Points to include
Clostridium species and Bacillus cereus can produce toxins in food kept at inadequate temperatures or produce spores that are ingested and later germinate in the human gut when conditions are more favorable. (Gerner-Smidt and Whichard, 2009)
Healthy animal’s digestive tract- can contaminate carcass during slaughter.(not thoroughly cooked)- Beef (E. coli O157), Chicken (Salmonella and Campylobacter)
Water contamination- with human/animal fecal material.(used to irrigate produce), Fruit and Vegetables
Food Handlers, the Fecal-oral route.- Shigella , hepatitis A virus, or norovirus, Skin lesions- Staphylococcus aureus .
Shellfish and oysters Harbor higher numbers of Vibrio (certain times of the year)
Deli meats and unpasteurized milk products Stored at refrigerated temperatures- L. monocytogenes and Yersinia enterocolitica can actively multiply
Salmonella spp., Escherichia coli O157:H7, Staphylococcus aureus, Campylobacter spp. and Listeria monocytogenes are the most common pathogens that contaminate fresh produce (Wadamori, Gooneratne and Hussain, 2016)
Common sources of foodborne illness are 1) Raw foods of animal origin (raw meat and poultry, raw eggs, unpasteurized milk, and raw shellfish. 2) Fruits and vegetables – which can become contaminated with animal waste (manure used as fertilizer) or unclean water is used for washing the produce. Raw sprouts are of particular risk as the conditions under which they are sprouted are ideal for growing microbes and they are most often eaten raw In the same way, unpasteurized fruit juices or cider- can be contaminated from pathogens on the fruit that is used to make it. 3) Human Contact – Any food item that is touched by a person who is ill with vomiting or diarrhea, or who has recently had such an illness, can become contaminated. Foods items that are not typically cooked (e.g. salads, cut fruit) are of most concern. (Linscott, 2011)
Some foods that have been linked to outbreaks include milk (Campylobacter) (CHRISTIDIS et al., 2016); shellfish (noroviruses)(Le Guyader et al., 2006); unpasteurized apple cider (Escherichia coli O157:H7) (BASARANAKGUL et al., 2009), raw and undercooked eggs (Salmonella) (OSIMANI, AQUILANTI and CLEMENTI, 2016); fish (ciguatera poisoning); raspberries (Cyclospora); strawberries (hepatitis A virus); and ready-to-eat meats (Listeria).
The most frequently reported vehicles for infection were multi-ingredient food (foods that contained more than one potential culprit, such as eggs, produce, and beef) and most organisms are found in many food commodities. However, some microorganisms were only associated with a limited number of food commodities, for example, Vibrio spp. with seafood; Trichinella spp. with beef, pork, and other meats and Cyclospora spp. with produce. Campylobacter spp. is most associated with dairy products, chicken, and multi-ingredient foods.
