Salmonella Blog - Surveillance & analysis on salmonella news & outbreaks

Questions linger about the contamination source and farming and irrigation practices. But in the current spinach-related E. coli O157:H7 outbreak, at least word got out quickly, says Susan Brink for the Los Angeles Times.

Less than a week elapsed between Sept. 8, when Wisconsin notified the Centers for Disease Control and Prevention of an uptick in E. coli cases, and Sept. 14, when the Food and Drug Administration told stores, restaurants and consumers to chuck their spinach. "This is an example of how fast it can work," says Dr. Patricia Griffin, acting chief of enteric diseases at the CDC.

Meat, poultry and produce that grows close to the ground (such as spinach, lettuce and cilantro) have all been implicated in E. coli outbreaks. It was even found inside watermelons, says Dr. Jeffrey Griffiths, professor of public health and family medicine at Tufts University School of Medicine, after sellers started injecting the fruit with water to make it heavier and increase its price.

Parents looking for more answers about last spring's salmonella outbreak at Jefferson Elementary School will have to wait a little longer, according to the Country Gazette.

School officials are waiting for a final report on an investigation of the incident by the state Department of Public Health, who have already linked the outbreak to a fifth-grade science experiment involving owl pellets, and in August issued new statewide guidelines for handling owl pellets.

A lawsuit was filed today against Wal-Mart Stores, Inc., the company whose Greenwood, Indiana, store was the source of a Salmonella outbreak. The lawsuit was filed in Johnson County Superior Court on behalf of a Greenwood resident whose son became violently ill and was hospitalized after consuming foods purchased at the Wal-Mart deli. The lawsuit was filed by Marler Clark, a Seattle-based law firm that has represented hundreds of victims of Salmonella outbreaks.

The complaint alleges that Mr. Merritt purchased ham and cheese from the Wal-Mart deli. Mr. Merritt’s son, Noah, consumed the ham and cheese in the subsequent days and became ill; Noah’s symptoms became severe, and he was seen in the Emergency Room at St. Francis Hospital in Indianapolis. Noah was subsequently admitted to the hospital; while hospitalized, Noah provided a stool sample that tested positive for Salmonella.

“The Indiana State Health Department reported that at least 84 customers who ate foods from the deli and bakery departments at Wal-Mart from May to August were part of this Salmonella outbreak,” said William Marler, attorney for Mr. Merritt. “We’ve seen this before and will see it again,” Marler continued. “Businesses who fail to enforce strict handwashing policies will continue to be the source of outbreaks, and will be held responsible for their failures through the legal system.”

Change in food-borne illness control became necessary because of the way food is distributed in the United States, reports Susan Brink of the Times. In the old days of food poisoning, the source usually could be traced back to a local event: potato salad at a family picnic or bad chicken at a church supper. Today, with massive amounts of food going from farms to food processing centers and then mixing with food from other farms before heading to tables in all 50 states, outbreaks are far less likely to be local, and thus, far more difficult to notice.

The change that came out of the 1993 Jack-In-The-Box tragedy is called PulseNet, a partnership between the CDC and state health departments. Stool samples are sent to state public health departments by doctors. The health departments then use DNA analysis to subtype pathogenic bacteria present in the stools. The resulting DNA fingerprints can identify not only species but also strains of such bacteria as E. coli, salmonella, shigella, listeria and Campylobacter.

Then the information gets sent to a central CDC database. This can quickly let public health officials know if cases strewn far and wide across the country carry identical fingerprints.

Epidemiologists also weigh in, fanning out within affected states and using food questionnaires to find out what people had eaten before getting sick (in the current outbreak, identifying pre-washed, bagged spinach).

But this is still not a perfect system, says Bala Swaminathan, acting senior advisor for laboratory science at CDC's division of food-borne safety.. It typically takes three to four days for a patient's symptoms to kick in, a day or two before the patient seeks medical care, then up to three days for results from a stool sample to reach the physician. And frustrating slowdowns can come from something as simple as how long it takes for positive results to make their way from a physician's office to state labs and then into the PulseNet database.

