Food safety types investigate multistate foodborne illness outbreak from possible turkey products

A new foodborne illness outbreak taking place in multiple states is, according to Food Safety Magazine, being investigated by federal officials, with turkey products identified as the likely source.

The U.S. Department of Agriculture’s Food Safety and Inspection Service indicated the cause of the outbreak in its investigation table as “Salmonella Hadar, turkey suspect.”

A U.S. Centers for Disease Control and Prevention (CDC) spokeswoman confirmed that the CDC is investigating the outbreak. As of March 15, there have been 22 patients reported across nine states. 

Turkey has been the source of food poisoning outbreaks in the United States in both 2018 and 2019 investigations, involving Salmonella Reading and Salmonella Schwarzengrund, respectively. According to the CDC, the 2019 Salmonella outbreak sickened at least seven people in three states.

The 2018 outbreak involved at least 358 people in the United States who became sick, across 42 states. One death was confirmed, and the illnesses were linked to raw human and pet foods from many sources, including Jennie-O turkey, which recalled some of its products. At the same time in 2018, Canadian officials investigated an outbreak of Salmonella Reading linked to poultry products. Testing showed the same strain on both side of the U.S./Canada border.

Beaver fever, er, giardiasis in the US

That’s what we call it in Ontario. Beaver poop in water consumed by thirsty hikers

Great source of Giardi. The Centers for Disease Control writes:

What is already known about this topic?

Giardiasis is a diarrheal disease caused by the parasite Giardia duodenalis, the most common cause of intestinal parasite infections in the United States.

Reported giardiasis outbreaks (N = 111), by mode of transmission* and year of earliest illness onset date — United States, 2012–2017

What is added by this report?

During 2012–2017, public health officials from 26 states reported 111 giardiasis outbreaks involving 760 cases. Leading causes of outbreaks were waterborne and person-to-person exposures. Private residences and child care facilities were the most common settings of giardiasis outbreaks across all transmission modes.

What are the implications for public health practice?

To prevent and control giardiasis outbreaks, CDC recommends prompt diagnosis, maintaining good hand hygiene, cleaning and disinfecting home environments and child care facilities, and monitoring water quality in private wells.

Giardiasis Outbreaks—United States, 2012-2017

Morbidity and Mortality Weekly Report

Erin E. Conners, PhD1,2; Allison D. Miller, MPH1; Neha Balachandran, MPH3; Brittany M. Robinson, MPH1; Katharine M. Benedict, DVM, PhD1

https://www.cdc.gov/mmwr/volumes/70/wr/mm7009a2.htm?s_cid=mm7009a2_e&ACSTrackingID=USCDC_921-DM51192&ACSTrackingLabel=This%20Week%20in%20MMWR%20-%20Vol.%2070%2C%20March%205%2C%202021&deliveryName=USCDC_921-DM51192

Vaccines still work: Estimated Medicaid costs associated with hepatitis A outbreak

What is already known about this topic?

Widespread outbreaks of hepatitis A among persons who use illicit drugs (injection and noninjection) have increased in recent years. Hepatitis A is a vaccine-preventable disease.

What is added by this report?

During January 1, 2018–July 31, 2019, hepatitis A–related clinical costs among West Virginia Medicaid beneficiaries ranged from $1.4 million to $5.6 million. Among those with a substance use disorder diagnosis, costs ranged from $1.0 million to $4.4 million.

What are the implications for public health practice?

In addition to insight on preventing illness, hospitalization, and death, the results from this study highlight the potential financial cost jurisdictions might incur when Advisory Committee on Immunization Practices recommendations for hepatitis A vaccination, especially among persons who use illicit drugs, are not followed.

Estimated Medicaid costs associated with hepatitis A outbreak—West Virginia, 2018-2019

Morbidity and Mortality Weekly Report

Samantha J. Batdorf, MPH1; Megan G. Hofmeister, MD2; Tamara C. Surtees, MPH3; Erica D. Thomasson, PhD1,4; Shannon M. McBee, MPH1; Nathan J. Pauly, PhD5

https://www.cdc.gov/mmwr/volumes/70/wr/mm7008a2.htm?s_cid=mm7008a2_e&ACSTrackingID=USCDC_921-DM50427&ACSTrackingLabel=This%20Week%20in%20MMWR%20-%20Vol.%2070,%20February%2026,%202021&deliveryName=USCDC_921-DM50427

(Viruses are not cells, but they need to cells to reproduce.)

Listeria outbreak linked to queso fresco made by El Abuelito Cheese Inc.

Fast Facts

Illnesses: 11

Hospitalizations: 10

Deaths: 1

States: 4

Recall: Yes

Investigation status: Active

The U.S. Centers for Disease Control reports that on February 28, El Abuelito Cheese Inc. recalled quesillo and requeson cheesesexternal icon, in addition to the previously recalled queso fresco cheesesexternal icon. These cheeses were made or packed at the same facility as the contaminated queso fresco.

