In my job over at Outbreak Database, I have been keeping track of foodborne illness outbreaks – small and large – over the last 12 months. Here are some of the more interesting:
Don Julio Mexican Restaurant December 2011 – 59 ill. A salmonellosis outbreak was linked to eating at the Don Julio’s Mexican Restaurant in Corinth, Mississippi. A food producer or supplier did not appear to be the cause. The food vehicle and the contributing factors were not described as of December 16.
Hannaford Hamburger Ground Beef December 2011 – 16 ill. On December 16, Hannaford, a Scarborough, Maine-based grocery chain, recalled fresh ground beef products that may have been contaminated with a strain of Salmonella Typhimurium. The recall resulted from an investigation into human illness. By December 20, the Centers for Disease Control and Prevention (CDC) reported 16 ill persons with an indistinguishable pulse field gel electrophoresis (PFGE) pattern. Eleven of those individuals reported consuming ground beef. Seven individuals were hospitalized. Ten of the 14 case-patients reported purchasing ground beef at Hannaford stores in Maine, New York, New Hampshire and Vermont between October 12 and November 20. The Salmonella Typhimurium was resistant to several commonly used antibiotics.
Organic Pastures Unpasteurized, Raw Milk November 2011 – 5 ill. Raw milk products produced by Organic Pastures were recalled and quarantined by the state of California after five children drank Organic Pastures raw milk and were infected with the same strain of E. coli O157:H7. The children were residents of Contra Costa, Kings, Sacramento, and San Diego counties. The only common food exposure was the unpasteurized raw milk. Laboratory sampling failed to detect E. coli O157:H7. The recall was ordered strictly on the basis of the epidemiologic findings of the California Department of Public Health, which concluded that Organic Pastures was the likely source of the outbreak. Organic Pastures was implicated in an earlier outbreak of E. coli O157:H7, in 2006; the E. coli O157:H7 associated with this outbreak was different than the strain implicated in 2006.
Cozy Vale Creamery Raw, Unpasteurized Milk Products November 2011 – 3 ill. Cozy Vale Creamery’s raw milk products were recalled due to their link to an outbreak of E. coli O157:H7 in Washington state that began in August. Cozy Vale Creamery’s whole and skim milk and cream were distributed through seven retail outlets in Pierce, Thurston and King counties. The recalled products had sell-by dates of December 6 or earlier. The Washington State Department of Agriculture discovered that locations in the milking parlor and processing areas were contaminated with the outbreak strain of E. coli O157:H7 bacteria. The milk products were sold at the farm store and at Marlene’s Market in Tacoma, two Olympia Food Co-Op locations in Olympia, Olympia Local Foods in Tumwater, Yelm Co-op in Yelm, Mt. Community Co-op in Eatonville and Marlene’s Market in Federal Way. Retail raw milk is legal in Washington state.
Utah State Prison Pruno October 2011 – 12 ill. Inmates of a Utah State Prison developed botulism after drinking pruno, a drink made from various fruit, potato, bread, water, table scraps and sugar, which are then fermented to make alcohol. Making pruno in prison is a violation of prison rules. Most illnesses began on October 1. The last illness began on October 3. Health officials planned to test pruno samples to pinpoint the specific source. Three of the 12 who became ill were critically ill.
Multistate Schnucks Salad Bars, College Campuses Romaine Lettuce October 2011 – 60 ill. An outbreak of E. coli O157:H7 was first identified in the region around Saint Louis, Missouri. Cases were found in Saint Louis, Jefferson, Saint Charles, and Saint Clair counties and in the city of Saint Louis. The cases ranged in age from 1 to 94. At least six people were hospitalized. Many of the cases had eaten items from salad bars prior to becoming ill. On October 28, Illinois state health officials revealed that they were investigating an illness that might be linked to the outbreak in Missouri. The link was not described. On October 31, health department officials acknowledged that Schnucks salad bars were a focus of the investigation, however other sources had not been excluded. Cases were identified in Minnesota and Missouri that were linked to college campuses. Additional cases were found in other states; the exposure location in these states was not described. Traceback analysis determined that a common lot of romaine lettuce, from a single farm, was used to supply the Schnucks’ grocery stores and the college campuses. The lettuce was sold to Vaughn Foods, a distributor, that supplied lettuce to the university campus in Missouri, but records were not sufficient to confirm that this lot was sent to this university campus. Preliminary findings of the investigation at the unnamed farm did not identify the source of the contamination.
