The Centers for Disease Control and Prevention (CDC) recently released a recap of a number of major 2014 food borne illness outbreaks, including four Salmonella, two E. coli, one Listeria, and one Cyclospora outbreaks, which it has been investigating this year. This is not the universe of all national outbreaks, but it highlights a few of the major nation-wide outbreaks and their sources in 2014. The CDC plays a major role in investigating outbreaks where individuals in more than one state have been infected by the same strain and serotype of a food borne pathogen.* Here is a recap of some of those outbreaks, ranging from renewed concern over raw chicken, peanut butters, and Cyclospora, to new outbreaks linked ot products like Chia Powder, beef and cheese.
1. Escherichia coli O121, a Shiga-Toxin Producing Strain of E. coli, Linked to Raw Clover Sprouts
At least 19 victims have been indentified in this outbreak of the Shiga-toxin producing Escherichia coli O121 (E. coli O121) in 6 states, including California (1), Idaho (3), Michigan (1), Montana (2), Utah (1), and Washington (11). Nearly half (44%) of these victims were hospitalized, though as of now, none has developed hemolytic uremic syndrome (HUS), a serious and often life-threatening condition linked to this pathogen.
The CDC, using both epidemiological and trace-back investigative techniques, has identified contaminated raw clover sprouts from Idaho, produced by Evergreen Fresh Sprouts, LLC, as the likely source. Major outbreaks of Salmonella and E. coli in recent years have caused a number of restaurant chains to remove sprouts from their menus.
2. Escherichia coli O157:H7, a Shiga-Toxin Producing Strain of E. coli, Linked to Wolverine Packing Company Ground Beef
At least 12 victims have been in this outbreak of the Shiga-toxin producing Escherichia coli O157:H7 (E. coli O157:H7) in 4 states, including Massachusetts (1), Michigan (5), Missouri (1), and Ohio (5). Over half (58%) of these victims were hospitalized, though as of now, none has developed hemolytic uremic syndrome (HUS), a serious and often life-threatening condition linked to this pathogen.
The CDC, using both epidemiological and trace-back investigative techniques, has identified contaminated beef processed by Wolverine Packing Company was the most likely source of the dangerous E. coli O157:H7, and Wolverine issued a responsive recall of the implicated products.
3. Listeriosis (Listeria monocytogenes) Linked to Roos Foods Dairy Products
At least eight victims were sickened by Listeria monocytogenes in two states, including California (1) and Maryland (7), after the victims consumed cheese products made by Roos Foods. Almost all of the victims were hospitalized, as is traditionally the case with Listeriosis when it is identified in victims. Here, 7 of the 8 were hospitalized. And at least one of the victims (the California case) died after contracting listeriosis. Also consistent with previous trends in Listeria outbreaks, a large percentage were linked to pregnancy, a complicating factor in listeriosis cases – five of the illnesses were pregnancy related in this outbreak.
Due to the fact that this product is popular among Latinos, all victims were Hispanics. The CDC, using both epidemiological and trace-back investigative techniques, identified contaminated cheese products made by Roos Foods as the likely source of this outbreak. Pregnant women are warned to avoid such Mexican-style cheeses due to possible Listeria contamination.
4. Salmonella Heidelberg Linked to Tyson Brand Mechanically Separated Chicken
At least nine inmates at a correctional institution in Tennessee were sickened by Salmonella Heidelberg. Two of those inmates had to be hospitalized. This strain of Salmonella Heidelberg is one of the more common strains in PulseNet, the national repository of food borne pathogens. In response to the illnesses, on January 10, 2014, Tyson Foods, Inc. recalled nearly 35,000 pounds of mechanically separated chicken products.
In addition to the victims at the Tennessee correctional institute, approximately two dozen other victims were identified in 15 other states with the same PFGE pattern of Salmonella Heidelberg.
The CDC has also been investigating the 18-month long Salmonella Heidelberg outbreak linked to Foster Farms chicken, which began in March of 2013 and continued until at least July of 2014.
5. Salmonella Stanley Infections Linked to The Cultured Kitchen Raw Cashew Cheese
At least 17 victims of an outbreak of Salmonella Stanley have been reported in three states, including California (15), Nevada (1), and Wyoming (1). One-in-five of those victims was hospitalized. The CDC, using both epidemiological and trace-back investigative techniques, has identified contaminated raw cashew cheese produced by The Cultured Kitchen of West Sacramento, California as the source of this particular Salmonella Stanley outbreak.
6. Outbreak of Salmonella Infections Linked to Organic Sprouted Chia Powder
So far, nearly three dozen victims have been indentified in an outbreak of Salmonella Hartford, Salmonella Oranienburg, and Salmonella Newport, all linked to the consumption of Organic Sprouted Chia Powder. The Chia Powder was the common ingredient in the diet of 20 victims who tested positive for Salmonella Newport, 7 victims who tested positive for Salmonella Hartford, and 4 victims who tested positive for Salmonella Oranienburg.
The victims were identified over a largely diffuse geographical area, including 16 states and Canada. The 16 states include Arizona (1), California (4), Colorado (1), Connecticut (3), Florida (1), Illinois (2), Maryland (1), Massachusetts (1), Michigan (1), New York (7), Ohio (1), Rhode Island (1), Texas (2), Utah (1), Washington (1), and Wisconsin (3). Other victims have been identified in Canada. At least five of the U.S. victims have been hospitalized.
The CDC, using both epidemiological and trace-back investigative techniques, has identified organic sprouted Chia powder from various sources as the likely source of this three-strain salmonella outbreak.
7. Cyclosporiasis Outbreak Investigations Continue in 2014
Following a record year of Cyclospora cases in 2013, as of August 26, 2014 the CDC is reporting a total of 304 confirmed Cyclospora cases in the first 8 months of 2014, with at least 207 having no history of foreign travel to areas commonly hit by Cyclospora.
The victims come from Arkansas, California, Connecticut, Florida, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nebraska, Pennsylvania, New Jersey, New York (and New York City), Texas, Virginia, Wisconsin, and Washington – though a majority of those 207coming from Texas (133) and the majority being reported in July.
Cilantro has been identified in many of the Texas cases, but the source is unknown in many others.
8. Salmonella Braenderup Infections Linked to Nut Butter Manufactured by nSpired Natural Foods, Inc.
At least six victims have been identified in an outbreak of Salmonella Braenderup in five states since January 1, 2014, including Connecticut (1), Iowa (1), New Mexico (1), Tennessee (1), and Texas (2). The U.S. Food and Drug Administration (FDA) isolated and identified Salmonella Braenderup during inspections of the nSpired Natural Foods facilities in both February and July of 2014.
Thereafter, victims were linked to this strain of Salmonella Braenderup between July 15 and August 29, leading to a recall of the contaminated product. The FDA then issued a Form 483 Inspection Report in which it documented eight “observations,” or deficiencies, it made during an inspection. While investigators hope the outbreak is over, due to the long shelf-life of this product, other victims may still become ill if the product is not discarded.
*In the case of Cyclospora, no strain or serotype is indentified and so trace-back investigations attempt to identify a common source when traditional levels of infection are significantly surpassed.