Department of Human Science, The Ohio State University, Columbus, OH, USA.
Department of Human Science, The Ohio State University, Columbus, OH, USA.
J Food Prot. 2024 Jun;87(6):100275. doi: 10.1016/j.jfp.2024.100275. Epub 2024 Apr 10.
Leafy green vegetables are a major source of foodborne illnesses. Nevertheless, few studies have attempted to estimate attribution and burden of illness estimates for leafy greens. This study combines results from three outbreak-based attribution models with illness incidence and economic cost models to develop comprehensive pathogen-specific burden estimates for leafy greens and their subcategories in the United States. We find that up to 9.18% (90% CI: 5.81%-15.18%) of foodborne illnesses linked to identified pathogens are attributed to leafy greens. Including 'Unknown' illnesses not linked to specific pathogens, leafy greens account for as many as 2,307,558 (90% CI: 1,077,815-4,075,642) illnesses annually in the United States. The economic cost of these illnesses is estimated to be up to $5.278 billion (90% CI: $3.230-$8.221 billion) annually. Excluding the pathogens with small outbreak sizes, Norovirus, Shiga toxin-producingEscherichia coli (both non-O157 and O157:H7), Campylobacter spp., and nontyphoidal Salmonella, are associated with the highest number of illnesses and greatest costs from leafy greens. While lettuce (romaine, iceberg, "other lettuce") takes 60.8% of leafy green outbreaks, it accounts for up to 75.7% of leafy green foodborne illnesses and 70% of costs. Finally, we highlighted that 19.8% of Shiga toxin-producingEscherichia coli O157:H7 illnesses are associated with romaine among all food commodities, resulting in 12,496 estimated illnesses and $324.64 million annually in the United States.
绿叶蔬菜是食源性疾病的主要来源。然而，很少有研究试图估计绿叶蔬菜的归因和疾病负担估计。本研究结合了基于暴发的三种归因模型的结果以及疾病发病率和经济成本模型，以开发美国绿叶蔬菜及其亚类的综合病原体特异性负担估计。我们发现，多达 9.18%（90%CI：5.81%-15.18%）与确定病原体相关的食源性疾病归因于绿叶蔬菜。包括与特定病原体无关的“未知”疾病，绿叶蔬菜每年在美国导致多达 2307558 例（90%CI：1077815-4075642）疾病。这些疾病的经济成本估计每年高达 52.78 亿美元（90%CI：32.30-82.21 亿美元）。排除暴发规模较小的病原体，诺如病毒、产志贺毒素大肠杆菌（非 O157 和 O157：H7）、弯曲杆菌和非伤寒沙门氏菌与绿叶蔬菜相关的疾病数量最多和成本最高。虽然生菜（罗马生菜、冰山生菜、“其他生菜”）占绿叶蔬菜暴发的 60.8%，但它占绿叶蔬菜食源性疾病的高达 75.7%和 70%的成本。最后，我们强调，19.8%的产志贺毒素大肠杆菌 O157：H7 疾病与所有食品中罗马生菜有关，在美国导致每年估计有 12496 例疾病和 3.2464 亿美元的损失。
