![]() At that time, no specific food was linked to the outbreak.ĭ. As a result, the multistate investigation conducted by FDA, federal, state, and local partners continued to determine what specific food caused the illnesses in Minnesota and in other states. Although the Minnesota Department of Health announced an outbreak of illnesses with a common point of service, this was only one point of service in the overall outbreak. The CORE Investigation Table was first implemented in 2020.Ĭ. A source was considered confirmed if it was implicated by epidemiologic plus traceback or laboratory data.ī. Typically, a food source was classified as suspected if it was implicated only by epidemiologic data. Outbreak food products are classified as suspected or confirmed on the basis of the strength of supporting epidemiologic, traceback, and laboratory data collected during the investigation. Outbreaks of Foodborne Illnesses Linked to Cashews and Cashew-Containing Products, 2013–2022Ī. 17 These consequences underscore the importance of applying appropriate food safety practices when producing new plant-based alternatives to control the presence of, and prevent their contamination with, Salmonella spp. Although most people recover without treatment, as of 2021, CDC estimated that over 26,000 people are hospitalized and approximately 420 persons die each year in the U.S. ![]() Food and Drug Administration (FDA), specifically the Center for Food Safety and Applied Nutrition's (CFSAN's) Coordinated Outbreak Response and Evaluation (CORE) Network, in collaboration with the Centers for Disease Control and Prevention (CDC) and state and local public health and regulatory partners, investigates foodborne illness outbreaks, including those caused by Salmonella spp. in the past ten years, including those in which cashew-containing products have been implicated as a vehicle. Salmonella contamination of such products has resulted in several notable outbreaks in the U.S. If a kill step is not applied in the U.S., it can result in the consumption of raw nuts or nut products. 13 Some nuts, including cashews, are imported as a "raw" product (i.e., one that has not been subjected to a process to adequately reduce pathogens, such as a kill step). 10,11,12 Virtually all cashews are imported to the U.S., with the top sources of cashew nuts in 2020 being Vietnam, India, and Brazil. have long been associated with low-moisture foods such as nuts and nut-derived products, with varying prevalence (0.20–0.55 percent) observed in tree nuts, including cashews, at retail. They are shaped and may be processed similarly to dairy milk-based cheese, such as by fermentation. 5,8 Nut-based cheese alternatives are also products made from the liquid extracts of nuts with the addition of other ingredients. 7 The fluid obtained from the breakdown of nuts soaked in water and homogenized is similar to the appearance of cow's milk. In addition to water and plant extracts, products may contain other ingredients such as sweeteners, salt, oils, functional ingredients, flavorings, and vitamin and mineral fortifications. Nut-based milk alternatives are generally made from liquid-based extracts of plant materials. However, in February 2023, FDA published a draft guidance on the labeling of plant-based milk alternatives and the use of voluntary nutrient statements. has not established compositional requirements for any nut-based milk alternatives or nut-based cheese alternatives. 3 This increase in popularity has led to a variety of plant-based alternative foods being available to consumers, including those made from almonds, soy, coconut, oats, and emerging products made of lupine and cashews. Annual retail sales of plant-based cheese alternatives increased 85 percent from 2018 to 2021. In the U.S., retail sales of plant-based milk and dairy alternatives totaled $2.6 and $2.1 billion dollars, respectively, in 2021. 1,2 Plant-based dairy food alternatives are also increasing in popularity and are capturing a small but robust part of the global food market. has markedly increased, due to their nutritional properties and perceived health benefits. Over the past 40 years, consumption of cashews and other nuts in the U.S.
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