Ten more cases and two more states have been added to the Salmonella Heidelberg outbreak associated with Cargill ground turkey, the Centers for Disease Control and Prevention reported Thursday.
The outbreak, which prompted the largest Class I recall in history, has so far spread over 34 states, sickening 129 and killing a California man.
In its update on the outbreak, the CDC said the patients became sick between Feb. 27 and Sept. 13. Texas reported 17 cases; Illinois 16; Michigan and Ohio 12 each; Missouri 7; California and Pennsylvania 6 each; Colorado, North Carolina and Wisconsin 4 each; Arizona, Kansas, Massachusetts and South Dakota 3 each; Georgia, Iowa, Kentucky, Minnesota, Mississippi, Nebraska, New York, Oklahoma and Tennessee 2 each; and Alabama, Arkansas, Connecticut, Indiana, Louisiana, Maryland, Nevada, New Jersey, Oregon, Utah and Vermont 1 each.
The patients ranged in age from less than 1 year to 90. Among 88 people with information about treatment available, 33 were hospitalized; a hospitalization rate of 38 percent.
Salmonella Heidelberg is resistant to several antibiotics, including ampicillin, streptomycin, tetracycline and gentamicin. The CDC notes that antimicrobial resistance may increase the risk of hospitalization or possible treatment failure.
The outbreak came to the public’s attention July 29 when the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) issued a national health alert
Advising people to cook frozen or fresh ground turkey products to an internal temperature of 165˚ F. FSIS did not name a brand of turkey.
Five days later, Aug. 3, Cargill Meat Solutions recalled 36 million pounds of ground turkey that had been processed at its Springdale, AR plant – establishment number P-963. On Sept. 11, Cargill recalled another 185,000 pounds of ground turkey when Salmonella Heidelberg turned up in more samples at the plant. FSIS confirmed on Sept. 27 that one positive sample was confirmed to have the outbreak strain.
Is this outbreak over? Illnesses that occurred after Sept. 1 might not be reported yet, according to the CDC.
The CDC posted this timeline of the outbreak:
May 23: CDC PulseNet identified multistate cluster of Salmonella Heidelberg infections (30 ill persons, 17 states) and began monitoring for additional illnesses. Investigators noted two ground turkey isolates matching the outbreak strain that were uploaded to PulseNet by Minnesota on April 11, 2011 (retail sample 1) and by New Mexico on May 11, 2011 (retail sample 2) as part of NARMS surveillance.
May 26: CDC began coordinating a multistate investigation, Minnesota reported retail Sample 1 was Brand A produced at establishment P-963.
June 1: CDC notified USDA-FIS. Frequent discussions between both agencies continue throughout the investigation.
June 16 – June 21: Exposure information from 19 ill persons revealed no single food that stood out as a likely source: 37 percent reported eating multiple brands and types of ground turkey.
June 21 – July 7: CDC asked states to use an expanded questionnaire to further examine other possible sources in addition to ground turkey.
July 19: FSIS began first traceback investigation of ground turkey as shopper card details received; purchased from three ill persons linked to P-963.
July 29: Tests of leftover ground turkey from the home of an ill person in Ohio yielded Salmonella Heidelberg. Laboratory analysis identified two closely related DNA ‘fingerprint’ patterns: one an exact match to the outbreak strain.
FSIS informed Cargill Meat Solutions about epidemiologic data, information from traceback of ground turkey products, and analysis of distribution records indicating establishment P-963 is a likely, but not definitive, source of the outbreak.
Aug. 1: CDC posted initial web announcement about the investigation.
Aug. 3: FSIS reported that the source of ground turkey for Brand B Retail Sample 3 was establishment P-963. Thirty (54 percent) of 56 interviewed ill persons reported eating any ground turkey prepared at home in the week before illness.
Cargill Meat Solutions recalled approximately 36 million pounds of ground turkey products that may be contaminated with a multi-drug resistant strain of Salmonella Heidelberg.
Aug. 11: 23 additional ill persons with Salmonella Heidelberg with a closely related DNA ‘fingerprint’ pattern with illness since March included in total number of ill persons.
Sept. 11: Cargill Meat Solutions recalled approximately 185,000 pounds of ground turkey that might be contaminated with Salmonella Heidelberg, based on sample results from an intensive in-plant investigation.
CDC Outbreak Map:
CDC Epi Curve: