Foodborne outbreaks in Brazil associated with fruits and vegetables: 2008 through 2014

Foodborne disease outbreaks linked to fruits and vegetables have been increasing in occurrence worldwide; therefore, the aim of this study was to identify the reported foodborne outbreaks associated with fruit and vegetable consumption in Brazil from 2008 to 2014. Thirty produce related outbreaks resulted in 2926 illnesses, 347 hospitalizations, and no deaths. Only bacterial pathogens were identified as etiological agents. Among these, Salmonella was the most frequent (30 per cent of outbreaks) followed by Staphylococcus aureus (23.3 per cent), Escherichia coli (10 per cent), Bacillus cereus (6.6 per cent), and thermotolerant coliforms (3.3 per cent), whereas etiological agents could not be determined for 26.6 per cent of outbreaks. The most common food vehicles implicated in outbreaks were generically named as fruits and vegetables (46.6 per cent of outbreaks). The term salad was used generically and specifically like salads (two outbreaks), raw/cooked salads (four outbreaks), vegetable salad, tropical salad, Caesar salad, and raw salad of cabbage and tomato. Only one outbreak was related exclusively to fruit (fruit pulp), whereas other outbreaks were related to cooked carrot, lettuce, cucumber, watermelon/cabbage, and chard/beet. Contamination sources and issues related to the future control of produce-related foodborne disease outbreaks are discussed.