In some states, reporting can happen the same day the physician gets lab results. In others, it can take up to a week. And all this time, Americans — oblivious to any problem — continue to eat the contaminated food.

Some frozen chicken entrees, such as Chicken Kiev and Chicken Cordon Bleu, have been linked to salmonella poisoning in consumers who thought they were microwaving pre-cooked meat. In fact, the entrees contained raw meat and the microwave did not sufficiently cook them.

At least 48 people have been stricken with salmonella poisoning over the past 19 months when they ate undercooked frozen chicken entrees that were microwaved, according to the Minneapolis Star Tribune.

The labels sometimes indicate "ready-to-cook" when referring to a raw product. Testing also found that some microwave cooking times were inadequate for safe preparation. New warning labels will appear before November, ordered by the USDA. Meanwhile, two manufacturers have changed their labels to suggest only conventional-oven preparation.

A customer left seriously disabled after contracting food poisoning from eating a kebab is suing a restaurant owner for more than £300,000.

Jubeyar Chowdhury, 50, had a severe case of salmonella after eating at the A1 Kebabish restaurant in Manor Park, east London, and later developed a rare neurological complication. Mr Chowdhury, who is now unable to work because of his illness, was among 160 people affected in the salmonella outbreak in February last year.

A1 Kebabish was closed down by environmental health officers after the salmonella outbreak which led to at least 60 people suffering food poisoning. Several were admitted to hospitals.

The restaurant has reopened less than three weeks later, after adopting the recommendations of the North East London Health Protection Unit, and is now under new management after being sold.

School officials say they still are waiting for a final report on an investigation of last spring's salmonella outbreak at Jefferson Elementary School by the state Department of Public Health. While 28 students were confirmed to have bacterial infections after the incident, at least 50 students came down with related symptoms.

State health officials already linked the outbreak to a fifth-grade science experiment involving owl pellets, and in August issued new statewide guidelines for handling owl pellets. An owl pellet is the regurgitated undigestable remains of prey an owl has eaten whole, and usually includes bone and feathers or fur.

Any projects with owl pellets have been postponed this school year, but before the district can take any further steps, it has to wait to see what the state has found and recommends, the superintendent said.

Donna Rheaume, a DPH spokeswoman, confirmed yesterday that a final report on the incident is in the works. She could not provide a date when the report will be finished.

There are still no firm answers as to what caused an E. coli outbreak in fresh spinach that has now been reported in 21 states and taken one life, and there are not many firm answers as to how to avoid similar outbreaks in the future.

We know that people should wash all fresh foods to kill most germs and bacteria, but water will not wash away E.coli, salmonella or listeria.

In August, the FDA approved the spraying of some foods with viruses in an effort to stop certain bacteria. The spray isn't intended to battle E.coli but to destroy the bacterium Listeria monocytogenes, reports the ABC News Medical Unit. The spray, called LMP 102, is a mixture of six different special viruses called bacteriophages — viruses that infect only bacteria, not people, animals or plants.

Travelers visiting many tropical, sub-tropical and developing countries run an increased risk of suffering a gastrointestinal illness. These are usually caused by bacteria, parasites and viruses, including E coli, the staphylococci, shigella and salmonella species, campylobacter jejuni, cryptosporidiosis, and hepatitis A.

Infected food is the biggest culprit, with water coming in second. Ice cream, cocktails served in re-used coconut shells, raw seafood, ice, and food from street vendors are also potential risks.

Rebecca Prescott says there are remedies you can take that will strengthen your immune and digestive system and hopefully give your body a better chance at dealing with its new environment.

She outlined a list of recommended herbs, and says the best form to take them in would be as a tincture, which can be made up by going to a local herbal dispensary if you have one in your area, or alternatively, a local herbalist:

Astragalus (Astragalus membranaceus)
Astragalus is a good anti-viral, anti-bacterial, and anti-microbial. The polysaccharides in it support the immune system. Astragalus increases the activity of phagocytes, natural killer cells, and the levels of antibodies in the blood.

