An Outbreak of Hepatitis A Associated with Green Onions

Wheeler, Charlotte; Vogt, Tara M.; Armstrong, Gregory L.; Vaughan, Gilberto; Weltman, André; Nainan, Omana V.; Dato, Virginia; Xia, Guoliang; Waller, Kirsten; Amon, Joseph J; Lee, Teresa M.; Highbaugh-Battle, Angela; Hembree, Cambria; Evenson, Stephanie; Ruta, Michael A.; Williams, Ian T.; Fiore, Anthony E.; Bell, Beth P.

doi:10.1056/nejmoa050855

Cited by 303 publications

(175 citation statements)

References 19 publications

(18 reference statements)

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“…The multiple outbreaks linked to imported products reported globally reflect these challenges (e.g. Hepatitis A outbreak (2003) in the US linked to green onions imported from Mexico (Wheeler et al, 2005), Salmonella…”

Section: Rapid Alert Systems Such As the Rapid Alert Systems For Foodmentioning

confidence: 99%

Food safety issues in fresh produce: Bacterial pathogens, viruses and pesticide residues indicated as major concerns by stakeholders in the fresh produce chain

et al. 2013

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(word count = 400)In January 2011, a workshop was organized by the EU FP7 Veg-i-Trade project to capture opinions of stakeholders on food safety issues in the global fresh produce supply chain. Food safety experts from various stakeholder types in the farm-to-fork chain were represented: farmer related organizations (n=6), fresh produce processing and trading companies (n=17), retail (n=3), consumer organizations (n=2), competent authorities (n=7) and lastly research institutes and universities (n=19). The experts were grouped in nine discussion groups per type of stakeholder and asked to rank food safety issues via a scoring approach according to perceived importance from their stakeholder type point of view. Also information sources for opinion making, appropriate food safety control measures and perceived contextual factors increasingly challenging governance of food safety in fresh produce were ranked according to perceived importance. Although some differences were noted between opinions of the different stakeholders, there was in general an agreement on the main priorities in food safety of fresh produce. Bacterial pathogens were overall considered to be the most important food safety issue for fresh produce, followed by foodborne viruses, pesticide residues and mycotoxins. Alert systems such as the European Commission"s Rapid Alert System for Food and Feed (RASFF) were considered as the most important source of information of food safety issues, followed by reports of international organizations (e.g. WHO, EFSA), legislative documents (e.g. EU legislation), national reports (e.g. on monitoring hazards, foodborne outbreaks) and exchange of information between people (informal contacts).Concerning the control measures, the application of good agricultural practices (GAP) was identified to be the most important control measure to assure the safety of fresh produce, followed by the application of good hygienic practices (GHP) and the certification of food safety management systems (FSMS). Increasing international trade and globalization were overall expected to have a large impact on food safety in fresh produce. Other contextual 3 factors perceived to be important were the food safety policies by governments and the (lack of) food safety knowledge by consumers and other stakeholders of the fresh produce supply chain. Although the various stakeholder groups may conceive issues differently from their proper position in the fresh produce supply chain, no deep disagreements emerged. This type of workshop enhances interaction and communication between stakeholders and contributes to a better understanding of each other"s concerns, constraints and motivating interests to deal with the food safety of the increasingly complex and globalized fresh produce supply chain. Key wordsdiscussion group, fresh produce, food safety issue, control measures, contextual factors, information source 4 IntroductionFresh produce is an important part of a healthy diet. Its consumption is known to have a protective health effe...

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Section: Rapid Alert Systems Such As the Rapid Alert Systems For Foodmentioning

confidence: 99%

Food safety issues in fresh produce: Bacterial pathogens, viruses and pesticide residues indicated as major concerns by stakeholders in the fresh produce chain

et al. 2013

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“…107 (7): 960-963, November 2012 Hepatitis A virus (HAV) is a non-enveloped RNA virus that belongs to the Picornaviridae family and the Hepatovirus genus. Usually, natural infection occurs from the ingestion of contaminated faeces, food or water or from person-to-person contact (Wheeler et al 2005). Acute hepatitis infection is endemic in developing countries, where 1.4 million new infections occur each year (Saha et al 2009).…”

mentioning

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An immunoenzymatic assay for the diagnosis of hepatitis A utilising immunoglobulin Y

Silva

Vasconcelos

Kappel

et al. 2012

Mem. Inst. Oswaldo Cruz

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“…Recently, a hepatitis A outbreak caused by the ingestion of contaminated green onions resulted in three deaths among a total of 601 cases (53).…”

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confidence: 99%

Procedure for Rapid Concentration and Detection of Enteric Viruses from Berries and Vegetables

Butot

Putallaz

Sánchez

2007

Appl Environ Microbiol

158

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Several hepatitis A virus (HAV) and norovirus (NV) outbreaks due to consumption of berries and vegetables have been reported during recent years. To facilitate the detection of enteric viruses that may be present on different fresh and frozen products, we developed a rapid and sensitive detection method for HAV, NV, and rotavirus (RV). Initial experiments focused on optimizing the composition of the elution buffer, improving the viral concentration method, and evaluating the performance of various extraction kits. Viruses were extracted from the food surface by a direct elution method in a glycine-Tris (pH 9.5) buffer containing 1% beef extract and concentrated by ultrafiltration. Occasionally, PCR inhibitors were present in the processed berry samples, which gave relatively poor detection limits. However, this problem was overcome by adding a pectinase treatment in the protocol, which markedly improved the sensitivity of the method. After optimization, this concentration method was applied in combination with real-time reverse transcription-PCR (RT-PCR) using specific primers in various types of berries and vegetables. The average detection limits were 1 50% tissue culture infective dose (TCID 50 ), 54 RT-PCR units, and 0.02 TCID 50 per 15 g of food for HAV, NV, and RV, respectively. Based on our results, it is concluded that this procedure is suitable to detect and quantify enteric viruses within 6 h and can be applied for surveillance of enteric viruses in fresh and frozen products.

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An Outbreak of Hepatitis A Associated with Green Onions

Abstract: Green onions that were apparently contaminated before arrival at the restaurant caused this unusually large foodborne outbreak of hepatitis A. The inclusion of contaminated green onions in large batches that were served to all customers contributed to the size of the outbreak.

Cited by 303 publications

References 19 publications

Food safety issues in fresh produce: Bacterial pathogens, viruses and pesticide residues indicated as major concerns by stakeholders in the fresh produce chain

Food safety issues in fresh produce: Bacterial pathogens, viruses and pesticide residues indicated as major concerns by stakeholders in the fresh produce chain

An immunoenzymatic assay for the diagnosis of hepatitis A utilising immunoglobulin Y

Procedure for Rapid Concentration and Detection of Enteric Viruses from Berries and Vegetables

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