1 Emerging Pathogens Institute, Institute for Sustainable Food Systems, Department of Animal Sciences, University of Florida, Gainesville, Florida 32610, USA (ORCID: http://orcid.org/0000-0002-6456-5460 [A.H.H.]).
2 Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida 32611, USA.
J Food Prot. 2018 Jul;81(7):1171-1186. doi: 10.4315/0362-028X.JFP-17-465.
Microbial contamination of fresh produce (fresh fruits and vegetables) poses serious public health concerns worldwide. This study was conducted as a comprehensive analysis of biological hazards in the global fresh produce chain. Data about produce-related outbreaks and illness were collected from the annual reports and databases of foodborne outbreak surveillance systems in different regions and countries from 2010 to 2015. The global patterns of and regional differences in documented outbreaks and cases were analyzed, and produce commodities and pathogens of greatest concern were identified. Data on sporadic illnesses were also collected through a comprehensive literature review of case-control studies. We found 988 produce-related outbreaks (with known agents) and 45,723 cases in all regions and countries. The numbers of produce-related outbreaks per million person-years were approximately 0.76, 0.26, 0.25, 0.13, 0.12, and 0.05 in New Zealand, Australia, the United States, the European Union, Canada, and Japan, respectively. The top three food categories and pathogens contributing to produce-related outbreaks were vegetables and nonfruits (i.e., food other than fruits; 27.0%), unspecified vegetables (12.2%), and vegetable row crops (11.7%) and norovirus (42.4%), Salmonella enterica (19.9%), and Staphylococcus aureus (7.9%), respectively. Produce consumption was identified as a protective factor, a risk factor, and either a protective or risk factor for sporadic illnesses in 11, 5, and 5 studies, respectively, among 21 case-control studies. Risks associated with produce consumption in the United States and the European Union have been linked to various factors such as irrigation water, cross-contamination, storage time and temperature abuse, infected food handlers, and unprocessed contaminated ingredients. The results of the current study indicate the complexity of produce products consumed across the globe and the difficulty in tracing illnesses back to specific food ingredients.
新鲜农产品（新鲜水果和蔬菜）的微生物污染对全球公共健康构成严重威胁。本研究对全球新鲜农产品链中的生物危害进行了综合分析。从 2010 年至 2015 年，从不同地区和国家的食源性疾病爆发监测系统的年度报告和数据库中收集了与农产品相关的爆发和疾病的数据。分析了有记录的爆发和病例的全球模式和区域差异，并确定了最受关注的农产品商品和病原体。通过对病例对照研究的综合文献回顾，还收集了散发性疾病的数据。我们在所有地区和国家发现了 988 起与农产品相关的爆发（有已知病原体）和 45723 例病例。新西兰、澳大利亚、美国、欧盟、加拿大和日本的每百万人年与农产品相关的爆发数量分别约为 0.76、0.26、0.25、0.13、0.12 和 0.05。导致农产品相关爆发的前三大食品类别和病原体是蔬菜和非水果（即水果以外的食品；27.0%）、未指明的蔬菜（12.2%）和蔬菜大田作物（11.7%）以及诺如病毒（42.4%）、肠炎沙门氏菌（19.9%）和金黄色葡萄球菌（7.9%）。在 21 项病例对照研究中，有 11 项研究确定农产品消费是散发性疾病的保护因素，5 项研究确定是风险因素，5 项研究确定既是保护因素也是风险因素。在美国和欧盟，与农产品消费相关的风险与灌溉水、交叉污染、储存时间和温度滥用、受感染的食品处理人员以及未加工的受污染成分等各种因素有关。本研究的结果表明，全球消费的农产品产品种类繁多，难以追踪疾病与特定食品成分之间的关系。