Picrorrhiza (Picrorrhiza kurroa)
This is an Ayurvedic herb that is best given in low doses, as higher doses can cause diarrhea and flatulence in more sensitive people. Its a bitter herb, so it stimulates the digestive system. It is also anti-malarial, supports the immune system, and protects the liver. Picrorrhiza encourages all aspects of the immune system, such as B and T cell activity, and the activity of phagocytes. This herb is used in Ayurvedic medicine for liver related problems and immune problems.

Goldenseal (Hydrastis Canadensis)
Goldenseal is a gut antibiotic, which for example helps reduce adhesive e coli, and encourages some immune functions of the body. For example, berberine, which is one of its active constituents, has been shown to increase the activity of macrophages, which digest bacteria and viruses. Barberry also contains berberine, so more information on this very valuable constituent is below. Goldenseal, being a bitter herb, it is also good for the digestive system. If you are pregnant or suffer from hypertension, however, you should not take goldenseal.

Barberry (Berberis Vulgaris)
Berberine, one of the active constituents in this herb is an anti protozoic, which helps protect travelers against giardia, leishmania, and treponema pallidum. Other notable effects of berberine are its activity against giardia, dysentery, and candida, as well as the cholera vibrio. The active constituents berberine and palmatine are also anti-bacterial. And berbamine, which like berberine is an alkaloid, is a strong anti-bacterial which seems to work by increasing white blood cells and platelets. The constituent palamtine is a uterine stimulant, however, and as such pregnant women shouldn't take this herb. Barberry is another gut antibiotic, but it is also anti-malarial (though no self-respecting herbalist would recommend anything other than doctor's treatment if you do contract malaria).

Echinacea (Echinacea purpurea or augustifolia)
Echinacea is an immune stimulant. Its main active constituents are the polysaccharides and the alkamides (especially the isobutylamides), which are both immune stimulating, and the polyaceytlenes, which are antibacterial, anti-viral, and anti-fungal. Echinacea supports the activity of phagocytes, which are part of the immune system, and is also considered anti-viral and anti-microbial. One of the ways echinacea appears to work is by inhibiting the action of the enzyme hyaluronidase. This enzyme is used by micro-organisms to break down the connective tissue that prevents them from entering and spreading through the body. For these reasons, it is excellent as part of a travelers remedy mix.

Prescott reminds us that these remedies are not designed as a prophylactic or a vaccine, but that they work on the principle of giving your body an increased chance at staying healthy. Nothing replaces common sense:

• Wash your hands before eating.
• Don't drink ice or from water bottles where the seal has been broken.
• Drink cocktails in glasses, not cute but probably old coconut shells.
• Don't eat anything fresh that you can't peel.
• Don't eat ice cream or drink unpasteurized milk.
• Be wary of eating from street vendors.

Overview Symptoms Treatment Prevention
Definition:
HUS is a disorder marked by kidney failure, hemolytic anemia, thrombocytopenia (platelet deficiency), coagulation defects, and variable nervous system signs.
Alternative Names:
HUS
Causes, incidence, and risk factors:
This disorder is most common in children. It frequently occurs after a gastrointestinal (enteric) infection, often one caused by a specific E. coli bacteria (Escherichia coli O157:H7). It has also been associated with other enteric infections including Shigella and Salmonella and some non-enteric infections.

The Canadian Food Inspection Agency and Wendy's Restaurants of Canada, Inc. are warning the public not to consume Wendy's Homestyle Garlic Croutons because the product may be contaminated with Salmonella.

The affected product has been sold at Wendy’s restaurants in Ontario and Quebec. A voluntary recall of the affected product from the marketplace has been initiated by Wendy’s.

There have been no reported illnesses associated with the consumption of this product.

Pasteurization kills bacteria present in food. As long as cross-contamination does not occur (from hands, utensils or other foods) pasteurized foods should be safe for even those in high risk groups.

To pasteurize recipes containing eggs, 160 degrees F must be reached or 140 degrees F reached and held for three minutes.

