Food

Analysis and Evaluation of Preventive Control Measures for the Control and Reduction/Elimination of Microbial Hazards on Fresh and Fresh-Cut Produce: Chapter IV. Outbreaks Tables

Incidence Tables   |   Outbreaks Tables   |   Growth/Survival Tables

Outbreaks Associated with Fresh Produce: Incidence, Growth, and Survival of Pathogens in Fresh and Fresh-Cut Produce

Table O-1: Examples of Reported Outbreaks of Foodborne Disease Associated with Melons

Pathogen Year Location Produce Source Venue Type of Melon No. of Cases No. of Deaths Isolated from Produce Comments Reference
Escherichia coli O157:H7 1993 Oregon NRa Restaurant Cantaloupe 9 0 NR Possible contamination of
cantaloupe with organism
from raw beef.
See Del Rosario and Beuchat 1995; Anonymous 1993
Norwalk virus 1987 United
Kingdom
NR NR Melon 206 0 NR Infected food handler. See Lund and Snowdon 2000
Salmonella Chester 1989-90 Multistate,
US
Mexico and Central America Unknown Cantaloupe >245 ( 25,000 estimated) 2 No Cut cantaloupe from salad bars. see CDC 1991; see Lund and Snowdon 2000
S. Javiana 1991 Michigan NA Indoor picnic and in-school party Watermelon 26 primary 13 secondary 0 Yes Melon not washed prior to cutting. Suspected contamination from
melon rind. Melon served over
3 hour period at room temperature. Leftovers served the next day.
Blostein 1993
S. Miami 1954 Massachusetts Florida Supermarket Watermelon 17 1 Yes Laboratory demonstration of
contamination of internal flesh
during slicing with either
contaminated melon surface or contaminated knife. Organism
recovered from shelf where knife
was kept but not from knife used to cut melons. Organism was isolated from home samples but not from supermarket samples. Melons were from Florida where S. Maimi is common.
Gayler and others 1955
S. Oranienburg 1979 Illinois Illonois Supermarket Watermelon 18 0 No Damaged fruits were cut, covered with plastic film, and displayed, sometimes without refrigeration until sold. CDC 1979
S. Oranienburg 1998 Ontario,
Canada
US, Mexico, or Central America Various Cantaloupe 22 0 No Possible contamination with organism from surface when slicing. Cut fruit was probably left sitting at room temperature for several hours before consumption. Deeks and others 1998
S. Poona 1991 Multistate,
US and Canada
Texas or Mexico Unknown Cantaloupe > 400 confirmed US, 72 Canada 0 NR Fruit salads containing sliced cantaloupes. CDC 1991
S. Poona 2000 Multistate,
US (8 states)
Mexico Various Cantaloupe       Case control study clearl
implicated.
Farrar; pers comm; unreferenced
S. Saphra 1997 California Mexico Home, grocery stores, and restaurants Cantaloupe 24 0 NR Multiple purchase sites suggest contamination during production or harvest. Lack of refrigeration at retail may have contributed to outbreak. Mohle-Boetani and others 1999; Farrar, pers comm; unreferenced
Salmonella 1950 Minnesota NA Roadside stand Watermelon 6 0 Yes Prepared cut melon. S. Bareilly isolated from melon. Melon kept at ambient temperature. See Blostein 1993
Shigella sonnei 1987 Sweden Morocco Dinner party Suspect watermelon 15 0 No Melon consumed immediately after slicing. Possible contamination of melon from injected water. Fredlund and others 1987
a NR, not reported

Table O-2: Examples of Reported Outbreaks of Foodborne Parasitic Disease Associated with Raw Berries

Pathogen Year Location Produce Source Venue Type of Berry No. of Cases No. of Deaths Isolated from Produce Comments Reference
Cyclospora cayetanensis 1995 Florida Guatemala likely Two social events Raspberries likely 87 0 No Raspberries from both events were purchased from separate sources.
Two clusters reported.
Koumans and others 1998
C. cayetanensis 1996 20 US states and 2 Canadian provinces Guatemala Various Raspberries 1465 0 No Possible contamination due to fruit spraying with insecticides and fungicides mixed with contaminated water. Herwaldt and Ackers 1997; Fleming and others 1998
C. cayetanensis 1997 Multistate, US and Ontario, Canada Guatemala Various Raspberries 1012 0 No Source of contamination unknown. Herwaldt and Beach 1999; CDC 1997b
C. cayetanensis 1998 Ontario, Canada Guatemala Various Raspberries 315 0 No Source of contamination unknown. CDC 1998c; Herwaldt 2000
C. cayetanensis 1999 Ontario, Canada Guatamala likely Banquet hall Blackberries suspected 104 0 NRa Source of contamination unknown. Herwaldt 2000
a NR, not reported

