Raw is risky: Outbreak of multidrug-resistant Salmonella infections linked to raw chicken products

The U.S. Centers for Disease Control (CDC) and public health and regulatory officials in several states are investigating a multistate outbreak of multidrug-resistant Salmonella infections linked to raw chicken products. The U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS) is monitoring the outbreak.

Always handle raw chicken carefully and cook it thoroughly to prevent food poisoning. This outbreak is a reminder that raw chicken can have germs that spread around food preparation areas and make you sick.

CDC is not advising that consumers avoid eating properly cooked chicken, or that retailers stop selling raw chicken products.

CDC advises consumers to follow these steps to help prevent Salmonella infection from raw chicken:

Wash your hands. Salmonella infections can spread from one person to another if hands have Salmonella germs on them. Wash hands before and after preparing or eating food, after contact with animals, and after using the restroom or changing diapers.

Cook raw chicken thoroughly to kill harmful germs. Chicken breasts, whole chickens, and ground poultry, including chicken burgers and chicken sausage, should always be cooked to an internal temperature of 165°F to kill harmful germs. Leftovers should be reheated to 165°F. Use a food thermometer to check, and place it in the thickest part of the food.

Don’t spread germs from raw chicken around food preparation areas. Washing raw poultry before cooking is not recommended. Germs in raw chicken can spread to other foods and kitchen surfaces. Thoroughly wash hands, counters, cutting boards, and utensils with warm, soapy water after they touch raw chicken. Use a separate cutting board for raw chicken and other raw meats if possible.

CDC does not recommend feeding raw diets to pets. Germs like Salmonella in raw pet food can make your pets sick. Your family also can get sick by handling the raw food or by taking care of your pet.

CDC will update the advice to consumers and retailers if more information comes available, such as a supplier or type of raw chicken product linked to illness.

Symptoms of Salmonella Infection

Most people infected with Salmonella develop diarrhea, fever, and stomach cramps 12 to 72 hours after being exposed to the bacteria.

The illness usually lasts 4 to 7 days, and most people recover without treatment.

In some people, the diarrhea may be so severe that the patient needs to be hospitalized. Salmonella infection may spread from the intestines to the bloodstream and then to other places in the body.

In rare cases, Salmonella infection can cause death unless the person is treated promptly with antibiotics.

Children younger than 5 years of age, adults older than 65 years of age, and people with weakened immune systems are more likely to have severe illness.
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44 sick from Salmonella Enteritidis linked to shell eggs from Gravel Ridge Farms

Amy and I helped make breakfast for 120 grade 4 and 5 school kids this morning.

The kids had their annual sleepover Friday night at the school, in tents, with activities and endless gossip until late night or early morning (that’s Hubbell being busy in the background).

We arrived about 5:50 a.m., ready to make breakfast.

The menu was bacon and egg sandwiches on rolls, brown beans, and juice, along with vegan and halal alternatives, reflecting the multi-cultural nature of our neighbourhood and Sorenne’s school.

Amy worked in the kitchen, prepping rolls and keeping things rolling, while me and another dude worked the grill.

We cooked the bacon we had, then cleaned the grill thoroughly out of respect for others, and then the eggs.

There were no runny eggs.

There was no cross-contamination.

There wasn’t going to be some sorta Salmonella outbreak on my watch.

And Australia still has an egg problem.

What you do at home is your own business, but when cooking for 120 children, risk management is a little different.

For example, the U.S. Food and Drug Administration, along with the Centers for Disease Control and Prevention (CDC) and state and local partners, investigated a multi-state outbreak of Salmonella Enteritidis illnesses linked to shell eggs.

As of October 25, 2018, there were 44 illnesses associated with shell eggs from Gravel Ridge Farms, in Cullman Alabama. The CDC has announced that this outbreak appears to be over.

The FDA advises consumers not to eat recalled shell eggs produced by Gravel Ridge Farms. Consumers who have purchased these products should discard the eggs or return them to the store for a refund. For a complete list of stores, visit the recall notice.

