236 Novel food packaging particularly after anti-microbial dipping treatments or within nitrogen flushed packages(Francis and O'Beirne, 1997). However, evidence is emerging that levels of virulence may vary greatly among L. monocytogenes strains, and that some serotypes found in MAP produce may be different(and less virulent) than those isolated in food poisoning outbreaks(Beuchat and Ryu, 1997). Further research is required to determine the significance of different L.monocytogenes strains for human health 12.2.2 Clostridium botulinum 1. botulinum is a member of the genus Clostridium, characterised as Gram- positive, rod-shaped, endospore forming, obligate anaerobes (Varnum and Evans, 1991). The foodborne Clostridia have been comprehensively reviewed by McClane(1997) and Dodds and Austin (1997). Cl. botulinum is divided into numerous sub-divisions, based on the serological specificity of the neurotoxin produced, and physiological differences between strains. Human botulism is normally attributed to sub-species antigenic types A, B, E and occasionally type F. Endospores of Cl. botulinum are ubiquitous, being distributed in soils, aquatic sediments and the digestive tract of animals and bird Vegetables are potentially contaminated during growth, harvesting and processing(Rhodehamel, 1992). Despite their ubiquity, a recent study identified only 0.36% of pre-cut MAP vegetables to be contaminated with Cl. botulinum pores (Lilly et al, 1996). In the case of mushrooms, a much lower incidence of Cl. botulinum was reported(Notermans et al, 1989)than had been reported previously(Hauschild et al, 1978), a change attributed to hygienic improve- ments in growing techniques The possibility of growth and toxin production by Cl. botulinum before obvious spoilage has long been of concern in over-wrapped mushrooms (Sugiyama and Yang, 1975)and in vacuum packaged prepared potatoes (O Beirne and Ballantyne, 1987). In addition, sufficiently anoxic conditions are frequently observed in Ma packages where the respiration rate of the product is not matched by the permeability of the packaging used. Anoxic conditions may also develop within MAP produce where edible coatings are used( Guilbert et al., 1996). Highly permeable or perforated over-wrapping films have been used for fresh mushrooms and low storage temperatures and short shelf-lives have been requirements in prepared potato products (IFST, 1990). In the case of other items of vacuum packaged/MAP prepared produce, the data suggest that spoilage is likely to preceed toxin production(Larson et al., 1997; Petran et al n in production to occur prior to obvious spoilage (Larson et al, 1997). However, there is a report linking a botulism outbreak with coleslaw prepared from a MAP dry coleslaw mix Solomon et al., 1990). The short shelf-lives of retail packs and the good control of temperature/modest storage lives of catering packs are likely to minimise such risks, but there is need for vigilance and further research
particularly after anti-microbial dipping treatments or within nitrogen flushed packages (Francis and O’Beirne, 1997). However, evidence is emerging that levels of virulence may vary greatly among L. monocytogenes strains, and that some serotypes found in MAP produce may be different (and less virulent) than those isolated in food poisoning outbreaks (Beuchat and Ryu, 1997). Further research is required to determine the significance of different L. monocytogenes strains for human health. 12.2.2 Clostridium botulinum Cl. botulinum is a member of the genus Clostridium, characterised as Grampositive, rod-shaped, endospore forming, obligate anaerobes (Varnum and Evans, 1991). The foodborne Clostridia have been comprehensively reviewed by McClane (1997) and Dodds and Austin (1997). Cl. botulinum is divided into numerous sub-divisions, based on the serological specificity of the neurotoxin produced, and physiological differences between strains. Human botulism is normally attributed to sub-species antigenic types A, B, E and occasionally type F. Endospores of Cl. botulinum are ubiquitous, being distributed in soils, aquatic sediments and the digestive tract of animals and birds. Vegetables are potentially contaminated during