Outbreaks of salmonellosis associated with eating uncooked tomatoes

Implications for public health

C. W. Hedberg, F. J. Angulo, K. E. White, C. W. Langkop, W. L. Schell, M. G. Stobierski, A. Schuchat, J. M. Besser, S. Dietrich, L. Helsel, P. M. Griffin, J. W. McFarland, M. T. Osterholm, D. Swerdlow, R. Tauxe, J. Townes, J. Hospedales, L. Wilson, R. Kingdon, Reena Roy & 31 others J. Feldman, R. Marrs, J. Scharmann, S. Bohm, K. J. Kuo, R. Martin, P. McDonnell, K. Michalak, K. Pannaralla, M. Schwartz, W. Hall, C. Klammer, T. Masso, K. MacDonald, J. Soler, L. Gabriel, R. Danila, J. Forfang, J. Korlath, J. Clare, E. Anderson, J. Mariotti, T. Ristinen, F. Mitchell, C. Schneider, M. Miller, G. Killiam, J. Tucker, E. Smyth, M. Proctor, J. Davis

Research output: Contribution to journalArticle

150 Citations (Scopus)

Abstract

Laboratory-based surveillance of salmonella isolates serotyped at four state health departments (Illinois, Michigan, Minnesota and Wisconsin) led to the identification of multistate outbreaks of salmonella infections during 1990 (176 cases of S. javiana) and 1993 (100 cases of S. montevideo). Community-based case-control studies and product traceback implicated consumption of tomatoes from a single South Carolina tomato packer (Packer A) MOR 16.0; 95% CI 2.1, 120.6; P < 0.0001 in 1990 and again in 1993 (MOR 5.7; 95% CI 1.5, 21.9; P = 0.01) as the likely vehicle. Contamination likely occurred at the packing shed, where field grown tomatoes were dumped into a common water bath. These outbreaks represent part of a growing trend of large geographically dispersed outbreaks caused by sporadic or low-level contamination of widely distributed food items. Controlling contamination of agricultural commodities that are also ready-to-eat foods, particularly fruits and vegetables, presents a major challenge to industry, regulators and public health officials.

Original languageEnglish (US)
Pages (from-to)385-393
Number of pages9
JournalEpidemiology and Infection
Volume122
Issue number3
DOIs
StatePublished - Jun 1 1999

Fingerprint

Salmonella Infections
Lycopersicon esculentum
Disease Outbreaks
Public Health
Eating
Food
Baths
Salmonella
Vegetables
Case-Control Studies
Fruit
Industry
Water
Health

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Infectious Diseases

Cite this

Hedberg, C. W., Angulo, F. J., White, K. E., Langkop, C. W., Schell, W. L., Stobierski, M. G., ... Davis, J. (1999). Outbreaks of salmonellosis associated with eating uncooked tomatoes: Implications for public health. Epidemiology and Infection, 122(3), 385-393. https://doi.org/10.1017/S0950268899002393
Hedberg, C. W. ; Angulo, F. J. ; White, K. E. ; Langkop, C. W. ; Schell, W. L. ; Stobierski, M. G. ; Schuchat, A. ; Besser, J. M. ; Dietrich, S. ; Helsel, L. ; Griffin, P. M. ; McFarland, J. W. ; Osterholm, M. T. ; Swerdlow, D. ; Tauxe, R. ; Townes, J. ; Hospedales, J. ; Wilson, L. ; Kingdon, R. ; Roy, Reena ; Feldman, J. ; Marrs, R. ; Scharmann, J. ; Bohm, S. ; Kuo, K. J. ; Martin, R. ; McDonnell, P. ; Michalak, K. ; Pannaralla, K. ; Schwartz, M. ; Hall, W. ; Klammer, C. ; Masso, T. ; MacDonald, K. ; Soler, J. ; Gabriel, L. ; Danila, R. ; Forfang, J. ; Korlath, J. ; Clare, J. ; Anderson, E. ; Mariotti, J. ; Ristinen, T. ; Mitchell, F. ; Schneider, C. ; Miller, M. ; Killiam, G. ; Tucker, J. ; Smyth, E. ; Proctor, M. ; Davis, J. / Outbreaks of salmonellosis associated with eating uncooked tomatoes : Implications for public health. In: Epidemiology and Infection. 1999 ; Vol. 122, No. 3. pp. 385-393.
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abstract = "Laboratory-based surveillance of salmonella isolates serotyped at four state health departments (Illinois, Michigan, Minnesota and Wisconsin) led to the identification of multistate outbreaks of salmonella infections during 1990 (176 cases of S. javiana) and 1993 (100 cases of S. montevideo). Community-based case-control studies and product traceback implicated consumption of tomatoes from a single South Carolina tomato packer (Packer A) MOR 16.0; 95{\%} CI 2.1, 120.6; P < 0.0001 in 1990 and again in 1993 (MOR 5.7; 95{\%} CI 1.5, 21.9; P = 0.01) as the likely vehicle. Contamination likely occurred at the packing shed, where field grown tomatoes were dumped into a common water bath. These outbreaks represent part of a growing trend of large geographically dispersed outbreaks caused by sporadic or low-level contamination of widely distributed food items. Controlling contamination of agricultural commodities that are also ready-to-eat foods, particularly fruits and vegetables, presents a major challenge to industry, regulators and public health officials.",
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Hedberg, CW, Angulo, FJ, White, KE, Langkop, CW, Schell, WL, Stobierski, MG, Schuchat, A, Besser, JM, Dietrich, S, Helsel, L, Griffin, PM, McFarland, JW, Osterholm, MT, Swerdlow, D, Tauxe, R, Townes, J, Hospedales, J, Wilson, L, Kingdon, R, Roy, R, Feldman, J, Marrs, R, Scharmann, J, Bohm, S, Kuo, KJ, Martin, R, McDonnell, P, Michalak, K, Pannaralla, K, Schwartz, M, Hall, W, Klammer, C, Masso, T, MacDonald, K, Soler, J, Gabriel, L, Danila, R, Forfang, J, Korlath, J, Clare, J, Anderson, E, Mariotti, J, Ristinen, T, Mitchell, F, Schneider, C, Miller, M, Killiam, G, Tucker, J, Smyth, E, Proctor, M & Davis, J 1999, 'Outbreaks of salmonellosis associated with eating uncooked tomatoes: Implications for public health', Epidemiology and Infection, vol. 122, no. 3, pp. 385-393. https://doi.org/10.1017/S0950268899002393