Table O-3: Examples of Reported Outbreaks of Foodborne Viral Disease Associated with Contaminated Frozen Berries

Pathogen Year Location Produce Source Venue Type of Berry No. of Cases No. of Deaths Isolated from Produce Comments Reference
Calicivirus 1997 Quebec, Canada Bosnia 2 separate events Raspberries (frozen) >200 0 NRa Likely contamination occurred before shipping from Bosnia. Gaulin and others 1999
Calicivirus 1998 Finland Imported Unknown Raspberries (frozen) > 500 0 NR Source of contamination unknown. See Lund and Snowdon 2000
Hepatitis A 1983 Scotland Scotland Hotel Raspberries (frozen) 24 0 No Suspected raspberry mousse prepared from frozen raspberries. Suggested contamination by infected picker(s). Reid and Robinson 1987
Hepatitis A 1988 Scotland Scotland Home Raspberries (frozen) 5 0 No Raspberries from a small farm were frozen at home. Several pickers at the farm had symptoms of Hepatitis A. Ramsay and Upton 1989
Hepatitis A 1990 Georgia Montana California (1988) School Institution for disabled Strawberries (frozen) 15 (Georgia) 13 (Missouri) +29 secondary 0 No Frozen strawberries used to make dessert. Empty strawberry containers with same lot number obtained from both locations implicated same source. Suspected contamination by infected picker(s). Strawberries picked and stems removed in field. Fruits washed in 3 ppm chlorine prior to slicing and freezing. Niu and others 1992
Hepatitis A 1997 Multistate US Mexico Schools Strawberries (frozen) 242 + 14 suspect 0 No Frozen strawberries and strawberry shortcake were implicated in the outbreak. Possible contamination during harvesting. Handwashing in field limited. Stems removed with fingernails. Evidence suggested low levels of nonuniform contamination. Hutin and others 1999; CDC 1997a
a NR, not reported

Table O-4: Examples of Reported Outbreaks of Foodborne Disease Associated with Seed Sprouts

