The 10 Riskiest Foods
The US Food and Drug Administration (FDA) identified the 10 riskiest foods in October 2009. This list identified the 10 foods regulated by the FDA that have accounted for 40% of all foodborne illnesses in the United States since 1990. These foods have cause 50,000 illnesses, some ending in death. However, many cases of foodborne illness are never reported.
In 1999, the Centers for Disease Control and Prevention (CDC) stated that for every case of clinically diagnosed and reported salmonellosis, another 38 cases are never proven and/or reported. The list included the following foods.
1. Leafy greens
Accounting for 24% of all illnesses in the FDA’s top 10 list, leafy greens most often are contaminated with either E coli, norovirus, or salmonella. Top reasons for contamination include unwashed hands of a handler, improper preparation, and cross-contamination. Contact with wild animals, manure, or contaminated water prior to harvest also is cause for concern.
Most illnesses from eggs are caused by salmonella. Regulations for cleaning and inspecting eggs have helped matters considerably, but if chickens are infected with Salmonella enteritidis, the chicken’s ovaries become infected and eggs are contaminated before the shells are even formed. In July 2010, regulations were changed for producers with 50,000 or more egg-laying hens to include controls to prevent Salmonella enteritidis. Catered events, prisons, and buffets are where most cases of salmonella from eggs originate, likely because of improper holding temperatures.
Many people have become ill from the scombroid illness after eating contaminated tuna. Fresh tuna decays quickly after it is caught, and if appropriate measures are not taken, tuna begins to release natural scombrotoxins. Cooking, freezing, smoking, curing, or canning cannot kill the toxin. More than 65% of illness related to tuna ingestion is tied to eating the fish at restaurants. Tuna also is linked to salmonella and norovirus.
Oysters sometimes are harvested in water that is contaminated with norovirus. If oysters are eaten raw or undercooked, they can lead to gastroenteritis. The most dangerous pathogens found in oysters are vibrio, which can kill immunocompromised people.
Outbreaks from foodborne illness usually are linked to dishes such as potato salad, which contain many other ingredients. Most illnesses are caused by E coli or salmonella, making it obvious that cross-contamination is a common problem when preparing dishes that contain potatoes. Shigella and Listeria monocytogenes, which also are linked to potato-containing dishes, point to improper handling and preparation by infected food preparers and improper cleaning of surfaces, such as deli counters.
Cheese can become contaminated, most often with salmonella, during production or processing. The vast majority of infections are caused by consumption of unpasteurized cheese. Pregnant women should avoid soft cheeses, which can carry Listeria monocytogenes, which frequently cause miscarriage even if the mother does not have any symptoms of illness. People who are immunocompromised and elderly people also are advised to avoid soft cheeses because of the risk of contracting listeriosis.
7. Ice cream
The most common reason for ice cream causing illness is people using undercooked eggs when making ice cream at home. Soft ice cream, like soft cheeses, can become a breeding ground for Listeria monocytogenes. The most famous case of contaminated ice cream, however, was caused by a truck that was used to haul both raw, unpasteurized eggs and pasteurized ice cream mix.
Salmonella can enter tomato plants through the roots or flowers and then can easily enter the fruit. It is very difficult to kill the salmonella without cooking the fruit. Norovirus also is sometimes found in tomatoes. Seventy percent of all illnesses associated with tomatoes were contracted in restaurants.
The CDC and the FDA strongly recommend that the elderly, children, and immunocompromised individuals avoid consumption of raw sprouts, which may carry E coli or salmonella because of a variety of reasons, including improper handling.
The most common cause of illness related to berry ingestion is the cyclospora parasite, which does not resolve itself without a round of antibiotics. A 1997 outbreak of hepatitis A, during which thousands of students became ill, was tied to consumption of frozen strawberries. The contamination may have occurred because of an infected farmworker from Baja, CA.
References and recommended readings
Center for Science in the Public Interest. Leafy greens, eggs, & tuna top list of riskiest FDA-regulated foods: CSPI urges Senate to pass Food Safety Modernization Act. Available at: http://www.cspinet.org/new/200910061.html. Accessed February 19, 2012.
Center for Science in the Public Interest. The Ten Riskiest Foods Regulated by the U.S. Food and Drug Administration. Available at: http://cspinet.org/new/pdf/cspi_top_10_fda.pdf. Accessed February 19, 2012.
Review Date 2/12