16-1462-F12016 also saw hepatitis A outbreaks linked to scallops imported from the Philippines (Genki Sushi Outbreak) and strawberries from Egypt (Tropical Smoothie Outbreak).

According to a recent survey by the CDC, approximately 19% of food consumed in the United States is imported, including 97% of fish and shellfish, 50% of fresh fruits, and 20% of fresh vegetables.

The proportion of food that is imported has increased steadily over the past 20 years because of changing consumer demand for a wider selection of food products and increasing demand for produce items year round.

Recently, the CDC reviewed outbreak reports to identify outbreaks associated with an imported food from the inception of the surveillance system in 1973 through 2014.

During 1996–2014, a total of 195 outbreak investigations implicated an imported food, resulting in 10,685 illnesses, 1,017 hospitalizations, and 19 deaths.

Outbreaks associated with imported foods represented an increasing proportion of all foodborne disease outbreaks where a food was implicated and reported (1% during 1996–2000 vs. 5% during 2009–2014). The number of outbreaks associated with an imported food increased from an average of 3 per year during 1996–2000 to an average of 18 per year during 2009–2014.

The most common agents reported in outbreaks associated with imported foods were scombroid toxin and Salmonella; most illnesses were associated with Salmonella and Cyclospora. Aquatic animals were responsible for 55% of outbreaks and 11% of outbreak-associated illnesses. Produce was responsible for 33% of outbreaks and 84% of outbreak-associated illnesses.

Information was available on the region of origin for 177 (91%) outbreaks. Latin America and the Caribbean was the most common region implicated, followed by Asia. Thirty-one countries were implicated; Mexico was most frequently implicated (42 outbreaks). Other countries associated with >10 outbreaks were Indonesia (n = 17) and Canada (n = 11). Fish and shellfish originated from all regions except Europe but were most commonly imported from Asia (65% of outbreaks associated with fish or shellfish). Produce originated from all regions but was most commonly imported from Latin America and the Caribbean (64% of outbreaks associated with produce). All but 1 outbreak associated with dairy products involved products imported from Latin America and the Caribbean.

Hat tip to Dr. Hannah Gould.