Sunrise Commodities Turkish Pine Nuts October 2011 – 43 ill. A confirmed outbreak of Salmonella Enteritidis was associated with eating Turkish pine nuts purchased from bulk bins at Wegman’s grocery stores between July 1 and October 18. As of November 17, there were 43 cases, ranging in age from less than one year to 94 years. Some of the pine nuts were eaten as an ingredient in prepared foods, such as Caprese salad or asparagus with pine nuts. Among 40 ill persons for whom information was available, 28 (70 percent) had eaten pine nuts or products containing pine nuts. Wegman shopper card records were helpful in identifying pine nut purchases. The outbreak strain of Salmonella Enteritidis was isolated from several consumer pine nut samples and from pesto made in a private home using the implicated pine nuts. Wegman’s grocery stores are located along the East Coast, mostly in New York, Pennsylvania, and New Jersey. Laboratory testing conducted by public health laboratories in several states identified the outbreak strain of Salmonella Enteritidis from at least five samples of Turkish pine nuts or pesto containing Turkish pine nuts.
Jensen Farms Rocky Ford Cantaloupe October 2011 – 146 ill. A multistate outbreak of Listeria monocytogenes was associated with consumption of cantaloupe that had been grown in the Rocky Ford region of Colorado and shipped by Jensen Farms. As of December 8, 2011, a total of 146 peo
ple had been reported
to the CDC and were infected with at least one of the four outbreak associated strains. Thirty-one people died, and one pregnant woman miscarried. Among those for whom information is available, reported illness onset ranged from July 31, 2011 through October 27, 2011. Ages of ill people ranged from less than 1 year to 96 years, with the median age of 77. Most ill people were over 60 years old or had health conditions that weakened their immune systems. Seven of the illnesses were related to pregnancy (three newborns; four pregnant women). Among the 144 ill people with available information on whether they were hospitalized, 142 (99 percent) were hospitalized. Among the 140 ill people with available information on what they ate, 131 (94 percent) reported consuming cantaloupes in the month before illness onset. Several ill people remembered the type of cantaloupe they had eaten and said they were Rocky Ford cantaloupes, which are grown in southeastern Colorado. Source tracing of the cantaloupes indicated that they came from Jensen Farms, and were marketed as being from the Rocky Ford region. These cantaloupes were shipped between July 29 through September 10 to at least 24 states with possible further distribution. Laboratory testing by the Colorado Department of Public Health and Environment identified Listeria monocytogenes bacteria on cantaloupes collected from grocery stores and from ill persons’ homes. Laboratory testing by FDA has identified L. monocytogenes matching outbreak strains in samples from equipment and cantaloupe at the Jensen Farms’ packing facility in Granada, CO. The FDA identified several factors at the packing plant that likely contributed to the introduction, spread, and growth of Listeria monocytogenes in the cantaloupe. This outbreak had several unusual features. This was the first listeriosis outbreak associated with melon. Four widely differing PFGE pattern combinations and two serotypes (1/2a and 1/2b) were associated with the outbreak. This outbreak was unusually large and resulted in the highest number of deaths of any U.S. foodborne outbreak since a listeriosis outbreak in 1998 (See Bil Mar Foods Ready-to-eat Meats 1998).
