{"title":"Foodborne Illnesses from Leafy Greens in the United States: Attribution, Burden, and Cost","authors":"Xuerui Yang, Robert Scharff","doi":"10.1016/j.jfp.2024.100275","DOIUrl":null,"url":null,"abstract":"<div><p>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-producing<!--> <em>Escherichia coli</em> (both non-O157 and O157:H7), <em>Campylobacter</em> spp., and nontyphoidal <em>Salmonella</em>, 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-producing<!--> <em>Escherichia coli</em> 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.</p></div>","PeriodicalId":15903,"journal":{"name":"Journal of food protection","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0362028X24000590/pdfft?md5=536fe70a4e0e57f867e660e00b1a9e79&pid=1-s2.0-S0362028X24000590-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of food protection","FirstCategoryId":"97","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0362028X24000590","RegionNum":4,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"BIOTECHNOLOGY & APPLIED MICROBIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
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-producing Escherichia 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-producing Escherichia 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.
期刊介绍:
The Journal of Food Protection® (JFP) is an international, monthly scientific journal in the English language published by the International Association for Food Protection (IAFP). JFP publishes research and review articles on all aspects of food protection and safety. Major emphases of JFP are placed on studies dealing with:
Tracking, detecting (including traditional, molecular, and real-time), inactivating, and controlling food-related hazards, including microorganisms (including antibiotic resistance), microbial (mycotoxins, seafood toxins) and non-microbial toxins (heavy metals, pesticides, veterinary drug residues, migrants from food packaging, and processing contaminants), allergens and pests (insects, rodents) in human food, pet food and animal feed throughout the food chain;
Microbiological food quality and traditional/novel methods to assay microbiological food quality;
Prevention of food-related hazards and food spoilage through food preservatives and thermal/non-thermal processes, including process validation;
Food fermentations and food-related probiotics;
Safe food handling practices during pre-harvest, harvest, post-harvest, distribution and consumption, including food safety education for retailers, foodservice, and consumers;
Risk assessments for food-related hazards;
Economic impact of food-related hazards, foodborne illness, food loss, food spoilage, and adulterated foods;
Food fraud, food authentication, food defense, and foodborne disease outbreak investigations.