Pathogen Year Location Seed Source Type of Sprout No. of Cases No. of Deaths Isolated from Sprouts/Seeds Comments Reference
Bacillus cereus 1973 Texas Uganda (soy), Holland (cress), and Denmark (mustard) Soy, mustard, and cress 4 0 Yes/Yes Sprouted from a home seed sprouting kit. Portnoy and others 1976
Escherichia coli O157:H7 1996 Japan NRa Radish 6561 (101 with HUSb), 160 secondary cases 2 No/No Contamination route unknown. WHO, Weekly Epidemiological Record 1996a, 1996b
E. coli O157:H7 1997 Japan NR Radish 126 0 Yes/No The pathogen was isolated from leftover sprouts in the refrigerator but not the seeds from the same seed lots. See Feng 1997; Taormina and others 1999
E. coli O157:H7 1997 Michigan and Virginia NR Alfalfa 108 0 NR/NR Sprouts were sprouted from same seed lot in both states. CDC 1997d
E. coli O157:NM 1998 California California and Nevada Clover / Alfalfa 8 0 Yes/No Sprouts were traced to a single sprouter. Contaminated seeds suspected (same sprouter as 1997-98 S.Senftenberg outbreak). Farrar; pers comm; unreferenced; Taormina and others 1999
Salmonella Bovismorbificans 1994 Sweden and Finland Australia Alfalfa 595 0 Yes/No Contaminated seeds came from the same seed lot and importer. Ponka and others 1995
S. Enteriditis 2000 Alberta and Saskatchewan, Canada China Alfalfa 8 0 NR/NR Outbreaks occurred at 5 Vietnamese restaurants. Sprouts came from 2 growers who received seeds imported from China. Farber 2000; personal communication; unreferenced
S. Enteriditis 2000 California China Mung 45 0 No/No Cluster of illness linked to 3 Vietnamese restaurants. S. Enteriditis isolated from environment at sprouter. California Dept. Health Services 2000; Farrar; pers comm; unreferenced
S. Gold-Coast 1989 U.K. The Netherlands Cress 31 0 Yes/No Contaminated seed and/or sprouter. Feng 1997; Taormina and others 1999
S. Havana 1998 California and Arizona NR Alfalfa 14 (California) 4 (Arizona) 1 No/Yes Sprouts were traced to a single producer. Seeds obtained from the same lot yielded sprouts from which S. Havana was cultured. Backer and others 2000
S. Havana / Cubana / Tennessee 1998 California California Alfalfa 34 0 Yes/Yes Contaminated seeds were suspected. Farrar; pers comm; unreferencd; Taormina and others 1999
S. Infantis and S. Anatum 1997 Kansas and Missouri Unknown Alfalfa 109 0 NR/NR Seeds were believed to be contaminated. Feng 1997; Taormina and others 1999
S. Mbandaka 1999 Oregon, California, Idaho, and Washington California Alfalfa Appx. 68 0 Yes/Yes Seeds were believed to come from the same lot and distributed to various growers in California, Florida, and Washington. No cases in Florida. Farrar; personal communication; unreferenced
S. Meleagridis 1997 Canada Unknown Alfalfa 124 0 NR/NR Sprouts were organically grown with no chlorine pre-soak. See Feng 1997; Farber 2000; pers comm; unreferenced
S. Montevideo and S. Meleagridis 1996 California California Alfalfa >500 1 Yes/No The sprouts were traced to a specific sprouter. Seeds traced to single California seed grower. Contaminated seeds suspected. Taormina and others 1999; Farrar; pers comm; unreferenced
S. Newport 1995 Denmark (probably US and Canada) The Netherlands Alfalfa 154 0 Yes/Yes Seeds came from the same shipper as US/Canada outbreak (see below). Source of contamination unknown. See Feng 1997; Farber 2000; personal communication; unreferenced
S. Newport 1995-96 British Columbia, Canada, Oregon (probably Georgia and Vermont) and Denmark The Netherlands Alfalfa 133 0 Yes/Yes Organism isolated were indistinguishable form the Denmark outbreak (see above). See Feng 1997; Taormina and others 1999
S. Paratyphi B var. Java 1999 Alberta, British Columbia, and Saskatchewan, Canada Unknown Alfalfa 46 0 NR/NR Spouts were from the same brand or common seed source. Farber 2000; personal communication; unreferenced
S. Saint-Paul 1988 U.K. Thailand and Australia Mung 143 0 Yes/Yes Multiple serovars isolated from bean spouts, seeds, and environmental samples (from producer waste materials). O'Mahony and others 1990
S. Saint-Paul
S. Havana
S. Muenchen
1988 Sweden NR Mung 148 0 Yes/NR Probably same seeds as UK outbreak. S. Havana and S. Muenchen but not S. Saint-Paul isolated from sprouts. See Nguyen-the and Carlin 2000; See O'Mahony and others 1990
S. Senftenberg 1997-98 California 5 US states Alfalfa and clover sprouts 52 0 Yes/No Sprouts were traced to a specific sprouter. Contaminated seeds suspected. Same sprouter as 1998 E. coli O157:NM outbreak. Jeff Farrar; pers comm; unreferenced; Taormina and others 1999
S. Stanley 1995 Multistate, US, Canada and Finland The Netherlands Alfalfa >272 0 No/No Seeds came from the same sprouter. At least 4 seed lots involved. Possible contamination occurred prior to shipping. Mahon and others 1997
S. Virchow 1988 U.K. Thailand and Australia Mung 7 0 Yes/NR Probably from the same outbreak as S. Saint-Paul in UK. O'Mahony and others 1990
Yersinia enterolitica 1982 Pennsylvania Unknown Bean sprouts 16 0 NR/NR Bean sprouts were immersed at home in well water contaminated with Yersinia. See Cover and Aber 1989
a NR, not reported
b Hemolytic uremic syndrome

Table O-5: Examples of Reported Outbreaks of Foodborne Disease Associated with Unpasteurized Fruit Juice

Pathogen

Year

Location

Fruit Source

Type of Juice

Venue

No. of Cases

No. of Deaths

Isolated from Juice

Comments

Reference

Crytosporidium parvum

1996

New York

New York

Apple

Small cider mill

20 confirmed, 11 suspected

0

NRa

No drops used; However, dairy farm across the street. E. coli detected in well water samples indicating fecal contamination. Apples were brushed and washed prior to pressing.

