Outbreaks of Foodborne Diseases Associated with Tomatoes1
Fresh-market tomatoes are a popular commodity in homes and food service around the world. Because fresh-market tomatoes are intended to be consumed raw, there is no "kill-step" to eliminate pathogens in the event that tomatoes become contaminated (Maitland et al. 2011). Public health officials often meet numerous challenges when conducting traceback investigations of produce outbreaks. Fresh produce items have often reached the end of their shelf life by the time they have been linked to an outbreak; obtaining samples from these items is difficult because these items have typically been consumed or discarded (Lynch et al. 2009). It can be difficult for public health officials to determine where the implicated food was produced and prepared. As a consequence, the challenges of recognizing unusual food vehicles, such as specific lots of fresh produce, can delay the foodborne outbreak investigation (Lynch et al. 2009). The number of sporadic (i.e., isolated) illnesses linked to the consumption of contaminated fresh fruits and vegetables is unknown (Heaton and Jones 2008).
This document is intended to serve as a reference for everyone interested in the safety of fresh-market tomatoes by providing a comprehensive list of tomato-related outbreaks in the United States. Three tables are presented below, which include foodborne outbreaks where tomatoes were i) confirmed as the food vehicle (Table 1), ii) part of a complex food vehicle (Table 2), and iii) suspected, but not confirmed, as the food vehicle (Table 3). Of 38 outbreaks linked to fresh tomatoes in the United States since 1990, 4,028 illnesses and four deaths are reported (Table 1). Salmonella sp. was confirmed as the causative agent in 30 of 38 outbreaks linked to fresh tomatoes (Table 1).
Credit: USDA Photo by Scott Bauer
References
CDC (Centers for Disease Control and Prevention). 2018. National Outbreak Reporting System (NORS). https://wwwn.cdc.gov/norsdashboard/. Accessed May 13, 2020
Cummings, K., E. Barrett, J. C. Mohle-Boetani, J. T. Brooks, J. Farrar, T. Hunt, A. Fiore, K. Komatsu, S. B. Werner, and L. Slutsker. 2001. "A Multistate Outbreak of Salmonella enterica Serotype Baildon Associated with Domestic Raw Tomatoes." Emerging Infectious Disease 7 (6): 1046–1048.
US FDA (US Food and Drug Administration). 2009. "Outbreaks Tables Analysis and Evaluation of Preventive Control Measures for the Control and Reduction/Elimination of Microbial Hazards on Fresh and Fresh-Cut Produce." http://www.fda.gov/Food/ScienceResearch/ResearchAreas/SafePracticesforFoodProcesses/ucm091270.htm. Accessed February 1, 2012.
Heaton, J. C., and K. Jones. 2008. "Microbial Contamination of Fruit and Vegetables and the Behaviour of Enteropathogens in the Phyllosphere: A Review." Journal of Applied Microbiology 104:613–626.
Hedberg, C. W., 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, and M. T. Osterholm. 1999. "Outbreaks of Salmonellosis Associated with Eating Uncooked Tomatoes: Implications for Public Health." Epidemiology and Infection 122:385–393.
Lynch, M. F., R. V. Tauxe, and C.W. Hedberg. 2009. "The Growing Burden of Foodborne Outbreaks Due to Contaminated Fresh Produce: Risks and Opportunities." Epidemiology and Infection 137:307–315.
Maitland, J. E., R. R. Boyer, J. D. Eifert, and R. C. Williams. 2011. "High Hydrostatic Pressure Processing Reduces Salmonella enterica Serovars in Diced and Whole Tomatoes." International Journal of Food Microbiology 149:113–117.
SSI (Statens Serum Institute). 2012. "Outbreak of Salmonella Strathcona." https://en.ssi.dk/news/epi-news/2012/no-4---2012. Accessed February 23, 2012.
Tables
Outbreaks of foodborne disease associated with multiple or complex foods including tomatoes in the United States, 1979–2017.
