Editing Lettuce (section)

== Food-borne illness ==
[[Food-borne illness|Food-borne]] [[pathogen]]s that can survive on lettuce include ''[[Listeria monocytogenes]]'', the causative agent of [[listeriosis]], which multiplies in storage. However, despite high levels of bacteria being found on ready-to-eat lettuce products, a 2008 study found no incidents of food-borne illness related to listeriosis, possibly due to the product's short [[shelf life]], indigenous microflora competing with the ''Listeria'' bacteria or inhibition of bacteria to cause listeriosis.<ref>{{cite journal|title=Precut prepackaged lettuce: a risk for listeriosis?|author1=Hanning, I.B. |author2=Johnson, M.G. |author3=Ricke, S.C |journal=Foodborne Pathogens and Disease|date=December 2008|volume=5|issue=6|pages=731–746|pmid=18847382|doi=10.1089/fpd.2008.0142}}</ref>

Other bacteria found on lettuce include ''[[Aeromonas]]'' species, which have not been linked to any outbreaks; ''[[Campylobacter]]'' species, which cause [[campylobacteriosis]]; and ''[[Yersinia intermedia]]'' and ''[[Yersinia kristensenii]]'' (species of ''[[Yersinia]]''), which have been found mainly in lettuce.<ref name="FDA">{{cite web|url=https://www.fda.gov/Food/ScienceResearch/ResearchAreas/SafePracticesforFoodProcesses/ucm091265.htm|archive-url=https://web.archive.org/web/20121109123857/https://www.fda.gov/Food/ScienceResearch/ResearchAreas/SafePracticesforFoodProcesses/ucm091265.htm|archive-date=2012-11-09|title=Chapter IV. Outbreaks Associated with Fresh and Fresh-Cut Produce. Incidence, Growth, and Survival of Pathogens in Fresh and Fresh-Cut Produce|publisher=US Food and Drug Administration|access-date=19 April 2012|work=Analysis and Evaluation of Preventive Control Measures for the Control and Reduction/Elimination of Microbial Hazards on Fresh and Fresh-Cut Produce|date=12 April 2012}}</ref> ''[[Salmonella]]'' bacteria, including the uncommon ''Salmonella braenderup'' type, have also caused outbreaks traced to contaminated lettuce.<ref>{{cite journal|title=Multiple outbreaks of ''Salmonella braenderup'' associated with consumption of iceberg lettuce|journal=International Journal of Environmental Health Research|volume=22|issue=2|date=April 2012|author1=Gajraj, Roger |author2=Pooransingh, Shalini |author3=Hawker, Jeremy |author4=Olowokure, Babatunde |pages=150–155|doi=10.1080/09603123.2011.613114|pmid=21916661|bibcode=2012IJEHR..22..150G |s2cid=27881973}}</ref> Viruses, including [[hepatitis A]], [[calicivirus]] and a [[Norwalk virus|Norwalk-like]] strain, have been found in lettuce. The vegetable has also been linked to outbreaks of parasitic infestations, including ''[[Giardia lamblia]]''.<ref name="FDA" />

Lettuce has been linked to numerous outbreaks of the bacteria [[E. coli O157:H7|''E.coli'' O157:H7]] and ''[[Shigella]]''; the plants were most likely contaminated through contact with animal<ref>{{cite web|url=http://www.ext.colostate.edu/pubs/foodnut/09369.html|title=Preventing ''E. coli'' from Garden to Plate|publisher=Colorado State University|author1=Davis, J. G.|author2=Kendall, P.|access-date=26 March 2012|archive-url=https://web.archive.org/web/20120305133942/http://www.ext.colostate.edu/pubs/foodnut/09369.html|archive-date=5 March 2012|url-status=dead}}</ref> or human feces.<ref name="Summ">{{cite journal|display-authors=3 |last1=Summerlin III |first1=HN |last2=Pola |first2=CC |last3=McLamore |first3=ES |last4=Gentry |first4=T |last5=Karthikeyan |first5=R |last6=Gomes |first6=CL |title=Prevalence of ''Escherichia coli'' and Antibiotic-Resistant Bacteria During Fresh Produce Production (Romaine Lettuce) Using Municipal Wastewater Effluents |journal=Front. Microbiol. |date=May 20, 2021 |volume=12 |issue=660047 |page=660047 |doi=10.3389/fmicb.2021.660047 |pmid=34093474 |pmc=8172605 |doi-access=free }}</ref> A 2007 study determined that the vacuum cooling method, especially prevalent in the California lettuce industry, increased the uptake and survival rates of ''E. coli'' O157:H7.<ref>{{cite journal|title=Impact of Vacuum Cooling on ''Escherichia coli'' O157:H7 Infiltration into Lettuce Tissue|journal=Applied and Environmental Microbiology |year=2008 |volume=74 |issue=10 |pages=3138–42 |pmid=18344328 |pmc=2394940 |doi=10.1128/AEM.02811-07 |last1=Li|first1=Haiping|last2=Tajkarimi|first2=Mehrdad|last3=Osburn|first3=Bennie I|bibcode=2008ApEnM..74.3138L|author-link3=Bennie Osburn}}</ref> Scientific experiments using treated [[municipal wastewater]] as irrigation for romaine lettuce have shown that the contamination levels of foliage, leachate, and soil with ''E. coli''<ref name="Summ"/> and [[bacteriophage AP205]] (used by researchers as a surrogate for [[enteric virus]]es), respectively, were directly correlated with the presence of these organisms in the irrigation water.<ref name="Summerlin 2">{{cite journal|display-authors=3 |last1=Summerlin III |first1=HN |last2=Pola |first2=CC |last3=Chamakura |first3=KR |last4=Young |first4=R |last5=Gentry |first5=T |last6=McLamore |first6=ES |last7=Karthikeyan |first7=R |last8=Gomes |first8=CL |title=Fate of enteric viruses during leafy greens (romaine lettuce) production using treated municipal wastewater and AP205 bacteriophage as a surrogate |journal= Journal of Environmental Science and Health, Part A|date=2021 |volume=566 |issue=10 |pages=1138–1144 |doi=10.1080/10934529.2021.1968231 |pmid=34427159|bibcode=2021JESHA..56.1138S |s2cid=237282172 }}</ref>

