Category Archives: outbreak

USA – Outbreak Investigation of Salmonella: Seafood (October 2022)

FDA

The FDA, along with CDC and state and local partners, is investigating a multistate outbreak of Salmonella Litchfield infections linked to fresh, raw salmon supplied to restaurants in California and Arizona by Mariscos Bahia, Inc.

Based on epidemiologic information provided by CDC and interviews conducted by state and local public health officials, of 16 people interviewed, 12 reported eating sushi, sashimi, or poke. Of those interviewed, 11 people remembered details about the type of fish consumed and 9 report eating raw salmon before getting sick. The FDA’s investigation traced the distribution of fresh, raw salmon back to Mariscos Bahia, Inc.

In addition, the FDA collected an environmental sample that included multiple swabs at Mariscos Bahia, Inc. (Pico Rivera, CA). Multiple environmental swabs collected at the facility are positive for Salmonella and subsequent  Whole Genome Sequencing (WGS) analysis is ongoing. The WGS completed to date indicates the Salmonella detected in at least one of the swabs from the facility matches the outbreak strain. While epidemiological evidence indicates that ill people consumed fresh, raw salmon processed at this firm, the presence of Salmonella in the processing environment indicates that additional types of fish processed in the same area of the facility could also be contaminated which includes fresh, raw halibut, Chilean seabass, tuna, and swordfish. Salmon, halibut, Chilean seabass, tuna, and swordfish processed in Marisco Bahia Inc.’s Pico Rivera, CA, facility could have also been sent to the Mariscos Bahia, Inc. facilities in Phoenix, AZ and then sent to restaurants.

The firm is cooperating with the FDA investigation and has agreed to initiate a voluntary recall. As a part of the firm’s voluntary recall, the firm will contact its direct customers who received recalled product.

The FDA’s investigation is ongoing. Updates to this advisory will be provided as they become available.

Recommendation

According to Mariscos Bahia, Inc., seafood was only sold directly to restaurants in California and Arizona and would not be available for purchase by consumers in stores.

Restaurants should check with their suppliers and not sell or serve salmon, halibut, Chilean seabass, tuna, and swordfish received fresh, not frozen from Mariscos Bahia, Inc. (Pico Rivera, CA and Phoenix, AZ) on or after June 14, 2022. If restaurants received these fish and then froze it, they should not sell or serve it. Restaurants should also be sure to wash and sanitize locations where these fish from Mariscos Bahia, Inc. were stored or prepared.

Consumers eating salmon, halibut, Chilean seabass, tuna, and swordfish at a restaurant in California or Arizona should ask whether the fish is from Mariscos Bahia, Inc and was received fresh, not frozen.


Map of U.S. Distribution

Map of U.S. Distribution

Case Count Map Provided by CDC

Salmon Outbreak of Salmonella - CDC Case Count Map as of October 19, 2022

Case Counts

Total Illnesses: 33
Hospitalizations: 13
Deaths: 0
Last illness onset: September 18, 2022
States with Cases: AZ (11), CA (21), IL (1)
Product Distribution*:  AZ, CA
*Distribution has been confirmed for states listed, but product could have been distributed further, reaching additional states

Norway – Smoked salmon suspected as source of Listeriosis outbreak

Matportalen

The patient samples were taken between February and August this year (2022). The four people are aged 50 – 90, two women and two men, and they live in Nordland, Trøndelag, Oslo and Viken.

Bacteria with the same genetic profile have been detected in samples from all four patients. In addition, there is one suspected case where we are awaiting final clarification of the test result. 

The Norwegian Food Safety Authority has collaborated with the Institute of Public Health, the municipal chief veterinarians and the Veterinary Institute, in order to map whether the patients may have a common source of infection.

Three of the four patients have been interviewed by the Norwegian Food Safety Authority. All state having eaten smoked salmon or smoked trout in the time before they became ill, and two of them state smoked salmon from the same producer. During the outbreak investigation, the outbreak bacteria was found in a product from this manufacturer that had been analyzed earlier this year. The sample was a routine sample, taken in connection with the Norwegian Food Safety Authority’s monitoring program for ready-to-eat products in 2022. The amount of listeria in the routine sample was so low that it posed no health risk.

