2012 outbreak of Salmonella

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The 2012 outbreak of Salmonella took place in 15 places worldwide with over 2,300 strains identified.

Contents

In general, the United States alone experiences 1 million cases of salmonellosis per year. [1] In Europe, although there are around 100,000 incidents of salmonellosis reported annually, there has been a steady decrease in cases over the past four years. [2] The exact number of those infected is impossible to know as not all cases are reported. Of these reported cases, some can be classified as foodborne disease outbreaks by the Centers for Disease Control and Prevention (CDC) if "two or more people get the same illness from the same contaminated food or drink" [3] or zoonotic outbreaks if "two or more people get the same illness from the same pet or other animal". [4] In 2012, the various strains or serotypes of the Salmonella bacteria, related to the outbreaks in the United States, infected over 1800 people and killed seven. [5] In Europe, the European Centre for Disease Prevention and Control (ECDC) reported 91,034 cases of Salmonella infection with 65,317 cases related to the 2012 outbreaks. [6] Of those 65,317 cases, there were 61 deaths. [6]

Salmonella bacteria can be found in almost any product or animal that has been exposed to fecal matter. [6] These exposures can occur from crops grown from waste-based fertilizers or from food items handled by infected humans. [7] [8] Salmonellosis is an intestinal disease, meaning that the bacteria must be ingested and processed through the intestines in order for infection to occur. [7] [8] Thus, salmonellosis is commonly spread to humans through ingestion of contaminated food items. [7] [8] It can also be spread through contact with reptiles and birds, usually after the person handles the animal or its environment (without hand-washing immediately) and then touches their mouth or food items. [7] Those infected usually develop symptoms anywhere from 12 to 72 hours after first contact with Salmonella bacteria, and most do not require serious medical attention. [8] This salmonellosis displays itself in humans with fever, abdominal pain, nausea, and, most commonly, diarrhea for a period of up to 7 days. [8] Those requiring hospitalization usually are dehydrated or have extreme diarrhea, which can turn deadly, especially if the salmonella bacteria reaches the bloodstream. [7] [8] The elderly, young children, and those with weakened immune systems are most at risk for developing salmonellosis and having severe reactions. [7] [8] The most common serotypes of Salmonella in the United States and Europe are Enteritidis and Typhimurium. [6] [8]

Origins of outbreak

The 2012 outbreak did not have one start and end date due to the multivariate origination sites and stages of investigation. Each outbreak followed its own pattern of contamination, spread, infection, and containment throughout the course of 2012. Worldwide, there were 15 different foodborne and zoonotic origins of the Salmonella outbreaks. [3] [6] Eighteen of the over 2,300 strains of Salmonella were found in infected humans and contaminated products in Europe and the U.S. [6] As with all diseases, there were certain places and serotypes that contributed more to the magnitude of the 2012 outbreak. As such, the origins listed below had the greatest frequency of occurrence and overall impact on society.[ citation needed ]

Hedgehogs

S. Typhimurium has traditionally been an uncommon serotype of Salmonella; however, beginning in January 2012 through the end of 2012, the number of cases steadily rose, with 18 human cases in the United States alone (spread among eight states). [9] The infection caused one death and four hospitalizations. [9] These infections stem from contact with pet hedgehogs or with the animals' surroundings. [9] No one pet provider was linked to the infected hedgehogs. [9]

Feeder rodents

One epidemic of Salmonella enterica I 4,5,12:i:- in the United States in February 2012 affected 46 people across 22 states. [10] The outbreak seemed to be linked to the handling of live or frozen feeder mice and rats for reptile and amphibian pets. [10] A similar outbreak occurred in the United States and United Kingdom in 2009 and 2010 from the same two breeders implicated in this 2012 occurrence. [10] Also, more than a third of those infected were young children, highlighting their propensity for infection. [10]

Live poultry

The outbreaks in 2012 that occurred due to contact with live poultry were of five different serotypes of Salmonella bacteria originating in three distinct locations. The first infections were reported in February 2012. [11] Spanning 23 states, there were 93 humans infected with the Montevideo serotype of Salmonella. [11] All were infected with this strain from contact with baby ducklings or chicks from the Estes Hatchery located in Springfield, Missouri. [11] This outbreak resulted in one casualty. [11] One month later (March 2012), 46 people in the United States were infected with Salmonella Hadar through contact with live poultry. [12] There were no deaths, and the infected humans were located in 11 different states. [12] The specific hatchery name is withheld, but it was concluded by the CDC that this strain of Salmonella originated in one unnamed hatchery in Idaho. [12] In the same month, one of three strains of Salmonella – Infantis, Newport, or Lille – were contracted by 195 people from contact with live poultry (whether for purposes of agriculture or pet keeping). [13] Of those infected, two died from infection. [13] This particular outbreak, though stemming from only the Mt. Healthy Hatchery in Ohio, expanded across 27 states. [13]

