Food recalls associated with foodborne disease outbreaks, United States, 2006-2016.

Qihua Qiu,Samuel J Crowe,Sanjana Subramhanya,William Lanier,Zhaohui Cui,Matthew E Wise,Daniel Dewey-Mattia,Susan Lance,Patricia M Griffin

doi:10.1017/s0950268821001722

Abstract

About 800 foodborne disease outbreaks are reported in the United States annually. Few are associated with food recalls. We compared 226 outbreaks associated with food recalls with those not associated with recalls during 2006-2016. Recall-associated outbreaks had, on average, more illnesses per outbreak and higher proportions of hospitalisations and deaths than non-recall-associated outbreaks. The top confirmed aetiology for recall-associated outbreaks was Salmonella. Pasteurised and unpasteurised dairy products, beef and molluscs were the most frequently implicated foods. The most common pathogen-food pairs for outbreaks with recalls were Escherichia coli-beef and norovirus-molluscs; the top pairs for non-recall-associated outbreaks were scombrotoxin-fish and ciguatoxin-fish. For outbreaks with recalls, 48% of the recalls occurred after the outbreak, 27% during the outbreak, 3% before the outbreak, and 22% were inconclusive or had unknown recall timing. Fifty per cent of recall-associated outbreaks were multistate, compared with 2% of non-recall-associated outbreaks. The differences between recall-associated outbreaks and non-recall-associated outbreaks help define the types of outbreaks and food vehicles that are likely to have a recall. Improved outbreak vehicle identification and traceability of rarely recalled foods could lead to more recalls of these products, resulting in fewer illnesses and deaths.

Highlights

We summarised foodborne disease outbreaks reported to the U.S Centers for Disease
We identified substantial differences between outbreaks with a food recall and those without in regards to the number of illnesses, proportions of hospitalisations and deaths, leading aetiologies, major food categories, and the proportion that were multistate
Outbreaks caused by the leading sources of non-recall-associated outbreaks, including norovirus, Campylobacter and Clostridium perfringens, have been frequently linked to food preparation errors or are difficult to identify with current laboratory techniques

Summary

Introduction

Only a small proportion of foodborne illnesses are associated with recognised outbreaks, outbreak investigations provide valuable epidemiological and risk mitigation information about the foods and pathogens that cause disease [2]. Investigators aim to identify the contaminated food as quickly as possible to prevent additional illnesses. A recall is accompanied by a published notification from a regulatory agency that stipulates that a food might be unsafe and that it should be returned or discarded. It may entail a similar notice from a company

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