The number of ill persons identified in each state is as follows: Alabama (2), Arkansas (1), Connecticut (5), District of Columbia (2), Georgia (4), Illinois (9), Louisiana (2), Maryland (10), Massachusetts (4), Mississippi (1), Missouri (1), New Jersey (7), New York (23), North Carolina (2), Pennsylvania (3), Rhode Island (4), South Carolina (3), Texas (3), Virginia (5), and Wisconsin (9). 10 ill persons have been hospitalized.

Many of the ill persons reported consuming sushi, sashimi, or similar foods in a variety of locations in the week before becoming ill.  Past sushi outbreak in the U.S.:

• Marinepolis Sushi Land Unknown 2011
• Uncle Sushi and Grill Sushi Outbreak 2011
• Tennessee Restaurant Sushi, Seafood 2008
• New York Restaurant Sushi Rolls, 2007
• Florida Restaurant Sushi and Sashimi 2007
• Colorado Restaurant Sushi 2007
• Sushi King California Rolls 2006
• Family Owned Sushi Restaurants 2004

According to a complaint (#11CV6618) filed in U.S. District Court in Rochester, Laurie Neff fell ill on October 21, 2011, days after consuming Turkish pine nuts purchased from a Wegmans Food Mart in Webster, New York. For ten days Miss Neff sustained gastrointestinal symptoms and on November 7 her child also began experiencing similar symptoms that worsened until the child was taken to the emergency room on November 10. Lab testing later showed that the child tested positive for Salmonella. The lawsuit alleges the Salmonella infection and related injuries suffered by the child were results of either consumption of pine nuts or her exposure to Miss Neff after she became infected with Salmonella after eating contaminated pine nuts.

Then she ate the leftovers the next day. Within hours, she became violently ill.

Twice, the 16-year-old was treated in the Emergency Room for extreme pain, shakiness and dehydration. She lost weight. The sight of food made her physically ill.

A few days later tests revealed she had Salmonella. The leftover pesto sauce also tested positive for the bacteria.

But it was only after a massive recall of the pine nuts that Veronika and her mother learned their illnesses were linked to the tainted nuts.

Now they are suing the New Jersey Company that supplied the turkish pine nuts. They are asking for $75,000 in damages, for pain and suffering and medical costs.

Their lawyer, Paul Nunes, of Underberg and Kessler Attorneys, says this is about accountibility. He says the company that supplied the tainted pine nuts needs to pay for the negligence that caused these illnesses.

Veronika says she was on pain medication for weeks and still is cautious whenever she eats anything.

There are 20 known cases of Salmonella in Monroe County, linked to the turkish pine nuts.

However, according to CIDRAP and efoodalert the numbers of ill and the states involved are different:

• 89 cases in New York State

• 64 cases in New Jersey

• Maryland health officials have received reports of nine cases linked to the outbreak, including seven adults and two children

• The Pennsylvania Department of Health (PDH) has confirmed seven outbreak-related cases that occurred from April through August

• Minnesota one

Let the counting begin.

According to the complaint (#11CV6561) which was filed in New York Federal District Court, college student Sean McGuirk consumed a pasta meal made with Turkish pine nuts on August 28, 2011. By September 3, he had developed gastrointestinal symptoms indicative of a Salmonella illness. Over the next week, Mr. McGuirk's symptoms worsened, resulting in his missing class at St. John Fisher College. By September 9, he was taken to Strong Memorial Hospital where he underwent treatment until he was discharged on September 11. The Mr. McGuirk was notified by health officials that his illness was part of a Salmonella outbreak linked to imported Turkish pine nuts.

“While food companies need to ensure the safety of all the products they sell, producers and distributers should be especially vigilant when it comes to ready-to-eat foods such as pine nuts,” said McGuirk's attorney, William Marler. “I am hopeful that American Pistachio will address this issue directly and proactively by not only making sure that the victims of this outbreak are compensated for their medical expenses, but by reevaluating their food safety procedures for the future.”

On October 27, Wegmans Food Markets recalled 5,000 pounds of pine nuts when the Centers for Disease Control and Prevention (CDC) announced that Turkish pine nuts sold in the grocery stores' bulk bins were linked to a Salmonella Heidelberg outbreak that had sickened 42 people in five states. On November 4, the US Food and Drug Administration issued a warning to consumers not to eat Turkish pine nuts imported by New Jersey-based Sunrise Commodities. Sunrise Commodities is a name under which American Pistachio Corp. does business.

