Otherindependent cross-checkabstract checked I-VEG-133 standard review
Raw produce causes a growing share of US outbreaks
Produce-associated foodborne disease outbreaks, USA, 1998-2013.
Overview
Bennett SD et al.. Epidemiol Infect 2018 · PMID 29923474 · DOI 10.1017/S0950268818001620
Raw produce caused 972 outbreaks in 1998-2013, rising from 8% to 16% of outbreaks with a known food; leafy row crops led.
Does the study support the specific claim? Yes · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Analyse raw-produce outbreaks.
- How was the study done?
Surveillance analysis.
- How many people, animals or samples were studied?
972 outbreaks.
- What was actually found?
Increasing share; row crops most common.
- How large was the observed effect?
72 deaths / 34,674 illnesses.
- What do the results mean in everyday life?
Produce safety matters, but serious outcomes are rare.
- What are the study's limitations?
Outbreak data only.
- What does it say about Elawady's specific claim?
Supports the claim.
- Do the results apply to Germany and Europe?
US.
- What can explicitly not be concluded from this study?
Cannot give per-serving risk.
Scientific in-depth review
1. Full reference
- Authors
- Bennett SD et al.
- Journal
- Epidemiol Infect
- Year
- 2018
- Identifier
- PMID 29923474 DOI 10.1017/S0950268818001620
- Verification
- verified – PubMed efetch 2026-10-26; Crossref 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
COI statement: None.
2. Research question
What are the trends and causes of raw-produce outbreaks in the US?
3. Study design and population
- Study design
- Other – Analysis of national outbreak surveillance data (CDC FDOSS)
- Population
US foodborne outbreaks
- Country
USA
- Period
1998-2013
- Sample size
972 raw-produce outbreaks; 34,674 illnesses
- Inclusion and exclusion criteria
not stated in abstract
4. Methods and endpoints
- Exposure / intervention
Raw produce types
- Comparator
All foodborne outbreaks
- Endpoints
Outbreaks, illnesses, hospitalisations, deaths
- Statistical methods
Descriptive trends
5. Actual results
- Results
972 raw-produce outbreaks with 34,674 illnesses, 2,315 hospitalisations, 72 deaths; share of outbreaks with a known food attributed to raw produce rose from 8% (1998-2001) to 16% (2010-2013); vegetable row crops 38%, fruits 35%, seeded vegetables 11%; norovirus 54%, Salmonella 21%, STEC 10%; food-handling errors in 39%.
- Absolute risks
not reported
- Authors' conclusion
The proportion of outbreaks attributable to raw produce has been increasing; safety measures should address farms, processing and preparation.
6. Strengths
- National data, 16 years
7. Weaknesses
- Outbreak-only data
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Surveillance bias.
9. Assessment of the statistical interpretation
CFR 0.21% (stats/C-VEG-03_outbreaks.py).
10. Relevance to the specific claim
Supports the rising importance of produce (incl. leafy row crops and cucurbit-type seeded vegetables) in the outbreak record.
11. Independent contrary findings
Low fatality.
12. Transferability to Germany and Europe
US.
13. Overall methodological judgement
Supports the claim.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | moderate |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
none
15. Linked fact checks
- Leafy greens and cucurbits are at the centre of the modern fresh-produce outbreak record (E. coli, Salmonella, Listeria). – Studies supporting the claim