The crowdsourcing site www.iwaspoisoned.com continues to show the Illinois-Wisconsin region as the center of a Salmonella montevideo outbreak likely caused by raw sprouts at Jimmy John’s restaurants.

The federal Centers for Disease Control and Prevention was able to get a public warning out on the latest outbreak involving Jimmy John’s on Friday, just before the brief government shutdown.

According to CDC, eight residents of three states —Illinois, Wisconsin and Minnesota — have been infected with Salmonella montevideo. That roughly tracks with the number of Jimmy John’s customers who had reported their illnesses as of Friday. Patrick Quade, the founder of iwaspoisoned.com, said 11 illness complaints were posted on the foodborne illness site by late Friday. Three more came in during the weekend.

The CDC reported the Salmonella montevideo outbreak has not resulted in any deaths or hospitalizations.

“Epidemiologic evidence indicates that raw sprouts at Jimmy John’s restaurants are a likely source of this multistate outbreak,” CDC’s outbreak notice said.

Jimmy John’s reacted to the outbreak by taking raw sprouts off the menu at all 2,727 franchise locations.

Before the restaurant company’s action to remove sprouts from the menus, CDC recommended consumers not eat raw sprouts served at any Jimmy John’s in Illinois and Wisconsin. The CDC also warned that raw and lightly cooked sprouts are a known source of foodborne illnesses and outbreaks.

The CDC, the U.S. Food and Drug Administration and state health departments are conducting traceback investigations, seeking further distribution information about Jimmy John’s sprouts. They are also looking for the potential route of contamination.

Public health officials say anyone eating sprouts should first cook them thoroughly.

Children, older adults, pregnant women and people with weakened immune systems are especially at risk from raw sprouts and the Salmonella that often contaminates them. People from those groups are advised to check deli or restaurant offerings to make sure they do not include fresh sprouts.

The state-federal public health investigation is using both pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS) to check for other people who are part of the outbreak.

In recent years, Jimmy John’s has temporarily dropped sprouts from its menu in response to foodborne outbreaks. It also changed up the types of sprouts it serves and its sources for those sprouts. But the sandwich maker continues to make its customers sick periodically with contaminated sprouts.

Seattle food safety attorney Bill Marler is keeping a log of the Jimmy John’s incidents. Here’s what it looks like as of today.

2014 multistate E. coli O121 outbreak; alfalfa sprouts; 19 sickened
Public health officials in California, Idaho, Michigan, Montana, Utah and Washington collaborated with the federal Centers for Disease Control and Prevention and the Food and Drug Administration to investigate an outbreak of E. coli O121 that occurred in May 2014. A total of 19 people with the outbreak strain, identified by PulseNet PFGE Pattern Identification Numbers EXKX01.0011/EXKA26.0001, were reported.

Among people for whom information was available, dates of illness onset ranged from May 1, 2014, to May 20, 2014. Ill people ranged from 11 years to 52 years old. Seven of 16 people reporting information were hospitalized. None of the confirmed victims developed hemolytic uremic syndrome. No deaths were reported.

Epidemiologic and traceback investigations by public health officials implicated raw clover sprouts produced by Evergreen Fresh Sprouts LLC of Hayden, ID, as the likely source of the outbreak.

Thirteen of 16 ill people, 81 percent, reported eating raw clover sprouts in the week before becoming ill. Ill people in Washington and Idaho reported eating sprouts in sandwiches at several local food establishments including several Jimmy John’s Gourmet Sandwiches locations, the Pita Pit, and Daanen’s Deli.

As part of the investigation, the FDA performed a traceback analysis and determined that Evergreen Fresh Sprouts supplied sprouts to seven restaurants with associated outbreak cases. This study used documents collected directly from distributors and from Evergreen Fresh Sprouts, as well as documents obtained by the states from the points of service.

The FDA conducted several inspections at the Evergreen Fresh Sprouts facility in May and June 2014. FDA investigators observed a number of unsanitary conditions, including condensate and irrigation water dripping from rusty valves; a rusty and corroded watering system in the mung bean room; tennis rackets used to scoop mung bean sprouts had scratches, chips and frayed plastic; a pitchfork used to transfer mung bean sprouts had corroded metal; and a squeegee used to agitate mung bean sprouts inside a soak vat had visible corroded metal and non-treated wood.

On June 26, 2014, the FDA and CDC met with the owner of Evergreen Fresh Sprouts to advise the firm of FDA’s concerns that the seed lot used to row clover sprouts linked to this outbreak might be contaminated. The officials encouraged Evergreen Fresh Sprouts to discontinue using that seed lot. The owner of Evergreen Fresh Sprouts agreed to stop using the suspected lot of seeds.

2012 multistate E. coli O26 outbreak, alfalfa sprouts; 29 sickened
A total of 29 individuals infected with the outbreak strain of E. coli O26 were reported from 11 states, including: Alabama with 1, Arkansas 1, Iowa 5, Kansas 2, Michigan 10, Missouri 3, Ohio 3, Pennsylvania 1, Washington 1, Wisconsin 1, and West Virginia 1.

Of the 27 ill people with available information, 23 of them, 85 percent, reported consuming sprouts at Jimmy John’s restaurants in the seven days before their illnesses. Among the 29 confirmed ill people, illness onset dates ranged from Dec. 25, 2011, to March 3, 2012. Ill people ranged in age from 9 to 57 years old, with a median age of 26 years. Female made up 89 percent of the victims. Among the 29 ill persons, 7 of them, 24 percent, were hospitalized. No HUS cases or deaths were reported.