Consumers should always practice safe food handling and preparation measures. Wash hands, utensils, and surfaces with hot, soapy water before and after handling raw eggs and raw egg-containing foods. Dishes containing eggs should be cooked to 160° F. For recipes that call for eggs that are raw or undercooked when the dish is use either eggs that have been treated to destroy Salmonella, by pasteurization or another approved method, or pasteurized egg products.

On September 5, 2018, the FDA and Alabama Department of Agriculture and Industry began an inspection at Gravel Ridge Farms and collected environmental and egg samples for laboratory testing. The results were used to confirm that Salmonella Enteritidis isolates collected from environmental and egg samples taken at the farm were genetically related to isolates obtained from ill persons.

As a result of the outbreak, Gravel Ridge Farms voluntarily recalled cage-free, large eggs and removed the eggs from the shelves at grocery stores, restaurants, and other retail locations.

Twenty-six of 32 (81%) people interviewed reported eating restaurant dishes made with eggs. These restaurants reported using shell eggs in the dishes eaten by ill people.

The whole restaurant dishes-made-with-raw-eggs-thing, such as mayo and aioli is problematic. My 9-year-old knows to ask how the aioli is made if she gets fish, and the server always comes back and says, chef makes it only with raw eggs, and she knows enough to say no.

But we are the poop family (it’s on the front door).

I had a couple of thermometers in my back pack but were not necessary.

Cute guinea pigs or Salmonella factories

In December 2017, the Colorado Department of Public Health and Environment reported two human Salmonella Enteritidis infections in persons with exposure to pet guinea pigs. The guinea pigs had been purchased from two separate pet stores, belonging to a single chain, and supplied by a common distributor located in California. Clinical isolates were indistinguishable by pulsed-field gel electrophoresis (PFGE), suggesting the infections were related. This PFGE pattern was previously seen in a 2010 multistate outbreak linked to contact with pet guinea pigs (1). An investigation was initiated to determine the number of patients affected and to identify the source of human illnesses.

A case was defined as Salmonella Enteritidis infection with a clinical isolate having an identical PFGE pattern to those from the Colorado isolates and closely related to a guinea pig isolate by whole genome sequencing (WGS), and with onset of clinical signs on or after January 1, 2015. State health departments were asked to review recent Salmonella Enteritidis illness records for patient exposure to guinea pigs. In addition, the U.S. Department of Agriculture’s National Veterinary Services Laboratories was queried for isolates from guinea pigs that matched the outbreak strain. All isolates underwent WGS using high-quality single nucleotide polymorphism (SNP) analysis. An isolate from the 2010 outbreak was sequenced for comparison. Guinea pig purchase invoices were used to trace guinea pigs with an epidemiologic link to human illness back to the distributor of origin.

Nine cases in humans were identified from eight states, including two cases in Colorado and one each in Iowa, Indiana, Massachusetts, Michigan, New York, Vermont, and Virginia. Five of eight patients reported exposure to guinea pigs. Onset dates ranged from July 15, 2015, to December 15, 2017. The median patient age was 12 years (range = 1–70 years). Five patients were female. One patient was hospitalized, and no deaths were reported. Six isolates submitted to veterinary diagnostic laboratories from ill guinea pigs and one isolate from a patient’s guinea pig were sequenced and found to be closely related to the outbreak strain. Including the 2010 isolate tested for comparison, all isolates were within 38 SNPs by WGS.

Traceback information was available for four guinea pigs purchased from two large pet store chains (Figure). The two distributors supplying guinea pigs to pet stores during this outbreak received guinea pigs from multiple wholesalers; however, a single common wholesaler was mentioned by both. This wholesaler also supplied guinea pigs that were associated with cases during the 2010 outbreak.