Jaquith Strawberry Farm Strawberries September 2011 – 15 ill. An outbreak of E. coli O157:H7 was linked to eating fresh strawberries produced by Jaquith Strawberry Farm in Oregon. The farm sold berries to buyers who in turn distributed them to roadside stands and farmers’ markets in Multnomah, Washington, Clackamas, Yamhill, and Clatsop counties. The berries were sold in unmarked containers and were last distributed on August 1. Confirmed cases included residents of Washington, Clatsop, and Multnomah counties. Strawberries had not previously been implicated in an E. coli O157:H7 outbreak in the U.S. Ten percent of the environmental samples collected at the Jaquith Strawberry Farm tested positive for E. coli O157:H7. Those samples included deer feces; deer were suspected to be the source of the contamination. The outbreak strain was found in samples from fields in three separate locations.
Tyson Fresh Meats Ground Beef September 2011 – 4 ill. An outbreak of E. coli O157:H7 was associated with eating ground beef in a private home in Butler County, Ohio. A consumer sample of leftover ground beef was tested and confirmed the presence of the outbreak strain of E. coli O157:H7. On September 27, Tyson Fresh Meats issued a voluntary recall of 131,300 pounds of ground beef. The recall involved beef sold as Kroger brands at Kroger Company supermarkets; Butcher’s Beef at Food Lion supermarkets; and generic beef sold to Save-A-Lot, Spectrum Foods, Supervalu and the Defense Commissary Agency.
Jerry Dell Farm Unpasteurized, Raw Milk September 2011 – 2 ill. At least two people became ill due to campylobacteriosis after drinking raw milk. Jerry Dell Farm in Freeville, New York had produced the milk. The farm had an agricultural permit to sell raw milk at the farm. The milk was confirmed to be contaminated with Campylobacter.
Larry Schultz Organic Farms Eggs August 2011 – 6 ill. An outbreak of Salmonella Enteritidis was associated with eating organic eggs produced by Larry Schultz Organic Farms, Owatonna, Minnesota. At least six illnesses were attributed to this outbreak. The illnesses occurred in adults and children in a seven-county metropolitan area surrounding Minneapolis, Minnesota. Five of the six cases reported eating the implicated eggs after purchasing them from grocery stores or co-ops. The eggs were distributed to restaurants, grocery stores, food wholesalers and foodservices companies in Minnesota, Wisconsin and Michigan and were voluntarily recalled.
J & B Meats Ground Beef July 2011 – 2 ill. J & B Meats recalled ground beef after an investigation into two cases of E. coli O157:H7 linked the product to the illnesses. The beef had been sold to restaurants in the Cincinnati, Ohio, region.
McNees Meats and Wholesale LLC Ground Beef July 2011 – 9 ill. An outbreak of E. coli O157:NM was attributed to the consumption of ground beef produced by McNees Meats and Wholesale, LLC, of North Branch, Michigan. The implicated beef was sold to restaurants through a retail establishment owned by McNees Meats and Wholesale, LLC. Illnesses were reported from Genesee, Isabella, Lapeer, and Sanilac counties.
Michigan Cow Share Raw Milk June 2011 – 3 ill. Three Michigan women who had consumed raw cow’s milk were infected with Q fever. The milk was obtained from a Livingston County farm through a dairy herd share program. Herd or cow share programs are where members own part of a cow and in return receive raw, dairy products. These programs are not subject to inspection or regulation under Michigan’s dairy laws. The milk was not sold at retail stores. Q fever is caused by the bacteria Coxiella burnetii. This organism is common in farm animals such as cattle, sheep and goats. Infected animals shed the organism in their urine, feces, milk and birthing fluids. One of the women was hospitalized due to Q Fever meningitis.
North Cape Elementary School Raw Milk June 2011 – 16 ill. Laboratory test results proved that the Campylobactor jejuni bacteria caused the diarrheal illnesses among 16 individuals at the North Cape Elementary School. Raw milk had been served at a school event on June 3. The same strain of Campylobacter jejuni bacteria was found in raw milk from the local farm where the milk originated. A parent supplied the milk for the school event. The farm had not sold the unpasteurized milk to the parent.
