Meta-analysis of the prevalence of norovirus and hepatitis a virus in berries

Diets rich in fruits and vegetables are widely recommended for their health-enhancing attributes. Among fruits, berries are particularly valued not only for their sharp colour, delicate texture and distinctive taste, but also for their abundant bioactive compounds, which are thought to yield significant antioxidant effects (Lu et al., 2021; Manganaris et al., 2014). These compounds are associated with health benefits, including protection against cardiovascular diseases, specific cancers, type II diabetes, and obesity (Rekhy and McConchie, 2014; Skrovankova et al., 2015).

In spite of their considerable health advantages, the Food and Agriculture Organization of the United Nations (FAO) and World Health Organization (WHO), categorized berries as the second highest concern (following leafy greens) in terms of produce safety (FAO and WHO, 2008). A review conducted by Bozkurt et al. (2021) documented that up until 2018, fresh and frozen berries were involved in 94 outbreaks, resulting worldwide in 23,433 cases of illness. Outbreaks have been linked to the ingestion of berries tainted with different pathogens, such as viruses, bacteria or parasites (Palumbo et al., 2013; Tavoschi et al., 2015), with norovirus (NoV) and hepatitis A virus (HAV) emerging as the predominant viral causal agents.

Berries can be contaminated with pathogens at several stages along the farm-to-fork pathway. This contamination may occur during cultivation in the field due to the use of contaminated water used for irrigation or spraying, as well as through the application of contaminated manure, biosolids, or other natural fertilizers. Post-harvest contamination can result from contact with contaminated harvesting equipment or from unhygienic practices employed by berry pickers in the fields, packing facilities, or supply chain prior to consumption (Bozkurt et al., 2021; Cook et al., 2018; Maunula et al., 2013). Since berries are frequently consumed in their fresh state, undergoing little or no processing, they present a notable health hazard to consumers if contamination occurs (EFSA, 2014a).

Comprehensive data regarding the prevalence of viruses in berries (not linked to foodborne outbreaks) are currently limited and are not yet summarized in a unified manner. Furthermore, prevalence rates in some cases display notable discrepancies across different studies. Given these circumstances, this review attempted to consolidate pooled prevalence data from existing global publications using a meta-analytical approach. The objective is to estimate the potential risk associated with berries as carriers for transmitting NoV and HAV to consumers.

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