Various food vehicles showed different degrees of specificity for a particular microorganism. Egg-associated outbreaks are almost all caused by Salmonella and Salmonella serotype Enteritidis alone accounting for 73.7% of the outbreaks reported. Bakery items are predominantly associated with outbreaks caused by Salmonella spp. and norovirus. Home-canned food, is associated with Clostridium botulinum. Beverages, including water, are commonly associated with norovirus, E. coli, Salmonella spp., and Hepatitis A virus. Turkey and poultry other than chicken are associated with Salmonella spp., Clostridium perfringens, Campylobacter, Staphylococcus aureus, norovirus, and Listeria monocytogenes. Outbreaks associated with any of the other food commodities involved even more microorganism
Specific produce items are more commonly linked to foodborne illness incidents; for example, leafy greens such as lettuce and spinach, as well as fresh herbs such as parsley and basil are conventional sources of bacterial infections.(Alegbeleye, Singleton and Sant’Ana, 2018) Berries, green onions, melons, sprouted seeds, and tomatoes are similarly high-level priority produce items In the US, between 2006 and 2014, 16 of 68 multistate foodborne outbreaks were associated with vegetables (CDC, 2014)
In the EU the occurrence of Campylobacter remained high in broiler meat. (EFSA, 2017). And the prevalence is high in retail poultry worldwide. For instance, in Ireland was 51.1% (2) In USA it was 71.5% (7 papers) and in Senegal 82.5%and Argentina 92.5% and in the Czech Prevalence of Campylobacter in retail poultry was 100% (1 paper).(Suzuki, 2018) In india Staphylococcus aureus, Vibrio, Salmonella, E.coli and Yersinia enterocolitica, are commonly found in milk and meat , B.cereus in rice. Some of the new emerging pathogens like Listeria monocytogenes Yersinia enterocolitica , Campylobacter jejuni , E.coli 0157:H7 were found to be isolated from different food products. (Rao Vemula, Naveen Kumar and Polasa, 2012)
Milk, milk based sweets, non-vegetarian foods like meat and fish were found to contain more pathogenic bacteria In India the pathogenic bacteria like Salmonella was found to be more common in meat, poultry, seafood and khoa but in other country like UK it is more common in meat poultry eggs and dairy products. (Rao Vemula, Naveen Kumar and Polasa, 2012) In the South American region between 1993 and 2010, 6313 bacterial outbreaks were reported by 20 countries. In the 1990’s the most frequent sources of bacterial disease were meat, dairy products, water and vegetables, eggs, vegetables, grains and beans were the most frequently reported the 2000s (Pires et al., 2012) Significant proportion of L. monocytogenes-positive sampling units in soft and semi-soft cheeses, and in hard cheeses made from raw or low-heat-treated milk or pasteurised milk has been reporting in EU Member States in 2016.
When the geographic region was also considered, three times more outbreaks caused by Salmonella Enteritidis were observed in the EU compared to the United States. In the multiple correspondence analysis, a strong association was seen between Salmonella Enteritidis and eggs in the EU and between E. coli and beef in Canada. Outbreaks of Salmonella Typhimurium with no specific food association were more predominant in Australia and New Zealand than in other regions.
(Gerner-Smidt and Whichard, 2009) Many foodborne pathogens also can be acquired through recreational or drinking water, from contact with animals or their environment, or through person-to-person spread. (Dept. of Health, 2018)
Produce + RTE
Increased desire for fresh produce has seen a growth in global production of fruit and vegetables of 94% from 1980-2004 (Wirsenius et al. 2010). As a consequence, fresh produce is responsible for a growing number of foodborne disease outbreaks each year (Beuchat 2002). An increase is reported in industrialised countries resulting from change in dietary habits and increased food imports. In the United Kingdom, between 1996-2006, 88 outbreaks (3435 reported cases) implicated fresh fruit and vegetables. (Organization 1998). And 531 cases between 2008-2010, including one death. (ACMSF, 2018). In developing countries, foodborne illnesses caused by contaminated fruits and vegetables are frequent and can cause a large proportion of illnesses, although reporting remains low in scientific literature. () In 1995– 1996, just 2% of foodborne disease outbreaks was related to fruits and vegetables in Latin America (PAHO/ INPPAZ 1996)