Small turtles

First investigated at the end of March 2012, there were a total of 84 cases of infected humans across 15 states of the United States by November 2012. [14] These people's salmonellosis (either from Salmonella Sandiego or Salmonella Newport) stemmed from contact with small turtles or their habitats. [14] Some of these turtles were purchased from street merchants. [14] No one source of the Salmonella contaminations was identified, and no human deaths occurred. [14] Due to past outbreaks, there is a law in place making it illegal to sell or own a turtle with a shell length less than four inches, as these seem to generally be the sources of most Salmonella bacteria in small turtles. [14]

Raw scraped ground tuna product

First reported in April 2012, an outbreak of salmonellosis caused by rarer serotypes, Salmonella Bareilly and Salmonella Nchanga, was reported in 28 states, mostly in the Eastern U.S., having caused no deaths, but 425 cases of illness and 55 hospitalizations. [15] This outbreak was linked to the consumption of raw scraped ground tuna product. [15] The source was frozen raw yellowfin tuna product aka Nakaochi Scrape manufactured by Moon Marine USA Corporation. [15] This product was voluntarily recalled after the CDC discovered strains of Salmonella in the packages. [15] The company eventually recalled another type of canned tuna for fear it may have been contaminated, too. [15] This outbreak was significant in that it was the first salmonellosis case in the United States connected to raw, scraped tuna products, as well as being the first time S. Nchanga was discovered in food products in the United States. [15]

Smoked salmon

In July 2012, an outbreak of salmonellosis occurred in the Netherlands and the United States. [16] According to the National Institute for Public Health and the Environment, by the end of 2012, 1060 people in the Netherlands and 100 in the United States contracted salmonellosis from smoked salmon infected with Salmonella Thompson. [17] [18] On November 2, the RIVM confirmed that there were 4 deaths and over 1060 cases linked to S. Thompson in the Netherlands. [17] The infections were linked to smoked salmon from the manufacturer Foppen, where the contamination had occurred. [16] A recall involving a quarter million customers was undertaken in the United States. [19] [20] The CDC did not classify this as an outbreak because there were not a verified number of people infected from only this source in the U.S. [3]

Presence in agriculture

Contamination through defecation

Because animals are the main transporters of Salmonella, crops can become infected. This generally occurs because of the use of manure-based fertilizers on farms. Some animals do not appear sick (especially infected poultry); however, they carry the Salmonella in their intestines and when they defecate, the bacteria spreads to the soil. [6] Sometimes, the sick animals manifest the illness in ways similar to humans with similar consequences. They may have diarrhea, fever, and then die if they are not treated. [6] After their death, the other animals raised with them can become infected through contact with their feces. [6] Therefore, if this infected manure is used as a fertilizer for crops, then the crops will contain trace amounts of infectious Salmonella bacteria that can spread to humans after the crops are harvested. [6]

Poultry can become infected by living close together in hatcheries, where multiple animals are defecating. Some poultry are hatched to be sold domestically, while others are hatched for production to be consumed later. If live poultry are infected and sold domestically, they can infect other animals who may be around them in a domestic situation e.g. other pets. [12] Because poultry do not show symptoms, infections are usually not obvious until humans or other animals in contact with the poultry become ill. [6]

Tomatoes

Notice of lack of tomatoes due to Salmonella outbreak in 2012 No Tomatoes.jpg
Notice of lack of tomatoes due to Salmonella outbreak in 2012

East Coast tomatoes tend to have higher rates of Salmonella infection than West Coast tomatoes. [21] This seems to be due to the microbiome of the East Coast of the United States, where there are far less soil bacteria that destroy Salmonella versus the microbiome of the West Coast where these bacteria are abundant. [21] Because of the anti-salmonella bacteria limiting its spread, fewer people on the West Coast report cases of salmonellosis. [21] Additionally, street-sold natural tomatoes have been consistently tied to outbreaks of Salmonella. Street-sold (unregulated) items are independently produced and sold to consumers. This does not include fresh produce markets. These strong links to salmonellosis is in due in part do the lack of Food and Drug Administration (FDA) oversight on unregistered vendors. Another cause of Salmonella bacteria growth may be due to contact with contaminated irrigation water. [21] [22] The tomatoes (or any plant) are much more likely to become infected if the soil in which the roots are located are contaminated or if the actual blossom is contaminated. [21] [22] These two entry points lead to the most likely scenarios in which a healthy tomato plant may become infected with some serotype of Salmonella. [22]

End of 2012 outbreak and future prevention

An infographic illustrating prevention methods to reduce Salmonella contamination in many scenarios Prevention of Salmonella from the farm to table infographic.png
An infographic illustrating prevention methods to reduce Salmonella contamination in many scenarios