CDC 1997c

Cryptosporidium

1993

Maine

Maine

Apple

School

160 primary and 53 secondary

0

Yes

Apples shaken from trees and gathered from ground, cattle grazed on grass beneath trees, oocysts found in calf manure, apples inadequately washed and pressed for juice at an agricultural fair.

Millard and others 1994

Escherichia coli O157:H7

1991

Massachusetts

Massachusetts

Apple

Small cider mill

23 (4 HUS)

0

No

90% drops used in making juice. Apples were not washed or scrubbed. Cattle raised nearby.

Besser and others 1993

E. coli O157:H7

1996

Connecticut

Connecticut

Apple

Small cider mill

14 (3 HUS, 1 HUS+TTPc)

0

No

Some drops used in juice. Apples were brushed and washed in potable water before juiced using a wooden press. Potassium sorbate (0.1%) added as a preservative.

CDC 1997c

E. coli O157:H7

1996

Washington

Washington

Apple

Small cider mill

6

0

No

Cider was made for local church event from local orchard. Apples were washed.

See Farber 2000

E. coli O157:H7

1996

British Columbia, Canada, California, Colorado, and Washington

US

Apple

Retail

70 (14 HUS)

1

Yes

Phosphoric acid wash, brushed, and rinsed; However, phosphoric acid based solutions may have been used incorrectly (not intended for produce/waxed produce) or sometimes used at low concentrations. Possibly poor quality apples, some dropped apples used, apple orchard near cattle/deer.

CDC 1996b; Cody and others 1999

E. coli O157:H7

1998

Ontario, Canada

Ontario, Canada

Apple

Farm / Home

14

0

No

Cattle kept in orchard prior to apple harvest. Apples collected from ground if suitable on inspection. Water supply on farm not potable. Apples used without further inspection, brushing or washing.

Tamblyn and others 1999

E. coli O157:H7

1999

Oklahoma

Oklahoma

Apple

-

7

0

NR

Drop apples used. Possible contamination from wild and domestic animal manure.

See Farber 2000

E. coli O157:H7 suspected

1980

Toronto, Ontario, Canada

Canada

Apple

Local market

14 HUSb

1

No

Juice purchased from a local market and fair. Juice tasted "bad" or "different".

Steele and others 1982

Enterotoxigenic E. coli

1992

India

India

Orange

Roadside vendor

6

0

Yes

Two roadside vendors selling fresh squeezed juice, one was 6 meters away form the garbage heap.

Singh and others 1995

Salmonella Enteriditis

2000

Multistate, US

California

Citrus

Retail and Food Service

14

0

No

Gallon sized containers of citrus juices were implicated in the outbreak.

Butler 2000

S. Gaminera, S. Hartford, and S. Rubislaw

1995

Florida

Florida

Orange

Retail

62 ill and 7 hospitalized

0

Yes

S. Gaminera was isolated from several containers of juice after outbreak. Numerous in-plant sanitation problems found. Surface water was used for orchard irrigation. Drops were used for juice. Salmonella was isolated from amphibiams and soil around the processing plant.

CDC 1995; Cook and others 1998

S. Muenchen

1999

US and Canada

Mexico

Orange

Restaurant

207 confirmed, +91 suspected

1

Yes

Multiple strains of Salmonella isolated from orange juice collected from producer. Juice squeezed in Mexico and transported to Arizona in tanker trucks where it was bottled. Follow-up investigations revealed that ice was added illegally to juice prior to transport.

CDC 1999a

S. Typhi

1898

France

France

Apple

NR

NR

NR

NR

-

 

S. Typhi

1922

France

France

Apple

NR

23

0

NR

Non-potable water was used to wash apples.

Paquet 1923

S. Typhimurium

1974

New Jersey

New Jersey

Apple

Farm and small retail outlets

296

0

Yes

A high proportion of dropped apples used to make the juice. Manure used to fertilize apple trees. Equipment rinsed with cold water, not sanitized. Six of thirty employees were S. Typhimurium positive.

