54 sick: Salmonella from contact with dairy calves

The U.S. Centers for Disease Control reports an on-going outbreak of multidrug-resistant Salmonella Heidelberg infections from contact with dairy calves:

  • Since the last update on August 2, 2017, eight more ill people have been reported from six states.
  • CDC, several states, and the U.S. Department of Agriculture’s Animal and Plant Health Inspection Service (USDA-APHIS) are investigating a multistate outbreak of multidrug-resistant SalmonellaHeidelberg infections.
  • A total of 54 people infected with the outbreak strains of SalmonellaHeidelberg have been reported from 15 states.
    • Seventeen (35%) people have been hospitalized. No deaths have been reported.
    • Illnesses started on dates ranging from January 27, 2015 to October 15, 2017.
    • Eighteen (33%) people in this outbreak are children under the age of 5.
  • Epidemiologic and laboratory investigations linked ill people in this outbreak to contact with calves, including dairy calves.
    • In interviews, ill people answered questions about contact with animals and foods eaten in the week before becoming ill. Of the 54 people interviewed, 34 (63%) reported contact with dairy calves or other cattle. Some of the ill people interviewed reported that they became sick after their dairy calves became sick or died.
    • Ongoing surveillance in veterinary diagnostic laboratories showed that calves in several states continue to get sick with the outbreak strains of multidrug resistant Salmonella ‎
    • Information collected earlier in the outbreak indicated that most of the calves came from Wisconsin. Regulatory officials in several states are now tracing the origin of the calves that are linked to the newer illnesses.
    • Whole genome sequencing has identified multiple antimicrobial resistance genes in outbreak-associated isolates from 43 ill people, 87 isolates from cattle, and 11 isolates from animal environments.
    • These findings match results from standard antibiotic resistance testingmethods used by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory on clinical isolates from eight ill people in this outbreak.
    • All eight isolates from ill people were resistant to amoxicillin-clavulanic acid, ampicillin, cefoxitin, ceftriaxone, streptomycin, sulfisoxazole, and tetracycline, and had reduced susceptibility to ciprofloxacin. Seven isolates were also resistant to trimethoprim-sulfamethoxazole. Five were also resistant to nalidixic acid. Three were also resistant to chloramphenicol. All eight isolates tested were susceptible to azithromycin and meropenem.

 

634 sickened in national Salmonella outbreak, 2013-14, from one poultry company (Foster Farms)

In June 2012, the Oregon Health Authority and the Washington State Department of Health noted an increase in the number of Salmonella enterica serotype Heidelberg clinical isolates sharing an identical pulsed-field gel electrophoresis (PFGE) pattern. In 2004, this pattern had been linked to chicken from Foster Farms by the Washington State Department of Health; preliminary 2012 interviews with infected persons also indicated exposure to Foster Farms chicken.

In the end, at least 634 Americans were sickened with Salmonella Heidelberg, all linked to Foster Farms, from 2013-2014.

Here is the scientific write-up of that outbreak, or I’m completely wrong in my interpretation and will blame the painkillers.

Importance

This large outbreak of foodborne salmonellosis demonstrated the complexity of investigating outbreaks linked to poultry products. The outbreak also highlighted the importance of efforts to strengthen food safety policies related to Salmonella in the chicken parts and has implications for future changes within the poultry industry.

Objective

To investigate a large multistate outbreak of multidrug resistant Salmonella Heidelberg infections.

Design

Epidemiologic and laboratory investigations of patients infected with the outbreak strains of Salmonella  Heidelburg and traceback of possible food exposures.

Setting

United States. Outbreak period was March 1, 2013 through July 11, 2014

Patients

A case was defined as illness in a person infected with a laboratory-confirmed Salmonella Heidelburg with 1 of 7 outbreak pulsed-field gel electrophoresis (PFGE) Xbal pattern with illness onset from March 1, 2013 through July 11, 2014. A total of 634 case-patients were identified through passive surveillance; 200/528 (38%) were hospitalized, none died.

Results

Interviews were conducted with 435 case-patients interviewed with a focused questionnaire, 201 (74%) reported eating chicken prepared at home. Among case-patients with available brand information, 152 (87%) of 175 patients reported consuming Company A brand chicken. Antimicrobial susceptibility testing was completed on 69 clinical isolates collected from case-patients; 67% were drug resistant, including 24 isolates (35%) that were multidrug resistant. The source of Company A brand chicken consumed by case-patients was traced back to 3 California production establishments from which 6 of 7 outbreak strains were isolated.