The various outbreaks of Salmonella serotypes in the U.S. and abroad began at different points either in late 2011 or early 2012; however, all cases were concluded at the end of 2012. Those who were infected either persisted through the symptoms or expired from Salmonella's destruction to their immune system. [3] If there was a specific point of origin for an outbreak, a recall of the product helped to decrease more possible exposure. None of the people infected showed symptoms or maintained symptoms into 2013. This biotic disturbance had a major impact on society. It increased awareness about the ease in which bacteria spread among organisms. It helped to prompt researchers to look into ways to prevent crops from becoming contaminated in the field. Most importantly, this disturbance has been occurring with increasing frequency, which seems counter-intuitive because salmonellosis is an easily preventable disease; if simple food safety steps were taken, unnecessary hospitalizations and deaths could have been eliminated in 2012. [23]

In order to prevent serious outbreaks similar to the one in 2012 in the future, some precautions must be taken. When handling food, one must be careful not to cross-contaminate raw poultry products or other meats with other foods. [24] Anyone handling food should also be sure to wash their hands frequently. [24] All persons should wash their hands after using the restroom as bacteria can survive for long periods of time outside of the body and the bacteria will be spread from the unwashed hands to possible food items or anything that may enter the mouth area. [24] When cooking, one should take care to heat foods to at least 167 °F (75 °C) for a minimum of ten minutes to ensure that the entire product is evenly cooked. [25] [26] [27] This is because heat and ultraviolet radiation are good neutralizers of Salmonella bacterium. [28] Recent outbreaks have occurred, and although not all infections can be eliminated, most can be hindered either through coating crops with Salmonella-fighting bacteria [22] or through human precautions.

Related Research Articles

<span class="mw-page-title-main">Zoonosis</span> Disease that can be transmitted from other species to humans

A zoonosis or zoonotic disease is an infectious disease of humans caused by a pathogen that can jump from a non-human to a human and vice versa.

<i>Salmonella</i> Genus of prokaryotes

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 2,600 serotypes. Salmonella was named after Daniel Elmer Salmon (1850–1914), an American veterinary surgeon.

<i>Campylobacter</i> Genus of Gram-negative bacteria

Campylobacter is a genus of Gram-negative bacteria. Campylobacter typically appear comma- or s-shaped, and are motile. Some Campylobacter species can infect humans, sometimes causing campylobacteriosis, a diarrhoeal disease in humans. Campylobacteriosis is usually self-limiting and antimicrobial treatment is often not required, except in severe cases or immunocompromised patients. The most known source for Campylobacter is poultry, but due to their diverse natural reservoir, Campylobacter spp. can also be transmitted via the air, though this is rare. Other known sources of Campylobacter infections include food products, such as unpasteurised milk and contaminated fresh produce. Sometimes the source of infection can be direct contact with infected animals, which often carry Campylobacter asymptomatically. At least a dozen species of Campylobacter have been implicated in human disease, with C. jejuni (80–90%) and C. coli (5-10%) being the most common. C. jejuni is recognized as one of the main causes of bacterial foodborne disease in many developed countries. It is the number one cause of bacterial gastroenteritis in Europe, with over 246,000 cases confirmed annually. C. jejuni infection can also cause bacteremia in immunocompromised people, while C. lari is a known cause of recurrent diarrhea in children. C. fetus can cause spontaneous abortions in cattle and sheep, and is an opportunistic pathogen in humans.

<span class="mw-page-title-main">Psittacosis</span> Infectious disease in humans

Psittacosis—also known as parrot fever, and ornithosis—is a zoonotic infectious disease in humans caused by a bacterium called Chlamydia psittaci and contracted from infected parrots, such as macaws, cockatiels, and budgerigars, and from pigeons, sparrows, ducks, hens, gulls and many other species of birds. The incidence of infection in canaries and finches is believed to be lower than in psittacine birds.

<span class="mw-page-title-main">Tularemia</span> Infectious disease caused by the bacterium Francisella tularensis

Tularemia, also known as rabbit fever, is an infectious disease caused by the bacterium Francisella tularensis. Symptoms may include fever, skin ulcers, and enlarged lymph nodes. Occasionally, a form that results in pneumonia or a throat infection may occur.

<i>Salmonella enterica</i> Species of bacterium

Salmonella enterica is a rod-headed, flagellate, facultative anaerobic, Gram-negative bacterium and a species of the genus Salmonella. A number of its serovars are serious human pathogens; many of them are serovars of Salmonella enterica subsp. enterica.

<span class="mw-page-title-main">Foodborne illness</span> Illness from eating spoiled food

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.

<span class="mw-page-title-main">Campylobacteriosis</span> Medical condition

Campylobacteriosis is an infection by the Campylobacter bacterium, most commonly C. jejuni. It is among the most common bacterial infections of humans, often a foodborne illness. It produces an inflammatory, sometimes bloody, diarrhea or dysentery syndrome, mostly including cramps, fever and pain.