Collaborative investigative efforts of state, local, and federal public health and regulatory agencies indicate that ground turkey is the likely source of this outbreak.

Contaminated ground turkey is being recalled from grocery stores but may still be in consumers' homes.

Consumers should check their homes for recalled ground turkey products and not eat them; restaurant and food service operators should not serve them.

The outbreak strain of Salmonella Heidelberg is resistant to several commonly prescribed antibiotics. This antibiotic resistance may be associated with an increased risk of hospitalization or possible treatment failure in infected individuals.

Timeline of Events: Multistate Outbreak of Salmonella Heidelberg Infections Associated with Ground Turkey—United States, 2011:

Failure to take necessary precautions to protect against contamination of food and food contact surfaces with microorganisms and foreign substances. Listeria monocytogenes was found on the surface of a stainless steel table in the packing room, according to the report. The raw sprouts were stored in unlined plastic crates so the sprouts at the bottom were in contact with pallets and other totes, which previously had been in contact with the floor.

Failure to clean food-contact surfaces as frequently as necessary to protect against contamination of food. Food debris and residue was found in the hard-to-clean areas in and around the conveyor belt and sprouts that passed along and got briefly stuck in these areas could fall back into the rinse tank. Inspectors said it appeared that equipment and fixtures in the seed disinfection room were not cleaned between use.

Failure to clean non-food-contact surfaces of equipment as frequently as necessary to protect against contamination. Listeria seeligeri was detected on the surface of a brown mass of old, thick food grime on a cross-support place at the top of the rinse incline belt, the report stated.

Effective measures are not being taken to protect against contamination of food on the premises by pests. Inspectors said gaps at the bottom of a door and along the roof line could allow pests access to the facility. They said they found rodent excreta pellets in the warehouse and noted that the processing room was accessible from the warehouse.

Failure to properly store equipment, remove litter and waste, and cut weeds or grass that may constitute an attractant, breeding place or harborage area for pests, within the immediate vicinity of the plant, building, or structures.

Failure to maintain buildings, fixtures, or other physical structures in a sanitary condition

Failure to hold raw materials in bulk or suitable containers so as to protect against contamination.

Four to five bags partially filled with seed were stored open or not tightly wrapped inside the warehouse, the inspectors reported.

“King Nut had a responsibility to Mrs. Almer, her family, and anyone else eating King Nut peanut butter to produce a safe product. That responsibility involves ensuring suppliers are providing unadulterated ingredients”

According to the complaint, Shirley Mae Almer consumed a peanut butter-based product manufactured by King Nut in 2008 when she was a resident of the Good Samaritan Society – Bethany Rehabilitation Center in Brainerd, Minnesota. On December 12, 2008 Ms. Almer began to suffer gastrointestinal pains. Over the next several days her condition worsened, and she was hospitalized. Ms. Almer was pronounced dead by causes related to a Salmonella infection December 21. Weeks later, the Minnesota Department of Agriculture issued a product safety advisory based on positive tests for Salmonella in a King Nut container of peanut butter. The next day King Nut voluntarily recalled all of its peanut butter products made with Peanut Corporation of America (PCA) products for potential Salmonella contamination.

“King Nut had a responsibility to Mrs. Almer, her family, and anyone else eating King Nut peanut butter to produce a safe product. That responsibility involves ensuring suppliers are providing unadulterated ingredients,” said Bill Marler, attorney for the Almer family.

King Nut was one of hundreds of companies that recalled products made with Salmonella-contaminated peanuts purchased from the now defunct PCA. The Centers for Disease Control and Prevention attributed 714 cases of illness and 9 deaths to PCA products.

Salmonella infection occurs when the bacteria are ingested, typically from food derived from infected food-animals, but it can also occur by ingesting the feces of an infected animal or person. Food sources include raw or undercooked eggs/egg products, raw milk or raw milk products, contaminated water, meat and meat products, and poultry. Raw fruits and vegetables contaminated during slicing have been implicated in several foodborne outbreaks. We are involved in representing families of children who have suffered from this bacterium.

