A total of 38 people infected with the outbreak strain of Salmonella Enteritidis have been reported from seven states – Montana, Colorado, Iowa, Ohio, Kentucky, Tennessee and Alabama.

Illnesses started on dates ranging from June 17, 2018, to August 16, 2018.

Ten people have been hospitalized. No deaths have been reported.

The outbreak strain of Salmonella Enteritidis was identified in environmental samples and in eggs collected from Gravel Ridge Farms.

On September 8, 2018, Gravel Ridge Farms recalled cage-free large eggs because they might be contaminated with Salmonella.

On September 8, 2018, Gravel Ridge Farms recalled cage-free large eggs because they might be contaminated with Salmonella.

Do not eat, sell, or serve recalled Gravel Ridge Farms cage-free large eggs.

Gravel Ridge Farms recalled packages of a dozen and 2.5 dozen eggs in cardboard containers with UPC code 7-06970-38444-6.

Recalled eggs have “best if used by” dates of July 25, 2018 through October 3, 2018.

Recalled eggs were sold in grocery stores and to restaurants in Alabama, Georgia, and Tennessee. For a full list of locations where recalled eggs were sold, visit the FDA website.

Summary

Public Health is investigating an outbreak of salmonellosis associated with food prepared in the service deli at the Costco Wholesale Warehouse in Issaquah. The service deli prepares and sells ready-to-eat foods, including rotisserie chicken, pork ribs, sandwiches, wraps, macaroni and cheese, poke, cilantro lime shrimp, and shrimp cocktail.

At this time, the source of the illnesses has not been identified. Everyone who reported illness has recovered.

Illnesses

Since August 28, 2017, we have learned of seven King County residents who tested positive for Salmonella I,4,[5], 12:i:- infections. DNA fingerprinting was performed on the Salmonella bacteria from the seven people who got sick and was identical for all cases, suggesting a common source of infection. Illness onsets occurred sporadically during August 28, 2017–July 13, 2018, and a common epidemiological link among all cases was not established until August 2018; no single food item prepared by the service deli has been identified as the source of the illnesses.

All seven people who got sick shopped at the Costco Wholesale Warehouse in Issaquah; five bought ready-to-eat food from the service deli, food purchase history cannot be verified for one person, and one was an employee at the Costco service deli. There is no evidence to indicate that the service deli employee is the source of the outbreak.

In September, an eighth person with Salmonella I,4,[5], 12:i:- infection was reported. However, this infection was caused by a Salmonella strain with a different DNA fingerprint that does not appear to be closely related to the other seven people who got sick, suggesting that this case is not related to the outbreak.

Public Health actions

As part of the Public Health investigation, Environmental Health investigators visited Costco Wholesale Warehouse in Issaquah on August 7, 2018. Investigators identified potential risk factors for cross contamination and spread of bacteria, including inconsistent handwashing practices and improper cleaning and sanitizing of surfaces that touch foods. Corrective actions were addressed with Costco Issaquah management, including food handling procedure changes, retraining employees on food safety practices, and documenting appropriate cleaning and sanitizing practices.

Investigators re-visited the service deli on August 30, 2018, to ensure corrective actions had been addressed. Investigators again identified concerns for inconsistent handwashing practices and improper cleaning and sanitizing of surfaces that touch foods. Corrective actions were addressed with Costco Issaquah management.

On September 19, 2018, Environmental Health investigators asked Costco Issaquah’s service deli to temporarily stop preparing ready-to-eat foods that would not be cooked further by the customer in order to reevaluate food handling practices and procedures. On September 20, 2018, investigators visited the facility and identified further areas for improvement to limit cross contamination. The facility was instructed to provide additional food handling training to service deli employees to minimize the risk of cross contamination, such as hand washing and sanitation of surfaces where foods are prepared and stored. In addition, completion of a deep cleaning and disinfection of the service deli was required before resuming preparing and selling of ready-to-eat foods.

