{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T20:09:38Z","timestamp":1792267778668,"version":"4.4.0"},"reference-count":40,"publisher":"Cambridge University Press (CUP)","issue":"14","license":[{"start":{"date-parts":[[2017,9,14]],"date-time":"2017-09-14T00:00:00Z","timestamp":1505347200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n                  <jats:p>\n                    Each year in the United States, an estimated 525 000 infections, 2900 hospitalizations, and 82 deaths are attributed to consumption of pork. We analyzed the epidemiology of outbreaks attributed to pork in the United States reported to the Centers for Disease Control and Prevention (CDC) 1998\u20132015. During that period, 288 outbreaks were attributed to pork, resulting in 6372 illnesses, 443 hospitalizations, and four deaths. The frequency of outbreaks attributed to pork decreased by 37% during this period, consistent with a decline in total foodborne outbreaks. However, outbreaks attributed to pork increased by 73% in 2015 (19 outbreaks) compared with the previous 3 years (average of 11 outbreaks per year), without a similar increase in total foodborne outbreaks. Most (&gt;99%) of these outbreaks occurred among people exposed in the same state. The most frequent etiology shifted from\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    toxin during 1998\u20132001 (19%) to\n                    <jats:italic>Salmonella<\/jats:italic>\n                    during 2012\u20132015 (46%). Outbreaks associated with ham decreased from eight outbreaks per year during 1998\u20132001, to one per year during 2012\u20132015 (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0\u00b701). Additional efforts are necessary to reduce outbreaks and sporadic illnesses associated with pork products.\n                  <\/jats:p>","DOI":"10.1017\/s0950268817002114","type":"journal-article","created":{"date-parts":[[2017,9,14]],"date-time":"2017-09-14T02:45:32Z","timestamp":1505357132000},"page":"2980-2990","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":42,"title":["Outbreaks attributed to pork in the United States, 1998\u20132015"],"prefix":"10.1017","volume":"145","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9584-7041","authenticated-orcid":false,"given":"J. L.","family":"SELF","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. E.","family":"LUNA-GIERKE","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"FOTHERGILL","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. G.","family":"HOLT","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. R.","family":"VIEIRA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2017,9,14]]},"reference":[{"key":"S0950268817002114_ref1","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12162"},{"key":"S0950268817002114_ref20","unstructured":"Centers for Disease Control and Prevention. Guide to Confirming an Etiology in Foodborne Disease Outbreak (http:\/\/www.cdc.gov\/foodsafety\/outbreaks\/investigating-outbreaks\/confirming_diagnosis.html). Accessed 17 March 2016."},{"key":"S0950268817002114_ref39","unstructured":"United States Department of Agriculture. Compliance Guidelines For Meeting Lethality Performance Standards For Certain Meat And Poultry Products (http:\/\/www.fsis.usda.gov\/wps\/wcm\/connect\/212e40b3-b59d-43aa-882e-e5431ea7035f\/95-033F-Appendix-A.pdf?MOD=AJPERES). Accessed 22 July 2016."},{"key":"S0950268817002114_ref11","first-page":"819","article-title":"Yersinia enterocolitica infections during the holidays in black families \u2013 Georgia","volume":"39","year":"1990","journal-title":"Morbidity and Mortality Weekly Report: Topics in Minority Health"},{"key":"S0950268817002114_ref18","unstructured":"United States Department of Agriculture. Livestock and meat domestic data: livestock, dairy, and poultry outlook (http:\/\/www.ers.usda.gov\/data-products\/livestock-meat-domestic-data.aspx#26105). Accessed 28 June 2016."},{"key":"S0950268817002114_ref33","unstructured":"United States Department of Agriculture. Sampling results for FSIS regulated products (https:\/\/www.fsis.usda.gov\/wps\/portal\/fsis\/topics\/data-collection-and-reports\/microbiology\/sampling-project-results\/results). Accessed 20 December 2016."