The 2018 American salmonella outbreak was an American foodborne disaster that started in Iowa, spreading to 7 other states, sickening as many as 265 people, killing one, with 94 hospitalized. [1] Ready-to-eat chicken salad was produced by Iowa-based Triple T Specialty Meats Inc. between January 2 and February 7 for distribution in Fareway grocery stores. Salad was sold in containers of various weights at Fareway stores deli from January 4 to February 9. [2] Total of approximately 20 630 pounds of chicken were deemed contaminated with Salmonella Typhimurium at the time of recall on February 21. [3]
Illnesses started from January 8 to March 20. 94 hospitalizations, including one death, were reported. [2] On February 9 Iowa Department of Public Health (IDPH) notified the US Department of Agriculture’s Food Safety and Inspection Service (FSIS) of its investigation of Salmonella-related illnesses. [4]
Samples of chicken salad were collected in February for testing at Iowa State Hygienic Laboratory (SHL). Test results were presumptive positive Salmonella Typhimurium, [5] leading to a joint public IDPH and the Iowa Department of Inspections and Appeals (IDIA) alert. [6]
265 people in 8 states were identified to carry similar Salmonella Typhimurium strains, [2] predominantly in Iowa (240 cases). Additional cases appeared in Illinois (10), Nebraska (5), Minnesota (4), South Dakota (3) and in Indiana, Mississippi and Wisconsin, with one case respectively. [7]
Out of 222 patients interviewed, 87% reported chicken salad consumption. [8] Overall, 94 people had to be hospitalised with one reported death in Iowa. Patients age ranged from less than 1 to 89 years, with a median of 57.67, the majority female (67%). [8]
Month | Date | Event |
---|---|---|
January 2018 | January 2 | Production of contaminated chicken salad by Triple T Specialty Meats, Inc. (until February 7) [3] |
January 4 | Products retailed at Fareway Grocery Stores [2] | |
January 8 | First patients identified with Salmonella [9] | |
February 2018 | February 9 | Voluntary removal of chicken salad from Fareway stores, after an alert by the Iowa Department of Inspections and Appeals (DIA) [2] |
February 13 | Department of Public Health & DIA issue consumer advisory [6] | |
February 14 | FSIS issues a Public Health Alert [10] | |
February 21 | Voluntary product recall by Triple T Specialty Meats, Inc. (Class I Recall) [3] | |
March 2018 | March 20 | Last patient identified [9] |
April 2018 | April 6 | Outbreak declared over [2] |
According to the Centre for Disease Control investigative report, likely source of this outbreak was chicken salad produced by Triple T Specialty Meats, Inc. from January 2, 2018, to February 7, 2018. [2] This specific product was sold in various weights at Fareway grocery stores in Illinois, Iowa, Minnesota, Nebraska and South Dakota and were subsequently recalled by Triple T Specialty Meats Inc. on February 21, 2018, due to the possible Salmonella contamination as at the time, the source had not been confirmed. [3]
During the investigation, public health officials in Iowa interviewed 222 people and 197 of those reported eating a chicken salad from Fareway grocery stores. Iowa Investigators then collected samples for laboratory testing from Fareway grocery stores and the outbreak strain of Salmonella Typhimurium was identified in both samples. [3]
Salmonella is a bacterium that produces the symptoms of diarrhoea, fever and abdominal cramps in infected individuals 12-72 hours after exposure. Most people recover without treatment and the illness usually lasts for 4-7 days. [11]
Some people may need hospitalization due to severe symptoms and in rare cases, Salmonella can cause death unless the person is treated with antibiotics promptly. Those most likely to develop severe salmonella are children under the age of 5, adults over the age of 65 and people with compromised immune systems. [11]
Treatment of salmonella infections depends on age and pre-disposition of the infected person and the severity of the symptoms. [12] One of the side-effects from salmonella infection is dehydration, making the replacement of fluids and electrolytes the main treatment for less severe infections. [13] In severe cases, patients are treated with antibiotics, rehydrated with intravenous (IV) fluids and hospitalized. In cases where the infection spreads from the intestines to the bloodstream, quick treatment with antibiotics is required to prevent the risk of death. [12]
Possible complications include resistances to certain antibiotics in the salmonella streaks, that might require treatment with different antibiotics than commonly prescribed antibiotics. In this case, whole-genome sequencing (WGS) analysis identified no antibiotic resistance in 112 of 127 isolates. [2]
Following the incident, the FSIS reviewed and revised foodborne illness related procedures to accelerate response times, clarify responsibilities and improve communication. [8] Measures include enhanced communication processes with partners, [14] [15] advice to strengthen collaboration with industry and updated guidelines on sampling. [8] The PulseNet national laboratory network [16] connects foodborne illness cases to detect outbreaks using DNA fingerprinting of bacteria that make people sick. Since establishment in 1996 PulseNet has been instrumental in detecting thousands of local and multistate outbreaks, identifying Salmonella 2018 [2] among others.
