The Chicago Department of Public Health identified an outbreak of Salmonella, impacting at least 14 people, on September 1, 2017.[1]The outbreak was detected by Chicago Department of Public Health officials’ ongoing surveillance, reviewing laboratory reports of patients diagnosed with specific diseases. Investigators recognized an uptick in a particular laboratory serotype of Salmonella cases, Salmonella Schwarzengrund, and then contacted patients to determine if there were any commonalities between the cases. This les to the determination that a number of individuals with Salmonella Schwarzengrund had recently eaten at Best BBQ Ribs restaurant, located at 1648 W. 115thStreet in Chicago, Illinois.

Food safety investigators inspected Best BBQ on August 31, 2017.[2]The inspection revealed critical violations that could have contributed to bacteria contamination, growth, and spread, including storage of meats at unsafe temperatures and inadequate measures to prevent contamination by pests and rodents.

After a request from Chicago Department of Public Health, Best BBQ voluntarily closed in order to fully cooperate with the outbreak investigation. Working with food protection inspectors, the restaurant addressed possible contamination issues to ensure that sanitation and health standards were met.

At least six individuals were hospitalized related to the Best BBQ Salmonella outbreak.

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[1]https://www.cityofchicago.org/city/en/depts/cdph/provdrs/inspections_and_permitting/news/2017/september/cdph-identifies-salmonella-outbreak-linked-to-morgan-park-restau.html

[2]http://webapps1.cityofchicago.org/healthinspection/inspection.jsp

CDC collaborated with public health and regulatory officials in several states and the U.S. Department of Agriculture’s Food Safety and Inspection Service to investigate a multistate outbreak of SalmonellaTyphimurium infections. Public health investigators used the PulseNet system to identify illnesses that were part of this outbreak. DNA fingerprinting was performed on Salmonellabacteria isolated from ill people by using PFGE and WGS.

A total of 265 people infected with the outbreak strains of SalmonellaTyphimurium were reported from 8 states. WGS performed on bacteria isolated from ill people showed that they were closely related genetically. This means that people in this outbreak were more likely to share a common source of infection.

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.

Public health officials in Iowa first detected this outbreak and linked the illnesses to chicken salad sold at Fareway grocery stores. CDC searched the PulseNet database and identified illnesses in other states, and those illnesses were added to this outbreak. In interviews, ill people answeredquestions about the foods they ate and other exposures in the week before they became ill. Of 222 people interviewed, 194 (87%) reported eating chicken salad purchased from Fareway grocery stores. Triple T Specialty Meats, Inc. produced the chicken salad that ill people reported eating.

On February 9, 2018, Fareway stopped selling chicken salad in all of its stores after the Iowa Department of Inspections and Appeals contacted the company about the illnesses. The Iowa Department of Public Health and the Iowa Department of Inspections and Appeals issued a consumer advisory on February 13, 2018 warning that chicken salad sold at Fareway may be contaminated with Salmonella.

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 July 24, 2018, 77 people infected with the outbreak strain of Salmonella Adelaide were reported from nine 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 July 2, 2018. Ill people ranged in age from less than 1 year to 97, with a median age of 67. Among ill people, 67% were female. Out of 70 people with information available, 36 (51%) were hospitalized. No deaths were reported.

Epidemiologic and traceback evidence indicated that pre-cut melon supplied by the Caito Foods, LLC of Indianapolis, Indiana 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. Thirty-six (64%) of 56 people interviewed reported eating pre-cut melon purchased from grocery stores, including cantaloupe, watermelon, or a fruit salad mix with melon. Twelve other people reported eating melon, but did not specify whether it was pre-cut.

Information collected from stores where ill people shopped indicated that Caito Foods, LLC supplied pre-cut melon to these stores. On June 8, 2018, Caito Foods, LLC recalled fresh-cut watermelon, honeydew melon, cantaloupe, and fresh-cut fruit medley products containing one of these melons that were produced at the Caito Foods facility in Indianapolis, Indiana.

An outbreak of Salmonella Javiana occurred in August of 2018 among patrons of La Luz restaurant in Fort Collins, Colorado.  Thirty-one laboratory confirmed caseswere included in the outbreak, including 6 employees of the restaurant. Analysis of data did not determine a food-specific cause for the outbreak.

The Larimer County Department of Health & Environment (LCDHE) received a complaint on Thursday, August 16, 2018 from an individual that reported dining at the restaurant on Friday, August 10, 2018. The complainant indicated that she/he dined with two employees from that restaurant. The complainant reported becoming ill approximately 15 hours after eatingat the restaurant and reported that theemployees with whom she/he had dined also become ill.

