1 California Epidemiologic Investigation Service Program, 1500 Capitol Avenue, Sacramento, California 95814.
2 Food and Drug Branch, California Department of Public Health, 1500 Capitol Avenue, Sacramento, California 95814.
J Food Prot. 2019 Mar;82(3):405-414. doi: 10.4315/0362-028X.JFP-18-316.
An increase in the number of foodborne illness outbreaks associated with produce has been noted in the literature, and leafy greens have been the most common produce category associated with these outbreaks. California is the largest leafy greens producer in the United States, and many related foodborne illness incidents were traced to this state. A systematic overview of leafy greens incidents linked to California was conducted by the California Department of Public Health, Food and Drug Branch through analysis of complaints, routine surveillance sampling, disease outbreaks, and investigations covering 1996 to 2016. The goal was to develop a risk assessment tool to modernize emergency response efforts to foodborne illnesses related to leafy greens. A database including environmental, epidemiologic, and laboratory information for each incident was developed, and descriptive analysis was performed to identify trends. In the 21-year period analyzed, 134 incidents were identified, the majority of which were surveillance related. Approximately 2,240 U.S. cases of confirmed illness were reported (298 California cases resulting in 50 hospitalizations). Romaine lettuce and spinach were the most commonly implicated vehicles. The most prevalent hazard type was microbiological, in particular bacterial, specifically associated with pathogenic strains of Escherichia coli. In California, the overview provided the Food and Drug Branch with a platform to (i) enhance its Food Safety Program, Emergency Response Unit, and California Food Emergency Response Team; (ii) assist in more efficient investigation, response, control, and prevention of California-linked foodborne illness incidents; and (iii) identify knowledge gaps and develop effective definitions, procedures, training, guidelines, and policies that will be used to help prevent future outbreaks. Outcomes provide insight into the situation in the largest leafy greens-producing state and may be used to prioritize limited national food safety resources and aid in future leafy greens-related research and foodborne incident investigations.
文献中指出，与农产品相关的食源性疾病暴发数量有所增加，而叶菜类是与这些暴发最相关的最常见农产品类别。加利福尼亚州是美国最大的叶菜类生产地，许多相关的食源性疾病事件都追溯到该州。加利福尼亚州公共卫生部食品和药物处通过对 1996 年至 2016 年期间的投诉、常规监测抽样、疾病暴发和调查进行分析，对与加利福尼亚州相关的叶菜类食品事件进行了系统综述。目的是开发一种风险评估工具，以实现与叶菜类相关的食源性疾病紧急应对工作的现代化。为此建立了一个包含每个事件的环境、流行病学和实验室信息的数据库，并进行了描述性分析以确定趋势。在分析的 21 年期间，确定了 134 起事件，其中大多数与监测有关。报告了约 2240 例美国确诊病例（加利福尼亚州有 298 例，导致 50 人住院）。罗马生菜和菠菜是最常涉及的载体。最常见的危险类型是微生物，特别是与致病性大肠杆菌菌株有关的细菌。在加利福尼亚州，该综述为食品和药物处提供了一个平台，以：（i）加强其食品安全计划、应急响应单位和加利福尼亚州食品应急响应小组；（ii）协助更有效地调查、应对、控制和预防与加利福尼亚州有关的食源性疾病事件；（iii）确定知识空白，并制定有效的定义、程序、培训、指南和政策，以帮助预防未来的暴发。这些结果深入了解了最大的叶菜类生产州的情况，并可用于优先考虑国家有限的食品安全资源，并为未来与叶菜类相关的研究和食源性疾病事件调查提供帮助。
