On January 14, 2022, the Lincoln-Lancaster County (Nebraska) Health Department (LLCHD) notified the Nebraska Department of Health and Human Services (NDHHS) of two cases of laboratory-confirmed Salmonella in inmates at a correctional facility (facility A). LLCHD initiated an investigation in collaboration with NDHHS to identify the source of the outbreak and develop recommendations. The investigation linked consumption of mechanically separated chicken to illness. Mechanically separated chicken, which is produced at chicken processing facilities by separating edible chicken from bone and cartilage under pressure, is frequently purchased for use in institutions, such as prisons, jails, and correctional facilities because of its affordability (1,2).
Staff members at facility A reported approximately 100 inmates experienced gastrointestinal symptoms during a period of a few days; no staff member reported illness. LLCHD conducted open-ended interviews with ill inmates. Because the facility was experiencing a concurrent outbreak of COVID-19, and access to inmates for interviews was limited, it is likely that additional cases existed among noninterviewed and untested inmates beyond the total cases identified in the investigation. Inmates who were designated food handlers were prioritized for interviews because of transmission risk to others; untested inmates were able to seek care through facility A medical staff. A probable case was defined as the onset of diarrhea, stomach cramps, or vomiting during January 9–11, 2022, but without a positive stool culture, in an inmate at facility A; a confirmed case was defined as isolation of Salmonella serotype Enteritidis highly related to the outbreak strain (within three alleles) by core genome multilocus sequence typing in a clinical specimen. LLCHD conducted an environmental assessment on January 15, 2022. A list of food handlers, food menus for January, and temperature logs were requested. During the environmental assessment, a sample of raw, unopened mechanically separated chicken from a 50-lb intact box from the same shipment used to prepare a meal on January 8, 2022, was collected for testing.
A total of 15 cases of S. Enteritidis infection were identifie
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