On Friday, August 17, 2018,routine follow-up of a reported Salmonellacase from the Colorado Department of Public Health and Environment communicable disease reporting system identified that this case had dined at the restaurant on August 9, 2018. Also on August 17,LCDHE staff conducted an on-site investigation/inspection at the restaurant. Therestaurant’s management reported that four employees had beenill with the “stomach flu” on Thursday, August 9, 2018 and thatthese employees were still out sick and had not returned to work as of August 17, 2018. LCDHE noted several food safetyviolations, including improper cooling and cold storage, employee drinkingcups in food preparation areas, no hand soap at hand washing sinks, flies in the kitchen, soiled kitchen utensils and storage areas, a dirty anddisconnected copper pipe on a shelf above clean dishes, old food containers used for food storage, and an unshielded glass flood light.

On Monday, August 20, 2018, LCDHE staff made a second on-site visit to the restaurant. The operator was notified that all of the establishment’s employees would need to be interviewed to determine scope of duties at the restaurant and to provide information on recent health status; employees were instructed to submit rectal swabs to testfor Salmonella. By Tuesday, August 21, 2018, five laboratory confirmed Salmonellacases had beenidentified, and all reported eating at the restaurant between Thursday, August 9, 2018 and Sunday, August 12, 2018. All five cases had been hospitalized. LCDHE staff conducted a third site visit that afternoon, and the establishment was requested to voluntarily close and discontinue all food preparation and sale of food; it closed late that afternoon.

An illness questionnaire was developed by CDPHE Epi Division, and 85 individuals completed the questionnaire. All individuals who completed the questionnaire reportedeating food from the restaurant,and 61of those peoplereported symptoms of gastrointestinalillness. Of the 61 individuals, 30 (49%) were female and 31 (51%) were males. Ages ranged from 4 years to 72 years of age with the median age of 36 years. Onset of illness ranged from 2 hours to 243.5 hours with an average of 59.6 hours. Duration of symptoms ranged from 1 day to 17 days with median of 6 days (mean of 6 days). Despite an analysis of foods consumed by the people interviewed, no specific food was noted to be associated with illness.

Overall, 31individuals were laboratory confirmed positive for Salmonella Javiana, including six of 20 restaurant employees. Cases were confirmed through culture and/or PCR; all cases had matching PFGE patterns. Five cases reported being hospitalized and no deaths were associated with this outbreak. On September 6, 2018, LCDHE approved the establishment to reopen to the public. The establishment reopened to the public on September 11, 2018, only to close for business permanently shortly after.

On Wednesday, November 22, 2017, Tri-County Health Department (TCHD) identified four laboratory-confirmed cases of Salmonellainfection with a common food exposure through routine case investigation. All four of the confirmed cases reported eating food from La California Restaurant, located at 1685 Peoria Street in Aurora, Colorado. TCHD investigated to implement disease control measures and identify the source of illness. Its investigation led TCHD to conclude that this outbreak of Salmonella I,4,5,12:i- (CDPHE PFGE patterns 07-T and 13-D) was associated with consuming food prepared at La California Restaurant. Based on results from the food exposure analyses and the environmental assessment, consumption of the family combo meal was the most likely menu item associated with Salmonella infection.

Fifteen (45%) of the cases were female. The case median age was 25 years (1-71 years). The range of illness onset was November 4, 2017 to November 26, 2017. The incubation period of the cases ranged from 8 hours to 5 days (median 16 hours). The median duration of illness was 7 days (range 6 hours to 16 days). Three confirmed cases were hospitalized, and one confirmed case died.

Each laboratory-confirmed case of Salmonellainfection was interviewed with a Colorado Department of Public Health and Environment (CDPHE) Salmonella Case Investigation Form to assess symptoms and exposures. TCHD Communicable Disease Epidemiologists conducted supplemental hypothesis-generating interviews with the initial four cases reported through routine surveillance to TCHD. A standard TCHD food worker and manager questionnaire was used to conduct interviews with restaurant employees. To explore possible associations between food exposures and illness, TCHD conducted a case-control study among patrons who consumed food from La California during November 1 to November 30, 2017. Additional case ascertainment resulted from interviewing dining companions of cases, restaurant employees, and persons enrolled in the case control study.

Although none of the five restaurant employees reported experiencing gastrointestinal symptoms during the month of November 2017, all five submitted stool specimens on November 22, 2017 for Salmonellatesting at CDPHE laboratory. One restaurant employee had a positive culture for the outbreak strain, Salmonella I,4,5,12:i-, and was excluded from work from November 27, 2017 until two consecutive culture results were negative. This employee denied having gastrointestinal symptoms and worked at the restaurant before being excluded by TCHD.

CDC, public health and regulatory officials in several states, as well as the FDA began investigating a multistate outbreak of Salmonella Montevideo infections on February 22, 2018 (Outbreak ID# 1801MLJIX-1). As of February 27, 2018, 10 people infected with the outbreak strain of Salmonella Montevideo were reported from 3 states. Genetic analysis showed that isolates from ill people were closely relatedly genetically (PFGE pattern JIXX01.0011). This means that people in this outbreak were more likely to share a common source of infection.

