An Outbreak of Gastrointestinal Illness and Erythema Nodosum from Grated Carrots Contaminated with<i>Yersinia pseudotuberculosis</i>

Jalava, Katri; Hakkinen, Marjaana; Valkonen, Miia; Nakari, Ulla-Maija; Palo, Taito; Hallanvuo, Saija; Ollgren, Jukka; Siitonen, Anja; Nuorti, J. Pekka

doi:10.1086/508191

Cited by 107 publications

(84 citation statements)

References 26 publications

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“…ersinia pseudotuberculosis is an important food-borne Gramnegative pathogen that has caused several outbreaks through raw vegetables or contaminated water (1)(2)(3)(4)(5). The average incidence of Y. pseudotuberculosis infections between the years 1995 and 2006 in Finland was 1.9/100,000 population (varied between 0.6 and 4.8) (6).…”

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confidence: 99%

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Alternative Sigma Factor σ ^E Has an Important Role in Stress Tolerance of Yersinia pseudotuberculosis IP32953

Palonen

Lindström

Somervuo

et al. 2013

Appl Environ Microbiol

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Yersinia pseudotuberculosis is an important pathogen that probably survives well in the modern food chain. However, little is known about the mechanisms that allow the growth of this pathogen in foods under stress conditions. The expression of rpoE encoding E was defined by quantitative real-time reverse transcription-PCR. Expression of rpoE was induced at 3°C, 37°C, and 42°C, under exposure to 3% NaCl, 3% ethanol, or high and low pH, in relation to its expression at the optimum growth temperature of 28°C of Y. pseudotuberculosis. Mutation of rpoE either impaired or abolished growth under stresses caused by low or high temperature, low pH, and ethanol. In addition, the growth temperature range of the mutant was significantly diminished compared to that of the wild-type strain IP32953. The results were confirmed with complementation of the mutant. Thus, E plays a significant role in the stress tolerance of Y. pseudotuberculosis IP32953 and probably contributes to the survival of this pathogen in the food chain.

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confidence: 99%

“…Y. pseudotuberculosis tolerates stressful conditions in the environment and in the modern food chain. It is able to survive over winter in soil (2) and at least 1 month in food storage facilities (1), and it can grow in pHs ranging from 5.0 to 9.6, at temperatures from 0 to 42°C (7), and in a NaCl concentration of 5% (6).…”

mentioning

confidence: 99%

Alternative Sigma Factor σ ^E Has an Important Role in Stress Tolerance of Yersinia pseudotuberculosis IP32953

Palonen

Lindström

Somervuo

et al. 2013

Appl Environ Microbiol

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“…Outbreaks of Yersinia pseudotuberculosis infection in Europe during 2007-2011 included those associated with raw and grated carrots in Finland, usually after storage at refrigerator temperatures (Jalava et al, 2006;Kangas et al, 2008;) and Yersinia enterocolitica with bagged "raddichio rosso" salad in Norway (MacDonald et al, 2011).…”

Section: Yersinia Enterocolitica and Pseudotuberculosismentioning

confidence: 99%

Scientific Opinion on the risk posed by pathogens in food of non-animal origin. Part 1 (outbreak data analysis and risk ranking of food/pathogen combinations)

Publication¹

2013

EFSA Journal

179

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European Food Safety Authority (EFSA), Parma, Italy ABSTRACTFood of non-animal origin (FoNAO) is consumed in a variety of forms, and a major component of almost all meals. These food types have the potential to be associated with large outbreaks as seen in 2011 associated with VTEC O104. A comparison of the incidence of human cases linked to consumption of FoNAO and of food of animal origin (FoAO) was carried out to provide an indication of the proportionality between these two groups of foods. It was concluded that outbreak data reported as part of EU Zoonoses Monitoring is currently the only option for EU-wide comparative estimates. Using this data from 2007 to 2011, FoNAO were associated with 10% of the outbreaks, 26% of the cases, 35% of the hospitalisations and 46% of the deaths. If the data from the 2011VTEC O104 outbreak is excluded, FoNAO was associated with 10% of the outbreaks, 18% of cases, but only 8% of the hospitalisations and 5% of the deaths. From 2008 to 2011 there was an increase in the numbers of reported outbreaks, cases, hospitalisations and deaths associated with food of non-animal origin. In order to identify and rank specific food/pathogen combinations most often linked to human cases originating from FoNAO in the EU, a model was developed using seven criteria: strength of associations between food and pathogen based on the foodborne outbreak data from EU Zoonoses Monitoring (2007-11), incidence of illness, burden of disease, dose-response relationship, consumption, prevalence of contamination and pathogen growth potential during shelf life. Shortcomings in the approach using outbreak data were discussed. The top ranking food/pathogen combination was Salmonella spp. and leafy greens eaten raw followed by (in equal rank) Salmonella spp. and bulb and stem vegetables, Salmonella spp. and tomatoes, Salmonella spp. and melons, and pathogenic Escherichia coli and fresh pods, legumes or grain.© European Food Safety Authority, 2013 KEY WORDSFood of non-animal origin, foodborne pathogens, foodborne outbreaks, food/pathogen combination, risk ranking SUMMARYThe European Commission asked EFSA"s BIOHAZ Panel to prepare a scientific Opinion on the public health risk posed by pathogens that may contaminate food of non-animal origin (FoNAO). In particular, this opinion addresses the first two terms of reference for the mandate, namely: (i) to compare the incidence of foodborne human cases linked to FoNAO and foodborne cases linked to food of animal origin (FoAO), and (ii) to identify and rank specific food/pathogen combinations most often linked to foodborne human cases originating from FoNAO in the EU.For the comparison of the incidence of foodborne human cases linked to FoNAO and foodborne cases linked to FoAO, the BIOHAZ Panel concluded that: the analysis of the outbreak data reported as part of EU Zoonoses Monitoring allows attribution of human cases to food of non-animal origin or food of animal origin, and is currently the only option for obtaining a EU-wide comparative estimate of the proportion ...