On February 22, 2018, the Centre for Disease Control released their first statement about a collaborative investigation into a multistate outbreak of Salmonella Typhimurium with public health officials and regulatory officials in several states. [2] As of February 21, 2018, 65 people were infected with the outbreak strain in 5 states. They used epidemiological and laboratory evidence to trace the source of the outbreak and this resulted in a recall. [3]
On March 7, 2018, the Centre for Disease Control announced a case count update of 105 more infected people in 6 states and they anticipated a delay in case number updates due to the 2-4 week window of initial infection to case reporting, their last announcement showed that as of April 6, 2018, the outbreak was over. [2]
Litigation cases in Iowa were set between the victims and Fareway grocery stores and Triple T Specialty Meats, Inc. with regards to the Salmonella outbreak and victims filed civil suits in federal court to seek reimbursement for medical costs as well as other costs. [17] The 50 lawsuits against Fareway and Triple T Specialty Meats were subsequently settled. [18]
Salmonella is a genus of rod-shaped (bacillus) gram-negative bacteria of the family Enterobacteriaceae. The two known species of Salmonella are Salmonella enterica and Salmonella bongori. S. enterica is the type species and is further divided into six subspecies that include over 2,650 serotypes. Salmonella was named after Daniel Elmer Salmon (1850–1914), an American veterinary surgeon.
Campylobacter is a type of bacteria that can cause a diarrheal disease in people. Its name means "curved bacteria", as the germ typically appears in a comma or "s" shape. According to its scientific classification, it is a genus of gram-negative bacteria that is motile.
Foodborne illness is any illness resulting from the contamination of food by pathogenic bacteria, viruses, or parasites, as well as prions, and toxins such as aflatoxins in peanuts, poisonous mushrooms, and various species of beans that have not been boiled for at least 10 minutes.
Campylobacteriosis is among the most common infections caused by a bacterium in humans, often as a foodborne illness. It is caused by the Campylobacter bacterium, most commonly C. jejuni. It produces an inflammatory, sometimes bloody, diarrhea or dysentery syndrome, and usually cramps, fever and pain.
Salmonellosis is a symptomatic infection caused by bacteria of the Salmonella type. It is the most common disease to be known as food poisoning, these are defined as diseases, usually either infectious or toxic in nature, caused by agents that enter the body through the ingestion of food. In humans, the most common symptoms are diarrhea, fever, abdominal cramps, and vomiting. Symptoms typically occur between 12 hours and 36 hours after exposure, and last from two to seven days. Occasionally more significant disease can result in dehydration. The old, young, and others with a weakened immune system are more likely to develop severe disease. Specific types of Salmonella can result in typhoid fever or paratyphoid fever. Typhoid fever and paratyphoid fever are specific types of salmonellosis, known collectively as enteric fever, and are, respectively, caused by salmonella typhi and paratyphi bacteria, which are only found in humans. Most commonly, salmonellosis cases arise from salmonella bacteria from animals, and chicken is a major source for these infections.
Cyclospora cayetanensis is a coccidian parasite that causes a diarrheal disease called cyclosporiasis in humans and possibly in other primates. Originally reported as a novel pathogen of probable coccidian nature in the 1980s and described in the early 1990s, it was virtually unknown in developed countries until awareness increased due to several outbreaks linked with fecally contaminated imported produce. C. cayetanensis has since emerged as an endemic cause of diarrheal disease in tropical countries and a cause of traveler's diarrhea and food-borne infections in developed nations. This species was placed in the genus Cyclospora because of the spherical shape of its sporocysts. The specific name refers to the Cayetano Heredia University in Lima, Peru, where early epidemiological and taxonomic work was done.