},{"key":"S0950268817002114_ref15","doi-asserted-by":"publisher","DOI":"10.4315\/0362-028X-71.6.1162"},{"key":"S0950268817002114_ref12","doi-asserted-by":"publisher","DOI":"10.3201\/eid0908.030103"},{"key":"S0950268817002114_ref5","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6514a4"},{"key":"S0950268817002114_ref28","first-page":"72686","article-title":"HACCP plan reassessment for not-ready-to-eat comminuted poultry products and related agency verification procedures","volume":"77","year":"2012","journal-title":"Federal Register"},{"key":"S0950268817002114_ref19","unstructured":"United States Department of Agriculture. Food Availability (Per Capita) Data System (http:\/\/www.ers.usda.gov\/data-products\/food-availability-(per-capita)-data-system\/food-availability-documentation.aspx). Accessed 9\/2\/2016."},{"key":"S0950268817002114_ref21","doi-asserted-by":"publisher","DOI":"10.4315\/0362-028X-60.6.701"},{"key":"S0950268817002114_ref40","first-page":"491","article-title":"Vital signs: foodborne norovirus outbreaks \u2013 United States, 2009\u20132012","volume":"63","author":"Hall","year":"2014","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"S0950268817002114_ref4","doi-asserted-by":"publisher","DOI":"10.3201\/eid1903.111866"},{"key":"S0950268817002114_ref29","unstructured":"Food and Drug Administration. National Antimicrobial Resistance Monitoring System 2012 Retail Meat Report (http:\/\/www.fda.gov\/downloads\/AnimalVeterinary\/SafetyHealth\/AntimicrobialResistance\/NationalAntimicrobialResistanceMonitoringSystem\/UCM442212.pdf). Accessed 7 December 2016."},{"key":"S0950268817002114_ref25","doi-asserted-by":"crossref","first-page":"19580","DOI":"10.2807\/ese.15.22.19580-en","article-title":"Multiresistant Salmonella enterica 4,[5],12:I:- in Europe: a new pandemic strain?","volume":"15","author":"Hopkins","year":"2010","journal-title":"Eurosurveillance"},{"key":"S0950268817002114_ref35","doi-asserted-by":"publisher","DOI":"10.1016\/j.foodcont.2004.06.003"},{"key":"S0950268817002114_ref36","doi-asserted-by":"publisher","DOI":"10.1016\/j.foodres.2011.02.050"},{"key":"S0950268817002114_ref13","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis053"},{"key":"S0950268817002114_ref10","first-page":"1","volume-title":"Morbidity and Mortality Weekly Report: Surveillance Summaries","volume":"64","author":"Wilson","year":"2002"},{"key":"S0950268817002114_ref16","unstructured":"Centers for Disease Control and Prevention. Foodborne Outbreak Tracking and Reporting (http:\/\/www.cdc.gov\/foodsafety\/fdoss\/). Accessed 24 June 2016."},{"key":"S0950268817002114_ref24","volume-title":"The Bad Bug Book: Foodborne Pathogenic Microorganisms and Natural Toxins Handbook"},{"key":"S0950268817002114_ref32","unstructured":"United States Department of Agriculture. Salmonella Action Plan (http:\/\/www.fsis.usda.gov\/wps\/wcm\/connect\/aae911af-f918-4fe1-bc42-7b957b2e942a\/SAP-120413.pdf?MOD=AJPERES). Accessed 28 January 2016."},{"key":"S0950268817002114_ref14","doi-asserted-by":"publisher","DOI":"10.1086\/381585"},{"key":"S0950268817002114_ref31","unstructured":"U. S. Food and Drug Administration. NARMS integrated report: 2012\u20132013 (http:\/\/www.fda.gov\/downloads\/AnimalVeterinary\/SafetyHealth\/AntimicrobialResistance\/NationalAntimicrobialResistanceMonitoringSystem\/UCM453398.pdf). Accessed 19 December 2016."},{"key":"S0950268817002114_ref30","unstructured":"U. S. Food and Drug Administration. 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National Outbreak Reporting System (NORS) Guidance Document (http:\/\/www.cdc.gov\/nors\/pdf\/NORS-Guidance_FINAL508c.pdf). Accessed 22 January 2016."},{"key":"S0950268817002114_ref3","doi-asserted-by":"publisher","DOI":"10.4315\/0362-028X-70.11.2676"},{"key":"S0950268817002114_ref38","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2015.09.018"},{"key":"S0950268817002114_ref2","doi-asserted-by":"publisher","DOI":"10.4315\/0362-028X.JFP-12-341"},{"key":"S0950268817002114_ref7","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-10-122"},{"key":"S0950268817002114_ref8","first-page":"1","volume-title":"Morbidity and Mortality Weekly Report Surveillance Summaries","volume":"52","author":"Roy","year":"2002"},{"key":"S0950268817002114_ref37","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268817001406"},{"key":"S0950268817002114_ref23","unstructured":"Centers for Disease Control and Prevention. National Antimicrobial Resistance Monitoring System (NARMS) 2014 Human Isolates Surveillance Report (https:\/\/www.cdc.gov\/narms\/pdf\/2014-annual-report-narms-508c.pdf). 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