On September 30, 2017, the Chincoteague Volunteer Fire Company (CVFC) hosted its 18thAnnual Chili/Chowder Cook-off and Classic Car Show at the carnival grounds in Chincoteague, Virginia. The fire company estimated 2,500 people from multiple states in the region attended the event.

After the event, some attendees developed gastrointestinal (GI) illness. The first complaint of suspected foodborne illness was received by the Accomack County Health Department (ACHD) on October 3. On the same day, ACHD found dozens of reports of GI illness in a conversation (started on October 2) on a social media page for Chincoteague Island residents and visitors. Some of the ill cook-off attendees reported seeking health care and receiving diagnoses of Salmonella infection.

Background: After a chili and chowder cook-off featuring 12 local vendors and attended by ~2,500 people, the Accomack County Health Department received reports of gastrointestinal illness among event attendees. Clinical stool specimens tested positive for Salmonellaserotype Javiana. An investigation was conducted to determine the source of—or practices that might have contributed to—contamination, and provide recommendations to prevent future outbreaks at similar events.

Methods: A cohort study was performed, with event attendees recruited through press releases and subsequent social media posts containing the link to an online survey asking about foods consumed at the cook-off and gastrointestinal illness. A case was defined as three or more episodes of diarrhea in less than 24 hours, or unquantified diarrhea in addition to at least one other symptom (abdominal pain, chills, dehydration, fever, nausea, or vomiting) in someone who consumed cook-off food. In addition to unadjusted relative risks (RRs), Mantel-Haenszel adjusted RRs were calculated to address potential confounding by multiple exposures. Environmental health specialists interviewed food handlers and conducted inspections of restaurants where professional competitors prepared food. Available food samples and stool specimens from ill attendees and asymptomatic food handlers were tested for Salmonella. Primary Salmonellaisolates were subtyped by pulsed-field gel electrophoresis (PFGE) and further characterized by whole-genome sequencing (WGS).

Results: Of 438 survey responses, 171 met the case definition. Of all exposures, Chowder A, prepared for the event by a professional vendor off-site, had the strongest association with illness (RR: 8.9; 95% confidence interval: 5.7–13.7). When stratified by exposure to Chowder A, all other chili or chowder adjusted RRs were less than 1.4. Environmental health inspections and interviews did not identify a specific source of contamination.Salmonella serotype Javiana was identified in stool specimens from 25 ill local and out-of-state attendees and an uneaten sample of Chowder A, but was not identified in the food handler specimens or raw frozen clam strips.

Conclusions: Epidemiologic and laboratory analyses provide evidence Chowder A was the most likely source of illness; however, the original source of Salmonellacould not be identified. Recommendations to prevent future outbreaks included requiring all food to be prepared at the event site and ensuring safe temperatures are maintained during food preparation and service.

Chincoteague Chili Cookoff- VA DOH General Outbreak Report

Bob’s Red Mill Natural Foods is voluntarily recalling 2,099 cases of Organic Amaranth Flour (22 oz.), after recent testing revealed the presence of Salmonella in a single LOT of Organic Amaranth Flour (22 oz.) with a Sell By date of Nov. 26, 2015.

Salmonella is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and produce more severe illnesses.

The recalled Organic Amaranth Flour (22 oz.) was distributed through retailers and distributors nationwide. This product and LOT was distributed in CA, FL, MI, ND, N, NY, OH, OR, TX, and WA starting June 11, 2014 and ended shipping on August 7, 2014

The recalled product is Organic Amaranth Flour (22 oz.) with a Sell By Date of 11/26/2015, LOT: 169617, which can be found on the side of the package, near the top of the panel. UPC: 0 39978 00911 1

While this product expired in November 2015, this product was found on the shelves of one retail store, and thus Bob’s Red Mill is recalling the product out of an abundance of caution.

Consumers who have any of this affected product should not consume it and should return it to the place of purchase for credit or refund or throw it away.

A total of 265 people infected with the outbreak strains of Salmonella Typhimurium were reported from South Dakota, Nebraska, Minnesota, Iowa, Wisconsin, Illinois, Indiana and Mississippi.

Illnesses started on dates ranging from January 8, 2018, to March 20, 2018. Ill people ranged in age from less than 1 year to 89 years, with a median age of 57. Sixty-seven percent of people were female. Ninety-four hospitalizations were reported, including one person from Iowa who died.

Epidemiologic, laboratory, and traceback evidence indicated that chicken salad produced by Triple T Specialty Meats, Inc. and sold at Fareway grocery stores was the likely source of this multistate outbreak.