CDC 1975

S. Typhimurium

1999

Australia

Australia

Orange

Retail

405

0

Yes

Salmonella was isolated from unopened cartons of orange juice.

Survellence Management Section 1999

a NR, not reported
b Hemolytic uremic syndrome
c Thrombotic thrombocytopenic purpura

Table O-6: Examples of Reported Outbreaks of Foodborne Disease Associated with Reconstituted Orange Juice

Pathogen

Year

Location

Produce

Type of Juice

Venue

No. of Cases

No. of Deaths

Isolated from Produce

Comments

Reference

Hepatitis A

1962

Missouri

Unknown

Orange (reconstituted)

Hospital

24

0

NR

The orange juice was prepared by subclinical Hepatitis A handler.

Eisenstein and others 1963

Salmonella Typhi, typhoid fever

1944

Ohio

Unknown

Orange (reconstituted)

Residential hotel

18

1

NR

Juice was handled by an asymptomatic food worker.

Duncan and others 1946

S. Typhi, typhoid fever

1989

New York

Unknown

Orange (reconstituted)

Resort hotel

46 confirmed 24 suspected

0

NR

An asymptomatic food handler prepared the juice at a New York hotel. Utensils used were difficult to clean. Orange juice distributed near restrooms.

Birkhead and others 1993

Unknown

1965

California

Unknown

Orange (reconstituted)

Unknown

563

0

NRa

Possible contaminated water source used to reconstitute juice.

Tabershaw and others 1967

a NR, not reported

Table O-7: Examples of Reported Outbreaks of Foodborne Disease Associated with Raw Lettuce or Salads

Pathogen

Year

Location

Produce Source

Venue

Type of Lettuce or Salad

No. of Cases

No. of Deaths

Isolated from Produce

Comments

Reference

Campylobacter jejuni

1984

British Columbia, Canada

NRa

University cafeteria

Salad

330

0

No

Possible cross contamination during food preparation and poor food storage practices. Salad appeared to initiate outbreak.

Allen 1985

C. jejuni

1996

Oklahoma

NR

Restaurant

Lettuce

14

0

NR

Probable cross contamination of lettuce with raw chicken juices.

CDC 1998b

Clostridium perfringens

1993

Ontario, Canada

Unknown

Wedding reception

Salad

48

0

No

Salad implicated but epidemiology weak.

Styliadis 1993

Cyclospora cayatenesis

1997

Florida

Possibly Peru

Restaurants cruise ship

Baby lettuce leaves (mesclun)

>91

0

NR

Possibly related outbreaks traced to cruiseship sailing out of Florida and several Florida restaurants. Lettuce originated from Peru and US, purchased from the same distributor.

See Herwaldt and Beach 1999

Calicivirus

1992

Ontario, Canada

NR

Catered event

Salad

27

0

NR

Salad served at a potluck. Vegetables may have been improperly washed or cross contaminated by an infected food handler.

Todd 1998

Escherichia coli O157:H7

1995

Idaho

Unknown

Unknown

Lettuce (romaine)

21

0

NR

Possibly infected food handler.

CSPI 2000

E. coli O157:H7

1995

Maine

California

Scout camp

Lettuce (iceberg)

30

0

NR

Cross contamination with raw hamburger juice.

CSPI 2000

E. coliO157:H7

1995

Ontario, Canada

NR

Acute care hospital

Iceberg lettuce

23

0

NR

Outbreak occurred in an acute care hospital. Lettuce received was heavily spoiled.

Preston and others 1997

E.coli O157:H7

1995

Alberta, Canada

NR

Restaurant

Caesar salad

37

0

NR

-

Farber; pers comm; unrefcd

E.coli O157:H7

1995

Montana

Montana and Washington

Retail

Lettuce

70

0

No

Possible contamination from irrigation runoff or compost used to fertilize the fields. Cattle had access to the stream above the pond used for irrigation.

Ackers and others 1998

E.coli O157:H7

1996

Connecticut and Illinois

US

Various

Mesclun lettuce

49

0

Yes

The implicated lettuce was traced to a single grower processor. Cattle was found near the lettuce fields.

