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Disease outbreaks caused by cereal ‘extremely uncommon’
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Kellogg’s voluntarily recalled packages of Honey Smacks last week after the cereal was linked to an outbreak of Salmonella involving dozens of patients in more than 30 states. While the company and others investigate the cause of the outbreak, the CDC has warned consumers not to eat Honey Smacks in any package size and told retailers to not to sell the cereal.
According to the CDC, 73 cases of Salmonella Mbandaka linked to the cereal have been reported from 31 states, including 24 hospitalizations.
Timothy F. Jones, MD, Infectious Disease News Editorial Board member and state epidemiologist for the Tennessee Department of Health, said breakfast cereals are “an extremely uncommon source” of foodborne outbreaks.
“Outbreaks like this are difficult for consumers to prevent, since the implicated food is not intended to be cooked prior to eating,” Jones told Infectious Disease News. “It can also be very difficult to identify a source if it ends up being an unexpected or very common product, which would not really raise anyone’s suspicion — as opposed to Salmonella in chicken or eggs, for example.”
According to the CDC, the outbreak involves patients aged less than 1 year to 87 years. A CDC spokesman told Infectious Disease News that 11% of the cases have been in children younger than 18. No deaths have been reported.
Salmonella infection can cause fever, diarrhea and abdominal cramps which can last from 4 to 7 days, according to the CDC. Most people recover without treatment. The CDC and FDA warned that children are most likely to be infected with Salmonella and, along with the elderly and individuals with a weakened immune system, are more likely to experience severe infections.
Jones said he is aware of only two foodborne disease outbreaks linked to cereal: both involved Salmonella Agona tied to cereal made by the brand Malt-O-Meal.
“In the current investigation they have not yet identified a specific source of contamination either,” Jones added. “While it could have been introduced due to environmental contamination in the plant, my guess is that it is due to an ingredient coming in contaminated, and then not killed during the production process.”
Kellogg’s recalled the 15.3 oz. and 23 oz. products with UPC codes 38000039103 and 3800014810, respectively, with best-by dates of June 14. However, the CDC has advised consumers to throw away or return all Kellogg’s Honey Smacks cereal, regardless of package size and best-by date.
The contaminated cereal was distributed across the United States and internationally, according to the FDA.
“It is important to order stool cultures if antibiotics are going to be used to treat an enteric infection. It is otherwise very difficult to distinguished between many pathogens clinically, and while some can be helped with antibiotics, others can actually have negative consequences,” Jones said. “Treatment of Escherichia coli O157 with antibiotics, for example, can increase the risk of developing HUS [hemolytic uremic syndrome], and use of antibiotics for Salmonella infection in otherwise lowrisk patients can lead to prolonged asymptomatic infection, with little effect on improving symptoms.” – by Marley Ghizzone
Reference:
CDC. Multistate Outbreak of Salmonella Mbandaka Infections Linked to Kellogg’s Honey Smacks Cereal. https://www.cdc.gov/salmonella/mbandaka-06-18/index.html. Accessed June 18, 2018.
FDA. Kellogg Company Voluntarily Recalls Honey Smacks Cereal Due to Possible Health Risk. https://www.fda.gov/safety/recalls/ucm610815.htm. Accessed June 18, 2018.
Disclosures: Jones works for the Tennessee Department of Health.