Strategies for the safety management of fresh produce from farm to fork

Reporting of Salmonellosis Markedly Declined in Finland During 28 Years of Surveillance, 1995-2022

Salmonellosis is the second most common foodborne bacterial gastroenteritis in humans in Finland and worldwide. In Finland, a national salmonella control program covering cattle, pigs, and poultry, as well as the meat and eggs obtained from them, has been in place since the country joined the EU in 1995. To identify trends in the incidence of salmonellosis and to reflect on their causes, we analyzed Salmonella case data from the Finnish Infectious Disease Register (FIDR) from 1995 to 2022 and outbreak data from the national food and waterborne outbreak register (the FWO register) in the period 2010-2022. From 1995-1999 to 2015-2019, the incidence of salmonellosis decreased by 66% and 63% for domestic and travel-related cases, respectively. Most salmonellosis cases (72%) were travel-related, and, of them, 27% were infected in Southeast Asia. The most common serovars were S. Typhimurium and S. Enteritidis (38% and 19% of domestic cases, and 7% and 39% of travel-related cases). During 2010-2022, Salmonella sp. was reported as a cause in 31 foodborne outbreaks. In 14 of them, the source was identified at foodstuff level, and 12 sources were of foreign origin. The results of this study indicate that the national salmonella control program may have prevented domestic human infections in Finland.

Critical Issues Faced by Industries Associated with Food Science and Technology: A Delphi Analysis

As the foundation of human health, the food system is arguably a cornerstone of society. However, despite the criticality of a safe and productive food value chain there are numerous critical issues faced by industries associated with food science and technology. Using a three round Delphi process, this study identified the most critical issues faced by these industries. Based on input from expert panelists representing industry, policy makers, and academics, a total of 120 critical issues were identified in the first round. Through a consensus-building process in two subsequent rounds, 38 issues were retained. The retained issues were then analyzed using the constant comparative method to identify themes. A total of eight themes emerged from the analysis, including the following (alphabetically): (1) education, training, and workforce development; (2) emerging technologies in food sciences; (3) food safety and public health; (4) fresh produce and raw food operations; (5) microbiome and pathogens; (6) product innovation and development; (7) quality assurance and systems management; and (8) sustainability and climate resilience. These results provide a robust foundation to help guide and inform strategic priorities and actions within the food industry.

Risks of foodborne pathogens associated with animal contamination of raw-agricultural commodities: A review

Pathogens that cause foodborne illness can contaminate raw-agricultural produce via animal intrusion and defecation in production fields. The Food and Drug Administration's Produce Safety Rule and related guidance cite published research on animal intrusion risk and risk-reduction practices. However, additional relevant research has been published since their release. Research on animal contamination often focuses on a single risk factor. This review summarizes current research on multiple risk factors and provides a basis for understanding how these factors may interact to influence risk to produce from animal contamination, providing regulators and educators with science-based information to inform education and outreach to growers. This review may also aid researchers by identifying future research needs. We conclude that when managing risks from animal contamination, a multi-pronged approach is necessary. This approach considers a range of factors, including animal type, nature of feces, rain and irrigation events, meteorology, and worker training. We also created an online tool that conveys the findings of this review in a succinct and digestible format for growers and regulatory and educational partners.

Combined treatment of pulsed light and nisin-organic acid based antimicrobial wash for inactivation of Escherichia coli O157:H7 in Romaine lettuce, reduction of microbial loads, and retention of quality

Microbial safety of fresh produce continues to be a major concern. Novel antimicrobial methods are needed to minimize the risk of contamination. This study investigated the antimicrobial efficacy of pulsed light (PL), a novel nisin-organic acid based antimicrobial wash (AW) and the synergy thereof in inactivating E. coli O157:H7 on Romaine lettuce. Treatment effects on background microbiota and produce quality during storage at 4 °C for 7 days was also investigated. A bacterial cocktail containing three outbreak strains of E. coli O157:H7 was used as inoculum. Lettuce leaves were spot inoculated on the surface before treating with PL (1-60 s), AW (2 min) or combinations of PL with AW. PL treatment for 10 s, equivalent to fluence dose of 10.5 J/cm2, was optimal and resulted in 2.3 log CFU/g reduction of E. coli O157:H7, while a 2 min AW treatment, provided a comparable pathogen reduction of 2.2 log CFU/g. Two possible treatment sequences of PL and AW combinations were investigated. For PL-AW combination, inoculated lettuce leaves were initially exposed to optimum PL dose followed by 2 min AW treatment, whereas for AW-PL combination, inoculated lettuce were subjected to 2 min AW treatment prior to 10 s PL treatment. Both combination treatments (PL-AW and AW-PL) resulted in synergistic inactivation as E. coli cells were not detectable after treatment, indicating >5 log pathogen reductions. Combination treatments significantly (P < 0.05) reduced spoilage microbial populations on Romaine lettuce and also hindered their growth in storage for 7 days. The firmness and visual quality appearance of lettuce were not significantly (P > 0.05) influenced due to combination treatments. Overall, the results reveal that PL and AW combination treatments can be implemented as a novel approach to enhance microbial safety, quality and shelf life of Romaine lettuce.