Evergreen Produce Alfalfa and Spicy Sprouts June 2011 – 21 ill. In late June, Idaho health officials announced an investigation into an outbreak of Salmonella Enteritidis suspected to be caused by the consumption of contaminated alfalfa and spicy sprouts. As of June 28, at least 21 cases were known in Idaho, Washington, Montana, North Dakota, and New Jersey. Six cases reported consumption of alfalfa sprouts obtained from a northern Idaho grower, Evergreen Produce, located in Moyie Springs, Idaho. On June 27, the Idaho Department of Health and the FDA recommended the public to avoid eating the sprouts while the investigation was underway. On July 1, Evergreen Produce voluntarily recalled its alfalfa and spicy sprouts.
Tucker Adkins Dairy Raw Milk June 2011 – 8 ill. On July 18, the Food and Drug Administration (FDA) warned consumers to avoid drinking raw milk from Tucker Adkins Dairy, located in York, South Carolina. The cases were from three different households and had consumed raw milk from the dairy on June 14, 2011. Although retail sale of raw milk is legal in South Carolina, it was illegal to distribute raw milk in final package form, for direct human consumption, in interstate commerce. Retail sale of raw milk for human consumption is illegal in North Carolina.
Matanuska-Suisitna Valley Cow Share Program Raw Milk May 2011 – 18 ill. An outbreak of Campylobacter jejuni was linked to the consumption of raw milk obtained through a cow share program in southeast Alaska. In Alaska, regulations do not allow the sale of raw milk; however owning shares of a cow to obtain milk is permissible. Campylobacter was not isolated from milk, but was isolated from manure samples collected at the dairy farm. Coincidentally Listeria was isolated, but no human illness had been attributed to this pathogen.
Portillo’s Restaurant Salad April 2011, Illinois – 36 ill. An investigation into an outbreak of Salmonella Typhimurium among patrons of Portillo’s Restaurant in St. Charles, Illinois, was first announced on May 10, 2011. Cases were infected with a rare strain of Salmonella Typhimurium. There were 36 case patients meeting the case definition of which 19 were laboratory-confirmed with S. Typhimurium. Cases resided in Kane, DuPage, Cook, DeKalb, Kenall and Will Counties. Two case patients lived in Minnesota but traveld to St. Charles in Kane County. An investigation was conducted by the Illinois Department of Public Health and the Kane County Health Department. Investigators concluded that a salad prepared at Portillos was the contaminated food item. They did not determine how the salad became contaminated with Salmonella.
Jason’s Deli Guacamole April 2011 – 11 ill. Patrons of Jason’s Deli in Killeen, Texas, became ill with E. coli O157:H7 bacteria. The epidemiologic investigation revealed that guacamole made on April 13 was the most likely cause of the outbreak. The guacamole had been used as a sandwich spread for the California Club sandwich. The guacamole had likely become contaminated at the deli.
DeFusco’s Bakery, Salmonella Heidelberg March 2011 – 79 ill. On March 26, the Rhode Island Department of Health announced an investigation into an outbreak of Salmonella linked to recalled baked goods produced by DeFusco’s Bakery in Johnston, Rhode Island. The products were first recalled on March 25 when it was discovered that the pastry cream used to fill zeppole, a doughnut-like pastry, and the eclairs, had been stored at unsafe temperatures. On March 27, it was revealed that the bakery had stored finished zeppole shells in used egg crates, which could have led to cross contamination of the zeppole shells. The bakery goods from DeFusco’s Johnston store were sold at all DeFusco Bakery locations, Crugnale Bakery locations in Providence, East Providence, North Providence, Cranston and Cumberland, Colvitto’s Bistro in Narragansett, Sal’s Bakery in Providence, and Focaccia World in Johnston. The zeppole were also sold to American Bakery Supplies, a distributor, which in turn distributed the pastries to Roch’s Market in West Warwick, Meal Works in Coventry, and Touch of Class Catering in West Warwick. Meal Works, a catering company, served the zeppole on March 17 and 18 at the West Warwick Manor Senior Center, St. John and Paul Church in Coventry, Sparrow Point Senior Center in West Warwick, and Crescent Park Manor in Riverside. Two deaths were linked to the outbreak. One of the decedents had been a resident of the West Warwick Manor Senior Center.
