Researchers identify 28 new foods associated with disease outbreaks

September 17, 2021

2 min read

The authors report no relevant financial disclosures.

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CDC researchers identified 28 food items that caused disease outbreaks for the first time between 2007 and 2016 in the United States.

The “novel outbreak-associated food vehicles” — as they were described by the researchers — caused 36 combined foodborne outbreaks. They included bison, frogs, kale, pistachios and pomegranates.

Whitham HK, et al. Emerg Infect Dis. 2021;doi:10.3201/eid2710.204080.

Whitham HK, et al. Emerg Infect Dis. 2021;doi:10.3201/eid2710.204080.

“Millions of people get sick from contaminated food every year,” Hilary K. Whitham, PhD, MPH, an epidemiologist in the CDC’s Division of Foodborne, Waterborne and Environmental Disease, told Healio. “Because we rely on data to guide foodborne illness prevention strategies, our team was interested to know if there were potential trends in terms of new risks for foodborne illness which could inform preemptive prevention efforts.”

To identify novel foods causing outbreaks, Whitham and colleagues reviewed 14,216 reported outbreaks with an implicated food or ingredient and compared outbreaks that occurred between 2007 and 2016 with those that occurred between 1973 and 2006 by using a three-stage process.

First, foods that were reported in both time frames were removed. Then, independent reviewers manually compared the remaining 878 food items and flagged any foods that seemed to be novel in 2007 to 2016. Finally, a five-member panel reviewed all the foods initially identified as novel.

Overall, the team identified 28 novel food vehicles, including six fish (almaco jack, carp, lionfish monchong, skate and swai), six nuts or seeds (cashews, chia seeds, hazel nuts, pine nuts, pistachios and sprouted nut butter), four fruits (apples, blueberries, papaya and pomegranate), three meats (bison, frog and goose), three vegetables (kale, lima beans and mini peppers), two grains (flour and tempeh), two herbs or spices (moringa leaf, pepper), cane sugar and sheep milk.

According to the study, one-third of the food items were imported from other countries, two-thirds did not require cooking after purchase and half did not require refrigeration.

The 36 outbreaks resulted in 1,294 illnesses, 263 hospitalizations, 14 deaths and 17 recalls. In all, 22 occurred in multiple states — a rate of 61%, compared with 5.7% for other outbreaks. The most commonly reported cause was Salmonella (19 outbreaks), followed by Shiga toxin-producing Escherichia coli (five outbreaks).

Whitham said it is not clear why these foods began causing outbreaks, but it could be explained as a combination of better surveillance and the foods gaining popularity.

“It is important that clinicians become aware of the diverse sources of foodborne illness, especially in times of globalization and changing food trends. This is particularly important when counseling vulnerable or high-risk patients so they can make informed decisions,” Whitham said.

“Additionally, effective outbreak detection and control relies heavily on whole-genome sequencing. While culture-independent diagnostic tests have become more accessible and offer faster results, these types of tests do not allow for sequencing to determine an organism’s DNA fingerprint, meaning doctors cannot tailor clinical therapy and public health.”

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