Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Oct;143(14):3011-21.
doi: 10.1017/S0950268815000047. Epub 2015 Feb 20.

Outbreaks attributed to fresh leafy vegetables, United States, 1973-2012

K M Herman  1 , A J Hall  1 , L H Gould  1
Affiliations

Outbreaks attributed to fresh leafy vegetables, United States, 1973-2012

K M Herman et al. Epidemiol Infect. 2015 Oct.

Abstract

Leafy vegetables are an essential component of a healthy diet; however, they have been associated with high-profile outbreaks causing severe illnesses. We reviewed leafy vegetable-associated outbreaks reported to the Centers for Disease Control and Prevention between 1973 and 2012. During the study period, 606 leafy vegetable-associated outbreaks, with 20 003 associated illnesses, 1030 hospitalizations, and 19 deaths were reported. On average, leafy vegetable-associated outbreaks were larger than those attributed to other food types. The pathogens that most often caused leafy vegetable-associated outbreaks were norovirus (55% of outbreaks with confirmed aetiology), Shiga toxin-producing Escherichia coli (STEC) (18%), and Salmonella (11%). Most outbreaks were attributed to food prepared in a restaurant or catering facility (85%). An ill food worker was implicated as the source of contamination in 31% of outbreaks. Efforts by local, state, and federal agencies to control leafy vegetable contamination and outbreaks should span from the point of harvest to the point of preparation.

Keywords: Escherichia coli; Norwalk agent and related viruses; Salmonella; food poisoning; food safety; foodborne infections.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
Number of reported leafy vegetable-associated outbreaks, including simple leafy vegetables and leafy vegetable-based salads, United States, 1973–2012.
Fig. 2.
Fig. 2.
Number of reported leafy vegetable-associated outbreaks by season when the outbreak began and aetiology, United States, 1973–2012. [Season: spring (March–May), summer (June–August), autumn (September–November), winter (December–February).]
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. Surveillance for foodborne disease outbreaks – United States, 2012: Annual Report (http://www.cdc.gov/foodsafety/fdoss/data/annual-summaries/index.html). Accessed 14 June 2014.
    1. Painter JA, et al. Attribution of foodborne illnesses, hospitalizations, and deaths to food commodities by using outbreak data, United States, 1998–2008. Emerging Infectious Diseases 2013; 19: 407–415. - PMC - PubMed
    1. Wendel AM, et al. Multistate outbreak of Escherichia coli O157:H7 infection associated with consumption of packaged spinach, August-September 2006: the Wisconsin investigation. Clinical Infectious Diseases 2009; 48: 1079–1086. - PubMed
    1. Sivapalasingam S, et al. Fresh produce: a growing cause of outbreaks of foodborne illness in the United States, 1973 through 1997. Journal of Food Protection 2004; 67: 2342–2353. - PubMed
    1. Bean NH, et al. Surveillance for foodborne-disease outbreaks – United States, 1988–1992. Morbidity and Mortality Weekly Report. Surveillance Summaries 1996; 45: 1–66. - PubMed

MeSH terms