Investigators in Iowa collected chicken salad from two Fareway grocery store locations in Iowa for laboratory testing. An outbreak strain of Salmonella Typhimurium was identified in both samples.

On February 21, 2018, Triple T Specialty Meats, Inc. recalled all chicken salad produced from January 2, 2018 to February 7, 2018. The recalled chicken salad was sold in containers of various weights from the deli at Fareway grocery stores in Iowa, Illinois, Minnesota, Nebraska, and South Dakota from January 4, 2018 to February 9, 2018.

As of April 6, 2018, this outbreak appears to be over.

The Public Health Agency of Canada collaborated with provincial public health partners, the Canadian Food Inspection Agency and Health Canada to investigate an outbreak of Salmonella Enteritidis infectionsin six provinces with cases of human illness linked to frozen raw breaded chicken products. Given there have not been reported illnesses in this outbreak since October 2017, the outbreak appears to be over and the outbreak investigation has been closed.

During the outbreak, the Canadian Food Inspection Agency issued a food recall warning for the following two products:

Janes Pub Style Chicken Burgers – Uncooked Breaded Chicken Burgers (800 g) with a best before date of May 12, 2018 (2018 MA 12) and UPC: 0 69299 12491 0.
Janes Pub Style Snacks Popcorn Chicken – Uncooked Breaded Chicken Cutlettes (800 g) with a best before date of May 15, 2018 (2018 MA 15) and UPC: 0 69299 12542 9.

All products were distributed nationally. These products were linked to this outbreak investigation and therefore the Public Health Agency of Canada advised Canadians not to consume the recalled products.

Since 2015, this was the third national outbreak investigation that has led to the recall of frozen breaded chicken products.

The risk to Canadians is low. Salmonella is commonly found in raw chicken and frozen raw breaded chicken products. Illnesses can be avoided if safe food handling, preparation and cooking practices are followed when preparing these types of food products.

Although the outbreak appears to be over, this outbreak is a reminder that frozen raw breaded chicken products contain raw poultry and should be handled and prepared no differently from other raw poultry products. Always follow cooking instructions carefully and verify the internal temperature after cooking, as recommended, before consuming these products. Frozen raw breaded chicken products must be cooked to an internal temperature of at least 74°C (165°F) to ensure they are safe to eat.

In total, there were 22 cases of Salmonella Enteriditis illness in six provinces: British Columbia (1), Alberta (1), Ontario (12), Quebec (3), New Brunswick (3), and Nova Scotia (2). Eight people were hospitalized. One of the ill individuals died; however, it was not determined if Salmonella contributed to the cause of death. Individuals were sick between June and October of this year. The average age of cases was 41 years, with ages ranging between 0 to 85 years. The majority of cases (59%) were female.

Based on the investigation findings, exposure to frozen raw breaded chicken products was identified as a source of illness. Several individuals involved in the outbreak reported eating Janes Pub Style Chicken Burgers before their illness occurred. Food samples of Janes Pub Style Chicken Burgers (800 g), with best before date 2018 MA 12, and Janes Pub Style Snacks Popcorn Chicken (800 g), with best before date 2018 MA 15, tested positive for Salmonella Enteritidis. The positive food samples had the same genetic fingerprint (using whole genome sequencing) as the cases of human illness reported in this outbreak. The Canadian Food Inspection Agency issued a food recall warning for these products and worked with industry to ensure the product was removed from the retail market.

King Arthur Flour Company is voluntarily recalling a limited quantity (6,300 cases) of Organic Coconut Flour (16 oz.), after testing revealed the presence of Salmonella in 1 pouch of Organic Coconut Flour (16 oz.).

Salmonella is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and produce more severe illnesses.

The recalled Organic Coconut Flour (16 oz.) was distributed through retailers and distributors nationwide.

The only product affected by the recall is Organic Coconut Flour (16 oz.) with Best If Used By Dates of 10/25/2018 LOT: CF22017E and 12/04/2018, LOT: CF22017E which can be found on the back of the pouch, near the bottom of the panel. UPC: 0 71012 10702 5

According to the CDC, as of March 20, 2018, 13 people infected with the outbreak strain of Salmonella Typhimurium have been reported from 8 states. WGS performed on bacteria isolated from ill people showed that they were closely relatedly genetically. This means that people in this outbreak are more likely to share a common source of infection.

Illnesses started on dates ranging from September 22, 2017 to February 26, 2018. Ill people range in age from 1 to 73 years, with a median age of 40. Sixty-seven percent are female. Three hospitalizations have been reported. No deaths have been reported.

Epidemiologic, laboratory, and traceback evidence indicates that dried coconut is the likely source of this multistate outbreak.