Preliminary traceback information identified a common lot of clover seeds used to grow clover sprouts served at Jimmy John’s restaurant locations where ill people ate. The FDA and states conducted a traceback that identified two separate sprouting facilities. Both used the same lot of seed to grow clover sprouts served at these Jimmy John’s restaurant locations. On Feb. 10, 2012, the seed supplier initiated notification of sprouting facilities that received the lot of clover seed to stop using it.

Results of the epidemiologic and traceback investigations indicated eating raw clover sprouts at Jimmy John’s restaurants was the likely cause of this outbreak.

2010 Salmonella outbreak, clover sprouts, 7 sickened
Sprouters Northwest of Kent, WA, issued a product recall after the company’s clover sprouts had been implicated in an outbreak of Salmonella Newport in Oregon and Washington.

At least some of the outbreak cases had consumed clover sprouts while at a Jimmy John’s restaurant. Concurrent with this outbreak, a separate Salmonella outbreak from Salmonella, serotype I 4,5,12, i- involving alfalfa sprouts served at Jimmy John’s restaurants was under investigation.

The recall of Northwest Sprouters products included: clover; clover & onion; spicy; and deli sprouts. The Sprouters Northwest products were sold to grocery stores and wholesale operations in Washington, Oregon, Idaho, Alaska, British Columbia, Saskatchewan and Alberta. The FDA inspection found severe sanitary violations at the Northwest Sprouters operation.

2010 multistate Salmonella outbreak, alfalfa Sprouts, 140 sickened
On Dec. 17, 2010, the Illinois Department of Health announced that an investigation was underway into an outbreak of Salmonella, serotype I4,[5],12: I :-. Many of the sick people in Illinois had eaten alfalfa sprouts at various Jimmy John’s restaurants in the Illinois counties of Adams, Champaign, Cook, DuPage, Kankakee, Macon, McHenry, McLean, Peoria and Will.

The sprouts were suspected to be the cause of the illnesses. On Dec. 21, 2010, Jimmy John Liautaud, the owner of the franchised restaurant chain, requested that all franchisees remove sprouts from the menu as a “precautionary” measure. On Dec. 23, 2010, the CDC revealed that outbreak cases had been detected in other states and that the outbreak was linked with eating alfalfa sprouts at a nationwide sandwich chain.

On Dec. 26, 2010, preliminary results of the investigation indicated a link to eating Tiny Greens’ alfalfa sprouts at Jimmy John’s restaurant outlets. The FDA subsequently advised consumers and restaurants to avoid Tiny Greens brand alfalfa sprouts and spicy sprouts produced by Tiny Greens Organic Farm of Urbana, IL. The spicy sprouts contained alfalfa, radish and clover sprouts.

On Jan. 14, 2011, it was revealed that the FDA had isolated Salmonella serotype I4,[5],12:i:- from a water runoff sample collected at Tiny Greens Organic Farm. The Salmonella isolated was indistinguishable from the outbreak strain. Several FDA inspections of the sprout growing facility revealed factors that likely led to contamination of the sprouts.

2009 Salmonella Saintpaul outbreak, alfalfa sprouts, 256 Sickened
In February 2009, Nebraska Department of Health and Human Services officials identified six isolates of Salmonella Saintpaul among sick people. Although it is a relatively common strain of Salmonella, during 2008, only three cases had been detected in Nebraska, and only four of the outbreak strain had been identified in the United States.

As additional reports were made in 2009, health officials conducted a case-control study. They found alfalfa sprout consumption to be significantly related to the illnesses.  Although the CDC followed it’s rule of thumb and did not identify the restaurant as Jimmy John’s, instead using “restaurant chain (Chain A)” in its report. The agency said many of the outbreak illnesses were traced to “Chain A.”

The initial tracebacks of the sprouts indicated that although various companies had distributed them, the sprouts from the first cases originated from the same sprouting facility in Omaha, NE.

Of the 256 outbreak cases, 42 of the illnesses that began on March 15 were attributed to sprout growing facilities in other states. Those facilities had obtained seed from the same seed producer, Caudill Seed Co. of Kentucky. The implicated seeds had been sold in many states.

On April 26, 2009, the FDA and CDC recommended that consumers not eat raw alfalfa sprouts, including sprout blends containing alfalfa sprouts. In May, FDA alerted sprout growers and retailers that a seed supplier, Caudill Seed Co. of Kentucky, was recalling all alfalfa seeds with a specific three-digit prefix.

2008 Colorado E. coli outbreak, alfalfa sprouts and iceberg lettuce, 28 sickened
Several University of Colorado students from one sorority became ill with symptoms of bloody diarrhea and cramping. Additional illnesses were reported and E. coli O157: NM(H) was determined to be the cause.

Consumption of alfalfa sprouts at the Jimmy John’s restaurants in Boulder County and Adams County was identified as a risk factor for illness among the outbreak victims. Also, an environmental investigation identified Boulder Jimmy John’s food handlers who were infected with E. coli and who had worked while ill.

The health department investigation found some critical food handling violations, including inadequate handwashing. The 14 isolates from confirmed cases were a genetic match to one another, a classic sign that the same food was the source of the illnesses.

Editor’s note: Bill Marler, a founding partner of Marler Clark LLP, is also the publisher of Food Safety News.

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