The Norwegian Food Safety Authority has followed up the manufacturer through an inspection of the premises and several environmental samples have been obtained which were analyzed at the Veterinary Institute. The bacterium Listeria monocytogene was found in some of the samples. Although that listeria bacterium was not genetically similar to the outbreak strain, a discrepancy has been found. The Norwegian Food Safety Authority therefore decided based on a precautionary principle that the company had to withdraw products from the market.

The company has initiated thorough internal work to find the source of the outbreak strain. Extra cleaning of premises and equipment has also been carried out, to ensure that their products are safe.

Types of Data Collected in Foodborne Outbreak Investigations

CDC

Three Types of Data

When a foodborne outbreak is detected, public health and regulatory officials work quickly to collect as much information as possible to find out what is making people sick.

Epidemiologic Data

map of the continental U.S. with sites of outbreaks highlighted

Where and when did people get sick? Has the same germ caused outbreaks before? If it has, what made people sick in those outbreaks?

plate of food

What foods did people eat before they got sick?

restaurant and diners

What restaurants, grocery stores, or events did sick people go to?

Traceback Data

flow chart and checklists

Is there a common point in the distribution chain where the food could have gotten contaminated?

farm with barn and fields

Is there anything about the food production facilities, farms, or restaurants that made germs likely to spread?

Food and Environmental Testing Data

person wearing gloves and shield testing food

Is the germ causing the outbreak also found in a food item or in the food production environment?

woman looking at viruses under microscope

Do the germs found in the food or food production environment have the same DNA fingerprints as germs found in sick people?

Actions to Stop the Outbreak

Outbreak investigators take actions to protect the public when there is clear and convincing information showing that people got sick from the same contaminated food.

Live breaking news: outbreak

Health officials warn the public

recalled packaged lettuce

Companies recall contaminated products

"closed" sign

Restaurants or food production facilities close temporarily

Constantly Improving

investigators working at a table

Investigators don’t solve every outbreak. Sometimes outbreaks end before enough information is gathered to identify the contaminated food. Outbreak investigators are constantly developing new ways to investigate and solve outbreaks faster.

Research – Phenotypic and genotypic characterization of salmonella Enteritidis isolated from two consecutive Food-Poisoning outbreaks in Sichuan, China

Wiley Online

Abstract

Salmonella enterica serotype Enteritidis (SE) is a primary pathogen that causes foodborne diseases in humans. Although whole-genome sequencing (WGS) -based typing analyses have been increasingly used to investigate food-poisoning outbreaks, they are rarely applied to the epidemiology of multiple Salmonella outbreaks in Sichuan, China. This study therefore isolated SE from patients and food of two consecutive food-poisoning outbreaks during 2020 in Sichuan, China. We tracked outbreak origin using epidemiological investigation, serotyping, antimicrobial susceptibility testing (AST), pulsed-field gel electrophoresis (PFGE), and WGS. We also determined phylogenetic relationships using PFGE, whole and core genome multilocus sequence typing (wg/cgMLST), and whole-genome single nucleotide polymorphism (wgSNP) analyses. Epidemiological investigations identified a correlation between cake consumption and food poisoning. Thirteen strains isolated from patients and one strain isolated from the cake were confirmed as SE. Among the 14 strains, only six shared the same AST pattern (AMP-AMS-Sul-STR). Isolates from patients and cakes were indistinguishable in PFGE results. All four methods, namely PFGE, wgMLST, cgMLST, and wgSNP were appropriate for bacterial typing in SE-related outbreak investigation. However, wgSNP can assign 12 SE strains from the first outbreak to one cluster and assign two SE strains from the second outbreak to another cluster, while PFGE, wgMLST, cgMLST did not successfully distinguish the SE strains from different outbreaks. Thus, we conclude that SNP-based phylogenetic analysis might be a viable method for differentiating SE strains at the outbreak level.

Sweden – Salmonella sickens more than 50 in Sweden

Food Safety News

More than 50 people have fallen ill in a national outbreak of Salmonella in Sweden with the source yet to be identified.

A total of 54 confirmed cases of Salmonella Typhimurium have been reported from 20 different regions in the country from Sept. 17 to Oct. 5.

Patients are aged between 8 and 86 years old; 31 of them are women.

Cases have been connected by whole genome sequencing of patient samples. This means they are suspected of having been infected by a common source, according to the Public Health Agency of Sweden (Folkhälsomyndigheten).

