Although the COVID-19 pandemic dominated the news in terms of illnesses, foodborne pathogens also sickened people across the United States in 2021. Packaged leafy greens were behind four outbreaks.

Two outbreaks of infections from Listeria monocytogenes were announced earlier this month by the Centers for Disease Control and Prevention. Both were traced to bagged salads. The contamination led Fresh Express and Dole to recall a total of more than 200 varieties of bagged salads.

The outbreak linked to the Fresh Express recall had killed one person and sickened at least 10 people across eight states as of the CDC’s most recent update on Dec. 22. 

The outbreak linked to the Dole recall had killed two people and sickened at least 16 people across 13 states as of the CDC’s update on Dec. 22.

The Fresh Express and Dole recalls involved salads packaged under those company names, as well as a variety of store brands such as those sold at Walmart, Safeway and Kroger stores.

Listeria infections are difficult to track because of the long incubation period, which can be up to 70 days, complicating outbreak investigations, according to the CDC.

Investigators from the CDC and the Food and Drug Administration continue their work on the outbreaks linked to the Fresh Express and Dole salads as the year closes.  

Another leafy greens outbreak was traced to baby spinach sold by and under the brand of Josie’s Organics. The outbreak of infections involves E. Coli O157-H7. It had sickened at least 14 people across nine states as of the most recent CDC update on Dec. 3.

Packaged leafy greens were responsible for yet another outbreak. Salad from Bright Farms has been linked to an outbreak of Salmonella infections At least 31 people across four states were confirmed patients in the outbreak.

The largest outbreak by far is ongoing and involves fresh onions imported from Mexico. The CDC has not updated the Salmonella outbreak numbers since Nov. 16, but at that time 892 patients across 38 states and Puerto Rico had been confirmed. The outbreak investigation was ongoing as of Dec. 27.

Multiple companies have recalled onions that were sold under a variety of brands and from unlabeled bulk bins. All recalled onions were supplied by ProSource Produce LLC and Keeler Family Farms and imported from the State of Chihuahua, Mexico.

Other outbreaks
A wide array of foods were responsible for outbreaks in 2021. The CDC reported that it is very likely that more people are sickened in any given outbreak than are reported by the agency. That is partly because some people who become ill do not seek medical attention. Others who do go to the doctor or emergency rooms are not tested for pathogens. Specific tests are required to determine whether illnesses are caused by foodborne pathogens or other bacteria or viruses.

The 2021 outbreaks included, in no particular order, the following.

  • An outbreak of infections from E. coli O121 involved cake mixes, but neither the FDA nor the CDC were able to zero in on any specific brands or flavors. At least 16 people were sickened. Public health officials continue to warn against eating raw cake batter and cookie dough because of the risks of foodborne pathogens that can be in raw eggs and raw flour, among other ingredients.
  • Soft cheeses from El Abuelito were behind a deadly outbreak of Listeria monocytogenes infections. At least one person died, two women had pregnancy losses and there was one premature birth. A total of 13 patients were confirmed and all required hospitalization.
  • Raw, unpasteurized yogurt caused an E. Coli outbreak that was referred to as a single-state outbreak confined to patients in Washington. However, three people in Arizona also became ill with the outbreak strain after travel to the Northwest. Pure Eire yogurt was implicated in the outbreak. The company issued a recall. At least 17 people were infected and four developed a serious complication involving kidney failure.
  • An outbreak traced to “Real Water” brand bottled water sickened at least 21 people. There were also four suspected cases. The outbreak was defined by the CDC as non-viral hepatitis. This kind of hepatitis causes acute liver damage through inflammation. The inflammation scars the liver tissue and liver failure can be the result.
  • A four-state outbreak of Salmonella infections sickened at least 20 people and was traced to Jule’s Foods brie. The company recalled five varieties of its brie. The outbreak resulted in the hospitalization of five patients.
  • An E. coli outbreak of unknown origin left one person dead. A total of 22 patients were confirmed with 11 requiring hospitalization. People across seven states were affected. The CDC closed the investigation and reminded the public to practice safe food handling procedures at home: clean, separate, cook and chill.
  • Ground turkey was the source of a Salmonella Hadar outbreak. A total of 33 patients were confirmed across 14 states. The CDC reported that four people were so sick that they had to be hospitalized. The U.S. Department of Agriculture issued a public alert involving more than 211,000 pounds of raw ground turkey products produced by Plainville Brands LLC. A recall was not requested because it was believed that the products were no longer available for consumers to purchase.
  • Frozen, raw chicken products that were breaded, pre-browned, and stuffed were the cause of an outbreak of Salmonella Enteritidis infections. At least 36 people across 11 states were sickened. Three brands of the chicken products were recalled: Dutch Farms, Milford Valley and Kirkwood. The CDC remained consumers to fully cook frozen chicken products even if they appear to have been browned.
  • The CDC determined that frozen, cooked shrimp was behind an outbreak of Salmonella Weltevreden. The outbreak sickened at least nine people across three states. Cooked shrimp supplied by Avanti Frozen Foods and sold under multiple brand names including 365, Ahold, Big River, Censea, Chicken of the Sea, CWNO, First Street, Food Lion, Hannaford, Harbor Banks, Honest Catch, HOS, Meijer, Nature’s Promise, Open Acres, Sandbar, Sea Cove, Waterfront Bistro, Wellsley Farms, and WFNO Brands were implicated. Avanti issued a recall of the shrimp.
  • Fully cooked chicken supplied by Tyson Foods Inc. was determined to be the cause of an outbreak of infections from Listeria monocytogenes. Although only three patients in two states were confirmed with the outbreak strain, one person died. All three required hospitalization and the CDC reported that additional illnesses were likely. Tyson recalled almost 9 million pounds of chicken products.
  • An outbreak of Salmonella Typhimurium infections was traced to Italian style meets. At least 40 people across 17 states were sickened. A dozen people required hospitalization. The outbreak spurred a recall by Fratelli Beretta of its  uncured antipasto trays with prosciutto, soppressata, Milano salami, and coppa.
  • Seafood distributed by Northeast Seafood Products was responsible for an outbreak of Salmonella infections, mostly among people in Colorado. There were 115 confirmed outbreak patients in 15 states; 20 people were so sick they required hospitalization. The implicated seafood included sushi. Investigators determined the seafood was sold by retailers and restaurants. The company recalled a variety of products, including salads sold under the Dole and Fresh Express brand names.
  • The CDC determined that an outbreak of Salmonella I 4,[5],12:i:- was caused by salami stick snacks. Euro Foods recalled more than 119,000 pounds of Citterio brand “Premium Italian-Style Salame Sticks” because of the outbreak. At least 34 people across 10 states became ill with seven hospitalizations reported to the CDC.

(To sign up for a free subscription to Food Safety News, click here.)