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Salmonella Heidelberg outbreak infections linked to chicken
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Between June 2012 and April 2013, nearly 150 cases of Salmonella infection were reported from multiple states, according to a CDC report.
A total of 134 people in 13 states were infected with the Salmonella Heidelberg outbreak strain. Patients ranged in age from younger than 1 year to 94 years; 33 patients were hospitalized. A multifaceted outbreak investigation revealed chicken as the source.
“Epidemiologic data, traceback investigations, and product testing support the conclusion that Foster Farms chicken was the likely source of this outbreak,” researchers wrote in Morbidity and Mortality Weekly Report. “Shopper card records collected from patients provided specific brand information for chicken, a commonly consumed food product, and were critical in linking this outbreak to a single chicken product.”
Data collected from a structured questionnaire revealed that of 70 people who responded, 79% reported consuming chicken in the week before illness onset. Out of 51 people who had brand information available 71% reported exposure to either Foster Farms chicken or another brand likely produced by Foster Farms.
The National Antimicrobial Resistance Monitoring System (NARMS) tested 14 clinical isolates from the outbreak and found that 12 were susceptible to all antimicrobials tested, and two were resistant to amoxicillin/clavulanic acid, ampicillin, cefoxitin, ceftiofur, and ceftriaxone.
Alison S. Laufer
“Compared with other foodborne pathogens, Salmonella is the most serious, it causes the msot annual hospitalizations and deaths and more than 1 million cases of illness each year,” Alison S. Laufer, PhD, of the CDC told Infectious Diseases in Children. “The astute clinician is often critical in outbreak investigation. Sometimes the first alarm of an outbreak is signaled by a clinician who reports a case to the local public health department or who refers a patients for a stool culture that grows a pathogen like Salmonella in the laboratory.”
Alison Laufer, PhD, can be reached at alaufer@cdc.gov.
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Kathleen F. Gensheimer, MD, MPH, FIDSA
Salmonella infections, a leading cause of hospitalizations and deaths from foodborne disease in the United States, constitute a major public health impact. The goal of public health officials investigating foodborne outbreaks is to be “quick but right.” Tools utilized by epidemiologists in foodborne investigations have evolved over the years, assisting public health and regulatory officials to achieve the “quick but right” outcome. The more rapid the response, the faster the implicated product can be removed from the market, minimizing the number of illnesses. If a root cause analysis is performed, work is done in real time to determine why the product became contaminated and determining what factors can be put in place to prevent a repeat of the scenario, further minimizing the impact of Salmonella infection.
The authors report on yet another tool of potential significance, which is a systematic examination of foodborne disease outbreaks by Salmonella serotype and implicated food commodity. They noted relationships between Salmonella serotypes and food commodities that point to major food reservoirs for different serotypes. Results of this analysis provide yet another tool to the investigator to more rapidly form hypotheses earlier in the course of the outbreak.
Armed with such information, the likely source of contamination may be identified in a more timely basis and the necessary preventive strategies put into place. However, as recognized by those within the infectious disease community, and as cautioned by the authors, microbes continue to evolve, and it is important to remain alert to the novel food or uncommon food vehicle.
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