Field study of parasitic contamination of fruits, vegetables and leafy greens in the Ecuadorian Andes

Background

Raw vegetables have been considered vehicles of enteroparasites. South American countries are among the most important exporters of fresh vegetables, including Ecuador, which has a tropical climate and soils rich in organic matter that allow it to harvest throughout the year for sale to different countries. The aim of the study was to assess the occurrence of the parasitic contamination of fruits, vegetables and leafy greens grown in an agricultural area of the Ecuadorian Andes.

Methods

A cross-sectional field study was conducted with snowball sampling on 1,416 samples (516 fruits, 488 vegetables, and 412 leafy greens). Each sample were washed with water, and the resulting solution after removing the vegetables, was subjected to 24-hour sedimentation. The concentrated sediment underwent microscopic analysis.

Results

The overall positivity for parasitic contamination was 63.4%, with leafy greens having the highest contamination rate (76.9%) (P<0.0001), surpassing vegetables (67.8%) and fruits (48.4%). Cabbage (100%), onions (84%), and strawberries (60.2%) emerged as the most contaminated within their respective groups. Protozoa were more prevalent (49.6%) than helminths (15.5%) (P<0.0001). Blastocystis sp. (33.5%) ranked highest, followed by Eimeria spp. (26.3%), Entamoeba spp. (10.3%), Giardia spp. (8.3%), Balantidium spp. (6.9%), Cryptosporidium spp. (6.6%), Cyclospora spp. (4.4%), Cystoisospora spp. (0.5%), Strongylida (15.5%), and Ascaris spp. (0.4%).

Conclusions

The study reveals that vegetables and fruits for human consumption from this area of the Ecuadorian Andes are highly contaminated with various parasites, constituting a possible source of infection for humans and animals in this area, or in non-endemic areas where these products are marketed. The finding emphasizes the need for strict hygienic measures in agricultural crops, which will be properly achieved through the treatment of soil, manure and water used for cultivation.

AI-enabled biosensing for rapid pathogen detection: From liquid food to agricultural water

Rapid pathogen detection in food and agricultural water is essential for ensuring food safety and public health. However, complex and noisy environmental background matrices delay the identification of pathogens and require highly trained personnel. Here, we present an AI-biosensing framework for accelerated and automated pathogen detection in various water samples, from liquid food to agricultural water. A deep learning model was used to identify and quantify target bacteria based on their microscopic patterns generated by specific interactions with bacteriophages. The model was trained on augmented datasets to maximize data efficiency, using input images of selected bacterial species, and then fine-tuned on a mixed culture. Model inference was performed on real-world water samples containing environmental noises unseen during model training. Overall, our AI model trained solely on lab-cultured bacteria achieved rapid (< 5.5 h) prediction with 80-100% accuracy on the real-world water samples, demonstrating its ability to generalize to unseen data. Our study highlights the potential applications in microbial water quality monitoring during food and agricultural processes.

Persistence and survival of Cryptosporidium parvum oocysts on lamb's lettuce leaves during plant growth and in washing conditions of minimally-processed salads

Cryptosporidium is the causative agent of cryptosporidiosis, which results, among others, in profuse diarrhoea. Transmission to humans occurs via the faecal-oral route directly by contact with infected hosts or indirectly by waterborne or foodborne routes. For the latter, parasite transmission is closely linked to the oocyst's ability to persist and survive in food matrices. In this study, we evaluated the persistence and survival of Cryptosporidium oocysts in lamb's lettuce: i) during plant growth and ii) in conditions mimicking the industrial washing process applied in minimally-processed vegetables (MPV). Results show that oocysts persisted during the growth of lamb's lettuce, i.e. two months from the 2-leaf stage until the 8-leaf harvest time (-0.89 Log10 of oocysts). However, their survival decreased from as early as one week (-0.61 Log10), and only 6 % of oocysts remained infective at the time of harvest. The washing process had a limited effect on parasite load (<0.5 Log10) and no effect on survival; chlorination of washing water did not improve the efficiency (removal and inactivation) of the process. The ability of C. parvum to persist and survive throughout the food chain may drive its transmission to humans through MPV products. Appropriate management measures should be implemented at each operational level to limit contamination and ensure food safety of fresh produce.