In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Seven (88%) of eight people interviewed reported eating dried coconut from grocery stores. Of the seven people who reported eating dried coconut, four people purchased the product at different Natural Grocers store locations. Public health officials continue to interview ill people to learn more about what they ate in the week before becoming sick.

FDA and state health and regulatory officials collected leftover dried coconut from ill people’s homes, as well as dried coconut from Natural Grocers store locations where ill people shopped and from the Natural Grocers’ Distribution Center. FDA testing identified the outbreak strain of Salmonella Typhimurium in an unopened sample of Natural Grocers Coconut Smiles Organic collected from Natural Grocers. The outbreak strain was also identified in an opened, leftover sample of Natural Grocers Coconut Smiles Organic collected from an ill person’s home.

FDA also collected dried coconut from International Harvest, Inc. The outbreak strain of Salmonella Typhimurium was identified in samples of International Harvest Brand Organic Go Smile! Dried Coconut Raw and Go Smiles Dried Coconut Raw.

On March 16, 2018, International Harvest, Inc. recalled bags of Organic Go Smile! Raw Coconut and bulk packages of Go Smiles Dried Coconut Raw. The recalled Organic Go Smile! Raw Coconut was sold online and in stores in 9-ounce bags with sell-by dates from January 1, 2018 through March 1, 2019. Recalled bulk Go Smiles Dried Coconut Raw was sold in a 25-pound case labeled with batch/lot numbers OCSM-0010, OCSM-0011, and OCSM-0014. These products were sold in various grocery stores. Regulatory officials are working to determine where else Organic Go Smile! Raw Coconut and Go Smiles Dried Coconut Raw were sold.

On March 19, 2018, Vitamin Cottage Natural Food Markets, Inc. recalled packages of Natural Grocers Coconut Smiles Organic labeled with barcode 8034810 and packed-on numbers lower than 18-075. Recalled Natural Grocers Coconut Smiles Organic were sold in 10-ounce clear plastic bags with the Natural Grocers label. The packed-on number can be found in the bottom left-hand corner of the label.

 

 

In cooperation with the Taylor Farms recall of diced yellow onions that may be contaminated with Salmonella, 12 Haggen stores are voluntarily recalling deli products that contain raw Taylor Farms brand diced yellow onions.

Salmonella is an organism that can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting, and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis, and arthritis.

The following recalled products were sold in the deli from the full-service and/or self-service cases and packaged in clear containers. The sell-by date was printed on the scale label that is affixed to the product’s packaging:

Product Name

First six digits of
the UPC code

Sell-by dates

Old Fashion Potato Salad

202932

3/15/18 up to and including 3/19/18

Cashew Chicken Salad

202928

3/15/18 up to and including 3/19/18

Turkey Curry Salad

202986

3/15/18 up to and including 3/19/18

The following recalled products were sold in the deli from the self-service case. The sell-by date was printed on the scale label that is affixed to the product’s packaging:

Product Name

First six digits of
the UPC code

Sell-by dates

Cashew Chicken Salad Wrap

203681

3/15/18 up to and including 3/19/18

Cashew Chicken Croissants (2-pack)

203908

3/15/18 up to and including 3/19/18

Cashew Chicken Croissant Tray

203812

3/15/18 up to and including 3/19/18

Tartar Sauce

202804

3/13/18 up to and including 3/27/18

The cashew chicken products were packaged on a tray with a clear plastic cover. The tartar sauce was packaged in a clear 12 oz. container. The recalled tartar sauce was also offered as a condiment with made-to-order Fish & Chips from the deli:

Product Name

First six digits of
the UPC code

Purchase dates

Tartar Sauce (Served as a condiment
with made-to-order Fish & Chips)

206000; 206001;
206004; 206006

3/13/18 up to and including 3/17/18

The products were sold at the following Haggen stores:

  • 31565 State Route 20 #1, Oak Harbor, WA 98277
  • 2814 Meridian, Bellingham, WA 98225
  • 757 Haggen Drive, Burlington, WA 98223
  • 1313 Cooper Point Road SW, Olympia, WA 98502
  • 2900 Woburn Street, Bellingham, WA 98226
  • 26603 72nd Avenue NW, Stanwood, WA 98292
  • 1301 Avenue D, Snohomish, WA 09290
  • 1815 Main Street, Ferndale, WA 98248
  • 17641 Garden Way NE, Woodinville, WA 98072
  • 2601 East Division, Mount Vernon, WA 98273
  • 8915 Market Place NE, Lake Stevens, WA 98258
  • 3711 88th Street NE, Marysville, WA 98270

No illnesses associated with this recall have been reported to date.

