Category Archives: food bourne outbreak

Research – Genomically Informed Strain-Specific Recovery of Shiga Toxin–Producing Escherichia coli during Foodborne Illness Outbreak Investigations

Journal of Food Protection

Next-generation sequencing plays an important role in the characterization of clinical bacterial isolates for source attribution purposes during investigations of foodborne illness outbreaks. Once an illness cluster and a suspect food vehicle have been identified, food testing is initiated for confirmation and to determine the scope of a contamination event so that the implicated lots may be removed from the marketplace. For biochemically diverse families of pathogens such as Shiga toxin–producing Escherichia coli (STEC), the ability to detect specific strains may be hampered by the lack of a universal selective enrichment approach for their recovery against high levels of background microbiota. The availability of whole genome sequence data for a given outbreak STEC strain prior to commencement of food testing may provide food microbiologists an opportunity to customize selective enrichment techniques favoring the recovery of the outbreak strain. Here we demonstrate the advantages of using the publicly available ResFinder tool in the analysis of STEC model strains belonging to serotypes O111 and O157 to determine antimicrobial resistance traits that can be used in formulating strain-specific enrichment media to enhance recovery of these strains from microbiologically complex food samples. The improved recovery from ground beef of model STEC strains with various antimicrobial resistance profiles was demonstrated using three classes of antibiotics as selective agents, suggesting the universal applicability of this new approach in supporting foodborne illness investigations.

USA – Raw Turkey Salmonella Reading Outbreak Grows to 216 Sick

Food Poisoning Bulletin

The raw turkey Salmonella Reading outbreak has grown to 216 sick, according to the Centers for Disease Control and Prevention (CDC). Eighty-four people are hospitalized and one person who lived in California has died. This outbreak has also sickened people in Canada.

 

USA -Outbreak of Multidrug-Resistant Salmonella Infections Linked to Raw Turkey Products – Investigation Notice

CDC

  • Since the last update on November 8, 2018, 52 ill people from 26 states and the District of Columbia have been added to this investigation.
  • As of December 18, 2018, 216 people infected with the outbreak strain of Salmonella Reading have been reported from 38 states and the District of Columbia.
    • 84 people have been hospitalized, and one death has been reported from California.
  • Epidemiologic and laboratory evidence(https://www.cdc.gov/foodsafety/outbreaks/investigating-outbreaks/index.html) indicates that raw turkey products from a variety of sources are contaminated with Salmonella Reading and are making people sick.
  • In interviews, ill people report eating different types and brands of turkey products purchased from many different locations. Three ill people lived in households where raw turkey pet food was fed to pets.
  • The outbreak strain has been identified in samples taken from raw turkey pet food, raw turkey products, and live turkeys.
    • On November 15, 2018, Jennie-O Turkey Store Sales in Barron, Wisconsin recalled approximately 91,388 pounds of raw ground turkey products.
    • On December 21, 2018, Jennie-O Turkey Store Sales, LLC, in Faribault, Minnesota recalled approximately 164,210 pounds of raw ground turkey products.
    • A single, common supplier of raw turkey products or of live turkeys has not been identified that could account for the whole outbreak.
  • The Public Health Agency of Canada has identified ill people infected with the same DNA fingerprint of Salmonella Reading bacteria in Canada.
  • The outbreak strain of Salmonella Reading is present in live turkeys and in many types of raw turkey products, indicating it might be widespread in the turkey industry. CDC and USDA-FSIS have shared this information with representatives from the turkey industry and asked about steps that they may be taking to reduce Salmonella contamination.

 

USA – FDA Investigating Multistate Outbreak of E. coli O157:H7 Infections Likely Linked to Romaine Lettuce Grown in California

FDA Eurofins Food Testing UK

Update: December 17, 2018

The FDA, along with CDC, state and local agencies, is investigating a multistate outbreak of E. coli O157:H7 illnesses linked to romaine lettuce grown in California this fall. The Public Health Agency of Canada (PHAC) and Canadian Food Inspection Agency (CFIA) are also coordinating with U.S. agencies as they investigate a similar outbreak in Canada.

On December 13, 2018, Adam Bros. Farming, Inc., in Santa Barbara County, recalled products that may have come into contact with water from the water reservoir where the outbreak strain was found. The firm recalled red leaf lettuce, green leaf lettuce and cauliflower harvested on November 27 through 30, 2018. According to the firm, cauliflower was distributed to wholesalers in the U.S. Mexico, and Canada.

The Adam Bros. recall has prompted a sub-recall by Spokane Produce Inc. of Spokane, WA. The firm recalled sandwiches and other products under the Northwest Cuisine Creations and Fresh&Local labels.

Recommendation:

Consumers:

Consumers should not eat recalled products and should throw them away. Consumers also should not eat romaine from Monterey, San Benito, and Santa Barbara counties in California.

