The study, based on data from 1998-2008, also found dairy accounted for the most hospitalizations (16%), followed by leafy vegetables (14%), poultry (12%), and fruits-nuts (10%).
Produce was attributed to 46% of illnesses with norovirus the major driver and meat-poultry commodities accounted for 29% of deaths.
Among the 17 commodities, poultry accounted for the most deaths (19%), dairy (10%), vine-stalk vegetables (7%), fruits-nuts (6%), and leafy vegetables (6%).
Of the 277 deaths attributed to poultry, most were from Listeria monocytogenes (63%) or Salmonella spp. (26%).
Painter et al defined three commodities for aquatic animals (fish, crustaceans, and mollusks), six for land animals (dairy, eggs, beef, game, pork, and poultry), and eight for plants (grains-beans; oils-sugars [refined plant foods]; fruits-nuts; fungi; and leafy, root, sprout, and vine-stalk vegetables).
The study follows a CDC report that found foodborne disease outbreaks topped 1,500 cases, including 23 deaths in 2009-2010.
Ten year analysis
During 1998–2008, a total of 13,352 foodborne disease outbreaks, causing 271,974 illnesses, were reported in the US.
Norovirus caused the most outbreaks (1,419) and outbreak-associated illnesses (41,257).
Most bacterial illnesses were attributed to dairy (18%), poultry (18%), and beef (13%) commodities and most chemical illnesses were fish (60%, most caused by the marine biotoxin ciguatoxin).
Most parasitic illnesses were driven by mollusks (33%) and fruits-nuts (29%), reflecting that one food outbreak was caused by Giardia intestinalis (mollusks) and one by Cryptosporidium spp. (fruits-nuts).
More illnesses were attributed to leafy vegetables (22%) than to any other commodity; illnesses associated with leafy vegetables were the second most frequent cause of hospitalizations (14%) and the fifth most frequent cause of death (6%).
The dairy commodity was the second most frequent food source for infections causing illnesses (14%) and deaths (10%).
“Foods in this commodity are typically consumed after pasteurization, which eliminates pathogens, but improper pasteurization and incidents of contamination after pasteurization occur,” said the researchers.
“The prominence of dairy in our model reflects a relatively high number of reported outbreaks associated with raw milk compared with the quantity of raw milk consumed.”
The team identified limitations and cited an example of outbreak data underrepresenting poultry (8%) and overrepresenting dairy (67%) as sources of Campylobacter spp. Infection.
CSPI Food Safety Director Caroline Smith DeWaal, said: “One surprising fact consumers should take away from the CDC study of foodborne illnesses between 1998 and 2008 is that dairy products, including milk, cheese, and ice cream, are big contributors to foodborne illness.
“The risk from dairy products has increased in recent years with the increased rise in popularity of unpasteurized raw milk and cheeses.”
Source: Emerging Infectious Diseases
Online ahead of print, DOI: 10.3201/eid1903.111866
“Attribution of Foodborne Illnesses, Hospitalizations, and Deaths to Food Commodities by using Outbreak Data, United States, 1998–2008”
Authors: John A. Painter, Robert M. Hoekstra, Tracy Ayers, Robert V. Tauxe, Christopher R. Braden, Frederick J. Angulo, and Patricia M. Griffin