• A & R Bar-be-que Salmonella Outbreak - Tennessee
• Adrift Restaurant Salmonella Outbreak – Washington
• Baker Street Restaurant Salmonella Outbreak 2010
• Beaches Sandy Bay Resort Salmonella Outbreak – Jamaica
• Black Forest Bakery Salmonella Outbreak - Michigan
• Bogey’s Restaurant / Quality Inn Salmonella Outbreak - Washington
• Brook-Lea Country Club Salmonella Outbreak - New York
• Café Santa Fe Salmonella Outbreak - Arkansas
• Cantaloupe Salmonella Litchfield Outbreak, 2008 - Nationwide
• Cargill Ground Beef Salmonella Newport Outbreak - Nationwide
• Caudill Alfalfa Sprouts Salmonella Outbreak - Multistate, 2009
• Chili’s Salmonella Outbreak - Illinois
• City of Alamosa Salmonella Outbreak - Colorado
• ConAgra Marie Callender’s Cheesy Chicken and Rice - Salmonella Chester outbreak
• ConAgra Peanut Butter Salmonella Outbreak - Nationwide
• ConAgra Pot Pie Salmonella Outbreak - Nationwide
• Corky & Lenny’s Salmonella Outbreak - Ohio
• Daniele International Pepper Salame/Salami - Salmonella: Nationwide
• Economart Salmonella Outbreak - North Dakota
• Fern Hill Golf & Country Club Salmonella Outbreak - Michigan
• Golden Corral Salmonella Outbreak - Georgia
• Harmony Farms Salmonella Outbreak - Washington and Oregon
• Illinois Subway Salmonella Hvittingfoss Outbreak
• KFC Salmonella Outbreak - Colorado
• King Soopers Salmonella Outbreak - Colorado
• Linh’s Bakery Salmonella Outbreak - Virginia
• Malt-O-Meal Salmonella Outbreak, 1998 - Nationwide
• Malt-O-Meal Salmonella Outbreak, 2008 - Maine, Minnesota
• Old South Salmonella Outbreak - South Carolina
• Orchid Island Orange Juice Salmonella Outbreak - Nationwide
• Outbreak of Salmonella Newport in Caldwell Foods Alfalfa Sprouts, 10 states
• Paramount Farms Almonds Salmonella Outbreak - California, Nationwide
• Pars Cove Salmonella Outbreak at Taste of Chicago - Illinois
• Peanut Corporation of America Peanut Butter Salmonella Outbreak - Nationwide
• Quizno’s Salmonella Outbreak - Minnesota
• San Antonio Taco Salmonella Outbreak - Tennessee
• Seasons on the Pond Salmonella Outbreak - Colorado
• Setton Pistachios Salmonella Outbreak - Nationwide
• Sheetz and Coronet Foods Salmonella Outbreak - Pennsylvania, Eastern States
• Sprouters Northwest Salmonella Typhimurium Outbreak - Washington and Oregon
• Sun Orchard Salmonella Outbreak - Multistate
• Sushi King Salmonella Outbreak - Arkansas
• Susie Cantaloupe Salmonella Outbreak - Nationwide
• Taco Bell Salmonella Hartford and Baildon outbreaks, Nationwide, 2010
• Union International Foods - Spices, sauces, oils Salmonella Outbreak - Western States
• Veggie Booty Salmonella Outbreak - Nationwide
• Viva Cantaloupe Salmonella Outbreak - Nationwide
• Wal-Mart Jalapeno and Serrano Pepper Salmonella Outbreak - Nationwide
• Wal-Mart Salmonella Outbreak - Indiana
• Western Sizzlin’ Salmonella Outbreak - North Carolina
• Wright County Egg Salmonella Outbreak Nationwide, 2010
• Wyndham Anatole Hotel Salmonella Outbreak - Texas

The Food and Drug Administration said earlier that it found salmonella in feed at Wright County Egg Co. but didn't know how the bacteria got there.

The agency has since collected and tested samples from companies that shipped feed ingredients to Wright County Egg, which had its own mill that produced finished feed for its chickens. Those tests so far have failed to find salmonella at the suppliers, raising the possibility that the contamination occurred after the feed shipments were delivered, FDA officials said.

Wright County Egg Recall Tied to Salmonella Illnesses Nationwide

An outbreak of Salmonella Enteritidis (SE) at a restaurant in Kenosha, Wisconsin has been linked to the recall of 280,000,000 eggs and nearly 300 illnesses in the rapidly widening nationwide outbreak linked to contaminated Wright County Eggs. The amended lawsuit was filed against Wright County Egg and the company’s insurer. The complaint was filed in the Kenosha County Branch of the Wisconsin District Court by Seattle-based food safety law firm Marler Clark.