The CDC reports as of March 6, 2018, 170 people infected with the outbreak strains of Salmonella Typhimurium have been reported from 7 states. Illness Count Iowa (149), Illinois (9), Nebraska (5), Minnesota (3), South Dakota (2) Indiana (1), Texas (1).

Illnesses started on dates ranging from January 8, 2018, to February 18, 2018. Ill people range in age from 7 to 89 years, with a median age of 59. Sixty-six percent of ill people are female. 62 hospitalizations and no deaths have been reported.

Illnesses that occurred after February 12, 2018, might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of two to four weeks.

WGS analysis did not identify predicted antibiotic resistance in 67 of 72 isolates (70 ill people and 2 food samples). Five isolates from ill people contained genes for resistance to all or some of the following antibiotics: amoxicillin-clavulanic acid, ampicillin, cefoxitin, ceftriaxone, gentamicin, streptomycin, sulfamethoxazole, and tetracycline. This resistance is unlikely to affect the treatment of most people, but some infections might be difficult to treat with antibiotics usually prescribed and may require a different antibiotic. Testing of outbreak isolates using standard antibiotic susceptibility testing methods is currently underway in CDC’s National Antimicrobial Resistance Monitoring System (NARMS)laboratory.

State and local health officials continue to interview ill people to ask about the foods they ate and other exposures in the week before they became ill. Of 159 people interviewed, 131 (82%) reported eating chicken salad from Fareway stores. Triple T Specialty Meats, Inc. produced the chicken salad that ill people reported eating.

It takes an average of two to four weeks from when a person becomes ill with Salmonella to when the illness is reported to CDC or health officials. Because of this reporting lag, the additional 105 people added to this investigation likely became ill from eating chicken salad recalled by Triple T Specialty Meats, Inc. which is no longer available for purchase. The last reported illness began on February 18, 2018.

The Weld County Department of Public Health and Environment (WCDPHE) continues to investigate an outbreak of Salmonella illness at several locations in Weld County. The source of the outbreak is the Burrito Delight restaurant, which has voluntarily closed both of its locations in Fort Lupton and Dacono. It is still under investigation as to what is the specific source. The investigation continues around possible food sources.

To date, there are 21 laboratory-confirmed cases of Salmonella and the number of probable cases continues to rise.  There have been 4 hospitalizations.

The breakdown of the laboratory-confirmed cases by county includes:

  • Weld = 14
  • Larimer = 3
  • Bolder = 2
  • Morgan = 1
  • Adams = 1

Cases by Event

  • Aims Event on February 6th = 3
  • Aims Event on February 12th = 9
  • Restaurant Dine-in (Ft. Lupton) = 5
  • Takeout to Place of Employment = 4

Cases by Restaurant

  • Fort Lupton = 20
  • Dacono = 1

Symptoms of Salmonella illness include diarrhea, upset stomach, fever, and occasionally vomiting. Symptoms typically last 4 to 7 days, and most people recover on their own. Anyone who suspects they became ill should contact their health care provider. For some people, the diarrhea may become so severe that they require hospitalization. Symptoms typically appear 6-72 hours after eating contaminated food and will typically last for 4 to 7 days without treatment. However, in severe cases, the symptoms may last longer.

The Weld County Health Department has created a “Salmonella Investigation Report Update” that can be found at: www.weldhealth.org (Click on Health Hot Topics).

For anyone who suspects they became sick with Salmonella in February, please call the Weld County Health Department Salmonella triage line: 970.400.2374 (staffed M-F, 8-5; messages can be left after hours).

A non-staffed hotline (available 24/7), is also available at: 970.400.4457.

The Weld County Department of Public Health and Environment (WCDPHE) continues to investigate an outbreak of Salmonella illness at several locations in Weld County. The source of the outbreak is the Burrito Delight restaurant, which has voluntarily closed both of its locations in Fort Lupton and Dacono. It is still under investigation as to what is the specific source. Laboratory testing results of the employees will not be available until Monday. The investigation continues around possible food sources.

There are presently 12 confirmed Salmonella cases which occurred in February: 6 from two different catered events at Aims Community College; 4 from patrons who ate at the Fort Lupton Burrito Delight restaurant; and 2 from a private business that had another catered event. The restaurants are closed and the public is not at risk.

Symptoms of Salmonella illness include diarrhea, upset stomach, fever, and occasionally vomiting. Symptoms typically last 4 to 7 days, and most people recover on their own. Anyone who continues to experience symptoms should contact their health care provider. For some people, the diarrhea may become so severe they require hospitalization. Symptoms typically appear 6-72 hours after eating contaminated food and will typically last for 4 to 7 days without treatment. However, in severe cases, the symptoms may last longer.