Researchers have found that Salmonella caused the most outbreaks linked to meat products in China over a 15-year period.

From 2002 to 2017, China recorded 2,815 outbreaks caused by meat and meat products, resulting in 52,122 illnesses, 25,361 hospitalizations, and 96 deaths. However, before 2011, there was no mandatory reporting to the foodborne disease surveillance system. 

Livestock meat was the most commonly implicated food category and improper processing was the main contributing factor.

Bacteria were the most common pathogenic cause of outbreaks and Clostridium botulinum was the top cause of death.

The proportion of meat products in the daily lives of Chinese people is increasing, according to the study published in Foodborne Pathogens and Disease.

Incidents by meat type and agent

Outbreaks were seasonal and concentrated from May to September because of the high temperature and humid climate, with August being the peak month.

They were mainly in the eastern coastal and southern region, with the leading provinces for outbreaks being Shandong Province, Jiangsu Province, and Guangdong Province. The top provinces for illnesses were Jiangsu Province, Yunnan Province, and Guangdong Province.

Livestock meat, including pigs, cattle, sheep, horses, rabbits, and other animals, was the top category behind outbreaks. This was followed by poultry meat, prefabricated meat products, and cooked meat. Livestock meat also caused the most illnesses, hospitalizations, and deaths.

Donkey meat was linked to 38 outbreaks and dog meat to 28 incidents.

Pork was the most common item leading to outbreaks, illnesses, and hospitalizations while beef was behind the most deaths. Among poultry meat, chicken caused the most outbreaks, illnesses, hospitalizations, and deaths.

Bacteria were the top reason for outbreaks followed by chemical contaminants. Salmonella was the most common cause, followed by Vibrio parahaemolyticus, Staphylococcus aureus, nitrites, Bacillus cereus, E. coli, and banned drugs. Salmonella was behind the most illnesses and hospitalizations.

Factors behind and places of outbreaks

Since 2012, nitrites have been banned from purchasing, storing, and use in Chinese food service establishments but they are misused as salt leading to food poisoning in households and restaurants.

The most common banned drug was clenbuterol. Since 1997, it has been prohibited in livestock production, but poisoning still occurs occasionally, said scientists.

Almost 900 outbreaks were caused by an unknown agent. A few were due to animal or plant toxicants, viruses and parasites.

The top contributing factor associated with outbreaks was improper processing. This was followed by various issues involving food handling, poor storage, and cross-contamination. More than 40 were due to contamination of personnel or equipment.

Households were the most common location of all outbreaks, followed by restaurants and canteens. Staff canteens were the most common type. More than 100 outbreaks were linked to street stalls or rural banquets. Restaurants took top spot in terms of illnesses and hospitalizations but households were first for deaths.

“In China, bacteria are the most critical pathogenic factors, so localities should strengthen meat and meat product regulation according to the epidemiological characteristics of foodborne disease outbreaks related to meat and meat products. The food safety awareness of residents should be improved by strengthening food safety health education, thus reducing the occurrence of foodborne diseases related to meat and meat products,” said researchers.