Ms. Dzinovic ate a cobb salad containing eggs at the Baker Street Restaurant and Pub in Kenosha on Friday, June 18. On Monday, she woke with severe abdominal cramps and diarrhea. By Wednesday, her symptoms were so severe she went to the hospital for treatment, where it was determined that she had been infected with Salmonella Enteritidis. Her SE was later linked to the Baker Street Restaurant outbreak, which is now linked to the nationwide recall of contaminated shell eggs.

Wright County Egg issued a voluntary recall of shell eggs distributed nationwide when the product was linked to SE illnesses. The eggs were sold under the brand names Lucerne, Albertson, Mountain Dairy, Ralph’s, Boomsma’s, Sunshine, Hillandale, Trafficanda, Farm Fresh, Shoreland, Lund, Dutch Farms and Kemps. Minnesota has 7 ill, and California announced 266 illnesses associated with the outbreak. This confirms CDC revelations that they have seen four times as many Salmonella illnesses reported each week for several months.

In January 2009 salmonella was found in a jar of peanut butter made by PCA. That led to the recall of thousands of food products, several lawsuits and PCA’s bankruptcy.

Last fall, the bankruptcy court set up a $12 million fund using money from Peanut Corp. insurance policies to pay the personal injury claims of people who had been sickened by the salmonella. Eventually 123 claims were submitted by people who had suffered from salmonella poisoning or whose relatives had died from it.

According to court documents, most claims are valued at $100,000 or less. One is valued at more than $2 million. Eight of the claims involve wrongful death claims, and 44 involve minors who became sick.

The U.S. trustee overseeing PCA’s bankruptcy received 123 claims from salmonella victims or surviving relatives and decided how much compensation should go to each claim.  Most of the claims are valued at less than $100,000. The largest is valued at more than $2 million, according to court documents. Those claims will be paid out of a $12 million fund established last fall.

Because bankruptcy courts do not have jurisdiction over personal-injury lawsuits, the case was moved to U.S. District Court in Roanoke earlier this year.  The court set an initial date of Aug. 18 to rule on the settlements, but on Wednesday stakeholders asked U.S. District Judge Michael Urbanski to move the date forward.

A Subway corporate spokesman said the company was sorry for the problems:

"We sincerely apologize to all Subway customers, those who have fallen ill, and those who now may hesitate to come back for a while," spokesman Kevin Kane noted. "We are truly sorry for the difficulty this situation has caused you, our customer, and are working diligently to solve this mystery and to regain your trust."

Most of the sick individuals have had improvement from their symptoms. The exact source of the Salmonella has not yet been confirmed, but this serotype is commonly associated with eggs or food items containing eggs. The restaurant has cooperated with DCHD officials and conducted the proper disposal of potentially affected food items. No violations in the restaurant have been identified with respect to their food handling practices, facilities or employees.

A person infected with Salmonella enteritidis may develop fever, abdominal cramps, and diarrhea beginning 12 to 72 hours after consuming a contaminated food or beverage. The illness usually lasts four to seven days, and most person recover without antibiotic treatment. However, the diarrhea can be severe, and the elderly, infants, and those with impaired immune systems may develop a more severe illness requiring hospitalization.

In general, there are several things that are recommended to reduce the risk of getting Salmonella enteritidis infection:

· Keep eggs refrigerated.

· Discard cracked or dirty eggs.

· Wash hands and cooking utensils with soap and water after contact with raw eggs.

· Eat eggs promptly after cooking. Do not keep eggs warm for more than 2 hours.

· Refrigerate unused or leftover egg- containing foods.

· Avoid eating raw eggs (as in homemade ice cream or eggnog). Commercially manufactured ice cream and eggnog are made with pasteurized eggs and have not been linked with Salmonella enteritidis infections.

· Avoid restaurant dishes made with raw or undercooked, unpasteurized eggs. Restaurants should use pasteurized eggs in any recipe (such as Hollandaise sauce or caesar salad dressing) that calls for pooling of raw eggs.

For more information about this investigation contact Gayle Harris, health director for the Durham County Health Department, at 919-560-7600 or via email at gharris@co.durham.nc.us. A resident that experience an illness similar to the above description should contact their personal physician.