growth, harvesting and processing (Rhodehamel, 1992). Despite their ubiquity, a recent study identified only 0.36% of pre-cut MAP vegetables to be contaminated with Cl. botulinum spores (Lilly et al., 1996). In the case of mushrooms, a much lower incidence of Cl. botulinum was reported (Notermans et al., 1989) than had been reported previously (Hauschild et al., 1978), a change attributed to hygienic improvements in growing techniques. The possibility of growth and toxin production by Cl. botulinum before obvious spoilage has long been of concern in over-wrapped mushrooms (Sugiyama and Yang, 1975) and in vacuum packaged prepared potatoes (O’Beirne and Ballantyne,1987). In addition, sufficiently anoxic conditions are frequently observed in MA packages where the respiration rate of the product is not matched by the permeability of the packaging used. Anoxic conditions may also develop within MAP produce where edible coatings are used (Guilbert et al., 1996). Highly permeable or perforated over-wrapping films have been used for fresh mushrooms and low storage temperatures and short shelf-lives have been requirements in prepared potato products (IFST, 1990). In the case of other items of vacuum packaged/MAP prepared produce, the data suggest that spoilage is likely to preceed toxin production (Larson et al., 1997; Petran et al., 1995), with a probability of 1 in 105 for toxin production to occur prior to obvious spoilage (Larson et al., 1997). However, there is a report linking a botulism outbreak with coleslaw prepared from a MAP dry coleslaw mix (Solomon et al., 1990). The short shelf-lives of retail packs and the good control of temperature/modest storage lives of catering packs are likely to minimise such risks, but there is need for vigilance and further research. 236 Novel food packaging techniques
Reducing pathogen risks in MAP-prepared produce 237 12.2.3 Escherichia coli 0157: H7 E. coli, type species of the type Enterobacteriaceae genus, Escherichia, is a common inhabitant of the gastrointestinal tract of mammals. Despite the commensal status of the majority of strains, pathogenic ula enterohaemorrhagic E. coli o157: H7. have emerged as foodborne pathogens. Gastroenteritis and haemorrhagic are classical symptoms, while complications including thrombocytopenic purpura and haemolytic uraemic syndrome have been documented(Martin et al., 1986) the latter potentially leading to renal failure and death in 3-5% of juvenile cases armani et al, 1983; Griffin and Tauxe, 1991) The principal reservoir of E. coli o157: H7 is believed to be the bovine gastrointestinal tract (Wells et al., 1991; Doyle et al., 1997).Hence, contamination of meat and other food products with faeces is a significant risk factor. Contamination of, and survival of the organism in natural water sources make these also potential sources in the distribution of infection particularly if untreated water is used to wash produce. The potential for cross- contamination during distribution and domestic storage are also of concern Information regarding contamination rates of MAP prepared vegetables is limited. Recent surveys in the UK and US failed to find this pathogen(FDA 2001) 12.2.4 Aeromonas hydrophila Aeromonas hydrophila is a motile, Gram-negative, rod-shaped bacterium in the family Vibrionaceae. It causes a broad spectrum of infections(septicaemia meningitis, endocarditis)in humans, often in immunocompromised hosts, and Aeromonas spp. have been associated epidemiologically with travellers diarrhoea. Its significance as a human pathogen has been reviewed by Altwegg and Geiss(1989) A hydrophila is considered to be ubiquitous and has been isolated from man ources. The best known sources are treated and untreated water and animals associated with water, such as fish and shellfish (ICMSF, 1996). hazen et al 1978)isolated A. hydrophila from the vast majority of aquatic environments. A hydrophila is also associated with soil Brandi et al., 1996)and with a range of foods including fresh vegetables. Foods in which A. hydrophila was isolated were most likely contaminated by water, soil or animal faeces A hydrophila possesses a number of characteristics of concern in relation to lAP prepared vegetables. It is a psychrotroph; it grows slowly at 0oC, but temperatures of 4-5C will support growth in foods. It is also a facultative anaerobe, capable of growing in atmospheres containing low concentrations of oxygen. Marchetti et al.(1992)isolated high counts (10-10/ hydrophila in commercial MAP prepared vegetable salads. Aeromonas spp were also recovered from green salad, coleslaw(Hudson and De Lacy, 1991). pre-made salad samples(Fricker and Tompsett, 1989), mayonnaise salad samples(Knochel and Jeppesen, 1990)and commercial mixed vegetable salads
