Viral outbreaks linked to fresh produce consumption: a systematic review

Abstract

Aims: Α systematic review to investigate fresh produce-borne viral outbreaks, to record the outbreak distribution worldwide and to analyse the implication of different types of fresh produce and viral types as well.

Methods and results: Four databases (PubMed/Medline, Scopus, Eurosurveillance Journal and Spingerlink electronic journal) and a global electronic reporting system (ProMED-mail) were searched up to 2016. One hundred and fifty-two viral outbreaks linked to fresh produce consumption were identified. The majority of the reported outbreaks was reported in Europe, followed by North America, Asia, Australia, Africa and South America. A great number of the outbreaks was recorded in Denmark and Finland. The most common viral pathogens were norovirus (48·7%) and hepatitis A virus (46·1%). The most frequent type of fresh produce involved was frozen raspberries (23·7%). Differences in the reporting of outbreaks were recorded between the scientific literature and ProMED.

Conclusions: The number of reported illnesses linked to fresh produce has increased in several countries. Consumption of contaminated fresh produce represents a risk to public health in both developed and developing countries, but the impact will be disproportionate and likely to compound existing health disparities. For this reason, all countries should systematically collate and report such data through a disease surveillance system, in order to adopt risk management practices for reducing the likelihood of contamination.

Keywords: fresh produce; hepatitis A; lettuce; norovirus; raspberries; salad; strawberries.