Following the 2010 outbreak, recommendations including environmental testing were made to the wholesaler regarding Salmonella prevention; however, the actions were not implemented. Failure to implement recommended prevention measures might have contributed to recurrence of the outbreak. To enhance compliance with recommendations made in this outbreak, CDC developed a document containing prevention measures aimed at reducing the prevalence of Salmonella in guinea pig colonies intended for use in the pet industry. Content was also posted on the CDC website to increase consumer awareness of risk for Salmonella infection linked to pet guinea pigs. Recommendations to pet owners during this outbreak focused on proper hand hygiene. Recommendations to distributors and wholesalers included routine monitoring of guinea pigs for Salmonella through diagnostic testing, recordkeeping to aid in traceback, and evaluating husbandry and environmental sanitation practices of guinea pig breeders to reduce the prevalence of Salmonella and other zoonotic diseases of concern to the pet industry (2).

1Epidemic Intelligence Service, CDC; 2Division of Foodborne, Waterborne and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC; 3Colorado Department of Public Health and Environment; 4Vermont Department of Health; 5National Veterinary Services Laboratories, U.S. Department of Agriculture, Ames, Iowa; 6CAITTA, Inc., Herndon, Virginia.

References

Bartholomew ML, Heffernan RT, Wright JG, et al. Multistate outbreak of Salmonella entericaserotype enteritidis infection associated with pet guinea pigs. Vector Borne Zoonotic Dis 2014;14:414–21. CrossRef PubMed

CDC. Multistate outbreak of Salmonella Enteritidis infections linked to pet guinea pigs.

Atlanta, GA: US Department of Health and Human Services, CDC; 2018. https://www.cdc.gov/salmonella/guinea-pigs-03-18/index.html

120 sick from Salmonella linked to JBS ground beef

The U.S. Centers for Disease Control (CDC), public health and regulatory officials in several states, and the U.S. Department of Agriculture’s Food Safety and Inspection Service are investigating a multistate outbreak of Salmonella Newport infections linked to ground beef produced by JBS Tolleson, Inc.

Reported Cases: 120

States: 22

Hospitalizations: 33

Deaths: 0

Recall: Yes

On October 4, 2018, JBS Tolleson, Inc., of Tolleson, Arizona, recalled approximately 6.5 million pounds of beef products, including ground beef, which may be contaminated with Salmonella Newport.

Recalled beef products were produced and packaged from July 26, 2018, to September 7, 2018 and were shipped to retailers nationwide under many brand names.

Products are labeled with the establishment number “EST. 267.” This is usually found inside the USDA mark of inspect

Sixty-three more ill people from 14 states were added to this investigation since the last update on October 4, 2018. Six more states reported ill people: Hawaii, Kansas, New Mexico, Oklahoma, Texas, and Washington.

As of October 23, 2018, 120 people infected with the outbreak strain of Salmonella Newport have been reported from 22 states.

Party on: It’s Global Handwashing Day- October 15

Kids, kids. It’s global handwashing day.

Join CDC expert, Dr. Vincent Hill for a Facebook Live handwashing demonstration on October 15 at 11:00 AM EDT in observance of Global Handwashing Day. Global Handwashing Day is an occasion to support a global and local culture of handwashing with soap, and promote handwashing with soap as an easy and affordable way to prevent disease in communities around the world.

The Facebook Live presentation will feature a handwashing contest between two volunteers to help viewers understand the importance of proper handwashing techniques. Tune in via CDC Facebook at www.facebook.com/cdcgov

I don’t do hashtags.

2299 confirmed sick from Cyclospora in US from multiple outbreaks May 1-Aug. 30, 2018

Shannon M. Casillas, Carolyne Bennett and Anne Straily of the U.S. Centers for Disease Control write in Morbidity and Mortality Weekly that cyclosporiasis is an intestinal illness caused by the parasite Cyclospora cayetanensis through ingestion of fecally contaminated food or water.