12.2.3 Escherichia coli O157:H7 E. coli, type species of the type Enterobacteriaceae genus, Escherichia, is a common inhabitant of the gastrointestinal tract of mammals. Despite the commensal status of the majority of strains, pathogenic strains, particularly enterohaemorrhagic E. coli O157:H7, have emerged as highly significant foodborne pathogens. Gastroenteritis and haemorrhagic colitis are classical symptoms, while complications including thrombocytopenic purpura and haemolytic uraemic syndrome have been documented (Martin et al., 1986), the latter potentially leading to renal failure and death in 3–5% of juvenile cases (Karmali et al., 1983; Griffin and Tauxe, 1991). The principal reservoir of E. coli O157:H7 is believed to be the bovine gastrointestinal tract (Wells et al., 1991; Doyle et al., 1997). Hence, contamination of meat and other food products with faeces is a significant risk factor. Contamination of, and survival of the organism in natural water sources make these also potential sources in the distribution of infection, particularly if untreated water is used to wash produce. The potential for crosscontamination during distribution and domestic storage are also of concern. Information regarding contamination rates of MAP prepared vegetables is limited. Recent surveys in the UK and US failed to find this pathogen (FDA, 2001). 12.2.4 Aeromonas hydrophila Aeromonas hydrophila is a motile, Gram-negative, rod-shaped bacterium in the family Vibrionaceae. It causes a broad spectrum of infections (septicaemia, meningitis, endocarditis) in humans, often in immunocompromised hosts, and Aeromonas spp. have been associated epidemiologically with travellers diarrhoea. Its significance as a human pathogen has been reviewed by Altwegg and Geiss (1989). A. hydrophila is considered to be ubiquitous and has been isolated from many sources. The best known sources are treated and untreated water, and animals associated with water, such as fish and shellfish (ICMSF, 1996). Hazen et al. (1978) isolated A. hydrophila from the vast majority of aquatic environments. A. hydrophila is also associated with soil (Brandi et al., 1996) and with a range of foods including fresh vegetables. Foods in which A. hydrophila was isolated were most likely contaminated by water, soil or animal faeces. A. hydrophila possesses a number of characteristics of concern in relation to MAP prepared vegetables. It is a psychrotroph; it grows slowly at 0ºC, but temperatures of 4–5ºC will support growth in foods. It is also a facultative anaerobe, capable of growing in atmospheres containing low concentrations of oxygen. Marchetti et al. (1992) isolated high counts (103 –106 /g) of A. hydrophila in commercial MAP prepared vegetable salads. Aeromonas spp. were also recovered from green salad, coleslaw (Hudson and De Lacy, 1991), pre-made salad samples (Fricker and Tompsett, 1989), mayonnaise salad samples (Knøchel and Jeppesen, 1990) and commercial mixed vegetable salads Reducing pathogen risks in MAP-prepared produce 237
238 Novel food packaging techniques ( Garcia-Gimeno et al, 1996). By contrast, none of the vegetable samples from shops in Sweden was positive for Aeromonas spp (Krovacek et al, 1992) salmonella, a genus of the family Enterobacteriaceae, are characterised as Gram-negative, rod-shaped bacteria. Pathogenic species include S Typhimurium, S. Enteritidis, S. Heidelberg, S. Saint-paul, and S. Montevideo Salmonellae are mesophiles, with optimum temperatures for growth of 35-43.C The growth rate is substantially reduced at <15C, while the growth of most salmonellae is prevented at <7C. Salmonella are facultatively anaerobic capable of survival in low O2 atmospheres These organisms are abundant in faecal material, sewage and sewage-polluted water; consequently they may contaminate soil and crops with which they come into contact. Sewage sludge may contain high numbers of salmonellae and, if used for agricultural purposes, will disseminate the bacterium. Once introduced into the environment, salmonellae remain viable for months (ICMSF, 1996). Potential contamination from workers who handle produce in the field or in processing plants is of great concern(see Section 12. 