Effects of Plasma on Physical Properties of Water: Nanocrystalline-to-Amorphous Phase Transition and Improving Produce Washing

Washing fresh produce using Plasma-activated water recently became a promising eco-friendly alternative to using chemical additives such as Chlorine. We discuss the produce-washing experiments that illustrate that addition of plasma to washing water is a multi-faced phenomena. Not only it increases the sterilization ability of water by killing pathogens, but it also has improved washibility: the ability to remove pathogens from the cleaning surface. We propose an explanation of these features based on the recently discoveries that many physical and chemical properties of water change their temperature dependence between about 35 and 60 degrees Celsius. In particular, heat conductance, light absorption, and surface tension all change their temperature dependence. These drastic changes were associated with water gradually changing its mesoscopic structure: while at the higher temperatures water is a uniform media (amorphous state), at the temperatures below transition it consists of many nano-to-micro-scale clusters (crystalline state). This transition is similar to the second order phase transition. In the present paper we propose that treating water with non-thermal plasma (adding plasma-created active compounds) can lower the temperature of the transition and thus cause a significant change in such physical quantities as surface tension, viscosity, freezing rate, and wettability and washability.

Evaluation of water-assisted UV-C light and its additive effect with peracetic acid for the inactivation of Listeria monocytogenes, Salmonella enterica and murine norovirus on whole and fresh-cut strawberries during shelf-life

BACKGROUND

The purpose of the present study was to examine the inactivation of Salmonella enterica (50 μL; 10⁹  CFU g^-1 ), Listeria monocytogenes (50 μL; 10⁹  CFU g^-1 ), and murine norovirus (MNV-1; 50 μL; 10⁷ 50% tissue culture infectious dose (TCID₅₀ ) mL^-1 ) on whole and fresh-cut strawberries after 2 min disinfection treatments (water (H₂ O), chlorine 200 mg L^-1 (NaClO), water-assisted ultraviolet-C (UV-C) (WUV), and the combination WUV and 40 mg L^-1 of PA (WUV + PA)) in a water tank (15 L) equipped with 4 UV-C lamps (17.2 W each), and after 7 days of cold storage (4 and 10 °C). For MNV-1, dry UV-C treatment (DUV) was also tested. For all UV-C treatments, an irradiation dose of 1.3 kJ m^-2 was used.

RESULTS

When strawberries were washed with WUV, L. monocytogenes and S. enterica were reduced by 2.8 and 2.2 log CFU g^-1 , respectively. The addition of 40 mg L^-1 of PA to WUV (WUV + PA) increased the reduction range of L. monocytogenes and S. enterica by 1.9 and 0.8 log, respectively. Regarding the wash water, no pathogens were recovered after the WUV + PA treatment (detection limit 50 CFU mL^-1 ). Depending on storage conditions (7 days at 4 or 10 °C), reductions observed were 0.5 to 2.0 log for S. enterica and 0.5 to 3.0 log for L. monocytogenes. The reductions in MNV-1 titer after disinfection treatments ranged from 1.3 to 1.7 log. No significant differences between storage conditions were observed for MNV-1: titers did not decline or were reduced up to 0.3 log after 7 days of cold storage.

CONCLUSION

The three-way action for disinfecting strawberries by UV-C irradiation and PA, plus the physical removal of the microorganisms by agitated water, are effective against foodborne pathogens on strawberries and water wash. During storage, WUV had a larger impact on the inactivation kinetics of S. enterica. Storage had little impact on MNV-1 inactivation. © 2022 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Microbial and Parasitic Contamination of Vegetables in Developing Countries and Their Food Safety Guidelines