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“…Assessment of the mitigations options is performed in a qualitative manner similar to that performed for the scientific opinion on the risk posed by Shiga toxin-producing Escherichia coli (STEC) and other pathogenic bacteria in seeds and sprouted seeds (EFSA Panel on Biological Hazards (BIOHAZ), 2011c), and include consideration of generic mitigation options previously identified for leafy greens eaten raw as salads (EFSA BIOHAZ Panel, 2014a) (Kangas et al, 2008;Vasala et al, 2014) and carrots contaminated with Norovirus (Kaminska et al, 2014). Additional information is available for outbreaks in the EU which occurred outside the previous 2007-2011 study period (EFSA Panel on Biological Hazards (BIOHAZ), 2013a) and were associated with: Y. pseudotuberculosis infection and consumption of grated carrots which occurred in 2003 and 2006 (111 and > 400 cases respectively (Jalava et al, 2006;Rimhanen-Finne et al, 2009);andNorovirus andfrozen carrots in 2012, Poland, 97 cases (Kaminska et al, 2014); four Norovirus outbreaks associated with consumption of carrots (one outbreak of 122 cases in Sweden in 2012; and the remaining three outbreaks in Germany in 2012 and 2013 with 2, 2, and 5 cases respectively).…”

Section: Introductionmentioning

confidence: 99%

Scientific Opinion on the risk posed by pathogens in food of non‐animal origin. Part 2 (Salmonella, Yersinia, Shigella and Norovirus in bulb and stem vegetables, and carrots)

Publication¹

2014

EFS2

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Bulb and stem vegetables as well as carrots may be minimally processed to obtain ready‐to‐eat products, and these steps include selection, washing, cleaning, cutting, packaging and storage. Risk factors for the contamination of bulb and stem vegetables as well as carrots with Salmonella, Yersinia, Shigella and Norovirus were considered in the context of the whole food chain. Available estimates of their occurrence in these vegetables were evaluated together with mitigation options relating to prevention of contamination and the relevance of microbiological criteria. Emphasis is given to vegetable types associated with public health risks, i.e. carrots, onion and garlic. It was concluded that each farm environment represents a unique combination of risk factors that can influence the occurrence and persistence of pathogens in the primary production of these vegetables. Appropriate implementation of food safety management systems including Good Agricultural Practices (GAP), Good Hygiene Practices (GHP) and Good Manufacturing Practices (GMP) should be the primary objectives of producers of bulb and stem vegetables as well as carrots. Considering the limited evidence for both the occurrence and public health risks from contamination of Salmonella, Shigella, Yersinia and Norovirus in the primary production and minimal processing of bulb and stem vegetables and carrots, no conclusions can be made on the impact of the establishment of microbiological Hygiene Criteria, Process Hygiene Criteria or Food Safety Criteria on public health. There is a lack of data on the occurrence and levels of Escherichia coli in bulb and stem vegetables as well as carrots. Thus, the effectiveness of E. coli criteria to verify compliance to GAP, GHP, GMP and food safety management systems (including HACCP) in the production and minimal processing of bulb and stem vegetables as well as carrots cannot be assessed.

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An Outbreak of Gastrointestinal Illness and Erythema Nodosum from Grated Carrots Contaminated withYersinia pseudotuberculosis

Abstract: Carrots contaminated early in the production process caused a large point-source outbreak. Our findings enable the development of evidence-based strategies to prevent outbreaks of this emerging foodborne pathogen.

Cited by 107 publications

References 26 publications

Alternative Sigma Factor σ ^E Has an Important Role in Stress Tolerance of Yersinia pseudotuberculosis IP32953

Alternative Sigma Factor σ ^E Has an Important Role in Stress Tolerance of Yersinia pseudotuberculosis IP32953

Scientific Opinion on the risk posed by pathogens in food of non-animal origin. Part 1 (outbreak data analysis and risk ranking of food/pathogen combinations)

Scientific Opinion on the risk posed by pathogens in food of non‐animal origin. Part 2 (Salmonella, Yersinia, Shigella and Norovirus in bulb and stem vegetables, and carrots)

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An Outbreak of Gastrointestinal Illness and Erythema Nodosum from Grated Carrots Contaminated withYersinia pseudotuberculosis

Abstract: Carrots contaminated early in the production process caused a large point-source outbreak. Our findings enable the development of evidence-based strategies to prevent outbreaks of this emerging foodborne pathogen.

Cited by 107 publications

References 26 publications

Alternative Sigma Factor σ E Has an Important Role in Stress Tolerance of Yersinia pseudotuberculosis IP32953

Alternative Sigma Factor σ E Has an Important Role in Stress Tolerance of Yersinia pseudotuberculosis IP32953

Scientific Opinion on the risk posed by pathogens in food of non-animal origin. Part 1 (outbreak data analysis and risk ranking of food/pathogen combinations)

Scientific Opinion on the risk posed by pathogens in food of non‐animal origin. Part 2 (Salmonella, Yersinia, Shigella and Norovirus in bulb and stem vegetables, and carrots)

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Product

Resources

About

Alternative Sigma Factor σ ^E Has an Important Role in Stress Tolerance of Yersinia pseudotuberculosis IP32953

Alternative Sigma Factor σ ^E Has an Important Role in Stress Tolerance of Yersinia pseudotuberculosis IP32953