Outbreaks have been associated with the consumption of fresh produce and specifically with the consumption of frozen raspberries or frozen strawberries, lettuce, melons, salads, diced tomatoes, fresh-cut fruit and manually prepared salad (Ponka et al.et al. 1999; Beuchat 2002; Maunula et al. 2009; Severi et al. 2015, Schmid et al., 2007) The most frequent type of fresh produce involved with outbreaks worldwide were frozen raspberries (23.7%) followed by frozen berries (19.1%) and salad/rocket/green salad (15.8%) (SARVIKIVI et al., 2011)
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. (Callejón et al., 2015)
United Nations and the World Health Organization (FAO- WHO) categorized leafy green vegetables as the highest priority in terms of fresh produce safety from a global perspective. (CHARDON et al., 2016) Salads are most frequently associated with colonization by human pathogens, including Salmonella enterica, Listeria monocytogenes, and Escherichia coli. Salmonella has the ability to attach to and colonize the surface of produce; however, some colonization is internal which makes elimination of the bacteria from these tissues even more challenging. (Hertrich et al., 2017)
There has been a continuous rise in the number of produce- based microbiological foodborne outbreaks in the recent decades. The majority of reported outbreaks -fruit and veg- in Europe (72.4%) (Ireland 0.7%). Denmark and Finland largest no of outbreaks reported (both 19.0%) (Chatziprodromidou et al., 2018) – higher occurrence or higher reporting? The centers for Disease control and prevention (cDc) estimates that 95% of Salmonella-based infections originate from foodborne sources, with multiple produce-based salmonellosis outbreaks occurring since 1990 (Fatica and Schneider, 2011)
The Type of vegetable effects persistence. For instance, a virus can remain stable on scallions for up to 14 days. (Kurdziel et al. 2001). Scallions cluster/outbreak are well recorded (hep A) (Chancellor et al. 2006) One outbreak having 575 cases and 1 death (Wheeler et al. 2005) These diseases may be caused by infectious agents, such as the Escherichia coli O104:H4 outbreak attributed to contaminated fenugreek sprouts, which caused 386 cases of illness and 54 deaths in Germany in 2011.(Havelaar et al., 2015)
In 2016, results from RTE food-product categories, such as ‘bakery products’, ‘confectionery products and pastes’, ‘egg products’, ‘fruits and vegetables’, ‘salads’, ‘sauces and dressings’, ‘spices and herbs’ and ‘other processed food products and prepared dishes’ were reported throughout Europe. (EFSA, 2017).
Ground meats, or products prepared from ground meat, were responsible for the transmission of Salmonella spp. in several foodborne outbreaks reported all over the world (CDC, 2006). Beef and pork products are a commonly reported vehicles for Salmonella spp. with predominance of serotype Salmonella enteritidis and Salmonella typhimurium in both Denmark and Brazil (the two largest producers) between 2000 and 2013 (Møller et al., 2016) In Saudi Arabia the majority (68.9%) of the cases got sick after consuming commercially prepared foods. Meat intake caused 67.7% cases, and Middle Eastern meat sandwich was a commonly implicated food. (Al-Goblan and Jahan, 2010)
In North America, Europe and Japan, campylobacteriosis is one of the leading food-borne bacterial illnesses and the consumption of poultry meats and/or by-products is the major cause of illness. (Suzuki, 2018) In most of the countries, a majority of retail poultry meats and by-products were contaminated with Campylobacter spp. C. jejuni was usually the dominant Campylobacter species isolated from retail poultry and C. coli was less frequently isolated, although the ratio of C. coli to C. jejuni was considerably different among the countries. However, in Thailand and South Africa, C. coli was the dominant Campylobacter species isolated from retail poultry
Poultry is acknowledged as an important potential reservoir of foodborne pathogens, particularly Campylobacter and Salmonella species. Microbiological surveys of raw, retail poultry have identified high prevalence rates. (Redmond et al., 2004) Of the 30 retail, raw chicken pieces used in meal preparation sessions, 80 % (24/30) were naturally contaminated with Campylobacter and six % (2/30) were naturally contaminated with Salmonella. 2 were contaminated with both. (Redmond et al., 2004) Up to 87% of the sites where Salmonellosis outbreaks occur are associated with foodstuffs prepared or consumed in households. (Soares et al., 2012) Another pathogen of concern for the meat industry, in particular for ready-to-eat (RTE) deli meats, is Listeria monocytogenes, a human pathogen of major public health (Møller et al., 2016)
