Fresh fruit and vegetables as vehicles of bacterial foodborne disease: A review and analysis of outbreaks registered by proMED-mail associated with fresh produce

Abstract

Raw food-containing diets have grown in popularity over the last decades since they correspond with the perception of a healthy lifestyle. However, infections from fruit and vegetables also represent an important food safety issue. Produce-borne out breaks are of concern because of their potentially serious health consequences and the high socioeconomic costs. This review summarizes outbreaks of bacterial disease associated with sprouts, salads, vegetables, fruit, fresh herbs, raw nuts and raw edible seeds registered by proMED-mail during the period between 2011 and mid-2015. The possible pathways of contamination are examined and discussed, with special attention to the role of E. coli and Salmonella as cross-domain pathogens. Various multidisciplinary approaches aimed at reducing the occurrence of pathogenic bacteria in fresh produce are discussed, including the enhancement of surveillance and consumer awareness, improvement of agricultural and trading practices and the development of novel materials and sanitizing methods in the food industry. Thirty-five outbreaks, each associated with a single raw produce were reviewed. Sprouts and lettuce were the most common produce associated with disease. E. coli, especially EHEC O157:H7, and Salmonella spp. were the most common pathogens, causing 42.9 % and 34.3 % of the outbreaks, respectively, while Listeria monocytogenes accounted for 14.3 %. Novel vehicles of disease were noted, including watercress, strawberries and stone fruit.