Hilborn and others 1999; See Tauxe 1997

E.coli O157:H7

1998

California

NR

Restaurant

Salad

2

0

No

 

Griffin and Tauxe 1999

Giardia

1989

New Mexico

NR

Church dinner

Lettuce and onions

21

0

NR

Possible contamination from potable water used in washing the vegetables. Possible cross contamination from using the same cutting board to cut all vegetables.

CDC 1989

Hepatitis A

1986

Florida

NR

Restaurant

Lettuce salad

103

0

No

The probable source for the outbreak was an infected foodhandler with poor hygiene practices. The lettuce was shredded with hands.

Lowry and others 1989

Hepatitis A

1988

Kentucky

US but possibly Mexico

Restaurants

Iceberg lettuce

202

0

No

Three restaurants received lettuce from the same produce distributor. Contamination suspected to have occurred before distribution.

Rosenblum and others 1990.

Shigella sonnei

1983

Texas

Arizona, California, New Mexico

University cafeteria

Lettuce

140

0

No

Two concurrent outbreaks at separate universities. Both universities purchased lettuce from the same supplier. Supplier purchased lettuce from three states. Farm source could not be determined.

Martin and others 1986

S. sonnei

1986

Texas

Texas

Restaurants

Shredded lettuce

347

0

No

Implicated restaurants received shredded lettuce from one source. Possible contamination from food handler at the shredding facility.

Davis and others 1988

S. sonnei

1994

Norway, Sweden, and UK

Spain

Various

Lettuce (iceberg)

110 (Norway),8 (Sweden), NR (UK)

0

No

Fecal coliforms and Salmonella were detected in iceberg lettuce obtained from patient's homes.

Kapperud and others 1995

Vibrio cholerae

1970

Israel

NR

NR

Mixed vegetables

176

0

NR

Possible contamination from waste water irrigation.

See Nguyen-the and Carlin 2000

a NR, not reported

Table O-8: Examples of Reported Outbreaks of Foodborne Disease Associated with Raw Produce Other than Melons, Berries, Seed Sprouts, and Lettuce or Salads

Pathogen

Year

Location

Produce Source

Venue

Type of Produce

No. of Cases

No. of Deaths

Isolated from Produce

Comments

Reference

Clostridium botulinum (type A)

1987

Florida

NRa

Home

Cabbage salad

4

0

Yes

Preformed toxin and spores were found in coleslaw dressing which contained cabbage and carrot pieces. Possible growth of C. botulinum in the cabbage.

Solomon and others 1990

C. botulinum (type A)

1989

New York

NR

Home

Chopped garlic in oil

3

0

Yes

Product was made from chopped garlic, ice water and olive oil sometime between 1985 and 1987. Chemical or acid additives not used. "Keep refrigerated" in small print. Jar was stored at room temperature for approximately 3 months prior to opening. Refrigerated after opening. Same processor as 1985 outbreak (Solomon and Kautter, 1988).

Morse and others 1990

C. botulinum (type B)

1985

British Columbia, Canada

US

Restaurants

Chopped garlic in oil

37

0

Yes

The product was made from dehydrated and rehydrated and soybean oil. Chemical or acid additives not used. "Keep refrigerated" in small print. Jar was stored at room temperature at the restaurant.

Solomon and Kautter 1988

Cryptosporidium parvum

1997

Washington

US

Restaurants

Green onions (inconclusive association)

54

0

No

Green onions were not washed before delivery to the restaurant and not washed before serving to customers. Possible contamination by a food handler.

CDC 1998a

Cyclospora cayatenansis

1997

Multistate, US

US

Retail / Catered events

Basil

>308

0

Yes

Suspected fresh basil. Mode of contamination unknown.

CDC 1997b

Escherichia coli (enterotoxigenic)

1993

Rhode Island New Hampshire

US

Airline, hotel

Shredded carrots

47 121

0

NR

Possible contamination of carrots used in salads. Carrots used came from same state.

CDC 1994

E. coli O157:H7

1998

Indianapolis

NR

Restaurant

Coleslaw

33

0

Yes

 

Griffin and Tauxe 1999

E. coli O157:H7

1998

Wisconsin

NR

Catered event

Fruit salad

47 (3 HUS)

0

No

 

Griffin and Tauxe 1999

Giardia lamblia

1989

US

NR

NR

Lettuce, tomatoes, onions

21

NR

NR

 

See Nguyen-the and Carlin 2000

Hepatitis A

1971

Tennessee

Tennessee

Home

Raw watercress

129

0

No

Watercress harvested from small streams near farm. Specimen cultures revealed gross contamination with fecal organisms. Several abandoned septic tanks were seen near the stream.

