The Centers for Disease Control and Prevention is working with public health officials across the country and the U.S. Department of Agriculture’s Food Safety and Inspection Service to investigate an outbreak of antibiotic-resistant Salmonella Heidelberg infections linked to eating ground turkey. So far there has been one death among the 77 illnesses reported in 26 states.

In response to an uptick in illnesses, FSIS issued a public health alert Friday warning consumers to use caution and thoroughly cook ground turkey, a broad and unusual move for the agency, which hasn’t yet named a manufacturer or announced a recall.
Federal public health authorities said Monday in an update they are using DNA “fingerprints” of Salmonella bacteria obtained through diagnostic testing with pulsed-field gel electrophoresis, or PFGE, to identify cases of illness that may be part of the outbreak.
Officials are using data from PulseNet, the national network of state, local and federal public health labs that track foodborne infections.

“The outbreak strain of Salmonella Heidelberg is resistant to many commonly prescribed antibiotics; this antibiotic resistance can increase the risk of hospitalization or possible treatment failure in infected individuals,” according to CDC’s update Monday.
According to CDC, illness linked to the outbreak have been reported between March 1 and August 1, 2011. The number of ill persons identified in each state is as follows:AL (1), AZ (2), CA (6), GA (1), IA (1), IL (7), IN (1), KY (2), LA (1), MA (1), MI (10), MN (1), MO (2), MS (1), NC (1), NE (2), NV (1), OH (10), OK (1), OH (10), OK (1), OR (1), PA (5), SD (3), TN (2), TX (9), and WI (3).

Ill persons range in age from less than 1 year to 88 years old, with a median age of 23 years old. Forty-eight percent are female. Among the 58 ill persons with available information, 22 (38%) have been hospitalized. One death has been reported.

Public health officials believe ground turkey is the likely source of this outbreak but have not yet named a producer. Among the 51 ill persons with available information, 25 (49%) reported consuming ground turkey, CDC reported.

“Cultures of four ground turkey samples purchased from four retail locations between March 7 and June 27, 2011 yielded Salmonella Heidelberg with the outbreak strain. Preliminary information indicates that three of these products originated from a common production establishment; the fourth is still under investigation,” CDC reported Monday, failing to name specifics.

“These were obtained as part of routine sampling in the National Antimicrobial Resistance Monitoring System (NARMS), and have not been linked to illnesses. Product information (such as date and location of purchase of ground turkey) is also being collected from ill persons and is being used by local, state, and federal public health, agriculture, and regulatory agencies to conduct traceback investigations.”

Food safety attorney Bill Marler, publisher of Food Safety News, said three positive samples should be enough to prompt a recall.  “Consumers have no idea what to do except not eat ground turkey,” he said.

In April, 12 people in 10 states were infected by another antibiotic-resistant bacteria, Salmonella Hadar, after eating turkey burgers from Jennie-O Turkey Store. The company recalled 54,960 pounds of frozen raw turkey products.

Officials are reminding consumers to be vigilant with handling ground turkey, avoiding cross-contamination and cooking all poultry to 165 °F internal temperature as measured with a food thermometer.

People who think they might have fallen ill from eating contaminated turkey should consult their health care providers. Most infected with Salmonella bacteria develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. Most people recover without treatment but in rare cases hospitalization is necessary.
“Salmonella infection may spread from the intestines to the bloodstream and then to other body sites and can cause death unless the person is treated promptly with antibiotics. Older adults, infants, and those with impaired immune systems are more likely to have a severe illness from Salmonella infection,” said CDC.


Case count map from the Centers for Disease Control and Prevention