4). Salmonellae have not generally been found in MAP produce, though they have been isolated from bean-sprouts(20%)in Malaysia(Arumugaswamy et al., 1994) 12.2.6 Yersinia enterocolitica Y. enterocolitica is currently considered to be the most significant genus member with respect to foodborne disease (Varnum and Evans, 1991) Traditional gastrointestinal symptoms, potentially mediated through the activity of a heat-stable enterotoxin, may develop into suppurative and autoimmune complications (Robins-Browne, 1997). The psychrotrophic status of y. enterocolitica is potentially of great significance with regard to refrigerated MAP prepared produce Y. enterocolitica occupies a broad range of ecosystems including the intestinal tract, birds, flies, fish and a variety of terrestrial and aquatic ecosystems. However, most environmental isolates lack virulence markers and are of doubtful significance for human or animal health(Delmas and idon, 1985). Isolation of Yersinia spp. from raw vegetables has been reported at rates ranging from 3.3%(Tassinari et al., 1994)to 46.1%(Delmas and Idon, 1985) although specific isolation rates of pathogenic Y enterocolitica strains are likely to be significantly lower 12.2.7 Campylobacter jejuni Since their principal identification as human gastrointestinal pathogens in the 1970s(Butzler et al., 1973: Skirrow, 1977) members of the thermophilic campylobacters, e.g. C. jejuni, have emerged as major human gastrointestinal
(Garcı´a-Gimeno et al., 1996). By contrast, none of the vegetable samples from shops in Sweden was positive for Aeromonas spp. (Krovacek et al., 1992). 12.2.5 Salmonella Salmonella, a genus of the family Enterobacteriaceae, are characterised as Gram-negative, rod-shaped bacteria. Pathogenic species include S. Typhimurium, S. Enteritidis, S. Heidelberg, S. Saint-paul, and S. Montevideo. Salmonellae are mesophiles, with optimum temperatures for growth of 35–43ºC. The growth rate is substantially reduced at <15ºC, while the growth of most salmonellae is prevented at <7ºC. Salmonella are facultatively anaerobic, capable of survival in low O2 atmospheres. These organisms are abundant in faecal material, sewage and sewage-polluted water; consequently they may contaminate soil and crops with which they come into contact. Sewage sludge may contain high numbers of salmonellae and, if used for agricultural purposes, will disseminate the bacterium. Once introduced into the environment, salmonellae remain viable for months (ICMSF, 1996). Potential contamination from workers who handle produce in the field or in processing plants is of great concern (see Section 12.4). Salmonellae have not generally been found in MAP produce, though they have been isolated from bean-sprouts (20%) in Malaysia (Arumugaswamy et al., 1994). 12.2.6 Yersinia enterocolitica Y. enterocolitica is currently considered to be the most significant genus member with respect to foodborne disease (Varnum and Evans, 1991). Traditional gastrointestinal symptoms, potentially mediated through the activity of a heat-stable enterotoxin, may develop into suppurative and autoimmune complications (Robins-Browne, 1997). The psychrotrophic status of Y. enterocolitica is potentially of great significance with regard to refrigerated MAP prepared produce. Y. enterocolitica occupies a broad range of ecosystems including the intestinal tract, birds, flies, fish and a variety of terrestrial and aquatic ecosystems. However, most environmental isolates lack virulence markers and are of doubtful significance for human or animal health (Delmas and Vidon, 1985). Isolation of Yersinia spp. from raw vegetables has been reported at rates ranging from 3.3% (Tassinari et al., 1994) to 46.1% (Delmas and Vidon, 1985), although specific isolation rates of pathogenic Y. enterocolitica strains are likely to be significantly lower. 12.2.7 Campylobacter jejuni Since their principal identification as human gastrointestinal pathogens in the 1970s (Butzler et al., 1973; Skirrow, 1977) members of the thermophilic campylobacters, e.g. C. jejuni, have emerged as major human gastrointestinal 238 Novel food packaging techniques