CDC 1971

Hepatitis A

1994

Arkansas

NR

NR

Diced tomatoes

92

0

NR

Suspected contamination by food handler.

Lund and Snowdon 2000

Listeria monocytogenes

1979

Boston

NR

Hospitals

Raw tomatoes, lettuce and celery suspected

20

5

NR

Multiple hospitals involved. Tuna fish, chicken salad and cheese sandwiches epidemiologically linked to listeriosis. All served with tomatoes, raw vegetables such as celery and lettuce.

Ho and others 1986; Schlech and others 1983

L. monocytogenes

1981

Nova Scotia, Canada

Nova Scotia, Canada

Various

Vegetable mix for coleslaw

41

17

Yes

Cabbage was grown on farm where two sheep had died of listeriosis. Raw and composed manure was used to fertilize the fields. Cold storage may have allowed for Listeria growth.

Farber 2000; pers comm; unreferenced; Schlech and others 1983

Norwalk virus

1982

Minnesota

NR

Hotel restaurant

Fruit salad, coleslaw, and tossed salad

233

0

NR

Outbreak traced to three separate banquets. Fruit salad and coleslaw prepared by one worker during her acute illness and up to 48 hours following her recovery. A second worker prepared implicated tossed salad 24 hours following her recovery.

White 1986

Norwalk virus

1990

Hawaii

NR

Cruise ship

Fresh cut fruit

>217

0

NR

Possible contamination occurred during preparation. Fresh cut fruits included pineapple, papaya, watermelon, cantaloupe, and honeydew melon.

Herwaldt and others 1994

Salmonella Baildon

1998-99

Multistate, US

Florida

Various

Tomatoes

85

3

NR

Tomates traced to two packers in Florida. Possible field contamination by domesting or wild animals.

Susman 1999; Cummings 1999

S. Javiana

1990

Multistate, US

South Carolina

Various

Tomatoes

174

0

NR

Contamination of water bath used by packer.

See Tauxe 1997; See Beuchat 1996b

S. Montevideo

1993

Multistate, US

South Carolina

Various

Tomatoes

84

0

No

Contamination of water bath used by packer.

See Lund and Snowdon 2000; See Wei and others 1995; Tauxe 1997

S. Typhi

1998-99

US

Brazil

Unknown

Mamey

13

0

Unknown

Imported frozen mamey. Source of contamination not known.

See Lund and Snowdon, 2000

Shigella flexneri 6A

1994

Multistate, US

Mexico

Various

Green onions

72

0

ND

Possible contamination during harvest or packaging in Mexico.

Tauxe, 1997

S. sonnei

1998

Multistate, US and Canada

Mexico

Restaurants

Parsley

310

0

No

Municipal water supplied to packing shed was unchlorinated. Water was used in hydrocooler where it was recirculated. Also used to make ice for packing the parsley. Workers had limited hygiene education and sanitary facilities. In restaurants parsley was often chopped and left at room temperature for several hours prior to serving.

CDC, 1999b

Vibrio cholerae

1970

Israel

NR

NR

Various raw vegetables

176

NR

NR

Contamination by irrigation and untreated waste water.

See Nguyen-the and Carlin, 2000

V. cholerae

1991

Peru

Peru

Various

Cabbage

Unknown

71

NR

Several factors were associated with cholera transmission including contaminated drinking water, going to fiestas, and eating raw or lightly cooked cabbage. Farmers in region commonly used untreated sewage to irrigate crops.

Swerdlow and others 1992

a NR, not reported

Table O-9: Examples of Reported Outbreaks of Foodborne Disease Associated with Raw Produce Due to Contamination During Final Preparation

Pathogen

Year

Location

Venue

Type of Produce

No. of Cases

No. of Deaths

Isolated from Produce

Comments

Reference

Campylobacter jejuni

1984

British Columbia, Canada

University cafeteria

Salad

330

0

No

Possible cross contamination during food preparation and poor food storage practices. The salad appeared to initiate outbreak.

Allen 1985

C. jejuni

1996

Oklahoma

Restaurant

Lettuce

14

0

NRa

Probable cross contamination of lettuce with raw chicken juices.