To pasteurize eggs at home, Debbie Wilburn of Poultry Today suggests the following method:

Combine at least 2 tablespoons of the liquid in the recipe for each beaten egg or egg yolk (4 egg yolks, 8 tablespoons liquid). Liquids used can be water, juice, milk or flavorings; but not oil or margarine.
Cook this mixture over medium-low heat, stirring constantly, until it just starts to bubble. Mixture should be thickened and should coat a spoon; if a candy thermometer is handy, use it.
If the mixture looks like it might start to curdle, remove it from heat and stir rapidly, return to low heat and continue cooking.

This pasteurization technique can be used for all recipes calling for uncooked eggs or egg yolks, containing at least 2 tablespoons of liquid per egg. More liquid can be used if the recipe contains more.

The September issue of the Journal of Food Protection investigated the interactions of growth temperature, heating temperature, NaCl concentration and pH on the thermal injury and recovery of Salmonella Enteritidis in ground chicken.

It was observed that the rate of recovery of heat-injured cells was similar at each pH level tested. Therefore, a pH range of 5.5 to 6.5 does not have a major inhibitory effect on the recovery of Salmonella Enteritidis.

UT hosted a microbiology seminar at Walters Life Sciences Building in Room 307 on Monday with a lecture from Dr. Bala Swaminathan of the CDC. His lecture focused on food disease surveillance and outbreak investigations.

Swaminathan’s biggest findings were in the area of salmonella surveillance.

“There are over 2,500 serotypes, (the) top 100 serotypes account for 98 percent of disease,” he said. “It’s important to determine the serotype.” A serotype is a group of microorganisms or viruses based on the cell surface of antigens. He mentioned the PulseNet database as being a great help in detecting these viruses.

“PulseNet surveillance is proven to be an effective and early warning system for detecting food-borne clusters,” Swaminathan said. “Significant progress has (been) made in the past 20 years in food safety. We are importing more products than we did 20 years ago, and we must see that in our own country, we must also practice sanitary food preparation.”
 

A September abstract from the Journal of Food Protection discusses detection methods of Salmonella on tomato surfaces within 8 hours of exposure to the bacteria.

The FTI-PCR method was compared with real-time PCR, direct plating of FTI beads on xylose lysine desoxycholate, and the conventional culture method for Salmonella found in the FDA Bacteriological Analytical Manual.

Unwaxed green tomatoes were spot inoculated with a five-serovar Salmonella cocktail on smooth surfaces at levels of 100 to 104 CFU per tomato and washed in lactose broth using a shake-rub method.

The FTI-PCR method was found to be superior to the BAM Salmonella culture method for the detection of Salmonella serovars on tomato surfaces.
 

September is National Food Safety Education Month. The point of the annual campaign is to make sure you don't get sick because of things you're doing - or not doing - in your kitchen. There are a few things you can do during dinner tonight that'll help keep you and your family safe, according to WETM 18 News of New York.

Health officials warn you that food in your grocery store might look ready to bring home and serve immediately, but it's not ready to eat. Poultry, for example, is synonymous with food-borne illnesses, like salmonella poisoning. Chicken cutlets might look nice and neat in their tightly-bound packaging, but Butts doesn't advise that you simply drop it on a grill. "Poultry draws contaminants easily, so you want to make sure anytime you buy poultry that you're thoroughly cleaning it before you grill it or cook it or whatever you're going to do with it," Butts said.

According to the FDA, I in 5 people don't wash his or her hands or kitchen counters before preparing food. But it's how you wash your counter that makes the difference. A third safety suggestion is this: Butts says choose paper towels, not kitchen sponges. "Sponges are fine for one-time use, but what they'll do is they'll actually absorb bacteria, said Butts. "So when you're using them to clean your kitchen, you're spreading more bacteria."

Using wooden cutting boards is a bad idea when cutting raw meat. The juices can seep into the wood, stay there, and get on other food. Instead, health officials recommend using a plastic cutting board.
 

A September abstract from the Journal of Food Protection covers the incidence of food-borne pathogens in retail marketplaces in Edmonton.

A total of 800 meat and poultry products were purchased from the retail marketplace in Edmonton, Alberta, Canada.

The products consisted of raw ground beef, chicken legs, pork chops, and ready-to-eat fermented sausage, roast beef, processed turkey breast, chicken wieners, and beef wieners. The samples were analyzed to determine the prevalence of Shiga toxin-producing Escherichia coli, Salmonella, Campylobacter spp., and Listeria monocytogenes.