Based on discussions with producers and distributors, romaine lettuce entering the market will now be voluntarily labeled with a harvest location and a harvest date or labeled as being hydroponically- or greenhouse-grown. Romaine lettuce with the new labeling is available in stores. Consumers should look for signs in stores where labels are not an option. If signs or labels do not have this information, you should not eat or use it.

If it does have this information, we advise avoiding romaine from Monterey, San Benito, and Santa Barbara counties in California. Romaine from outside those regions need not be avoided. Additional counties may be added or subtracted as FDA traceback investigation continues.

For example, romaine lettuce harvested from areas that include, but are not limited to, the following do not appear to be related to the current outbreak:

  • the desert growing region near Yuma, Arizona
  • the California desert growing region near Imperial County and Riverside County
  • the counties of Ventura, San Luis Obispo, and Santa Cruz in California
  • the state of Florida
  • Mexico

Additionally, there is no evidence hydroponically- and greenhouse-grown romaine is related to the current outbreak, and there is, also, no recommendation to avoid romaine from these sources.

Restaurants and Retailers:

Restaurants and retailers should not serve or sell romaine from Monterey, San Benito, and Santa Barbara counties in California. Romaine from outside those regions need not be avoided. See the list above of examples of growing areas not related to the current outbreak. Retailers and restaurants should discard any recalled product.

Retailers should ensure that there is labeling with the harvest date and location on each bag of romaine, or that there is signage when labels are not an option.

Suppliers and Distributors:

Suppliers, distributors and others in the supply chain should not ship or sell romaine from Monterey, San Benito, and Santa Barbara counties in California. Romaine from outside those regions need not be. Distributors and suppliers should discard any recalled product.

FDA recommends that labels are placed on romaine lettuce entering the market to help consumers, restaurants and retailers determine that the romaine is from unaffected growing regions outside of Monterey, San Benito, or Santa Barbara counties in California.

Information – The International Outbreak Museum – Portland – Orgegon

Outbreak Museum

The International Outbreak Museum began in the office of Dr. Bill Keene in his early years investigating infectious disease outbreaks at the Oregon state health department. Bill realized early on that outbreak investigations are very public opportunities to teach large audiences about the kinds of foods and products that can become contaminated and cause widespread dissemination of disease. From one of the very first (and still the oldest) exhibits, an actual box of “Rely Tampons” that associated with Toxic Shock Syndrome and Staphylococcus aureus in 1978, to painstakingly reproduced products (like Sally Jackson artisanal raw milk cheese), the physical museum includes some pretty cool stuff. We’ve got bunches of restaurant menus, cans of contaminated leather spray, bottles of MRSA-contaminated tattoo ink and equipment, and packaging from many products that were recalled from the market because they caused outbreaks and made citizens sick.

The museum is part of The Northwest Center for Foodborne Outbreak Management, Epidemiology, and Surveillance (FOMES), a program that fosters the public health practice of foodborne and diarrheal disease surveillance and outbreak investigation. FOMES will be working to bring all of the physical IOM exhibits to digital life and feature them in their proper place on the web. Our hope is that Dr. Keene’s museum can be used to share the fascinating stories behind outbreak investigations. Please consider submitting information about your latest investigation (even if you didn’t find a smoking gun).

USA – Notes from the Field: Multiple Modes of Transmission During a Thanksgiving Day Norovirus Outbreak — Tennessee, 2017

CDC

On November 28, 2017, the manager of restaurant A in Tennessee reported receiving 18 complaints from patrons with gastrointestinal illness who had dined there on Thanksgiving Day, November 23, 2017. Tennessee Department of Health officials conducted an investigation to confirm the outbreak, assess exposures, and recommend measures to prevent continued spread.

On November 23, one patron vomited in a private dining room, and an employee immediately used disinfectant spray labeled as effective against norovirus* to clean the vomitus. After handwashing, the employee served family-style platters of food and cut pecan pie. For the November 23 Thanksgiving Day, restaurant A served 676 patrons a limited menu from 11 a.m. to 8 p.m. The manager provided contact information, seating times, and seating locations for 114 patrons with reservations. All patrons with contact information were telephoned, and a questionnaire was used to assess illness and exposures for anyone living in the household who ate at restaurant A on November 23. Stool specimens were requested from ill patrons. Among the 676 patrons, 137 (20%) were enrolled in a case-control study.

A probable case was defined as diarrhea (three or more loose stools in 24 hours) or vomiting within 72 hours of eating at restaurant A on November 23; probable cases with norovirus RNA detected in a stool specimen by real-time reverse transcription–polymerase-chain reaction (RT-PCR) were considered confirmed. On November 30, environmental swabs for norovirus testing were collected in the restaurant. Patient and environmental samples were tested by real-time RT-PCR and sequenced at the Tennessee State Public Health Laboratory.

