Healthcare-associated foodborne outbreaks in high-income countries: a literature review and surveillance study, 16 OECD countries, 2001 to 2019.
Idesbald Boone, Bettina Rosner, Raskit Lachmann, Michele Luca D'Errico, Luigi Iannetti, Yves Van der Stede, Frank Boelaert, Steen Ethelberg, Tim Eckmanns, Klaus Stark, Sebastian Haller, Hendrik Wilking
Author Information
Idesbald Boone: Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany.
Bettina Rosner: Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany.
Raskit Lachmann: Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany.
Michele Luca D'Errico: Istituto Superiore di Sanità, Department of Food Safety, Nutrition and Veterinary Public Health, Rome, Italy.
Luigi Iannetti: Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise G. Caporale, National Reference Laboratory for Listeria monocytogenes, Teramo, Italy.
Yves Van der Stede: European Food Safety Authority, Parma, Italy.
Frank Boelaert: European Food Safety Authority, Parma, Italy.
BackgroundHealthcare-associated foodborne outbreaks (HA-FBO) may have severe consequences, especially in vulnerable groups.AimThe aim was to describe the current state of HA-FBO and propose public health recommendations for prevention.MethodsWe 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.ResultsThe 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 (n = 24), norovirus (n = 22) and (n = 19). Based on the number of deaths, 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.ConclusionTo 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.