Shiga toxin-producing E. coli O22: H8 was found in one raw ground beef sample. Salmonella and Campylobacter were found in 30 and 62% of raw chicken legs, respectively. L. monocytogenes was found in 52% of raw ground beef, 34% of raw chicken legs, 24% of raw pork chops, 4% of fermented sausages, 3% of processed turkey breast, 5% of beef wieners, and 3% of chicken wieners.

The occurrence of pathogens in this study is similar to that in retail products in many other international locales.
 

This September is National Food Safety Education Month.

It is estimated by the Centers for Disease Control and Prevention that 76 million people get sick, more than 300,000 are hospitalized, and 5,000 Americans die each year from food-borne illness.

The Jefferson County Department of Health and Environment is celebrating food safety month with educational displays and the Leader in Food Safety Award. The Food Safety Program works to prevent food-borne illness outbreaks and assure that Jefferson County citizens and visitors are provided with safe food. Staff routinely inspect the over 1,800 food service establishments in the County to insure compliance with state regulations and to educate about food safety.

Throughout the month of September, the public is encouraged to visit one of the six educational displays set up in the Jefferson County libraries. This year's display theme "Don't Let Food-borne Illness Spoil a Good Meal" highlights the most common food borne illnesses and how to prevent them; the importance of proper hand-washing in fighting the spread of disease as well as information on getting the most nutrition out of your meals. An additional food safety display will be in the atrium of the Jefferson County Courts and Administration Building.
 

The number of food poisoning cases caused by the consumption of spoilt sandwiches from a restaurant in Ruseifa, Jordan on Sunday rose from 170 to 762.

Lab tests revealed that the cause was the salmonella bacteria, usually found in poultry. Health Minister Saeed Darwazeh, who checked on the patients at the Yajouz and Zarqa hospitals yesterday, said 100 of the cases are still at the hospital, while the rest were discharged after treatment.

During his weekly press conference yesterday, Government Spokesperson Nasser Judeh said the government would take firm measures in this regard, not only by penalising the violators but also in controlling the situation.

He stressed that the concerned government agencies would take the necessary action.

The restaurant has been shut down and its contents were seized, Darwazeh said, adding that the ministry does not impose penalties on restaurant owners, it only refers them to the authorities.

The minister said it was decided that the patients would be treated at no charge.
 

U.S. researchers say they have determined hogs raised on small farms have little or no Salmonella infections.

"These farms have very low levels of Salmonella," explained D.L. Harris, an Iowa State University Food Safety Consortium researcher and animal science professor. "They're traditional farms that don't use antibiotics."

Harris' group surveyed 50 traditional family farms in the Midwest ranging in size from 20 to 150 sows. The researchers found practices such as maintaining small herd sizes, limiting the use of vaccines and refraining from using growth-promoting antibiotics did not translate into high prevalence of Salmonella. But such practices apparently don't have as much affect on keeping Salmonella levels low as do other practices such as the use of meal feed and straw bedding.

Said Harris: "The difficulty comes in how they market their pigs. We know that they can get exposed to Salmonella on transport vehicles or when they're held before they're slaughtered. So here you've got this organic farmer doing a good job raising pigs and being welfare-conscious. But when he takes them to market they could be contaminated with Salmonella depending on how that phase is done."
 

Brian White recently wrote an editorial in regards to the recent lawsuit against Wal-Mart, in which a Greenwood, Indiana family is suing the global retailer for damages after a boy in the family had to be hospitalized after eating a ham and cheese sandwich from the Greenwood Wal-Mart store.

It appears from initial reports that health officials traced the salmonella outbreak to the deli and bakery sections of this specific Wal-Mart. Over 84 people from the communities of Marion and Johnson counties in Indiana were made sick from eating food from the Greenwood Wal-Mart.

White feels that Wal-Mart should be held liable for food poisoning outbreaks that cause "personal injury" to customers of its stores. Especially in the case of pre-prepared or pre-packaged food, such as deli products, which are then subsequently handled by employees prior to consumption, according to White.
 