Queso Fresco with sell-buy dates through 03/28/21

Brand names: El Abuelito, Rio Grande, Rio Lindo

The El Abuelito brand 5-lb product may be repacked by stores and sold without a brand label or labeled with a different brand.

Quesillo (Oaxaca, string cheese) with sell-buy dates through 04/16/21

Brand names: El Abuelito, El Viejito, El Paisano, El Sabrosito, La Cima, Quesos Finos, San Carlos, Ideal

Many of the quesillo products were sold in bulk (5-14 lb bags). These products may be repacked by stores and sold without a brand label or labeled with a different brand.

Requeson (ricotta) with sell-buy dates through 03/14/21

Brand names: El Abuelito, El Viejito

These products were sold in 12-oz clamshell containers.

What You Should Do

Do not eat recalled queso fresco, quesillo, or requeson cheeses. Throw them away or return them to where you bought them.

22 sick, 1 dead: Small turtles linked to Salmonella outbreak

I’ve written before about small turtles as my only pet when I was a young child.

The Centers for Disease Control and Prevention is reporting that a Salmonella outbreak in seven states is being linked back to small turtles.

According to the notice posted on Tuesday, there have been 22 reported illnesses linked to the outbreak, including eight hospitalizations and one death.

The CDC says that pet turtles carry germs in their droppings even when they appear clean and healthy, which can spread in their tank and anything they come into contact with.

People can get sick from touching the turtle and anything in its environment after touching their mouth and swallowing the Salmonella germs, the CDC says.

The CDC also asks people to avoid kissing or snuggling turtles and to not eat or drink around them.

7 sick: Listeria (listeriosis) in Hispanic-style fresh and soft cheeses

The U.S. Centers for Disease Control (CDC), public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are collecting different types of data to investigate a multistate outbreak of Listeria monocytogenes infections.

Epidemiologic data show that Hispanic-style fresh and soft cheeses may be contaminated with Listeria and may be making people sick. A specific type or brand of Hispanic-style fresh and soft cheese has not yet been identified.

As of February 11, 2021, seven people infected with the outbreak strain of Listeria monocytogenes have been reported from four states (see map). Illnesses started on dates ranging from October 20, 2020, to January 22, 2021, with six recent illnesses in 2021 (see timeline).

The true number of sick people in an outbreak is likely higher than the number reported, and the outbreak may not be limited to the states with known illnesses. This is because some people recover without medical care and are not tested for Listeria. In addition, recent illnesses may not yet be reported as it usually takes 2 to 4 weeks to determine if a sick person is part of an outbreak.

Sick people range in age from 45 to 75 years, with a median age of 61. Six people are Hispanic, and 43% are female. All seven people have been hospitalized. No deaths have been reported.

State and local public health officials are interviewing people about the foods they ate in the month before they got sick. Of the four people interviewed, three reported eating at least one type of Hispanic-style fresh and soft cheeses and all three reported eating queso fresco. Public health officials are continuing to interview sick people to try to identify a specific type or brand of cheese.

Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause foodborne illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS).

WGS showed that bacteria from sick people’s samples are closely related genetically. This means that people in this outbreak likely got sick from the same food.

State officials are testing samples of Hispanic-style fresh and soft cheeses that they collected from stores where sick people report purchasing cheeses from.

CDC is advising people at higher risk for severe Listeria illness to not eat Hispanic-style fresh and soft cheeses (like queso fresco) until we learn more and to contact their healthcare provider right away if they have any symptoms of severe Listeria illness after eating Hispanic-style fresh and soft .

Foodborne illness source attribution estimates for 2018 for Salmonella, Escherichia coli O157, Listeria monocytogenes, and Campylobacter using multi-year outbreak surveillance data, United States, December 2020

The U.S. Centers for Disease Control and Prevention reported in Dec.2020 that each year in the U.S.an estimated 9 million people get sick, 56,000 are hospitalized, and 1,300 die of foodborne disease caused by known pathogens. These estimates help us understand the scope of this public health problem. However, to develop effective prevention measures, we need to understand the types of foods contributing to the problem.

The Interagency Food Safety Analytics Collaboration (IFSAC) is a tri-agency group created by the Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), and the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS). IFSAC developed a method to estimate the percentages of foodborne illness attributed to certain sources using outbreak data from 1998 through the most recent year for four priority pathogens: Salmonella, Escherichia coli O157, Listeria monocytogenes, and Campylobacter. IFSAC described this method and the estimates for 2012 in a report, peer-reviewed journal article, and at a public meeting. IFSAC derived the estimates for 2018 using the same method used for the 2012 estimates, with some modifications. The data came from 1,459 foodborne disease outbreaks that occurred from 1998 through 2018 and for which each confirmed or suspected implicated food was assigned to a single food category. The method relies most heavily on the most recent five years of outbreak data (2014 – 2018). Foods are categorized using a scheme IFSAC created that classifies foods into 17 categories that closely align with the U.S. food regulatory agencies’ classification needs. Salmonella illnesses came from a wide variety of foods.