The investigators re-visited the service deli on September 21, 2018, to confirm the facility had completed a thorough cleaning and disinfection and that a plan for further training and procedure changes had been initiated. Costco Issaquah provided sufficient evidence of a thorough disinfection and corrective actions so the service deli was allowed to resume their normal food preparation operations. Another follow-up visit will occur within 14 days to ensure all corrective actions have been completed.

Environmental testing

Raw poultry and environmental samples collected in the service deli on August 7, 2018, tested negative for SalmonellaI,4,[5], 12:i:- at the Washington State Public Health Laboratory.

As of September 25, 2018, 135 people infected with the outbreak strain of Salmonella Mbandaka were reported from 36 states. A list of the states and the number of cases in each state can be found on the Case Count Map page.

Illnesses started on dates from March 3, 2018, to August 29, 2018. Ill people ranged in age from less than one year to 95, with a median age of 57. Sixty-nine percent of ill people were female. Out of 101 people with information available, 34 (34%) were hospitalized. No deaths were reported.

WGS analysis did not predict antibiotic resistance in bacteria isolated from 91 ill people and 8 food and environmental samples. Testing of five clinical isolates using standard antibiotic susceptibility testing methods by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory also did not show antibiotic resistance.

Epidemiologic and laboratory evidence indicated that Kellogg’s Honey Smacks cereal was 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. Sixty-three (75%) of 84 people interviewed reported eating Kellogg’s Honey Smacks cereal. Ill people in this outbreak reported this cereal more often than any other cereals or food items.

Health officials in several states collected Kellogg’s Honey Smacks cereal from retail locations and ill people’s homes for testing. Laboratory testing identified the outbreak strain of Salmonella Mbandaka in a sample of unopened Kellogg’s Honey Smacks cereal collected from a retail location in California. Laboratory testing also identified the outbreak strain in samples of leftover Kellogg’s Honey Smacks cereal collected from the homes of ill people in Montana, New York, and Utah. WGS showed that Salmonella bacteria isolated from sick people and the cereal were closely related genetically. This result provides more evidence that people in this outbreak got sick from eating Kellogg’s Honey Smacks.

On June 14, 2018, the Kellogg Company recalled all Honey Smacks cereal that were on the market within the cereal’s one-year shelf-life.

Today the CDC reported that it, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Salmonella Enteritidis infections.

As of September 7, 2018, 14 people infected with the outbreak strain of Salmonella Enteritidis have been reported from Alabama and Tennessee.

Illnesses started on dates ranging from July 10, 2018 to August 7, 2018 Ill people range in age from 1 year to 94, with a median age of 31. Fifty percent are female. Of 9 people with information available, 2 (22%) have been hospitalized. No deaths have been reported.

Epidemiologic and traceback evidence indicates that shell eggs from Gravel Ridge Farms in Cullman, Alabama are a likely source of the outbreak.

On September 8, 2018, Gravel Ridge Farms recalled cage-free large eggs because they might be contaminated with Salmonella Enteritidis bacteria. Recalled eggs were sold in grocery stores and to restaurants in Alabama, Georgia, and Tennessee. The FDA website has a list of the grocery stores where recalled eggs were sold. Consumers who have any Gravel Ridge Farms cage-free large eggs in their homes should not eat them. Return them to the store for a refund or throw them away. Restaurants and retailers should not serve or sell recalled Gravel Ridge Farms cage-free large eggs.

Gravel Ridge Farms is recalling Cage Free Large Eggs due to a potential contamination of Salmonella. The recall was initiated because reported illnesses were confirmed at locations using Gravel Ridge Farm Eggs, and we are voluntarily recalling out of an abundance of caution.

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 producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis.

On 9/6/2018 the firm was notified by FDA that the product they supplied may be contaminated with Salmonella. 