CDC 1998b

Crytosporidium parvum

1997

Washington

Restaurants

Green onions (inconclusive association)

54

0

No

Green onions were not washed before delivery to the restaurant and not washed before serving to customers. Possible contamination by a food handler.

CDC 1998a

Calicivirus

1992

Ontario, Canada

Catered event

Salad

27

0

NR

Salad served at a potluck. Vegetables may have been improperly washed or cross contaminated by an infected food handler.

Todd 1998

Escherichia coli O157:H7

1993

Oregon

Restaurant

Cantaloupe

9

0

NR

Possible contamination of cantaloupe with organism from raw beef.

See Del Rosario and Beuchat 1995; Anonymous 1993

E. coli O157:H7

1995

Idaho

Unknown

Lettuce (romaine)

21

0

NR

Possibly contaminated by food handler.

CSPI 2000

E. coli O157:H7

1995

Maine

Scout camp

Lettuce (iceberg)

30

0

NR

Cross contamination with raw hamburger juice.

CSPI 2000

Giardia

1989

New Mexico

Church dinner

Lettuce and onions

21

0

NR

Possible contamination from potable water used in washing the vegetables. Possible cross contamination from using the same cutting board to cut all vegetables.

CDC 1989

Hepatitis A

1986

Florida

Restaurant

Lettuce salad

103

0

No

The probable source for the outbreak was an infected food handler with poor hygiene practices. Lettuce was shredded by hand.

Lowry and others 1989

Hepatitis A

1994

Arkansas

Unknown

Diced tomatoes

92

0

Unknown

Suspected contamination by food handler.

Lund and Snowdon 2000

Norwalk virus

1987

United Kingdom

NR

Melon

206

0

NR

Infected food handler.

See Lund and Snowdon 2000

Norwalk virus

1990

Hawaii

Cruise ship

Fresh cut fruit

>217

0

NR

Possible contamination occurred during preparation. Fresh cut fruits included pineapple, papaya, watermelon, cantaloupe, and honeydew melon.

Herwaldt and others 1994.

a NR, not reported
Note: These outbreaks are also found in Tables 1 to 8.

Table O-10: Examples of Reported Outbreaks of Foodborne Disease Associated with Temperature Abuse

Pathogen

Year

Location

Produce Source

Venue

Type of Produce

No. of Cases

No. of Deaths

Isolated from Produce

Comments

Reference

Clostridium botulinum (type A)

1989

New York

NRa

Home

Chopped garlic in oil

3

0

Yes

Product was made from chopped garlic, ice water and olive oil sometime between 1985 and 1987. Chemical or acid additives not used.  "Keep refrigerated" in small print.  Jar was stored at room temperature for approximately 3 months prior to opening.  Refrigerated after opening.  Same processor as 1985 outbreak (Solomon and Kautter, 1988).

Morse and others 1990

C. botulinum (type B)

1985

British Columbia, Canada

US

Restaurants

Chopped garlic in oil

37

0

Yes

Product was made from dehydrated and rehydrated and soybean oil. Chemical or acid additives not used. "Keep refrigerated" in small print. Jar was stored at room temperature at the restuarant.

Solomon and Kautter 1988

Salmonella Javiana

1991

Michigan

NA

Indoor picnic and in-school party

Watermelon

26 primary 13 secondary

0

Yes

Melon not washed prior to cutting.  Suspected contamination from melon rind.  Melon served over 3 hour period at room temperature.   Leftovers served the next day.

Blostein 1993

S. Oranienburg

1979

Illinois

Illinois

Supermarket

Watermelon

18

0

No

Damaged fruits were cut, covered with plastic film, and displayed, sometimes without refrigeration until sold.

CDC 1979

S. Oranienburg

1998

Ontario, Canada

US, Mexico, or Central America

Various

Cantaloupe

22

0

No

Possible contamination with organism from surface when slicing.  The cut fruit was probably left sitting at room temperature for several hours before consumption.

Deeks and others 1998

Salmonella

1950

Minnesota

NR

Roadside stand

Watermelon

6

0

Yes

Prepared cut melon. S. Bareilly isolated from melon.  Melon kept at ambient temperature.

See Blostein 1993

a NR, not reported
Note: These outbreaks are also found in Tables 1 to 8.

 

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