A lawsuit was filed today against Wal-Mart Stores, Inc., the company whose Greenwood, Indiana, store was the source of a Salmonella outbreak between May and August, 2006.

The lawsuit was filed by Marler Clark and Greenwood attorney John M Reames on behalf of Ryan Merritt, a Greenwood resident whose son became violently ill and was hospitalized after consuming foods purchased at the Wal-Mart deli.

The attorneys allege that Mr. Merritt purchased ham and cheese from the Wal-Mart deli on August 13.  Mr. Merritt’s son, Noah, consumed the ham and cheese in the subsequent days and became ill on August 18.  Noah’s symptoms became severe, and he was admitted to the ER at St. Francis Hospital in Indianapolis. While hospitalized, Noah provided a stool sample that tested positive for Salmonella.

An Indiana State Department of Health investigation into the Salmonella outbreak led ISDH to believe that infected food workers who did not exhibit symptoms of Salmonellosis, or who were a-symptomatic carriers of the bacterium, contaminated the deli and bakery foods.

“We’ve seen this before and will see it again,” Marler continued. “Businesses who fail to enforce strict handwashing policies will continue to be the source of outbreaks, and will be held responsible for their failures through the legal system.”
 

The deli and bakery departments of an Indianapolis Wal-Mart have been identified as the source of the recent salmonella outbreak in northern Johnson and southern Marion counties.

Wal-Mart officials report that all employees from the deli and bakery areas have been moved to other parts of the store until the investigation is complete. They have also discarded all possibly contaminated foods, and cleaned and sanitized both departments.

The State Department of Health was contacted on July 11 by the Marion County Health Department about an increase in salmonella cases in that area. Currently, 84 cases of salmonella have been reported to be part of the outbreak, which began in May 2006. State health officials say additional cases may be identified for the next few weeks, as the investigation concludes, but expect them to eventually taper off, now that the source has been identified and addressed.

State health officials say the salmonella contamination occurred at the store, and that the public should not be concerned with purchasing items from the deli and bakery departments in the future. Health officials do recommend that individuals who purchased ready-to-eat items at the deli and bakery areas of this Wal-Mart on or before August 25 should discard those items, or return them to the store for a refund.
 

Iowa State University researchers Isabel Harris and Matthew Erdmann have found that hogs on small farms already have little or no Salmonella.

“These farms have very low levels of Salmonella,” explained D.L. Harris, an ISU Food Safety Consortium researcher and animal science professor. “They’re traditional farms that don’t use antibiotics.”

Harris’ research group surveyed 50 traditional family farms in the Midwest ranging in size from 20 to 150 sows. The pigs there are raised on open lots using management procedures with varying risks of contributing to Salmonella on the premises.

The researchers found that practices such as maintaining small herd sizes, limiting the use of vaccines and refraining from using growth-promoting antibiotics did not translate into high prevalence of Salmonella. But those practices apparently don’t have as much impact on keeping Salmonella levels low as do other practices such as the use of meal feed and straw bedding, low stocking densities or rodent control. The lesson here, Harris noted, is that avoidance of antibiotics by itself isn’t enough to keep Salmonella out. The other factors play more important roles.
 

The Indiana State Department of Health says a Wal-Mart store is the source of a recent salmonella outbreak that affected 84 people in Johnson and Marion counties.

Wal-Mart officials say the problem was detected in the deli and bakery areas. The health department says Wal-Mart officials have taken steps to fix the problem. Wal-Mart officials report that all employees from the deli and bakery areas have been moved to other parts of the store until the investigation is complete. They have also discarded all possibly contaminated foods, and cleaned and sanitized both departments.

A Wal-Mart deli and bakery has been identified as the source of a recent salmonella outbreak affecting people in Johnson and Marion counties, the Indiana State Health Department reported.

But according to Donna Chastain and Elizabeth Young of the Morgan County Health Department, no food from the Wal-Mart or from other food services in Martinsville have caused salmonella poisoning in residents in Morgan County.

An Associated Press article reported food handlers who did not have any symptoms might have contaminated products in the Wal-Mart deli and bakery.