Symptoms of cyclosporiasis might include watery diarrhea (most common), loss of appetite, weight loss, cramping, bloating, increased gas, nausea, and fatigue. Typically, increased numbers of cases are reported in the United States during spring and summer; since the mid-1990s, outbreaks have been identified and investigated almost every year. Past outbreaks have been associated with various types of imported fresh produce (e.g., basil, cilantro, and raspberries) (1). There are currently no validated molecular typing tools* to facilitate linking cases to each other, to food vehicles, or their sources. Therefore, cyclosporiasis outbreak investigations rely primarily on epidemiologic data.

The 2018 outbreak season is noteworthy for multiple outbreaks associated with different fresh produce items and the large number of reported cases. Two multistate outbreaks resulted in 761 laboratory-confirmed illnesses. The first outbreak, identified in June, was associated with prepackaged vegetable trays (containing broccoli, cauliflower, and carrots) sold at a convenience store chain in the Midwest; 250 laboratory-confirmed cases were reported in persons with exposures in three states (illness onset mid-May–mid-June) (2). The supplier voluntarily recalled the vegetable trays (3).

The second multistate outbreak, identified in July, was associated with salads (containing carrots, romaine, and other leafy greens) sold at a fast food chain in the Midwest; 511 laboratory-confirmed cases during May–July occurred in persons with exposures in 11 states who reported consuming salads (4). The fast food chain voluntarily stopped selling salads at approximately 3,000 stores in 14 Midwest states that received the implicated salad mix from a common processing facility (5).

The traceback investigation conducted by the Food and Drug Administration (FDA) did not identify a single source or potential point of contamination for either outbreak.

In addition to the multistate outbreaks, state public health authorities, CDC, and FDA investigated cyclosporiasis clusters associated with other types of fresh produce, including basil and cilantro. Two basil-associated clusters (eight confirmed cases each) were identified among persons in two different states who became ill during June. Investigation of one cluster, for which the state health department conducted an ingredient-specific case-control study, found consumption of basil to be significantly associated with illness. A formal analytic study was not conducted for the other cluster, but all patients reported consuming basil. Three clusters associated with Mexican-style restaurants in the Midwest have resulted in reports of 53 confirmed cases in persons who became ill during May–August. Analytic studies were conducted for two clusters; consumption of cilantro was found to be significantly associated with illness in both. Although a formal analytic study was not possible for the third cluster, all 32 identified patients reported consuming cilantro at the restaurant. FDA traceback of the basil and cilantro from these clusters is ongoing. Additional clusters associated with Mexican-style restaurants were identified in multiple states; but investigations to determine a single vehicle of infection were unsuccessful because of small case counts, limited exposure information, or because fresh produce items (including cilantro) were served as components of other dishes (e.g., in salsa).

Many cases could not be directly linked to an outbreak, in part because of the lack of validated molecular typing tools for C. cayetanensis. As of October 1, 2018, a total of 2,299 laboratory-confirmed cyclosporiasis cases† have been reported by 33 states in persons who became ill during May 1–August 30 and did not have a history of international travel during the 14 days preceding illness onset. Approximately one third of these cases were associated with either the convenience store chain outbreak or the fast food chain outbreak.

The median patient age was 49 years (range = <1–103 years) and 56% were female (1,288 of 2,285). At least 160 patients were hospitalized; no deaths have been reported.

The 2,299 domestically acquired, laboratory-confirmed cases reported in persons who became ill during May–August 2018 are markedly higher than the numbers of cases reported for the same period in 2016 (174) and 2017 (623). This increase might be due, in part, to changes in diagnostic testing practices, including increased use of gastrointestinal molecular testing panels. CDC is working with state public health partners to determine whether and to what extent changes in testing practices might have contributed to increased case detection and reporting.

Consumers should continue to enjoy fresh produce as part of a well-balanced diet. To reduce risk from most causes of foodborne illness and other contaminants, CDC recommends washing fresh fruits and vegetables with clean running water; however, washing, including use of routine chemical disinfection or sanitizing methods, is unlikely to kill C. cayetanensis. Persons with diarrheal illness that lasts >3 days or who have any other concerning symptoms should see a health care provider if they think they might have become ill from eating contaminated food.