<span class="mw-page-title-main">Listeriosis</span> Medical condition

Listeriosis is a bacterial infection most commonly caused by Listeria monocytogenes, although L. ivanovii and L. grayi have been reported in certain cases. Listeriosis can cause severe illness, including severe sepsis, meningitis, or encephalitis, sometimes resulting in lifelong harm and even death. Those at risk of severe illness are the elderly, fetuses, newborns and those who are immunocompromised. In pregnant women it may cause stillbirth or spontaneous abortion, and preterm birth is common. Listeriosis may cause mild, self-limiting gastroenteritis and fever in anyone.

<span class="mw-page-title-main">Salmonellosis</span> Infection caused by Salmonella bacteria

Salmonellosis is a symptomatic infection caused by bacteria of the Salmonella type. It is also a food-borne disease and 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.

<span class="mw-page-title-main">Paratyphoid fever</span> Bacterial infection caused by one of the three types of Salmonella enterica

Paratyphoid fever, also known simply as paratyphoid, is a bacterial infection caused by one of three types of Salmonella enterica. Symptoms usually begin 6–30 days after exposure and are the same as those of typhoid fever. Often, a gradual onset of a high fever occurs over several days. Weakness, loss of appetite, and headaches also commonly occur. Some people develop a skin rash with rose-colored spots. Without treatment, symptoms may last weeks or months. Other people may carry the bacteria without being affected; however, they are still able to spread the disease to others. Typhoid and paratyphoid are of similar severity. Paratyphoid and typhoid fever are types of enteric fever.

Exogenous bacteria are microorganisms introduced to closed biological systems from the external world. They exist in aquatic and terrestrial environments, as well as the atmosphere. Microorganisms in the external environment have existed on Earth for 3.5 billion years. Exogenous bacteria can be either benign or pathogenic. Pathogenic exogenous bacteria can enter a closed biological system and cause disease such as Cholera, which is induced by a waterborne microbe that infects the human intestine. Exogenous bacteria can be introduced into a closed ecosystem as well, and have mutualistic benefits for both the microbe and the host. A prominent example of this concept is bacterial flora, which consists of exogenous bacteria ingested and endogenously colonized during the early stages of life. Bacteria that are part of normal internal ecosystems, also known as bacterial flora, are called Endogenous Bacteria. A significant amount of prominent diseases are induced by exogenous bacteria such as gonorrhea, meningitis, tetanus, and syphilis. Pathogenic exogenous bacteria can enter a host via cutaneous transmission, inhalation, and consumption.

<span class="mw-page-title-main">2008 United States salmonellosis outbreak</span> Disease outbreak in the United States

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.

<span class="mw-page-title-main">2011 United States listeriosis outbreak</span> Disease outbreak in the United States

The 2011 United States listeriosis outbreak was a widespread outbreak of Listeria monocytogenes food poisoning across 28 US states that resulted from contaminated cantaloupes linked to Jensen Farms of Holly, Colorado. As of the final report on August 27, 2012, there were 33 deaths and 147 total confirmed cases since the beginning of the first recorded case on July 31, 2011. It was the worst foodborne illness outbreak in the United States, measured by the number of deaths, since the Centers for Disease Control and Prevention began tracking outbreaks in the 1970s, or tied with the worst, an outbreak of listeria from cheese in 1985, depending on which CDC report is used.

Salmonellosis annually causes, per CDC estimation, about 1.2 million illnesses, 23,000 hospitalizations, and 450 deaths in the United States every year.

<span class="mw-page-title-main">2018 American salmonella outbreak</span>

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. 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. Total of approximately 20 630 pounds of chicken were deemed contaminated with Salmonella Typhimurium at the time of recall on February 21.

<span class="mw-page-title-main">Food safety in the United States</span>

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.

Antibiotic use in the United States poultry farming industry is the controversial prophylactic use of antibiotics in the country's poultry farming industry. It is important to note that this practice does not reflect the position in other countries.

<span class="mw-page-title-main">Milk borne diseases</span>

Milk borne diseases are any diseases caused by consumption of milk or dairy products infected or contaminated by pathogens. Milk borne diseases are one of the recurrent foodborne illnesses—between 1993 and 2012 over 120 outbreaks related to raw milk were recorded in the US with approximately 1,900 illnesses and 140 hospitalisations. With rich nutrients essential for growth and development such as proteins, lipids, carbohydrates, and vitamins in milk, pathogenic microorganisms are well nourished and are capable of rapid cell division and extensive population growth in this favourable environment. Common pathogens include bacteria, viruses, fungi, and parasites and among them, bacterial infection is the leading cause of milk borne diseases.

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