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Healthcare-associated foodborne outbreaks in high-income countries: a literature review and surveillance study, 16 OECD countries, 2001 to 2019*
- Idesbald Boone1 , Bettina Rosner1 , Raskit Lachmann1 , Michele Luca D'Errico2 , Luigi Iannetti3 , Yves Van der Stede4 , Frank Boelaert4 , Steen Ethelberg5 , Tim Eckmanns1 , Klaus Stark1 , Sebastian Haller1,* , Hendrik Wilking1,*
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View Affiliations Hide AffiliationsAffiliations: 1 Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany 2 Istituto Superiore di Sanità, Department of Food Safety, Nutrition and Veterinary Public Health, Rome, Italy 3 Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise G. Caporale, National Reference Laboratory for Listeria monocytogenes, Teramo, Italy 4 European Food Safety Authority, Parma, Italy 5 Statens Serum Institut, Infectious Disease Epidemiology and Prevention, Copenhagen, Denmark* These authors contributed equally.Correspondence:Idesbald Booneboonei rki.de
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Citation style for this article: Boone Idesbald, Rosner Bettina, Lachmann Raskit, D'Errico Michele Luca, Iannetti Luigi, Van der Stede Yves, Boelaert Frank, Ethelberg Steen, Eckmanns Tim, Stark Klaus, Haller Sebastian, Wilking Hendrik. Healthcare-associated foodborne outbreaks in high-income countries: a literature review and surveillance study, 16 OECD countries, 2001 to 2019*. Euro Surveill. 2021;26(41):pii=2001278. https://doi.org/10.2807/1560-7917.ES.2021.26.41.2001278 Received: 24 Jun 2020; Accepted: 25 Mar 2021
Abstract
Healthcare-associated foodborne outbreaks (HA-FBO) may have severe consequences, especially in vulnerable groups.
The aim was to describe the current state of HA-FBO and propose public health recommendations for prevention.
We searched PubMed, the Outbreak Database (Charité, University Medicine Berlin), and hand-searched reference lists for HA-FBO with outbreak onset between 2001 and 2018 from Organisation for Economic Co-operation and Development (OECD) countries and HA-FBO (2012–2018) from the German surveillance system. Additionally, data from the European Food Safety Authority were analysed.
The literature search retrieved 57 HA-FBO from 16 OECD countries, primarily in the US (n = 11), Germany (n = 11) and the United Kingdom (n = 9). In addition, 28 HA-FBO were retrieved from the German surveillance system. Based on the number of outbreaks, the top three pathogens associated with the overall 85 HA-FBO were Salmonella (n = 24), norovirus (n = 22) and Listeria monocytogenes (n = 19). Based on the number of deaths, L. monocytogenes was the main pathogen causing HA-FBO. Frequently reported implicated foods were ‘mixed foods’ (n = 16), ‘vegetables and fruits’ (n = 15) and ‘meat and meat products’ (n = 10). Consumption of high-risk food by vulnerable patients, inadequate time-temperature control, insufficient kitchen hygiene and food hygiene and carriers of pathogens among food handlers were reported as reasons for HA-FBO.
To prevent HA-FBO, the supply of high-risk food to vulnerable people should be avoided. Well working outbreak surveillance facilitates early detection and requires close interdisciplinary collaboration and exchange of information between hospitals, food safety and public health authorities.
This work is licensed under a Creative Commons Attribution 4.0 International License.
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