CDC Investigating Multistate Outbreak of Salmonella Typhimurium Infections Linked to Ground Beef

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The Centers for Disease Control and Prevention (CDC) is collaborating with public health officials in many states and the U.S. Department of Agriculture's Food Safety and Inspection Service (USDA-FSIS) to investigate a multistate outbreak of Salmonella Typhimurium infections. Public health investigators are using DNA "fingerprints" of Salmonella bacteria obtained through diagnostic testing with pulsed-field gel electrophoresis, or PFGE, to identify cases of illness that may be part of this outbreak. They are using data from PulseNet, the national subtyping network made up of state and local public health laboratories and federal food regulatory laboratories that performs molecular surveillance of foodborne infections.

A total of 16 individuals infected with the outbreak strain of Salmonella Typhimurium have been reported from 5 states. The number of ill people identified in each state with the outbreak strain is as follows: Arizona (1), Illinois (2), Iowa (1), Michigan (9), and Wisconsin (3).

Among 16 persons for whom information is available, illness onset dates range from Dec. 9, 2012 to Jan. 7, 2013. Ill persons range in age from 2 years to 87 years, with a median age of 48 years. Forty-three percent of ill persons are female. Among 13 persons with available information, seven (53 percent) reported being hospitalized. No deaths have been reported. Preliminary results of antibiotic susceptibility testing indicate that this strain of Salmonella Typhimurium is susceptible to commonly prescribed antibiotics.

This PFGE pattern has rarely been seen before in PulseNet and in the past typically caused 0-1 case per month. The outbreak can be visually described with a chart showing the number of people who became ill each day or week. This chart is called an epi curve. Illnesses that occurred after Jan. 3, 2013 might not be reported yet 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 3 weeks.

Epidemiologic and traceback investigations conducted by officials in local, state, and federal public health, agriculture, and regulatory agencies indicate that ground beef produced by Jouni Meats, Inc. and Gab Halal Foods are likely sources of this outbreak of Salmonella Typhimurium infections.

Initial investigations focused on six ill persons in Michigan and one ill person in Arizona who reported eating at the same restaurant before their illness began. All seven of these ill persons reported eating raw ground beef kibbeh (a dish typically made of finely ground red meat, usually beef, minced onions, and bulghur wheat) at this restaurant before becoming ill. Investigations are ongoing to determine if the additional nine ill persons may be linked to the recalled products.

CDC and state and local public health partners are continuing laboratory surveillance through PulseNet to identify additional ill persons and to interview ill persons about foods eaten before becoming ill. FSIS is continuing to work closely with CDC and state partners during this investigation.

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