Due to the increase in food demand, the use of treated wastewater effluent for irrigation and animal or human excreta (i.e., manure or biosolids) as soil amendments is increasing.<ref name="Mays">{{cite journal |last1=Mays |first1=C |last2=Garza |first2=GL |last3=Waite-Cusic |first3=J |last4=Radniecki |first4=TS |last5=Navab-Daneshmanda |first5=Tala |title=Impact of biosolids amendment and wastewater effluent irrigation on enteric antibiotic-resistant bacteria – a greenhouse study |journal=Water Res X |date=1 Dec 2021 |volume=13 |issue=100119 |page=100119 |doi=10.1016/j.wroa.2021.100119 |pmid=34585133 |pmc=8452883 |bibcode=2021WRX....1300119M }}</ref> As such, so are the outbreaks of food-borne illnesses. Due to the overuse of antibiotics in farming, the number of pathogens [[antibiotic resistance|resistant]] to antibiotics is increasing,<ref>{{cite journal |last1=Xu |first1=C |last2=Kong |first2=L |last3=Liao |first3=Y |last4=Wu |first4=Q |last5=Liu |first5=H |last6=Wang |first6=X |title=Mini-Review: Antibiotic-Resistant Escherichia coli from Farm Animal-Associated Sources |journal=Antibiotics |date=Nov 2022 |volume=11 |issue=11 |page=1535 |doi=10.3390/antibiotics11111535 |pmid=36358190 |pmc=9686710|doi-access=free }}</ref> one of these being ''AR E.coli'', which has been found on lettuce irrigated with wastewater.<ref>{{cite journal |last1=O'Flaherty |first1=E |last2=Solimini |first2=AG |last3=Pantanella |first3=F |last4=De Giusti |first4=M |last5=Cummins |first5=E |title=Human exposure to antibiotic resistant-Escherichia coli through irrigated lettuce |journal= Environment International|date=Jan 2019 |volume=122 |pages=270–280 |doi= 10.1016/j.envint.2018.11.022 |pmid=30449627 |doi-access=free |bibcode=2019EnInt.122..270O }}[https://reader.elsevier.com/reader/sd/pii/S016041201831643X?token=6585D28FDB16B77BA3788376DE943682C9ACD372BB9D47147E75615A28E1D9FDE92B07AE629981AED95FDED694DB104F&originRegion=us-east-1&originCreation=20230412164332 PDF]</ref>

Pathogens found on lettuce are not specific to lettuce (though some ''E. coli'' strains have affinity for Romaine). But, unlike other vegetables which tend to be cooked, lettuce is eaten raw, thus food-borne outbreaks associated with it are more frequent and affect a larger number of people.<ref>{{cite journal |last1=Gudda |first1=FO |last2=Waigi |first2=MG |last3=Odinga |first3=ES |last4=Yang |first4=B |last5=Carter |first5=L |last6=Gao |first6=Y |title=Antibiotic-contaminated wastewater irrigated vegetables pose resistance selection risks to the gut microbiome |journal= Environmental Pollution|date=Sep 2020 |volume=264 |pages=114752 |doi=10.1016/j.envpol.2020.114752 |pmid=32417582|bibcode=2020EPoll.26414752G |s2cid=218679107 }}</ref>