Brunton Dairy Pasteurized Milk March 2011 – 16 ill. An outbreak of Yersinia enterocolitica was associated with drinking milk or eating ice cream made by the Brunton Dairy. Nine individuals in Beaver County and seven in Allegheny County were sickened(Pennsylvania). On August 26, it was revealed that Yersinia enterocolitica was found in an unopened container of Brunton Dairy ice cream. Later Yersinia enterocolitica was isolated from homemade yogurt made from the dairy’s milk. Through home delivery and retail sales, Brunton’s Dairy distributed approximately 10,000 milk containers per week to 650 households and 40 retail outlets. The mechanism of milk and ice cream contamination was unknown. The dairy resumed milk production and distribution following a Pennsylvania Department of Agriculture culture of a test batch of products that demonstrated no growth of Yersinia. No additional outbreak-associated cases of Yersinia were reported after August 5. The dairy farm had been operated by the Brunton family since 1832 and had bottled milk beginning in 1964.
Frederick County 4-H Country Butchering Event and Benefit Pancake Breakfast Sausage March 2011 – 18 ill. An outbreak of Salmonella Infantis occurred among people attending a benefit pancake breakfast on March 5, in Thurmont, Maryland, at the Trinity United Church of Christ. Sausage and meat pudding were named as the vehicles of infection. These originated from a Frederic County, 4-H Camp Center Country Butchering event; the sausage was confirmed to be contaminated with Salmonella bacteria.
Del Monte Fresh Produce Cantaloupe February 2011 – 21 ill. Del Monte Fresh Produce recalled whole cantaloupes after an epidemiologic link was found between the cantaloupe and an outbreak of Salmonella Panama. The cantaloupes were sold as a package of three through warehouse clubs in Alaska, California, Colorado, Idaho, Montana, Oregon, and Washington. The cantaloupes were grown in Guatemala.
Cargill Meat Solutions Ground Turkey February 2011 – 136 ill. The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) issued a public health alert, on July 29, due to concerns about illnesses caused by Salmonella Heidelberg associated with the use and the consumption of ground turkey. The alert was initiated after continuous medical reports; ongoing investigations and testing conducted by various departments of health across the nation determined an association between consumption of ground turkey products and illness. On August 3, Cargill Meat Solutions issued a recall of ground turkey products. The products subject to recall bear the establishment number “P-963” inside the USDA mark of inspection. On August 4, the CDC published their first outbreak summary. The Salmonella Heidelberg was multi-drug resistant, resistant to ampicillin, streptomycin, tetracycline, and gentamycin. The CDC began their investigation on May 23, after recognizing an “unusual clustering” of Salmonella Heidelberg cases. About the same time, routine surveillance by a federal food monitoring system found the same strain of Salmonella Heidelberg in ground turkey in stores. On July 29, the initial outbreak strain and a second, closely related, strain of Salmonella Heidelberg was isolated from a sample of leftover unlabeled frozen ground turkey from the home of an outbreak case in Ohio. The consumer product sample originated from the Cargill Meat Solutions Corporation establishment in Springdale, Arkansas. On September 11, Cargill Meat Solutions recalled an additional, approximately 185,000 pounds, of ground turkey contaminated with an identical strain of Salmonella Heidelberg that had led to the earlier recall on August 3. As of September 27, no illnesses had been linked to the additionally recalled, ground turkey products.
Palmyra Bologna Company Lebanon Bologna January 2011 – 21 ill. On March 23, the CDC announced that there was an investigation underway into an outbreak of E. coli O157:H7 that had been epidemiologically linked to the consumption of Lebanon bologna. The Palmyra Bologna Company, of Palmyra, Pennsylvania, issued a recall of the product on March 22. Lebanon bologna is a fermented, semi-dry, sausage. The suspect bologna was produced in December 2010, and had been shipped to five states.