Outbreaks of salmonellosis associated with eating uncooked tomatoes : Implications for public health. / Hedberg, C. W.; Angulo, F. J.; White, K. E.; Langkop, C. W.; Schell, W. L.; Stobierski, M. G.; Schuchat, A.; Besser, J. M.; Dietrich, S.; Helsel, L.; Griffin, P. M.; McFarland, J. W.; Osterholm, M. T.; Swerdlow, D.; Tauxe, R.; Townes, J.; Hospedales, J.; Wilson, L.; Kingdon, R.; Roy, Reena; Feldman, J.; Marrs, R.; Scharmann, J.; Bohm, S.; Kuo, K. J.; Martin, R.; McDonnell, P.; Michalak, K.; Pannaralla, K.; Schwartz, M.; Hall, W.; Klammer, C.; Masso, T.; MacDonald, K.; Soler, J.; Gabriel, L.; Danila, R.; Forfang, J.; Korlath, J.; Clare, J.; Anderson, E.; Mariotti, J.; Ristinen, T.; Mitchell, F.; Schneider, C.; Miller, M.; Killiam, G.; Tucker, J.; Smyth, E.; Proctor, M.; Davis, J.

In: Epidemiology and Infection, Vol. 122, No. 3, 01.06.1999, p. 385-393.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Outbreaks of salmonellosis associated with eating uncooked tomatoes

T2 - Implications for public health

AU - Hedberg, C. W.

AU - Angulo, F. J.

AU - White, K. E.

AU - Langkop, C. W.

AU - Schell, W. L.

AU - Stobierski, M. G.

AU - Schuchat, A.

AU - Besser, J. M.

AU - Dietrich, S.

AU - Helsel, L.

AU - Griffin, P. M.

AU - McFarland, J. W.

AU - Osterholm, M. T.

AU - Swerdlow, D.

AU - Tauxe, R.

AU - Townes, J.

AU - Hospedales, J.

AU - Wilson, L.

AU - Kingdon, R.

AU - Roy, Reena

AU - Feldman, J.

AU - Marrs, R.

AU - Scharmann, J.

AU - Bohm, S.

AU - Kuo, K. J.

AU - Martin, R.

AU - McDonnell, P.

AU - Michalak, K.

AU - Pannaralla, K.

AU - Schwartz, M.

AU - Hall, W.

AU - Klammer, C.

AU - Masso, T.

AU - MacDonald, K.

AU - Soler, J.

AU - Gabriel, L.

AU - Danila, R.

AU - Forfang, J.

AU - Korlath, J.

AU - Clare, J.

AU - Anderson, E.

AU - Mariotti, J.

AU - Ristinen, T.

AU - Mitchell, F.

AU - Schneider, C.

AU - Miller, M.

AU - Killiam, G.

AU - Tucker, J.

AU - Smyth, E.

AU - Proctor, M.

AU - Davis, J.

PY - 1999/6/1

Y1 - 1999/6/1

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AB - Laboratory-based surveillance of salmonella isolates serotyped at four state health departments (Illinois, Michigan, Minnesota and Wisconsin) led to the identification of multistate outbreaks of salmonella infections during 1990 (176 cases of S. javiana) and 1993 (100 cases of S. montevideo). Community-based case-control studies and product traceback implicated consumption of tomatoes from a single South Carolina tomato packer (Packer A) MOR 16.0; 95% CI 2.1, 120.6; P < 0.0001 in 1990 and again in 1993 (MOR 5.7; 95% CI 1.5, 21.9; P = 0.01) as the likely vehicle. Contamination likely occurred at the packing shed, where field grown tomatoes were dumped into a common water bath. These outbreaks represent part of a growing trend of large geographically dispersed outbreaks caused by sporadic or low-level contamination of widely distributed food items. Controlling contamination of agricultural commodities that are also ready-to-eat foods, particularly fruits and vegetables, presents a major challenge to industry, regulators and public health officials.

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