Food safety is used as a scientific method/discipline describing handling, preparation, and storage of food in ways that prevent foodborne illness. The occurrence of two or more cases of a similar illness resulting from the ingestion of a common food is known as a food-borne disease outbreak. This includes a number of routines that should be followed to avoid potential health hazards. In this way, food safety often overlaps with food defense to prevent harm to consumers. The tracks within this line of thought are safety between industry and the market and then between the market and the consumer. In considering industry-to-market practices, food safety considerations include the origins of food including the practices relating to food labeling, food hygiene, food additives and pesticide residues, as well as policies on biotechnology and food and guidelines for the management of governmental import and export inspection and certification systems for foods. In considering market-to-consumer practices, the usual thought is that food ought to be safe in the market and the concern is safe delivery and preparation of the food for the consumer. Food safety, nutrition and food security are closely related. Unhealthy food creates a cycle of disease and malnutrition that affects infants and adults as well.
The 2008 United States salmonellosis outbreak was an outbreak of salmonellosis across multiple U.S. states due to Salmonella enterica serovar Saintpaul. Over the course of the outbreak, 1442 cases were identified across 43 U.S. states, the District of Columbia, and Canada. The U.S. Centers for Disease Control and Prevention (CDC) investigation determined that jalapeño peppers imported from Mexico as well as Serrano peppers were major sources of the outbreak. Tomatoes may have been a source as well. The outbreak lasted from April to August 2008.
Pasteurized eggs are eggs that have been pasteurized in order to reduce the risk of foodborne illness in dishes that are not cooked or are only lightly cooked. They may be sold as liquid egg products or pasteurized in the shell.
Raw meat generally refers to any type of uncooked muscle tissue of an animal used for food. In the meat production industry, the term ‘meat’ refers specifically to mammalian flesh, while the words ‘poultry’ and ‘seafood’ are used to differentiate between the tissue of birds and aquatic creatures.
Michael R. Taylor is an American lawyer who has played leadership roles in the US Food and Drug Administration, agrochemical company Monsanto, and law firm King & Spalding. He currently co-chairs the board of STOP Foodborne Illness, a non-profit that supports victims of serious illness and their families in efforts to strengthen food safety culture and practices in government and industry.
Salmonella enterica subsp. enterica is a subspecies of Salmonella enterica, the rod-shaped, flagellated, aerobic, Gram-negative bacterium. Many of the pathogenic serovars of the S. enterica species are in this subspecies, including that responsible for typhoid.
The Food Safety and Inspection Service (FSIS), an agency of the United States Department of Agriculture (USDA), is the public health regulatory agency responsible for ensuring that United States' commercial supply of meat, poultry, and egg products is safe, wholesome, and correctly labeled and packaged. The FSIS draws its authority from the Federal Meat Inspection Act of 1906, the Poultry Products Inspection Act of 1957 and the Egg Products Inspection Act of 1970.
The 2012 outbreak of Salmonella took place in 15 places worldwide with over 2,300 strains identified.
The Australian Food Safety Information Council is a health promotion charity The Council develops consumer-targeted food safety information to address the number of Australians getting sick from food poisoning by providing simple, easy to follow consumer information on the handling, storage and preparation of food. A study by Food Standards Australia New Zealand and the Australian National University in 2022 estimated there are 4.67 million cases of food poisoning in Australia each year that result in 47,900 hospitalisations, 38 deaths and a cost to the economy of $2.1 billion.
Food safety in Australia concerns the production, distribution, preparation, and storage of food in Australia to prevent foodborne illness, also known as food safety. Food Standards Australia New Zealand is responsible for developing food standards for Australia and New Zealand.
Salmonellosis annually causes, per CDC estimation, about 1.2 million illnesses, 23,000 hospitalizations, and 450 deaths in the United States every year.
Food safety in the United States relates to the processing, packaging, and storage of food in a way that prevents food-borne illness within the United States. The beginning of regulation on food safety in the United States started in the early 1900s, when several outbreaks sparked the need for litigation managing food in the food industry. Over the next few decades, the United States created several government agencies in an effort to better understand contaminants in food and to regulate these impurities. Many laws regarding food safety in the United States have been created and amended since the beginning of the 1900s. Food makers and their products are inspected and regulated by the Food and Drug Administration and the Department of Agriculture.
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