Products affected are:

Product Size UPC Use By Dates
Gravel Ridge Farms
Large Cage Free Eggs
Single Dozen and 2.5 Dozen Flats 7-06970-38444-6 7/25/18 through 10/3/18

The products were distributed between 6/25/2018 and 9/6/2018. These products were packaged in a cardboard container and sold primarily in restaurants and retail stores in AL, GA, and TN. Consumers who have purchased these products can return to store for refund or discard the product immediately. If any consumers have Gravel Ridge Farms eggs in their refrigerator, they should be discarded, regardless of the date stamped on the package. Consumers with questions may call Dustin Smith at 205-363-1105 M-F Between 8AM and 4PM Central Time.

The following retail stores carried the product:

Atlanta

Candler Park Market

Grant Park Market

Westview Corner Market

Sevananda Natural Foods

The Merchantile

Birmingham

Piggly Wiggly Clairemont

Piggly Wiggly River Run

Piggly Wiggly Crestline

Piggly Wiggly Bluff Park

Piggly Wiggly Dunnavent Valley

Piggly Wiggly Warrior

Piggly Wiggly Homewood

Western Market Mt. Brook

Western Market Rocky Ridge

Foodland Eva

Warehouse Discount Grocery Hanceville

Warehouse Discount Grocery Cullman 2 locations

Foodland Priceville

Star Market Huntsville

Manna Grocery Tuscaloosa

The company has ceased the production and distribution of the product as FDA and the company continue their investigation as to what caused the problem.

The Kansas Department of Health and Environment (KDHE) and Doniphan County Health Department continue to investigate an outbreak associated with an election day Indian Taco Dinner at the Highland United Methodist Presbyterian Church in Highland, Kansas on August 7, 2018.

A survey was launched on August 10, 2018 to collect illness and exposure information from those that attended the dinner.

As of August 31, 2018, 115 persons have completed the survey, 69 have reported gastrointestinal illnesses, and 14 have tested positive for Salmonella Newport. These numbers are preliminary.

Testing of food that was served at the dinner has been completed and all tested negative for Salmonella except for a sample of tomatoes that tested positive for the same strain of Salmonella Newport. Tomatoes were provided by multiple people so an environmental assessment of the sources of tomatoes is planned to potentially determine how this contamination occurred.

In addition, KDHE is assessing whether other persons that did not attend the taco dinner could have been sickened from consuming these tomatoes.

The Larimer County Department of Health and Environment (LCDHE) is investigating an outbreak of Salmonella illness at La Luz Mexican Restaurant in Old Town Fort Collins. As of August 21, there are six confirmed cases with additional cases pending investigation and testing. Some of the confirmed cases have been hospitalized.

La Luz has been proactive in collaborating with the Health Department to try and identify the source of the outbreak.  La Luz is primarily concerned with the safety of its customers and integrity of its food supply and wants to prevent any further illness as best they can. Out of concern for its customers and employees, La Luz has voluntarily closed until more is known about the outbreak.

Salmonella are bacteria that can cause infections affecting the intestinal tract, urinary tract, bloodstream or other body tissues. Salmonella is often spread to people through food consumption.  The bacteria can be found in many food items including raw meats, eggs, produce. Salmonella can be spread through people who are sick who handle food. Some people who are infected are asymptomatic and can spread the infection unknowingly.

Symptoms may include, diarrhea, fever, abdominal cramps, vomiting and bloody stool. Symptoms typically appear 6-72 hours after eating contaminated food and will usually last for 4 to 7 days. In severe cases, the symptoms may last longer or require hospitalization.

Hy-Vee, Inc., based in West Des Moines, Iowa, is voluntarily recalling its Hy-Vee Spring Pasta Salad due to the potential that it may be contaminated with Salmonella. The potential for contamination was brought to Hy-Vee’s attention last night when approximately 20 illnesses in Minnesota, South Dakota, Nebraska and Iowa were potentially linked back to customers consuming the salad. The voluntary recall includes Hy-Vee Spring Pasta Salads in both 1 pound (16 oz.) and 3 pound (48 oz.) containers produced between June 1, 2018, and July 13, 2018, and available from the deli service case.

