Purpose: Describe the frequency and characteristics of outbreaks attributed to raw produce.
Methods: We reviewed outbreaks (≥ 2 persons with a similar illness) attributed to the consumption of produce likely consumed raw, reported to CDC’s Foodborne Disease Outbreak Surveillance System during 1998–2013. We analyzed the number of outbreaks, outbreak-associated illnesses, hospitalizations, and deaths over time, and etiologic agents. Implicated produce items were further categorized for analysis.
Results: During 1998–2013, 17,374 foodborne disease outbreaks were reported; 972 outbreaks (10% of outbreaks with a food reported) were attributed to raw produce, resulting in 34,674 (17%) outbreak-associated illnesses, 2,315 (25%) hospitalizations, and 72 (31%) deaths. Over time, raw produce outbreaks accounted for an increasing proportion of outbreaks with a food reported, from 8% during 1998–2005 to 14% during 2006–2013. Among the 778 outbreaks caused by a single etiologic agent, norovirus (418, 54%), Salmonella enterica (167, 21%), and Shiga Toxin-producing Escherichia coli (74, 10%) were most commonly reported. Among outbreaks attributed to a single produce category (n = 612), raw vegetable row crops (235 outbreaks, 38%), fruits (216, 35%), and seeded vegetables (66, 11%) were most frequently implicated. The most common etiologic agent-produce categories reported were norovirus in vegetable row crops (119 outbreaks), norovirus in fruits (93), and Salmonella enterica in fruits (51).
Significance: The proportion of all foodborne outbreaks attributed to raw produce has increased. Outbreaks caused by norovirus and Salmonella suggest that contamination of raw produce during food preparation, as well as during harvest and processing, are important. Implementation of FSMA could result in fewer outbreaks attributed to raw produce.