The California Department of Public Health (CDPH), along with contributory information from the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Agriculture-Food Safety and Inspection Service (USDA-FSIS), has issued a “final report” on the Salmonella Enterica Outbreak of Heidelberg, CDC Cluster 1306MLJF6-1, that was confirmed in nearly 500 Californians and over 600 in a wider 29 state geographical outbreak. According to the report, between March of 2013 and July of 2014, the outbreak strains of Salmonella Heidelberg were epidemiologically confirmed in 634 victims in 29 states and Puerto Rico, including the 490 California residents. Most food safety experts agree the actual number of victims is in the thousands.
The outbreak was made complicated by the fact that it was associated with at least seven strains of Salmonella Heidelberg. All seven of the strains were eventually traced to raw chicken products produced and packaged at three separate Foster Farms facilities in California through a combination of epidemiologic, laboratory, and environmental investigations. Six of the seven strains were isolated at one of the three Foster Farms facilities by the FSIS. The FSIS investigations led to a “Notice of Intended Enforcement,” addressed to Ron Foster (the former president of Foster Farms who stepped down earlier this year), on October 7, 2013.
Salmonella Heidelberg Commonly Linked to Chicken
Salmonella Heidelberg is one of the more common serotypes of salmonella affecting the U.S. each year, and as in this outbreak originates most commonly in chicken – in fact, in 2011 there was also an outbreak of Salmonella Heidelberg linked to broiled chicken livers and ground turkey. And in June of 2012, lasting nearly a year, an outbreak of Salmonella Heidelberg mostly in Washington, Oregon, Alaska, and California (small numbers of victims were identified in 9 other states) sickened at least 134 persons. This outbreak was also linked to Foster Farms processing plants, including one in California and one in Washington.
2013 Investigation Begins: PFGE Patterns JF6X01.0045, JF6X01.0258, JF6X01.0326, JF6X01.0672, JF6X01.0022, JF6X01.0041, and JF6X01.0122
The most recent outbreak began to appear on health department radars in March of 2013 as a series of clusters of separate PFGE patterns of Salmonella Heidelberg, but by July the CDPH’s Infectious Diseases Branch (IDB) was informed by their own Microbial Diseases Laboratory that seven clusters of Salmonella Heidelberg cases appeared linked to the same source. As a result, IDB combined these investigations into a single cluster, in coordination with the CDC, as cluster 1306MLJF6-1. The PFGE patterns that were combined include JF6X01.0045, JF6X01.0258, JF6X01.0326, JF6X01.0672, JF6X01.0022, JF6X01.0041, and JF6X01.0122. PFGE pattern JF6X01.0122 had been at the heart of the 2012-2013 outbreak, whereas two of the new and rare PFGE patterns accounted for about half of all identified cases in this outbreak – nearly one third were infected with JF6X01.0258 and another quarter with JF6X01.0045. But it was JF6X01.0041 that was most associated with increased rates of hospitalization and salmonella blood infection.
National Breakdown of Cases Identified
By July 24 of 2014, over one year after the first cases were reported, at least 634 laboratory confirmed victims had been identified in at least 29 states and Puerto Rico. Of those, three quarters (77 %, or 490) were California residents. The others came from the following states: Alaska (1), Alabama (1), Arkansas (1), Arizona (25), Colorado (9), Connecticut (1), Delaware (1), Florida (4), Georgia (1), Hawaii (1), Idaho (5), Illinois (4), Kentucky (1), Louisiana (1), Michigan (4), Missouri (5), Montana (1), Nevada (11), New Mexico (2), North Carolina (1), Oregon (17), Tennessee (1), Texas (13), Utah (6), Virginia (4), Washington (20), West Virginia (1), and Wisconsin (1); and Puerto Rico (1). Victims included those less than 1 year old to at least one 93 year old victim. The average age was 18. In addition, among those for whom information is readily available, approximately 38% required hospitalization.
In California, the state hit hardest, the victims were identified in the following counties: Alameda (31), Berkeley (1), Butte (6), Calaveras (2), Colusa (1), Contra Costa (26), El Dorado (2), Fresno (6), Humboldt (2), Kern (7), Kings (1), Lake (1), Lassen (1), Long Beach (3), Los Angeles (51), Madera (4), Marin (2), Mendocino (2), Merced (5), Monterey (9), Napa (1), Nevada (2), Orange (24), Placer (1), Riverside (16), Sacramento (30), San Benito (2), San Bernardino (20), San Diego (43), San Francisco (23), San Joaquin (15), San Luis Obispo (1), San Mateo (49), Santa Barbara (10), Santa Clara (26), Santa Cruz (2), Shasta (3), Siskiyou (2), Solano (16), Sonoma (7), Stanislaus (13), Tehama (2), Tulare (1), Ventura (11), Yolo (6), and Yuba (1). In California, 175 victims required hospitalization.
Foster Farms Chicken Consumed Prior to Illness Onset Linked to P-6137 and P-6137A
At least 74% of all interviewed victims recalled eating chicken within seven days of becoming ill, and 87% of those who could remember the brand stated it was Foster Farms chicken. In addition, an initial review of the PulseNet uncovered that the strains of concern had been identified by the NARMS Retail Meat Surveillance Program, in which chicken samples had previously revealed contamination with four of the outbreak strains, including JF6X01.0022, JF6X01.0041, JF6X01.0122, and JF6X01.0258. The chicken had been taken for the shelves of Northern California grocery stores between March and July of 2013. The positive test samples also had a single production site in common, known as P-6137, a Foster Farms California processing plant. Further testing was positive for PFGE patterns JF6X01.0041, JF6X01.0045, and JF6X01.0258, again implicating P-6137, but also implicating another facility, P-6137A.
In addition to NARMS testing, at least 17 samples of chicken were collected from the homes of 11 victims. Of these, about half of the samples tested positive for either JF6X01.0041, JF6X01.0122, or JF6X01.0258 (this last one accounted for 5 positive tests). The samples included both rotisserie chicken and Foster Farms chicken breast.
Concern Grows as Samples Prove to be Antibiotic Resistance
At least 68 clinical isolates have been screened from victims infected with one of the seven strains of Salmonella Heidelberg. Of these, a total of 35% (or 24) demonstrated multidrug resistant properties. In addition, an alarming number of the victims were demonstrating blood infections, which can pose serious and life-threatening complications.
Investigation Closed for Now – Ron Simon & Associates Representing Numerous Victims
On July 31, 2014, the CDC announced that the Salmonella Heidelberg outbreak appeared to have run its course. Earlier announcements had to be revised, but as of December 2014, there appear to be no evidence of higher-than-normal occurrence of Salmonella Heidelberg in California or any other states affected by this outbreak.
But as the outbreak appears to be closing, the legal battle to protect the legal rights of many victims is just beginning. The food safety firm, Ron Simon & associates, is currently representing many victims of the foster Farms Salmonella Heidelberg outbreak. If you or a loved one were sickened by Salmonella Heidelberg after having consumed Foster Farms chicken, feel free to speak to one of the food safety attorneys at Ron Simon & Associates at 1-888-335-4901.