The safety of humans is of paramount importance in the vegetable production chain. Evidence of microbial and parasitic contamination of these products poses a great threat to consumers. This is an emerging issue the world is battling, and it is still in the process of unravelling. However, one of the contributing factors responsible for the rapid spread of these pathogens to millions of people among other factors is the distribution of food in our food systems. The purpose of this study was to draw the attention of producers, retailers, consumers, and various stakeholders to the occurrence and potential hazard of these organisms, their contamination origin, and food safety protocols. Among the food system, vegetables play a major role, and their consumption has increased as they form a larger portion of daily diets. This urge for healthy diets coupled with changing dietary habits and human population explosion has therefore accelerated their production. This has resulted in parasitic and microbial contamination gaining grounds in salad vegetables, and as such, a wide range of microbes such as Escherichia coli O157: H7, Listeria monocytogenes, Salmonella spp., Shigella, and Staphylococcus, and parasites such as Giardia lamblia, Entamoeba coli, Entamoeba histolytica, Cystoisospora belli, Toxoplasma gondii, Trichuris trichiura, and Ascaris lumbricoides have been isolated from them. Therefore, major routes for salad vegetable contamination and prevention methods have been pointed out in this review article. The topic of protective countermeasures will also be covered here in this review. Notwithstanding, several control measures have been reported to be effective and efficient in removing or eliminating pathogens, including treatment of irrigation water and fertilizers, use of disinfectants like vinegar and saltwater, irradiation, ozone, and bacteriophages. Though consumption of vegetables and salads is encouraged due to their nutritional advantage, appropriate systems should be put in place to ensure their safety.

A 2019 Outbreak Investigation of Hepatitis A Virus Infections in the United States Linked to Imported Fresh Blackberries

Globally, hepatitis A virus (HAV) is one of the most common agents of acute viral hepatitis and causes approximately 1.4 million cases and 90,000 deaths annually despite the existence of an effective vaccine. In 2019, federal, state, and local partners investigated a multi-state outbreak of HAV infections linked to fresh blackberries sourced from multiple suppliers in Michoacán, Mexico. A total of 20 individuals with outbreak-related HAV infection were reported in seven states, including 11 hospitalizations, and no deaths. The Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and Nebraska State and Douglas County Health Departments conducted a traceback investigation for fresh blackberries reportedly purchased by 16 ill persons. These individuals reported purchasing fresh blackberries from 11 points of service from September 16 through 29, 2019 and their clinical isolates assessed through next-generation sequencing and phylogenetic analysis were genetically similar. The traceback investigation did not reveal convergence on a common grower or packing house within Mexico, but all of the blackberries were harvested from growers in Michoacán, Mexico. FDA did not detect the pathogen after analyzing fresh blackberry samples from four distributors, one consumer, and from nine importers at the port of entry as a result of increased screening. Challenges included gaps in traceability practices and the inability to recover the pathogen from sample testing, which prohibited investigators from determining the source of the implicated blackberries. This multi-state outbreak illustrated the importance of food safety practices for fresh produce that may contribute to foodborne illness outbreaks.

Bioactive compounds in lettuce: Highlighting the benefits to human health and impacts of preharvest and postharvest practices

Lettuce is one of the most commonly consumed leafy vegetables worldwide and is available throughout the entire year. Lettuce is also a significant source of natural phytochemicals. These compounds, including glycosylated flavonoids, phenolic acids, carotenoids, the vitamin B groups, ascorbic acid, tocopherols, and sesquiterpene lactones, are essential nutritional bioactive compounds. This review aims to provide a comprehensive understanding of the composition of health-promoting compounds in different types of lettuce, the potential health benefits of lettuce in reducing the risks of chronic diseases, and the effect of preharvest and postharvest practices on the biosynthesis and accumulation of health-promoting compounds in lettuce.

Role played by the environment in the emergence and spread of antimicrobial resistance (AMR) through the food chain

The role of food-producing environments in the emergence and spread of antimicrobial resistance (AMR) in EU plant-based food production, terrestrial animals (poultry, cattle and pigs) and aquaculture was assessed. Among the various sources and transmission routes identified, fertilisers of faecal origin, irrigation and surface water for plant-based food and water for aquaculture were considered of major importance. For terrestrial animal production, potential sources consist of feed, humans, water, air/dust, soil, wildlife, rodents, arthropods and equipment. Among those, evidence was found for introduction with feed and humans, for the other sources, the importance could not be assessed. Several ARB of highest priority for public health, such as carbapenem or extended-spectrum cephalosporin and/or fluoroquinolone-resistant Enterobacterales (including Salmonella enterica), fluoroquinolone-resistant Campylobacter spp., methicillin-resistant Staphylococcus aureus and glycopeptide-resistant Enterococcus faecium and E. faecalis were identified. Among highest priority ARGs bla CTX -M, bla VIM, bla NDM, bla OXA -48-like, bla OXA -23, mcr, armA, vanA, cfr and optrA were reported. These highest priority bacteria and genes were identified in different sources, at primary and post-harvest level, particularly faeces/manure, soil and water. For all sectors, reducing the occurrence of faecal microbial contamination of fertilisers, water, feed and the production environment and minimising persistence/recycling of ARB within animal production facilities is a priority. Proper implementation of good hygiene practices, biosecurity and food safety management systems is very important. Potential AMR-specific interventions are in the early stages of development. Many data gaps relating to sources and relevance of transmission routes, diversity of ARB and ARGs, effectiveness of mitigation measures were identified. Representative epidemiological and attribution studies on AMR and its effective control in food production environments at EU level, linked to One Health and environmental initiatives, are urgently required.