Agromod Produce Papayas January 2011 – 99 ill. Agromod Produce recalled papayas purchased prior to July 23 after an outbreak of Salmonella Agona had been linked to the papayas. The outbreak related illnesses began after January 16 and continued to occur over several months. On August 25, the Food and Drug Administration banned imports of papayas grown in Mexico because of widespread and ongoing salmonella contamination. More than 15 percent of fresh papayas entering the U.S. from Mexico were contaminated with Salmonella.
Schreiber Processing Company, MealMart Brand, Kosher Broiled Chicken Livers January 2011 – 179 ill. An outbreak of Salmonella Heidelberg was associated with eating broiled chicken liver or chopped chicken liver produced by the Schreiber Processing Company under the MealMart brand. As of November 16, 99 cases were identified in New York, 61 cases in New Jersey, 10 cases in Pennsylvania, 6 cases in Maryland, 2 cases in Ohio, and 1 case in Minnesota. Consumers believed that the product was fully cooked; however it was not. The product should have been heated before eating. The outbreak strain of Salmonella was found in samples of kosher broiled chicken livers and in samples of chopped chicken liver made from the same broiled chicken liver. In stores, “broiled chicken livers” are often re-packaged and sold in smaller quantities or are used to prepare chopped liver sold at deli-style establishments.
Three notable outbreaks began in December, 2010, but were reported in 2011:
Sprouters Northwest/Jimmy John’s Restaurants Clover Sprouts – 7 ill. Sprouters Northwest of Kent, Washington, issued a product recall Jan. 3, 2011 after the company’s clover sprouts had been implicated in an outbreak of Salmonella Newport in Oregon and Washington. At least some of the cases had consumed clover sprouts while at a Jimmy John’s restaurant. The recall of Sprouters Northwest products included: clover; clover & onion; spicy sprouts; and deli sprouts sold to grocery stores and wholesale operations in Washington, Oregon, Idaho, Alaska, British Columbia, Saskatchewan, and Alberta. The FDA inspection found serious sanitary violations.
DeFranco and Sons In Shell Hazelnuts – 8 ill. An outbreak of E. coli O157:H7 was associated with eating in-shell hazelnuts (also known as filberts) purchased from bulk bins in grocery stores or in a repacked form. The E. coli strains isolated from case patients, and from a consumer product sample, matched genetically. The investigation led to a common distributor, DeFranco and Sons, a California based firm. On March 4, 2011, DeFranco and Sons issued a recall of all hazelnut and mixed nut products distributed from November 2, 2010, to December 22, 2010. Only in shell nuts were included in the recall. The nuts were shipped to stores in Minnesota, Iowa, Michigan, Montana, North Dakota, South Dakota, Wisconsin and to Canada. Based on a consumer hazelnut sample that proved to be contaminated with the outbreak strain of E. coli O157:H7, the Minnesota Department of Health traced the hazelnuts to a December 9 shipment from DeFranco and Sons. Later the states of Wisconsin and California isolated the outbreak strain of E. coli O157:H7 from mixed nut samples.
Jenny-O-Turkey Burgers – 12 ill. Jennie-O-Turkey Store recalled about 54,960 pounds of frozen All Natural Lean White Meat Turkey Burgers on April 1, 2011, after an outbreak of Salmonella Hadar had been linked with the consumption of this product. The turkey burgers were sold exclusively in 4-pound cartons through Sam’s Club stores. Consumer turkey burger samples in two states were confirmed to be contaminated with the outbreak strain of Salmonella Hadar. The Salmonella Hadar is known to be resistant to several antibiotic drugs, including ampicillin, amoxicillin/clavulanate, cephalothin and tetracycline. The Jenny-O Turkey Store is part of the Hormel Foods Company.
Janice Boase is a former nurse epidemiologist for Public Health Seattle & King County and an infectious disease expert. She has been on the frontlines in numerous foodborne illness investigations, such as the outbreaks involving Jack in the Box hamburgers, Odwalla apple juice, Sun Orchard orange juice. She was involved in setting initial, national,
health and safety practice standards for child care programs. She currently works for Group Health Cooperative in the practice of travel medicine, but keeps her interest in outbreak investigation by monitoring, and writing about, outbreaks for the food safety law firm Marler Clark.