Acknowledgments

Contributing state and local public health department personnel; Food and Drug Administration

14 sick from Salmonella linked to Gravel Ridge Farms Shell Eggs

On September 8, 2018, Gravel Ridge Farms recalled cage-free large eggs because they might be contaminated with Salmonella.

Do not eat, sell, or serve recalled Gravel Ridge Farms cage-free large eggs.

Gravel Ridge Farms recalled packages of a dozen and 2.5 dozen eggs in cardboard containers with UPC code 7-06970-38444-6.

Recalled eggs have “best if used by” dates of July 25, 2018 through October 3, 2018.

Recalled eggs were sold in grocery stores and to restaurants in Alabama, Georgia, and Tennessee. For a full list of locations where recalled eggs were sold, visit the FDA website.

Return any Gravel Ridge Farms eggs to the store for a refund or throw them away, regardless of the “best if used by” date. Even if some eggs were eaten and no one got sick, do not eat them.

Wash and sanitize drawers or shelves in refrigerators where recalled eggs were stored. Follow these five steps to clean your refrigerator.

Contact a healthcare provider if you think you got sick from eating recalled Gravel Ridge Farms shell eggs.

Consumers and restaurants should always handle and cook eggs safely to avoid foodborne illness from raw eggs. It is important to handle and prepare all fresh eggs and egg products carefully.

Eggs should be cooked until both the yolk and white are firm. Scrambled eggs should not be runny. Egg dishes such as casseroles and quiches should be cooked to an internal temperature of 160°F or hotter.

Make sure that foods that contain raw or lightly cooked eggs, such as eggs over easy or hollandaise sauce, are made only with pasteurized eggs. Pasteurization kills disease-causing germs.

Wash hands and items that came into contact with raw eggs—including countertops, utensils, dishes, and cutting boards—with soap and water.

And a song dedicated to my high school girlfriend, Susie.

Multistate outbreak of Vibrio parahaemolyticus infections linked to fresh crab meat imported from Venezuela

The U.S. Centers for Disease Control (CDC), is getting in on the vibrio outbreak linked to crab meat imported from Venezuela – often posing as Maryland crab – along with state and local health officials, and the U.S. Food and Drug Administration.

CDC recommends that consumers not eat, restaurants not serve, and retailers not sell fresh crab meat imported from Venezuela at this time.

How would consumers know? Ask questions?

Consumers are not the critical control point of this food safety system.

Yet my 9-year-old knew enough to ask if the aioli that was served with her chips at a hockey tournament in Newcastle, Australia, this was weekend, contained raw egg.

I wasn’t around, but a shiver of pride went through my body.

This type of product may be labeled as fresh or precooked. It’s commonly found in plastic containers.

Food contaminated with Vibrio parahaemolyticus usually looks, smells, and tastes normal.

Steamed crab meat from blue crab (close up)

If you buy crab meat and do not know whether it is from Venezuela, do not eat, serve, or sell it. Throw it away.

CDC, state and local health officials, and the U.S. Food and Drug Administration are investigating a multistate outbreak of Vibrio parahaemolyticus infections linked to eating fresh crab meat imported from Venezuela.

Epidemiologic evidence indicates that precooked fresh crab meat imported from Venezuela is the likely source of this outbreak.

Twelve people infected with Vibrio parahaemolyticus who ate fresh crab meat have been reported from Maryland, Louisiana, Pennsylvania, and the District of Columbia.

Four people (33%) have been hospitalized. No deaths have been reported.

Illnesses started on dates ranging from April 1, 2018 to July 3, 2018.

100 sick from Salmonella in 33 states: Kellogg’s Honey Smacks Cereal still suck and still being sold

The U.S. Food and Drug Administration (FDA) has become aware that recalled Kellogg’s Honey Smacks cereal are still being offered for sale. All Honey Smacks cereal was recalled in June 2018.