Thirty-six (26%) case-patients (two confirmed and 34 probable) and 101 (74%) controls were enrolled in the case-control study. Illness onsets occurred during November 23–25, with 17 of 35 (49%) cases occurring on November 24 (Figure). The mean incubation period was 31 hours (range = 2.5–54.5 hours), and the mean illness duration was 3 days (range = 0–6 days). Only one case-patient sought medical care. Diarrhea was reported by 33 (94%) case-patients, fatigue by 29 (83%), nausea and abdominal cramps by 28 (80%), vomiting by 24 (69%), and fever by six (17%).

Among menu items, only pecan pie was significantly associated with illness (odds ratio [OR] = 2.6; 95% confidence interval [CI] = 1.1–5.8); however, it was eaten by only 16 (47%) of 34 case-patients. The vomiting event occurred around noon; patrons seated during 11 a.m.–1 p.m. were significantly more likely to become ill than were patrons seated during other times (OR = 6.0; 95% CI = 2.6–15.3). No significant differences between dining locations (i.e., private dining room versus general seating) were identified (OR = 1.4; 95% CI = 0.4–4.3). Logistic regression was used to evaluate the effects of eating pecan pie, seating time, and seating location; only seating time during 11 a.m.–1 p.m. remained statistically significant (OR = 6.0; 95% CI = 2.2–16.5).

Stool specimens from two case-patients identified Norovirus GII.P16-GII.4 Sydney. Norovirus GII was identified in one environmental swab collected from the underside of a table leg adjacent to the vomitus.

Belgium – Belgian agency issues warning about meat linked to Salmonella outbreak

Food Safety News

Food Poisoning Salmonella

Authorities in Belgium have warned that certain meat products could be contaminated with Salmonella following processing of potentially contaminated raw materials from the Netherlands.

The Federal Agency for the Safety of the Food Chain (FASFC) said an alert through the Rapid Alert System for Food and Feed (RASFF) shows fresh meat used as raw material that could be contaminated with Salmonella Goldcoast was delivered to Belgium from the Netherlands.

This RASFF alert covers a suspected foodborne outbreak caused by pig meat from the Netherlands. As well as Belgium, 14 other countries received pig meat products. These are Austria, Canada, Croatia, Cyprus, Denmark, France, Germany, Greece, Italy, Luxembourg, Poland, Romania, Spain and the United Kingdom.

According to figures from the national public health institute of Belgium, Sciensano, there has not been an increase detected in the number of infections with Salmonella in 2018 compared to the previous year.

USA – E. coli O157:H7 Romaine Outbreak Increases With 52 Sick and 19 Hospitalized

Food Poisoning Bulletin

E. coli O157:H7 Romaine Outbreak 12618

The E. coli O157:H7 romaine outbreak has grown, according to an update posted by the Centers for Disease Control and Prevention (CDC). Since the last update posted in November 26, 2018, an additional nine patients have been added to the total for 52 sick. Those patients live in 15 states. Nineteen people have been hospitalized.

USA – Michigan Cracker Barrel Shuttered due to Salmonella

Food Poison Journal

The Cracker Barrel restaurant near I-94 and S. 9th St. is voluntarily closing its’ doors for good following a salmonella outbreak investigation.The Kalamazoo County Health & Community Services Department (HCS), along with the Michigan Department of Health and Human Services (MDHHS) began investigating the location in June 2018 for health code violations and reports of food borne illnesses. HCS officials said the establishment voluntarily closed in June to begin facility renovations and worked with them to ensure all Michigan Food Law requirements were met to reopen.

Singapore – 131 fall ill in third mass food-poisoning case this month

Yahoo News

In the third case of mass food poisoning this month, 131 people – including kindergarten pupils and teachers – fell ill on Monday (26 November) after consuming food from a caterer while attending a learning camp.

In a joint statement released on Tuesday, the National Environment Agency (NEA), Ministry of Health (MOH) and Agri-Food and Veterinary Authority (AVA) said they are investigating an outbreak of gastroenteritis – inflammation of the stomach and intestines which causes vomiting and diarrhoea.

The outbreak was traced to the consumption of food prepared by FoodTalks Caterer & Manufacturer, located at Shimei East Kitchen along Bedok North Street 5. The three authorities carried out a joint inspection of the premises on Tuesday, with food and environmental samples taken for testing and food handlers being sent for stool screening.

According to Chinese daily Lianhe Zaobao, the food poisoning victims had attended a learning camp organised by Busy Bees Asia. Organisers said that the camp was stopped immediately upon the outbreak of food poisoning.

As of Tuesday, 131 cases of gastroenteritis had been reported. None of the victims have been hospitalised.