July 2005

The N.C. Laboratory of Public Health has detected nearly five times as many cases of a food-borne illness called Salmonella enteritidis in 2005, as compared with the first six months in 2004. State health officials are continuing to investigate, and no common source for all these cases has been found.

But recent outbreaks of the illness in nearby states have largely been associated with eggs, as have several of North Carolina’s previous outbreaks, reports Dave Harbin for The Charlotte Observer.

Salmonella can be found inside eggs that appear perfectly normal but, if the eggs are eaten raw or undercooked, the bacterium can cause illness.

Eggs can be an important source of nutrition but, unlike egg-borne salmonellosis of past decades, the current epidemic has been traced to intact and disinfected grade A eggs. The reason is that salmonella can infect healthy appearing hens and contaminate eggs before the shells are even formed. These food-safety rules can help you avoid these illnesses:

  • Don’t eat raw eggs or foods containing raw eggs, like cookie dough, blender drinks, homemade mayonnaise, or homemade ice cream. Use a pasteurized liquid egg product or pasteurized in-shell eggs if the food won’t be cooked before eating. Buy clean eggs. Choose Grade A or AA eggs with clean, uncracked shells.
  • Keep eggs refrigerated in their carton in the coldest part of the refrigerator, not in the door, and use them within three to five weeks. The refrigerator should be set at 40 degrees Fahrenheit (5 degrees Celsius) or slightly cooler.
  • Freeze eggs for longer storage by breaking the eggs, beating the yolks and whites together, and putting the mixture in a freezer container. Use frozen eggs within one year.
  • Cook eggs until yolks are firm. Poaching, hard cooking, scrambling, frying and baking are some of the cooking methods that can be used to safely cook eggs.
  • Eat eggs promptly after cooking. Do not keep eggs warm for more than two hours.
  • Cleanliness is very important. Wash hands, utensils, equipment and work areas with warm, soapy water before and after contact with eggs and egg-rich foods.

The LA County Department of Health Services issued a health alert Wednesday to diners who ate at the Il Fornaio restaurant located at 310 N. Beverly Drive in Beverly Hills. At least three people became ill with Salmonella infections and two were hospitalized after eating at Il Fornaio between July 12 and 16. The restaurant used raw and undercooked eggs in some of its recipes.

www.About-Salmonella.com provides information on the symptoms and risks involved with Salmonella infection, together with links to information on outbreaks and resources for victims. Marler Clark, the Seattle attorneys who have represented hundreds of victims of Salmonella outbreaks, sponsor the site.

Marler said, "Il Fornaio could have taken some very simple steps to preventing illness among its customers, starting with using pasteurized shell eggs in recipes that call for raw or under-cooked eggs."

In North Carolina, 453 cases of salmonella have been reported in the first five months of 2005, according to North Carolina’s State Health Director Leah Devlin, M.D.

The North Carolina cases to date are four times the number of cases reported through all of 2004, and the state’s division of public health believes that the outbreak resulted from ingesting raw or undercooked eggs, according to WFMY News 2.

In the report, Dr. Devlin stated: "The bacterium that causes Salmonella enteritidis can be found inside seemingly normal eggs, but if eggs are eaten raw or undercooked, the bacteria can cause sickness and even death."

In the past several months alone, salmonella has sickened individuals in numerous states. Already this summer, residents in Minnesota, Washington, Oregon and Ohio were allegedly sickened by Salmonella typhimurium after consuming ice cream purchased at Cold Stone Creamery outlets. The ice cream was recalled last month.

The FDA also suggests using pasteurized eggs for all dishes that call for raw or softly cooked eggs.

The National Restaurant Association is also trying to increase awareness levels, recommending that eggs be cooked to 145 degrees, and held there, in order to eliminate salmonella. Few cooks actually temperature test their egg dishes, in turn preparing many eggs in styles with soft yolks that don’t meet these safe temperature levels, such as over-easy eggs which are a favorite for dunking toast.

There has been an outbreak of salmonella at a popular Beverly Hills restaurant.

Los Angeles County health officials say at least three people who ate at Il Fornaio in Beverly Hills have contracted salmonellosis, and they are searching for other diners who also may have gotten ill.

A Department of Health Services spokeswoman says the three patrons have all recovered or are recovering. She says the cases likely stemmed from the restaurant’s use of raw or undercooked eggs.

Federal disease detectives say they’ve seen a significant decline in rates of E. coli infections because of better testing of the meat supply, but they’re making slow progress against contamination by drug-resistant strains of salmonella.

Robert Tauxe, chief of the foodborne-disease unit at the CDC, said he’s also concerned by increasing rates of contamination of shellfish – mainly raw oysters – from a bacterium called vibrio that can be lethal to people with chronic liver problems.