Molecular characterization of Salmonella spp. isolates from river and dam water, irrigated vegetables, livestock, and poultry manures in Jordan

Background and Aim

Salmonellosis is an important food-borne and zoonotic disease with high morbidity and mortality rates. The objectives of this study were to isolate, serotype, and genetically characterize Salmonella spp. from Zarqa river and King Talal dam waters, vegetables irrigated by such waters, and manure of poultry and livestock farms located in the Zarqa river basin in Jordan. In addition, certain virulence factors and antimicrobial resistance patterns of isolated Salmonella strains were determined.

Materials and Methods

A total of 250 samples were cultured using routine microbiological methods. Suspected Salmonella spp. were identified based on colony morphology and confirmed using biochemical and molecular methods. Virulence genes including invA, stn, and pCT plasmid were detected using multiplex PCR. Phylogenetic analysis was performed using pulsed-field gel electrophoresis (PFGE).

Results

In total, 32/250 (12.8%) Salmonella spp. isolates were recovered from different sources. Of these, the most common serotype was Salmonella subspecies 1 (23 isolates), followed by Salmonella enterica serovar Typhimurium (4 isolates), Salmonella enterica serovar Typhi (3 isolates), and finally Salmonella enterica serovar Enteritidis (2 isolates). The PFGE indicated that Salmonella enterica serovar Typhimurium isolated from poultry manure and from parsley were closely related (84.6%). Salmonella enterica serovar Enteritidis isolated from the dam water was closely related to Salmonella enterica serovar Enteritidis isolated from spearmint (73.8%). Salmonella enterica serovar Typhi isolated from the river and dam water were 100% related to Salmonella enterica serovar Typhi isolated from lettuce. In the antimicrobial sensitivity test, 14 out of 32 (43.8%) isolated Salmonella strains were resistant to two or more of the major antimicrobial agent groups. However, the majority of isolates were sensitive to ceftriaxone, ciprofloxacin, cefuroxime, and gentamicin (97%, 93.8%, and 87.5%, 84.4%, respectively). All isolates were resistant to erythromycin and amoxicillin.

Conclusion

Results of this study indicate a serious potential threat to public health associated with consuming leafy green vegetables grown on the banks of Zarqa river and its dam because of widespread Salmonella spp. contamination. Appropriate monitoring of irrigation water must be applied to reduce the possibility of cross-contamination.

Horticulture and Orchards as New Markets for Manure Valorisation with Less Environmental Impacts

Animal manure management is a real challenge to minimize environmental impacts and ensure that this valuable material is efficiently used in a circular economy context. One of the main limitations for larger use of animal manure as fertilizer is the availability of land to receive it in an area close to the farm. Indeed, animal manure is traditionally used for cereals and animal feed growth, but the soil area occupied with these crops might not be enough to receive all the manure produced and/or part of this soil might have nutrient contents, namely phosphorous, that do not permit further application of manure. Hence, extra land used for other agricultural activities might be an option. The main objective of the present review was to analyse the constraints and solutions to increase the use of manure in horticulture and orchards. Emphasis was given to the legal framework for manure utilization in the EU that might stimulate or restrain such a solution. The main characteristics of manure that might limit or stimulate manure reuse were also described, and the potential of some treatments to valorise manure was analysed. Several examples of alternative uses of manure in horticulture and orchards were examined, and the society and farmers’ acceptance of the proposed solution was addressed.

COVID 19: challenges for virologists in the food industry

The COVID-19 pandemic is not only a challenge for public health and hospitals, but affects many aspects of our societies. This Lilliput minireview deals with problems that the pandemic causes for the food industry, addressing the presence and persistence of SARS-CoV-2 in the food environment, methods of virus inactivation and the protection of the food worker and the consumer. So far food has not been implicated in the transmission of the infection, but social disruptions caused by the pandemic could cause problems with food security.

