanta, Georgia 30333, USA
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ROBERT V. TAUXE
ROBERT V. TAUXE
1Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, 1600 Clifton Road, Atlanta, Georgia 30333, USA
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J Food Prot (2004) 67 (10): 2342–2353.
Article history
Received:
December 31 2003
Accepted:
April 10 2004
Citation
SUMATHI SIVAPALASINGAM, CINDY R. FRIEDMAN, LINDA COHEN, ROBERT V. TAUXE; Fresh Produce: A Growing Cause of Outbreaks of Foodborne Illness in the United States, 1973 through 1997. J Food Prot 1 October 2004; 67 (10): 2342–2353. doi: https://doi.org/10.4315/0362-028X-67.10.2342
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