According to the Centers for Disease Control and Prevention, 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 pasta salad was distributed to all of Hy-Vee’s 244 grocery stores across its eight-state region of Iowa, Illinois, Missouri, Kansas, Nebraska, South Dakota, Minnesota and Wisconsin. The product comes in a plastic container with a plastic lid. The expiration date range is between June 22, 2018, and Aug. 3, 2018. The expiration date can be found on the side of the container.

Out of an abundance of caution, Hy-Vee voluntarily removed the product last night from all of its shelves and service cases as soon as the grocery chain was notified about the situation.

As of July 12, 2018, 100 people infected with the outbreak strain of Salmonella Mbandaka have been reported from 33 states.

Illnesses started on dates from March 3, 2018, to July 2, 2018. Ill people range in age from less than one year to 95, with a median age of 57. Of ill people, 68% are female. Out of 77 people with information available, 30 (39%) have been hospitalized. No deaths have been reported.

Illnesses that occurred after June 19, 2018, might not yet be reported due to the time it takes between when a person becomes ill and when their illness is reported. This takes an average of 2 to 4 weeks.

State and local health officials continue to interview ill people and ask questions about the foods they ate and other exposures in the week before they became ill. Fifty-five (85%) of 65 people interviewed reported eating cold cereal. In interviews, 43 people specifically reported eating Kellogg’s Honey Smacks cereal. Ill people in this outbreak reported this cereal more often than any other cereals or food items.

Health officials in several states collected Kellogg’s Honey Smacks cereal from retail locations and ill people’s homes for testing. Laboratory testing identified the outbreak strain of Salmonella Mbandaka in a sample of unopened Kellogg’s Honey Smacks cereal collected from a retail location in California. Laboratory testing also identified the outbreak strain in samples of leftover Kellogg’s Honey Smacks cereal collected from the homes of ill people in Montana, New York, and Utah.

The Kellogg Company recalled all Honey Smacks products that were on the market within the cereal’s one-year shelf-life. However, Honey Smacks products with earlier dates could also potentially be contaminated. Do not eat Kellogg’s Honey Smacks cereal of any size package or with any “best if used by” date.

As of June 14, 2018, 73 people infected with the outbreak strain of Salmonella Mbandaka have been reported from 31 states. A list of the states and the number of cases in each can be found on the Case Count Map page.

Illnesses started on dates from March 3, 2018, to May 28, 2018. Ill people range in age from less than one year to 87, with a median age of 58. Sixty-five percent are female. Out of 55 people with information available, 24 (44%) have been hospitalized. No deaths have been reported.

Illnesses that occurred after May 22, 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 2 to 4 weeks. Please see the Timeline for Reporting Cases of Salmonella Infection for more details.

Epidemiologic evidence indicates that Kellogg’s Honey Smacks cereal is a 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. Thirty (77%) of 39 people interviewed reported eating cold cereal. In interviews, 14 people specifically reported eating Kellogg’s Honey Smacks cereal. Ill people in this outbreak reported this cereal more often than any other cereals or food items.

On June 14, 2018, the Kellogg Company recalled packages of Kellogg’s Honey Smacks cereal.

As of June 18, 2018, 70 people infected with the outbreak strain of Salmonella Adelaide have been reported from seven states. A list of the states and the number of cases in each can be found on the Case Count Map page.

Illnesses started on dates ranging from April 30, 2018, to June 3, 2018. Ill people range in age from less than 1 year to 97, with a median age of 67. Sixty-seven percent are female. Out of 63 people with information available, 34 (54%) have been hospitalized. No deaths have been reported.

Illnesses that occurred after May 28, 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 2 to 4 weeks. Please see the Timeline for Reporting Cases of Salmonella infection for more details.

Epidemiologic and preliminary traceback evidence indicates that pre-cut melon supplied by Caito Foods, LLC of Indianapolis, Indiana is a likely source of this multistate outbreak. Most of the ill people reported eating pre-cut cantaloupe, watermelon, or a fruit salad mix with melon purchased from grocery stores. Information collected from stores where ill people shopped indicates that Caito Foods, LLC supplied pre-cut melon to these stores.