Retailers cannot legally offer the cereal for sale and consumers should not purchase Kellogg’s Honey Smacks cereal.

The FDA has learned that some retailers are still selling this product. The FDA will continue to monitor this situation closely and follow up with retailers as we become aware of recalled products being offered for sale. Additionally, the public is urged to report any product being offered for sale to the FDA Consumer Complaint Coordinator in their region. More information about the recall can be found at FDA.gov.

The FDA, CDC, along with state and local officials are investigating a multi-state outbreak of Salmonella Mbandaka infections linked to Kellogg’s Honey Smacks sweetened puffed wheat cereal.

The CDC reports that 100 people in 33 states have become ill. There have been 30 hospitalizations and no deaths.

Following discussion with FDA, CDC, and state partners, the Kellogg Company voluntarily recalled Kellogg’s Honey Smacks cereal. The recalled products were distributed across the United States including Guam and Saipan and internationally. Consumers should not eat any Honey Smacks cereal.

As this is an ongoing investigation, the FDA will update this page as more information becomes available, such as product information, epidemiological results, and recalls.

The FDA provided a more detailed a list of foreign countries to which the Kellogg’s Honey Smacks cereal was distributed.. Here is the list of the foreign countries: Aruba/Curaçao/Saint Maarten (Netherlands Antilles), the Bahamas, Barbados, Tortola (British Virgin Islands), Costa Rica, Guatemala, Haiti, Mexico, Panama, and Tahiti (French Polynesia).

The FDA is advising consumers to not eat and to discard any Kellogg’s Honey Smacks cereal. This is regardless of size or “best if used by” dates. The recall notice accounts for all of the product that is on the market within the cereal’s estimated one year shelf-life. However, Honey Smacks products with earlier dates could also potentially be contaminated.  

The FDA quickly initiated an inspection at the contract facility where Kellogg’s Honey Smacks is manufactured. As part of the inspection, investigators collected environmental and product samples. Analysis of the environmental samples is now complete, and they were found to be a match to the outbreak strain. In addition, product samples collected and analyzed by state partners were positive for the outbreak strain of Salmonella Mbandaka. As of June 12, 2018, the manufacturing facility is no longer producing product. The FDA continues to work with the firm to address corrective actions.

When the Miami Herald filed a Freedom of Information Act request for the inspection of the facility, the FDA denied the request. The agency claimed two exemptions: “disclosure could reasonably be expected to interfere with enforcement proceedings” and possible disclosure of “trade secret and confidential commercial information.”

61 sick in 7 states from Cyclospora in new outbreak linked to McDonald’s; 3000 locations removing salads

At least 61 people in seven Midwestern States have been sickened with Cyclospora possibly linked to salads served at McDonald’s restaurants.

The U.S. Food and Drug Administration and the Centers for Disease Control and Prevention (CDC) report that two people have been hospitalized and to date, no deaths have been reported.

Ashley Nickle of The Packer reports that health authorities in Illinois and Iowa have reported 105 recent cases of cyclosporiasis and have linked some of them to McDonald’s salads.

“Out of an abundance of caution, we decided to voluntarily stop selling salads at impacted restaurants until we can switch to another lettuce blend supplier,” McDonald’s said in a statement. “We are in the process of removing existing salad blends from identified restaurants and distribution centers, which includes approximately 3,000 of our U.S. restaurants, primarily located in the Midwest.”

McDonald’s spokeswoman Terri Hickey said, “McDonald’s is committed to the highest standards of food safety and quality control. We are closely monitoring this situation and cooperating with state and federal public health authorities as they further investigate”

In June, federal agencies investigated cyclosporiasis cases that were linked to Del Monte vegetable trays. More than 225 illnesses have been reported in that outbreak. At this time, no link has been made by health authorities between the outbreak linked to McDonald’s salads and the outbreak linked to Del Monte vegetable trays, which included broccoli, cauliflower, carrots and dip.