Ultrasound improves the decontamination effect of thyme essential oil nanoemulsions against Escherichia coli O157: H7 on cherry tomatoes

Development of novel and effective decontamination technologies to ensure the microbiological safety of fresh produce has gained considerable attention, mainly driven by numerous outbreaks. This work presented the first approach regarding to the application of the previously reported hurdle technologies on the sanitization of artificially contaminated cherry tomatoes. Thyme (Thymus daenensis) essential oil nanoemulsion (TEON, 8.28 nm in diameter with a narrow size distribution) was formulated via ultrasonic nanoemulsification, showing remarkably improved antimicrobial activity against Escherichia coli (E. coli) O157:H7, compared to the coarse emulsion. The antimicrobial effect of ultrasound (US), thyme essential oil nanoemulsion (TEON) and the combination of both treatments was assessed against E. coli O157:H7. The remarkable synergistic effects of the combined treatments were achieved, which decontaminated the E. coli populations by 4.49-6.72 log CFU/g on the surface of cherry tomatoes, and led to a reduction of 4.48-6.94 log CFU/sample of the total inactivation. TEON combined with US were effective in reducing the presence of bacteria in wastewater, which averted the potential detrimental effect of cross-contamination resulted from washing wastewater in fresh produce industry. Moreover, the treatments did not noticeably alter the surface color and firmness of cherry tomatoes. Therefore, ultrasound combined with TEON is a promising and feasible alternative for the reduction of microbiological contaminants, as well as retaining the quality characteristics of cherry tomatoes.

Evaluation of a modified method for the detection of Cryptosporidium oocysts on spinach leaves

Despite the infection risk associated with the consumption of contaminated food, techniques for recovering and detecting Cryptosporidium oocysts from fruit and vegetables are generally inadequate due to the variable recovery efficiencies and high reagent costs, such as those presented by ISO 18744:2016 "Microbiology of the food chain -Detection and enumeration of Cryptosporidium and Giardia in fresh leafy green vegetables and berry fruits". Although an improved method for recovering these parasites from Iceberg lettuce, which reported increased recovery efficiency as well as lower costs, has been published, it appears to have limitations for the recovery of Cryptosporidium from saponin-rich leaves such as spinach (Spinacia oleraceae), which have previously been implicated in Cryptosporidium parvum outbreaks. In this study, we refined the method to improve its use with these more challenging samples. The use of alkaline elution buffer (1 M glycine) of different pH values was evaluated for their effectiveness in removing C. parvum from spinach leaves. The refinement of Utaaker's method showed, from spinach leaves inoculated with 100 oocysts, an increased oocyst recovery rate with an overall mean recovery rate of 33.79% ± 2.82%. The emergence of parasitic foodborne illnesses and outbreaks associated with the consumption of fresh produce demonstrates the need for the development of an optimal recovery process for parasites from suspected foods. Results showed that refinement of existing protocols could improve the retrieval of Cryptosporidium oocysts from these more challenging leafy greens.

Microbial Contamination of Fresh Produce: What, Where, and How?

Promotion of healthier lifestyles has led to an increase in consumption of fresh produce. Such foodstuffs may expose consumers to increased risk of foodborne disease, as often they are not subjected to processing steps to ensure effective removal or inactivation of pathogenic microorganisms before consumption. Consequently, reports of ready-to-eat fruit and vegetable related disease outbreak occurrences have increased substantially in recent years, and information regarding these events is often not readily available. Identifying the nature and source of microbial contamination of these foodstuffs is critical for developing appropriate mitigation measures to be implemented by food producers. This review aimed to identify the foodstuffs most susceptible to microbial contamination and the microorganisms responsible for disease outbreaks from information available in peer-reviewed scientific publications. A total of 571 outbreaks were identified from 1980 to 2016, accounting for 72,855 infections and 173 deaths. Contaminated leafy green vegetables were responsible for 51.7% of reported outbreaks. Contaminated soft fruits caused 27.8% of infections. Pathogenic strains of Escherichia coli and Salmonella, norovirus, and hepatitis A accounted for the majority of cases. Large outbreaks resulted in particular biases such as the observation that contaminated sprouted plants caused 31.8% of deaths. Where known, contamination mainly occurred via contaminated seeds, water, and contaminated food handlers. There is a critical need for standardized datasets regarding all aspects of disease outbreaks, including how foodstuffs are contaminated with pathogenic microorganisms. Providing food business operators with this knowledge will allow them to implement better strategies to improve safety and quality of fresh produce.