(Salmonella) Beside frequently mentioned foods like poultry, pork, or egg products, the role of ready-to-eat products is increasingly recognized. spices and herbs make a significant contribution. . If spices or herbs are contaminated with bacterial pathogens like Salmonella, such pathogens might enter the food chain in part due to the high tolerance to desiccation stress. Salmonella spp. can thereby survive for an extended period of time in dried products such as spices. The contamination of spices and herbs with Salmonella can occur at all stages including growing, harvesting, processing, storage, packaging, and sale. (Zweifel and Stephan, 2012)
Microbial contamination of peanut butter by Salmonella poses a significant health risk as Salmonella may remain viable throughout the product shelf life. Typical grinding and packaging of roasted peanuts occurs at 48 C, yet inactivation of microorganisms in peanut butter and peanut butter products is minimal at this temperature. (Grasso et al., 2015)
Norovirus (NoV) is a leading cause of foodborne illness outbreaks. Its prevalence is only newly understood but has been linked to Leafy greens (Gallimore et al. 2005; Makary et al. 2009; Ethelberg S et al. 2018; Wadl et al. 2010). Soft red fruit (Le Guyader et al. 2004; Maunula et al. 2009), food handlers responsible (sandwiches, catered meals)(Gaulin et al. 1998) as well as water, bivalve shellfish (tbr) and other fresh produce. Stool from one or more ill harvesters was implicated in a
Noroviruses and hepatitis A virus are responsible for most well characterized foodborne virus outbreaks. Additionally, hepatitis E virus has emerged as a potential zoonotic threat. Viruses may contaminate a wide variety of food products at pre-harvest or post-harvest stages. (Bosch, Pintó and Guix, 2016) Norovirus outbreak caused by contaminated oysters (Kohn, 1995) The majority of viral outbreaks occur in schools, restaurants/cafes and catering.
Pre-harvest contamination- bivalve molluscan shellfish and fruits are most commonly associated with foodborne outbreaks
2014 report Europe of the Rapid Alert System for Food and Feed (RASFF, http://ec.europa.eu/food/ safety/rasff/) Bivalve mollusks were involved in 85% of the alerts, while fruits accounted for 15% of the alerts. Among bivalves, clams, usually imported frozen, caused 57% of all foodborne alerts, followed by oysters (15%) and mussels (11%). Among fruits, frozen strawberries and raspberries were involved each in 5% of all foodborne alerts, while 3% of the alerts involved frozen berry mix. Post-harvest contamination- poor hygiene practices during food handling- most at risk are uncooked or lightly cooked products.. Surfaces employed for food preparation,other types of fomites- vehicles for foodborne virus transmission.
Microbial contamination can occur during any of the steps in the farm-to-consumer continuum (production, harvest, fresh-cut processing, wholesale storage, transportation or retailing and handling in the home) and this contamination can arise from environmental, animal or human sources (WHO/FAO, 2008). A wide spectrum of pathogens and food vehicles has been documented in produce-associated outbreaks.
The condition of manure, soil and irrigation water used
Pre-harvest sources of contact between produce and Salmonella spp may be facilitated through contaminated irrigation water, manure, fecal matter, or through animal contact(Fatica and Schneider, 2011)
The soil environment as a natural habitat for (potential) bacterial pathogens. Soils typically harbor an abundant consortium of microorganisms, some of which are human pathogens such as B. cereus, Clostridium botulinum, C. perfringens, Listeria monocytogenes and Aeromonas.
Pre-harvest hazard; Some of the established bacterial contamination sources include contaminated manure, irrigation water, soil, livestock/ wildlife- Predisposes to pathogen contamination due to agricultures increased intensity of production
Introduction of pathogens into soil via manure/compost application- Irrigation water has been identified as a potential source of produce contamination- Pathogens survive in irrigation water. Hepatitis A outbreaks associated with lettuce and spring onions were linked to sewage-contaminated irrigation water. Irrigation water represents a greater microbiological risk to produce in regions where water is scarce can result in use of sub-optimal supplementary irrigation (Alegbeleye, Singleton and Sant’Ana, 2018)
Wild animals such as birds, reptiles, rodents, amphibians, some helminths, and insects like flies and beetles can also serve as vehicles of pathogens to contaminate cultivation media and produce. determined to be carriers of pathogens such as E. coli, Salmonella and Campylobacter. Many bacterial species have evolved to exploit insects as hosts or vectors.