Tauxe said the industry is responding to the problem, and he noted that this year, California’s Almond Board is requiring that all nuts harvested be pasteurized after sporadic cases of salmonella were traced to raw almonds. Some 95 percent of the almond crop was already being treated through roasting or heating to kill the pathogen.

Tauxe said CDC disease detectives are also improving their ability to use genetic fingerprints to track the source of outbreaks.

He said fingerprinting was responsible for last year’s breakthrough that allowed the CDC to match several outbreaks at Mexican and Italian restaurants in Pennsylvania to Roma tomatoes shipped from a Florida distributor.

Tauxe said government surveillance data shows that the meat industry has made improvements in averting outbreaks of E. coli O157:H7, a particularly virulent strain of the common pathogen that can attack the kidneys of young children and has killed some.

Blue Cross Blue Shield of Michigan and Blue Care Network are working to help keep everyone cool, calm and well all season long.

"If you’re packing a picnic, the recipe for perfect outdoor events includes preparing your food properly. Unless you freeze dishes, don’t prepare your picnic items more than one day ahead," says George Kipa, M.D., deputy corporate medical director for Blue Cross Blue Shield of Michigan. "Be sure foods like potato salad are quickly cooled after making to retard bacteria growth."

Other tips include:

  • Once at the site, keep this and other mayonnaise-based foods cold. One way is to serve it in a bowl kept on ice. The two more common bacteria that cause food poisoning, salmonella and shigella, are always waiting for an opportunity to become uninvited guests and ruin a good time outdoors.
  • Keeping food at around 40 degrees in a cooler will prevent bacteria growth. Use commercial frozen packs. Keep cold drinks in a separate cooler from food, Kipa recommends.
  • Since the trunk of your car can reach upwards of 150 degrees, try transporting your cooler in the passenger area. Once at the site, store it in the shade or keep a blanket over it for extra insulation. Keep it closed and out of the sun until you’re ready to serve.
  • Melons can be a wonderful taste treat at the picnic table, but because they are not acidic, they are good bacteria nurseries, often on the rind. Wash all watermelons, honeydew or muskmelons before cutting and serving, and keep these and all other ready-to-eat foods away from uncooked meats, poultry or seafood.
  • Don’t partially pre-cook food and finish cooking the day of the event. Doing so encourages bacteria growth, and reheating does not make it safe, Kipa advises. If you’re serving hot food, keep it hot. Don’t reuse utensils that have touched raw foods unless you wash them in hot, soapy water first.
  • Wash your hands as well each time after handling raw foods. Thoroughly cook foods like burgers, and make sure poultry is cooked until juices run clear. Don’t use the same plate to serve meats that you prepared them on unless they’re thoroughly washed first, and never reuse marinades.
  • When the party is over, properly refrigerate leftovers and freeze them if you don’t plan to use them within a day. And remember the abiding rule of all good party hosts: When in doubt, throw it out.


There is a large variety of Salmonellae organisms that can cause the food infection Salmonellosis.

These bacteria grow inside the host and produce a toxin which causes illness by irritating the intestinal walls. One million or more organisms must be ingested in order to cause illness.

Most cases of salmonellosis are a result of contact of prepared foods with raw meet or its juices. Eating raw or rare meat is also a danger. Other cases result from insufficiently cooked poultry, eggs, and dairy products especially when kept unrefrigerated for longer periods of time.

Salmonellae bacteria can be prevented by cleanliness and sanitation of food handlers and equipment, pasteurization, and refrigeration.

Oneida County health officials have yet to find the cause of a recent outbreak of food poisoning that left two people hospitalized.

Kenneth Fanelli, public information officer for the Oneida County Health Department, said the department is searching for a "commonality" in 10 cases of salmonellosis, which is caused by eating foods contaminated with the salmonella bacteria.

Officials are not overly concerned, but caution the public to properly cook and prepare foods, he said.

Health officials are still searching for the source of 15 cases of salmonella reported here in late May and early June.

Julie Goplin, an epidemiologist for the State Health Department, said the first case found in Williston was May 23 and the last cases were reported June 14. Health officials said one woman, who was older than 65, died. She has not been identified.

A food supplier may be a source of the salmonella, but no link to all the cases has been pinpointed in Williston, she said. DNA samples taken in North Dakota have been sent to the CDC to see if they match samples that were taken in 17 other states.

No common source has been found for all 15 cases of salmonella cases reported in late May and early June in Williston, but a search for a possible food supplier responsible is going nationwide.

The original cases seemed they had a common link to Economart, but as we included further cases to the report, we could not determine the same link to the store. Therefore, the source of the cases remains unknown at this time," said Julie Goplin, an epidemiologist for the State Health Department.

"We reported all cases to the Center for Disease Control and found matches to this strain nationwide. There were 28 others in 17 states … There may be a possible source in all the cases. If it happened about the same time in 17 other states, it leads us to believe there may be a possible common source in the supplier," Goplin said.