66 sick with Salmonella in another chick outbreak

Media doesn’t tell people what to think; but it does tell people what to think about.

And that includes doctors, epidemiologists and other mere mortals.

So the numerous previous chick-related Salmonella outbreaks mean people of all professions may be more attuned to the chick link.

The outbreak is the fourth linked to mail-order chicks and ducklings since 2011.

The U.S. Centers for Disease Control reports at least 66 persons have been infected with the outbreak strain of Salmonella Montevideo in 20 states; 16 ill persons have been hospitalized. One death was reported in Missouri, but Salmonella infection was not considered a contributing factor in this person’s death.

35% of ill persons are children 10 years of age or younger.

Epidemiologic, laboratory, and traceback findings have linked this outbreak of human Salmonella infections to contact with chicks, ducklings, and other live baby poultry from Estes Hatchery in Springfield, Missouri.

CDC, why didn’t you say Hatchery A, or Hatchery A in Missouri? What are the guidelines on publicly fingering sources of food- or chick-related illness?

It was the hemp seed flour from the Dutch; dietary supplement sickens 15 with Salmonella Montevideo in Germany, 2010

"There are only two things I can’t stand in this world. People who are intolerant of other people’s cultures and the Dutch."

Michael Caine in Austin Powers, Goldmember

The freaky dekey Dutch got some salmonella in their groovy hemp seed flour and it made a bunch of Germans sick.

In March 2010 the Rapid Alert System for Food and Feed (RASFF) was used to inform about Salmonella Montevideo in a herbal food supplement, formulated in capsules, distributed under a Dutch label in Germany.

Simultaneous to the first RASFF notice, in the last two weeks of March 2010 an unusual number of 15 infections with S. Montevideo was notified within the electronic reporting system for infectious diseases at the Robert Koch Institute. Adult women (median age: 43, range: 1–90 years) were mainly affected.

An outbreak was suspected and the food supplement hypothesised to be its vehicle. Cases were notified from six federal states throughout Germany, which required efficient coordination of information and activities. A case–control study (n=55) among adult women showed an association between consumption of the specific food supplement and the disease (odds ratio (OR): 27.5, 95% confidence interval (CI): 3.1–infinity, p-value=0.002). Restricting the case–control study to the period when the outbreak peaked (between 29 March and 11 April 2010) resulted in an OR of 43.5 (95% CI: 4.8–infinity, p-value=0.001).

Trace-back of the supplement’s main ingredient, hemp seed flour, and subsequent microbiological testing by pulsed-field gel electrophoresis supported its likely role in transmission. This outbreak investigation illustrates that information from RASFF may aid in hypothesis generation in outbreak investigations, though likely late in the outbreak.

The authors note in the discussion that, “while investigations of the food safety authorities were thorough, without delay, and strictly following regulations, it is worth noting that the process from the beginning of the analysis of the first positive sample from an opened package to the recall took more than five weeks. In potential outbreak situations, strength of evidence for a suspected food product ought to be weighed against the potential harm to the consumers posed by the suspected food.

"Interestingly, in the end there was no international aspect to this outbreak (as the Dutch label on the product did not correspond to sales in the Netherlands). … In Germany, unfortunately, currently there is no general requirement to communicate non-international food contamination events to the public health authorities."

Final salmonella-in-pepper-on-salami report; loyalty cards helped with traceback

From July 2009 until April 2010, the U.S. Centers for Disease Control identified 272 cases of Salmonella Montevideo in people from 44 states and the District of Columbia.

The outbreak strain was identified in salami products, one company A facility environmental sample, and sealed containers of black and red pepper used to produce company A salami products.

This outbreak highlights the importance of preventing post-processing contamination of ready-to-eat products from raw ingredients such as spices.

This nationwide outbreak of Salmonella Montevideo infections was associated with salami products containing contaminated imported black and red pepper. This outbreak highlights the importance of preventing product contamination between its production and its use and the potential for spices, such as pepper, to contaminate ready-to-eat products.

Eight spice-associated Salmonella outbreaks occurred during 1973–2009, accounting for 1,656 human illnesses. In September 2008, an outbreak of Salmonella Rissen infections was associated with ground white pepper. An increasing number of dried spice recalls have occurred over the past several years, with only two during the 1990s and 16 during 2000—2004.

Membership cards helped provide important brand-specific information in this investigation. During hypothesis generation, it was learned that many patients reported shopping at different locations of a national warehouse chain. This prompted WADOH to collect data on items purchased by patients based on membership card records. Information gathered from these cards, with patient permission, helped determine the brand name and purchase dates of implicated products. Based on this information, USDA-FSIS traced back lots of ingredients, which helped FDA identify lots of black and red pepper used to produce the contaminated salami products. As this investigation demonstrates, membership and shopper cards can provide critical information to quickly identify potentially contaminated foods and should be considered for use in future foodborne disease outbreak investigations.

The complete report is available at:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5950a3.htm?s_cid=mm5950a3_x