Illnesses started on dates ranging from December 20, 2017 to January 28, 2018. Ill people ranged in age from 26 to 56, with a median age of 42. All 10 (100%) were female. No hospitalizations and no deaths were reported. Laboratory confirmed cases of Salmonella Montevideo were interviewed about their food history. In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Eight (80%) of ten people interviewed reported eating at multiple Jimmy John’s restaurant locations. Of these eight people, all eight (100%) reported eating raw sprouts on a sandwich from Jimmy John’s in Illinois and Wisconsin. Two ill people in Wisconsin ate at a single Jimmy John’s location in that state. One ill person reported eating raw sprouts purchased from a grocery store in Minnesota. These results indicated that raw sprouts sold at Jimmy Johns were the likely source of this multistate outbreak.

FDA and state, and local regulatory officials conducted traceback investigations to help determine the source of the sprouts and their distribution chain. To date, no contamination source has been identified,

As of September 25, 2018, 135 people infected with the outbreak strain of SalmonellaMbandaka were reported from 36 states. 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 SalmonellaMbandaka 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 Salmonellabacteria 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.As of September 26, 2018, this outbreak investigation is over.

A total of 403 people infected with the outbreak strain of Salmonella Newport were reported from 30 states.

Illnesses started on dates ranging from August 5, 2018 to February 8, 2019.

117 people were hospitalized. No deaths were reported.

Epidemiologic, laboratory, and traceback evidence indicated that ground beef produced by JBS Tolleson, Inc. was a likely source of this outbreak.

On October 4, 2018, JBS Tolleson, Inc. recalled  approximately 6.9 million pounds of beef products that may be contaminated with Salmonella Newport bacteria. On December 4, 2018, JBS Tolleson, Inc. recalled an additional 5.2 million pounds of beef products.

Although the outbreak investigation is over, contaminated beef could still be in freezers. Check your freezer for beef recalled by JBS Tolleson, Inc., of Tolleson, Arizona, and do not eat, serve, or sell it.

Recalled beef products were produced and packaged from July 26, 2018, to September 7, 2018 and were shipped to retailers nationwide under many brand names.

When you check your freezer for recalled beef, look for beef labeled with the establishment number “EST. 267.” This is usually found inside the USDA mark of inspection but can be elsewhere on the package.

The Chicago Department of Public Health (CDPH) is investigating an outbreak of Salmonella, a bacteria that is a common cause of food poisoning. At least six people associated with the outbreak consumed carnitas or other foods purchased on February 23 or 24, 2019, from the Supermercado Rivera kitchen counter located at 4334 W. 51st St., Chicago.
If you have carnitas or other food purchased from the kitchen counter at this establishment on February 23 or 24 in your freezer, do not eat—discard.
If you ate food purchased from the kitchen counter on these dates, you may have been exposed to Salmonella. Although most infections resolve without antibiotics, older individuals or those with weakened immune systems may need medical evaluation and treatment. If you are experiencing severe diarrhea, symptoms of dehydration, or high fever, seek medical attention. Most people who are infected develop diarrhea, fever and abdominal cramps between 12 and 72 hours after eating contaminated food.
CDPH performed an environmental assessment of the grocery store and provided guidance on safe food handling practices and environmental cleaning to prevent further spread of disease. Implicated food items were no longer available at the store as of March 1, 2019 and at this point there is no evidence that food made after this date was contaminated.
CDPH is monitoring closely for additional reports of illness. If you experienced diarrheal illness after consuming foods from this establishment, contact the Chicago Department of Public Health by calling 312-746-SICK (7425) or emailing outbreak@cityofchicago.org to file a suspected food poisoning complaint.
Salmonella symptoms usually last four to seven days, and most individuals recover without any treatment. The Centers for Disease Control and Prevention estimates that Salmonella causes approximately one million illnesses and 450 deaths in the United States each year. CDPH has also issued an alert to area physicians about the outbreak, providing medical guidance.

Six people infected with the outbreak strain of Salmonella Schwarzengrund have been reported from 3 states.

Illnesses started on dates ranging from December 19, 2018 to February 2, 2019.

One person has been hospitalized. No deaths have been reported.

Epidemiologic and laboratory evidence indicates that ground turkey produced by Butterball, LLC is a likely source of this outbreak.

On March 13, 2019, Butterball, LLC recalled approximately 78,164 pounds of ground turkey products that may be contaminated with Salmonella Schwarzengrund.

Consumers should check their homes for Butterball brand ground turkey labeled with the establishment number “EST. P-7345”. Do not eat recalled ground turkey. Return it to the store or throw it away.