Local infection control units, the Swedish Food Agency (Livsmedelsverket) and Folkhälsomyndigheten are investigating the outbreak to identify the source of infection, which is suspected to be a food with wide distribution in Sweden.

Patient interviews to compile information about what those sick have eaten before falling ill are ongoing. Answers will be used to form a hypotheses about the source and compared to what people in a control group that are not part of the outbreak have eaten.

The incident doesn’t appear to be connected to a Salmonella Typhimurium outbreak that is ongoing in Denmark. Officials believe the outbreak in Sweden is caused by a different source because the strains don’t cluster.

USA – Old Europe Cheese Listeria Outbreak holds at six sick in six States

Food Poison Journal

Epidemiologic and Traceback Data

As of September 28, 2022, six people infected with the outbreak strain of Listeria have been reported from six states (see map). Sick people’s samples were collected from August 6, 2017, to August 5, 2022 (see timeline).

Sick people range in age from 56 to 83 years, with a median age of 78, and 67% are female. Five people have been hospitalized, and no deaths have been reported.

The true number of sick people in this 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 3 to 4 weeks to determine if a sick person is part of an outbreak.

USA – Big Olaf’s Ice Cream Listeria Outbreaks stands at 25 sick with 24 hospitalized with 1 death

Food Poison Journal

Epidemiologic Data

Since the last update on July 13, 2022, two more illnesses have been reported. As of August 2, 2022, a total of 25 people infected with the outbreak strain of Listeria monocytogenes have been reported from 11 states (see map). Thirteen sick people are residents of Florida and ten reported traveling to Florida before getting sick. Illnesses started on dates ranging from January 24, 2021, to June 24, 2022 (see timeline).

Sick people range in age from less than one to 92 years, with a median age of 72, and 56% are male. Of 25 people with information available, 24 have been hospitalized. One death in a person who was not pregnant has been reported from Illinois. Five people got sick during their pregnancy, and one person’s illness resulted in a fetal loss.

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 3 to 4 weeks to determine if a sick person is part of an outbreak.

USA – Michigan hit hardest in Falafel E. coli Outbreak

Food Poison Journal

As of October 7 2022, 20 people infected with the outbreak strain of E. coli O121 have been reported from 6 states (see map). Illnesses started on dates ranging from July 13, 2022, to September 13, 2022 (see timeline).

 

 

 

 

 

 

Sick people range in age from less than 1 to 71 years, with a median age of 31, and 79% are female. Of 14 people with information available, 5 have been hospitalized, including 1 who developed hemolytic uremic syndrome, a serious condition that can cause kidney failure. No deaths have been reported.

The true number of sick people in this 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 E. coli. In addition, recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak.

State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Among 18 people interviewed, 15 reported shopping at ALDI stores. Among these 15 ALDI shoppers, 6 reported eating Earth Grown brand frozen falafel purchased from ALDI in the week before getting sick.

Netherlands – Dutch retailer issues recall after Ferrero chocolate error – Salmonella

Food Safety News

A Dutch retailer has issued a recall after mistakenly sending Ferrero chocolate potentially contaminated with Salmonella to market.

Jumbo is recalling Ferrero Kinder Schokobons 300 grams with an expiry date of Oct. 5, 2022 or earlier.

These products were recalled by Ferrero in April this year in relation to a multi-country monophasic Salmonella Typhimurium outbreak. However, Jumbo said some chocolate had recently been delivered to a limited number of stores.

The retailer added that as soon as the error became known, all stock was removed from stores as a precaution.

Jumbo asked customers not to consume the affected Ferrero Kinder Schokobons and to return them to one of its stores.

Official figures show the Netherlands had three cases related to the outbreak that affected more than 450 people from December 2021 to June 2022.

Denmark searches for source of Salmonella outbreak with 14 sick

Food Safety News

Danish officials are trying to find the source of a Salmonella outbreak that has sickened 14 people in a month.

Between Aug. 15 and Sept. 16, more than a dozen cases with the same type of Salmonella Typhimurium have been registered at the Statens Serum Institut.

Patients are seven men and seven women aged between 4 and 84 years old, with a median age of 61. Ten cases were reported in one week. Six sick people live in Midtjylland, five in Hovedstaden and three in Syddanmark.

The Statens Serum Institut (SSI), Danish Veterinary and Food Administration (Fødevarestyrelsen) and DTU Food Institute are investigating the outbreak.