More than 75% of Salmonella illnesses were attributed to seven food categories: Chicken, Seeded Vegetables (such as tomatoes), Pork, Fruits, Other Produce (such as nuts), Eggs and Turkey. E. coli O157 illnesses were most often linked to Vegetable Row Crops (such as leafy greens) and Beef. Over 75% of illnesses were linked to these two categories. Listeria monocytogenes illnesses were most often linked to Dairy products and Fruits. More than 75% of illnesses were attributed to these two categories, but the rarity of Listeria monocytogenes outbreaks makes these estimates less reliable than those for other pathogens. Non-Dairy Campylobacter illnesses were most often linked to Chicken. Over 75% of non-Dairy foodborne illnesses were attributed to Chicken, Other Seafood (such as shellfish), and Turkey, with Campylobacter illnesses most often linked to Chicken. An attribution percentage for Dairy is not included because, among other reasons, most foodborne Campylobacter outbreaks were associated with unpasteurized milk, which is not widely consumed, and we think these over-represent Dairy as a source of illness caused by Campylobacter. Removing Dairy illnesses from the calculations highlights important sources of illness from widely consumed foods, such as Chicken.

This collaborative effort to provide annual attribution estimates continues IFSAC’s work to improve foodborne illness source attribution, which can help inform efforts to prioritize food safety initiatives, interventions, and policies for reducing foodborne illnesses. These consensus estimates allow all three agencies to take a consistent approach to identifying food safety priorities to protect public health. For more information on IFSAC projects visit https://www.cdc.gov/foodsafety/ifsac/projects/index.html.

No hair, sharper blog, more love: US E. coli investigation details

Yeah, I fell again a couple of weeks ago, lost a lot of blood, so the doc wanted to have a look at the two contusions.

She started shaving the back of my head, the long hair that gives me strength, and eventually my friend and I told the doc, “Let’s try something different and take it all off.”

There are those who call me Uncle Fester.

The U.S. Centers for Disease Control, public health and regulatory officials in several states, the U.S. Food and Drug Administration (FDA), and the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS) are collecting different types of data to identify the food source of a multistate outbreak of E. coli O157:H7 infections.

As of February 1, 2021, a total of 16 people infected with the outbreak strain have been reported from 5 states.

Illnesses started on dates ranging from December 23, 2020, to January 7, 2021.

Sick people range in age from 10 to 95 years, with a median age of 31, and 88% are female. Of 12 people with information available, 9 have been hospitalized. Of 11 people with information, 3 developed a type of kidney failure called hemolytic uremic syndrome (HUS). One death has been reported from Washington.

State and local public health officials are interviewing people to find out what foods they ate in the week before they got sick.

What’s so funny ‘bout peace, love and understanding? CDC could further strengthen efforts to identify and respond to foodborne illnesses

The U.S. Government Accountability Office writes the Centers for Disease Control and Prevention estimates that 1 in 6 people in the U.S. get food poisoning each year—leading to 128,000 hospital stays and 3,000 deaths. CDC has seen an increase in foodborne illness outbreaks that span multiple states in recent years.

CDC has developed tools to identify possible multistate outbreaks, investigate their cause, and communicate about them to the public. But it needs to balance the need to communicate quickly against the need to provide accurate and specific information.

Our recommendations include that CDC publicize its decision-making process for communicating about multistate outbreaks.

The continuing prevalence of shiga-toxin producing E. coli in produce

Chris Koger of The Packer writes the U.S. Centers for Disease Control and Prevention has added 16 more people to an E. coli outbreak investigation of unknown origin, bringing the total to 39. Cases have been reported in 18 states; there have been no deaths.

According to the CDC’s Nov. 23 update, “Of the 22 ill people interviewed to date, all reported eating a variety of leafy greens, like spinach (16), romaine lettuce (15), iceberg lettuce (12), and mixed bag lettuce (8). No single type or brand of leafy greens or other food item has been identified as the source of this outbreak. CDC is not advising people avoid any particular food at this time.

Dole Fresh Vegetables, Inc. is voluntarily recalling a limited number of cases of organic romaine hearts. The products being recalled are Dole™ Organic Romaine Hearts 3pk (UPC 0-71430-90061-1), combined English/French packaging, with Harvested-On dates of 10-23-20 and 10-26-20, and Wild Harvest Organic Romaine Hearts (UPC 7-11535-50201-2), with Harvested-On dates of 10-23-20 and 10-26-20.  The recall is being conducted due to a possible health risk from E. coli in the two products.  Dole Fresh Vegetables is coordinating closely with regulatory officials. No illnesses have been reported to date in association with the recall. 

Pathogenic E. coli can cause diarrhea, severe stomach cramps and vomiting.  Most people recover within a week, but some illnesses can last longer and can be more severe.

This precautionary recall notification is being issued due to an isolated instance in which a package of Dole™ Organic Romaine Hearts – 3pk yielded a positive result for pathogenic non-O157 E.coli STEC in a routine sample collected at a retail store by the Michigan Department of Agriculture and Rural Development. There is no indication at this time that this positive result is related to any illnesses nor consumer complaints and it is not associated with the strains connected to the ongoing outbreaks currently under regulatory investigation.