Conclusions

Epidemiologic, laboratory, traceback, and environmental investigations conducted by local state, and federal public health and regulatory officials indicated that consumption of Company A chicken was the cause of this outbreak. The outbreak involved multiple PFGE patterns, a variety of chicken products, and 3 production establishments, suggesting a reservoir for contamination upstream from the production establishments. Sources of bacteria and genes responsible for resistance, such as farms providing birds for slaughter environmental reservoir on farms that raise chickens, might explain how multiple PFGE patterns were linked to chicken form 3 separate production establishments and many different poultry products.

National outbreak of multidrug resistant Salmonella Heidelberg infections linked to a single poultry company

PLoS ONE, 11(9), doi:10.1371/journal.pone.0162369

http://forum.efeedlink.com/contents/07-05-2017/976bf575-6e5a-4067-a763-0598a663f48d-c784.html

 

Consumers as critical control point: 190 sickened in multistate outbreak of human Salmonella Heidelberg infections linked to kosher broiled chicken livers

I don’t know who eats broiled chicken livers, but enough people do that 190 of them got sick in six states since April 2011, from Salmonella Heidelberg in the partially-cooked product.

The outbreak is another talking point in the point-the-finger approach to foodborne illness: dumb consumers, you should read the labels and know these thingies need to be fully cooked. And watch the cross-contamination.

• A total of 190 illnesses due to Salmonella Heidelberg with the outbreak pattern were reported from 6 states.
• The number of ill persons identified in each state the product is distributed to is as follows: New York (109), New Jersey (62), Pennsylvania (10), Maryland (6), Ohio (2), and Minnesota (1).
• Collaborative investigative efforts of state, local, and federal public health and regulatory agencies indicated that a product labeled as “kosher broiled chicken livers” is the source of this outbreak.
• Contaminated "kosher broiled chicken livers" were recalled from grocery stores but may still be in consumers’ homes.
• Among persons for whom information is available in in these states, ill persons ranged in age from <1 to 97 years with a median age of 14 years. Forty-nine percent were female. Among the 154 ill persons with available information, 30 (19%) were hospitalized. No deaths were reported.

Consumers may have incorrectly thought the use of the word “broiled” in the label meant the chicken liver was ready-to-eat; however, these chicken livers must be fully cooked before eating. How the hell would anyone know?

77 sick from salmonella in ground turkey

At least 77 illnesses of Salmonella Heidelberg in 26 states have been linked to consumption of ground turkey products.

The U.S. Department of Agriculture’s (USDA) Food Safety and Inspection Service (FSIS) is issuing a public health alert due to concerns about illnesses caused by Salmonella Heidelberg that may be associated with use and consumption of ground turkey.

This public health alert was initiated after continuous medical reports, ongoing investigations and testing conducted by various departments of health across the nation determined there is an association between consumption of ground turkey products and an estimated 77 illnesses reported in 26 states. The illnesses were linked through an epidemiologic investigation and PFGE analyses by state health departments and The Centers for Disease Control and Prevention (CDC).

FSIS reminds consumers of the critical importance of following package cooking instructions for frozen or fresh ground turkey products and general food safety guidelines when handling and preparing any raw meat or poultry. In particular, while cooking instructions may give a specific number of minutes of cooking for each side of the patty in order to attain 165 °F internal temperature, consumers should be aware that actual time may vary depending on the cooking method (broiling, frying, or grilling) and the temperature of the product (chilled versus frozen) so it is important that the final temperature of 165 °F must be reached for safety. Please do not rely on the cooking time for each side of the patty, but use a food thermometer.

Ground turkey and ground turkey dishes should always be cooked to 165 °F internal temperature as measured with a food thermometer; leftovers also should be reheated to 165 °F. The color of cooked poultry is not always a sure sign of its safety. Only by using a food thermometer can one accurately determine that poultry has reached a safe minimum internal temperature of 165 °F throughout the product. Turkey can remain pink even after cooking to a safe minimum internal temperature of 165 °F. The meat of smoked turkey is always pink.

Better than ‘piping hot.’ But watch out for the cross-contamination.