Reducing pathogen risks in MAP-prepared produce 239 pathogens(Ketley, 1997). Despite fastidious growth requirements, members of the genus survive at refrigeration temperatures for extended periods within nutrient limited environments. This property, combined with the low infective dose(robinson, 1981) and their microaerophilic nature, indicates the potential gnificance of the genus with respect to refrigerated MAP prepared produce Campylobacter are zoonotic pathogens, being primarily associated with the intestinal tracts of wild and domestic animals(Thomas et al, 1995)and are distributed throughout the environment through vehicles including birds, surface water and flies. Inappropriate food preparation and handling procedures may lead to the cross-contamination of fresh produce with Campylobacter from uncooked meats. and such errors could have resulted in the identification of MAP prepared vegetable products as sources of infection(Bean and Griffin, 1990, Altrkruse et al., 1994). A Canadian study of 296 fresh-cut MAP vegetable products detected no Campylobacter contamination(Odomeru et al, 1997) 12.2.8 Shigella species The genus Shigella is composed of four species, S. dysenteriae, S. sonnei, S boydii and S flexneri, all of which are pathogenic to humans at a low dose of infection. Fruits and vegetables may become contaminated with Shigella via fected food handlers or through the use of contaminated manure and irrigation water(FDA, 2001; Saddik et al, 1985). Several outbreaks of shigellosis have been attributed to contaminated produce(Freudland et al, 1987; see Table 12 and a 1986 outbreak of shigellosis was traced back to commercially distributed shredded packaged lettuce( Davis et al., 1988). Despite their mesophilic status Shigella can survive on lettuce stored at 5C for seven days(Davis et al., 1988) and on coleslaw at 4C for 16 days with numbers decreasing slightly during 12.2.9 Viral and protozoan pathogens The significance of viruses with respect to foodborne disease is clear with the inclusion of Norwalk virus, Hepatitis a virus and other viruses within the top ten causes of foodborne disease outbreaks in the USA(1983-1987, Cliver 1997). Outbreaks caused by hepatitis A virus, calicivirus and Norwalk-like viruses have been associated with the consumption of frozen raspberries and strawberries, melons, lettuce, watercress and diced tomatoes(Beuchat, 1996 Hedberg and Osterholm, 1993; Hutin et al., 1999: Lund and Snowdon, 2000 Rosenblum et al., 1990). Viruses can be transmitted by infected food handlers, through the fecal-oral route, and have been isolated from sewage and untreated water used for crop irrigation. Despite their significance, data regarding the effects of food preparation and storage conditions on the survival and infectivity of viruses is extremely limited, partly through the complexity of viral detection assays. Nonetheless, the potential of several viruses to survive on vegetables for periods exceeding their normal shelf-life has been identified(Badawy et al
pathogens (Ketley, 1997). Despite fastidious growth requirements, members of the genus survive at refrigeration temperatures for extended periods within nutrient limited environments. This property, combined with the low infective dose (Robinson, 1981) and their microaerophilic nature, indicates the potential significance of the genus with respect to refrigerated MAP prepared produce. Campylobacter are zoonotic pathogens, being primarily associated with the intestinal tracts of wild and domestic animals (Thomas et al., 1995) and are distributed throughout the environment through vehicles including birds, surface water and flies. Inappropriate food preparation and handling procedures may lead to the cross-contamination of fresh produce with Campylobacter from uncooked meats, and such errors could have resulted in the identification of MAP prepared vegetable products as sources of infection (Bean and Griffin, 1990; Altrkruse et al., 1994). A Canadian study of 296 fresh-cut MAP vegetable products detected no Campylobacter contamination (Odomeru et al., 1997). 12.2.8 Shigella species The genus Shigella is composed of four species, S. dysenteriae, S. sonnei, S. boydii and S. flexneri, all of which are pathogenic to humans at a low dose of infection. Fruits and vegetables may become contaminated with Shigella via infected food handlers or through the use of contaminated manure and irrigation water (FDA, 2001; Saddik et al., 1985). Several outbreaks of shigellosis have been attributed to contaminated produce (Freudland et al., 1987; see Table 12.1) and a 1986 outbreak of shigellosis was traced back to commercially distributed shredded packaged lettuce (Davis et al., 1988). Despite their mesophilic status, Shigella can survive on lettuce stored at 5ºC for seven days (Davis et al., 1988) and on coleslaw at 4ºC for 16 days with numbers decreasing slightly during storage (Rafii and Lundsford, 1997). 12.2.9 Viral and protozoan pathogens The significance of viruses with respect to foodborne disease is clear with the inclusion of Norwalk virus, Hepatitis A virus and ‘other viruses’ within the top ten causes of foodborne disease outbreaks in the USA (1983–1987; Cliver, 1997). Outbreaks caused by hepatitis A virus, calicivirus and Norwalk-like viruses have been associated with the consumption of frozen raspberries and strawberries, melons, lettuce, watercress and diced tomatoes (Beuchat, 1996; Hedberg and Osterholm, 1993; Hutin et al., 1999; Lund and Snowdon, 2000; Rosenblum et al., 1990). Viruses can be transmitted by infected food handlers, through the fecal-oral route, and have been isolated from sewage and untreated water used for crop irrigation. Despite their significance, data regarding the effects of food preparation and storage conditions on the survival and infectivity of viruses is extremely limited, partly through the complexity of viral detection assays. Nonetheless, the potential of several viruses to survive on vegetables for periods exceeding their normal shelf-life has been identified (Badawy et al., Reducing pathogen risks in MAP-prepared produce 239
Table 12.2 Foodborne infections linked to the consumption of raw fruits and vegetables n Product suspected No. of cases Location Reference Bacteria Shredded cabbage in coleslaw 41 Schlech et al 1983 Raw tomatoes, lettuce and celery ston. US Ho et al. 1986 Shredded cabbage in coleslaw Solomon et al. 1990 3 British Columbia Solomon and Kautter. 1988 Salmonella spp Blostein. 1993 melon Canada Cress sprouts 923 UK O Mahony et al, 1990 Multi-state US Tomatoes 1997 E. coli 0157: H Oregon, US Del Rosario and beuchat, 1995 WHO,1996 Alfalfa sprouts a, US ackers et aL. 1998 Canada Watermelon Sweden Freudlund et 997 Preston et al Shredded lettuce Davis er al,1988987 Lettuce Lettuce Norway, UK, Sweden, Kapperud et al, 1995 310 Multi-state US
Table 12.2 Foodborne infections linked to the consumption of raw fruits and vegetables Pathogen Product suspected No. of cases Location Reference Bacteria L. monocytogenes Shredded cabbage in coleslaw 41 Canada Schlech et al., 1983 Raw tomatoes, lettuce and celery 20 Boston, US Ho et al., 1986 Cl. botulinum Shredded cabbage in coleslaw 4 Florida, US Solomon et al., 1990 Chopped garlic in oil 37 British Columbia Solomon and Kautter, 1988 Salmonella spp. Sliced watermelon 39 Michigan, US Blostein, 1993 Cantaloupe melon 22 Canada Deeks et al., 1998 Cress sprouts 31 UK Feng, 1997 Mung sprouts 143 UK O’Mahony et al., 1990 Tomatoes 85 Multi-state US Susman, 1999 Tomatoes 174 Multi-state US Tauxe, 1997 E. coli O157:H7 Cantaloupe melon 9 Oregon, US Del Rosario and Beuchat, 1995 Radish sprouts 6561 Japan WHO, 1996 Alfalfa sprouts 108 US CDC, 1997a Lettuce 70 Montana, US Ackers et al., 1998 Lettuce 23 Canada Preston et al., 1997 Shigella sonnei Watermelon 15 Sweden Freudlund et al., 1987 Shredded lettuce 347 Texas Davis et al., 1988 Lettuce 140 Texas Martin et al., 1986 Lettuce 118 Norway, UK, Sweden, Kapperud et al., 1995 Spain Parsley 310 Multi-state US CDC, 1999