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An outbreak is defined as an event in which “two or more people get the same illness from the same contaminated food or drink.” This year the United States has seen plenty with the Center for Disease Control and Prevention (CDC) busily investigating outbreaks throughout 2018. Public health officials, alongside CDC to help control outbreaks by linking together those who have become sick from the same source, finding that source quickly, and then learning how to prevent similar outbreaks from occurring in the future. Let’s take a look at the most notable of these 2018 food poisoning outbreaks.
CDC Investigates More Outbreaks than Advertised
Each year the CDC investigates thousands of outbreaks behind the scenes. Many are handled quickly or only affect a small amount of people. Sometimes a clear outbreak cannot be identified with the current information. Barbara Kowalcyk, epidemiologist and professor of Food Science at Ohio State University explains, “We have a lot of foodborne illnesses each year. The CDC estimates that one in six Americans are sickened each year – and 3,000 die. And only a fraction of those get reported to health department[s].” Over 80 percent of foodborne illness are considered “sporadic,” she admits. This means that they haven’t been associated with an outbreak of infections. It “doesn’t mean they’re not part of one,” says Kowalcyk. “It just means that they’re not linked to an identifiable outbreak.”
Those that are more notable make the list for “Select Multistate Foodborne Outbreak Investigations.” These are the ones that make the evening news and are often linked back to products which end up in a large-scale recall.
A select 24 were chosen for this published list. According to CNN, this is the most undertaken by the agency in the last decade. This increase in identification could mean a true increase in foodborne infections, though many suspect that advances in technology could be contributing to the rising statistics.
Technology Plumps Up Statistics
In the last two decades a few major technological advances have contributed to more outbreaks being identified. First, the national database, Pulsenet became available. Second, DNA fingerprinting using whole genome sequencing contributed to connecting data.
Pulsenet is a national database established in 1996 that is used by the CDC, local and state health departments, and epidemiological investigators. Foodborne illnesses are uploaded to the database. When a few people with the same strain of pathogen are reported, an investigation is initiated.
DNA fingerprinting was added to the public health communities toolbelt in 2008. This technology uses whole genome sequencing to identify the exact genetic information of the pathogen responsible for the illness. This helps to link other in the outbreak and a potential food source with more certainty. Alongside implementation of this new tool, a spike in detected outbreaks grew. This affected outbreak investigation so much so that you cannot even compare pre-2008 data to modern outbreak detection statistics.
Let’s take a moment to walk down memory lane with the 24 most notable outbreaks according to the CDC. These outbreaks were selected for this publication category because they were novel in the food source, were significant in their investigation, or had a large impact on potential new regulations.
Salmonella Newport Linked to Frozen Shredded Coconut
The first notable outbreak of the year linked the Coconut Tree Brand Frozen Shredded Coconut to a Salmonella Newport outbreak. I speculate this made the list due to the type of food product identified as the source. A recall was initiated, but not before 27 people across 9 states became ill. Of the 27 linked, 6 required hospitalization. No deaths were reported for this outbreak.
Salmonella Montevideo Linked to Raw Sprouts
Soon after, raw sprouts were linked to a Salmonella Montevideo outbreak. This was linked to Jimmy John’s restaurants in Illinois and Wisconsin. While no recalls were initiated, Jimmy Johns did remove sprouts from their menu for some time. This outbreak was linked to 10 patients across 3 states. No hospitalizations or deaths were reported for this outbreak.
Salmonella Linked to Kratom
Several strains of Salmonella were linked to many different brands of kratom in the next notable outbreak. No common source of contamination was identified, so many different brands initiated recalls after testing positive for Salmonella. Most likely this outbreak made the list for two reasons. No source could be identified and novel food source. This outbreak affected 199 people across 41 states resulting in 50 hospitalization. No deaths were reported for this outbreak.
Salmonella Typhimurium Linked to Chicken Salad
The next notable outbreak involved Salmonella Typhimurium linked to Triple T Specialty Meat Chicken Salad. This outbreak was on the larger side, affecting 265 people across 8 states. This outbreak is responsible for 94 hospitalizations and 1 death. The high number of cases and hospitalization in addition to the death is the likely reason this outbreak made the notable list.
Salmonella Typhimurium Linked to Dried Coconut
Coconut makes the list again. This time a Salmonella Typhimurium outbreak was linked to International Harvest, Inc. brand Go Smiles Dried Coconut Raw. This outbreak resulted in a recall, but not before 14 cases were linked across 8 states. There were 3 cases serious enough to require hospitalization. No deaths were reported. This outbreak likely made the notable list due to the novel food source but could have been because of the number of states affected or the ratio of hospitalizations to case patients.
E. coli O157:H7 Linked to Romaine Lettuce
Romaine lettuce from the Yuma growing region was indicated as the likely source of an E. coli O157:H7 outbreak. While this outbreak investigation did not result in a recall, many advocacy groups stressed avoidance of this leafy green due to the number of people who had fallen ill linked to the outbreak. This was 210 in this outbreak across 36 states. A significant 96 patients required hospitalization and 5 deaths were reported. Later investigations identified the outbreak strain in canal water samples taken from the Yuma growing region. The FDA continued investigation on how the bacteria may have made its way into the water and how the contaminated water could have contaminated romaine lettuce crops. This outbreak was significant due to the number of hospitalizations and deaths as well as the incomplete investigation on the source and mode of contamination. Little did investigators know that we would see this problem again later in the year.
Salmonella Braenderup Linked to Shell Eggs
Rose Acre Farms shell eggs was linked to the Salmonella Braenderup outbreak. This outbreak resulted in a huge egg recall. This is most likely the reason it made it to the notable list. A total of 45 patient cases that resulted in 11 hospitalizations across 10 states were linked to this outbreak. No deaths were reported.
Salmonella Adelaide Linked to Pre-cut Melon
A Salmonella Adelaide outbreak was linked to Caito Foods, LLC pre-cut melons. This resulted in 77 linked cases that resulted in 36 hospitalizations across 9 states. No deaths were linked to this outbreak. This outbreak likely made the notable list due to the severity of illness. Almost half of the patients identified required hospitalization.
Salmonella Mbandaka Linked to Kellogg’s Honey Smack Cereal
A Salmonella Mbandaka outbreak was linked to Kellogg’s Honey Smack Cereal. This outbreak resulted in a recall, though 135 patients across 36 states were linked to the outbreak. This resulted in 34 hospitalizations. No deaths were linked to this outbreak. This outbreak likely made the notable list due to the number of hospitalizations and the type of food product linked.
Vibrio Parahaemolyticus Linked to Imported Fresh Crab Meat
A Vibrio parahaemolyticus outbreak was linked to fresh crab meat imported from Venezuela. No actual recall was initiated as a specific source could not be identified. A total of 26 people across 8 states were linked to this outbreak. No deaths were reported, but 9 patients required hospitalization. This outbreak likely made the notable list for many reasons. A specific source was not identified but was narrowed to an imported food product. Additionally, the pathogen could be considered novel as it doesn’t commonly make the list.
Cyclospora Linked to Del Monte Fresh Produce Vegetable Trays
The parasite, Cyclospora was linked to an outbreak involving Del Monte Fresh Produce Vegetable Trays that claimed 250 patients across 4 states. A recall was initiated after investigation linked vegetable trays containing broccoli, cauliflower, carrots, and dill dip to sick patients. No deaths were reports, though 8 people were sick enough to require hospitalization. This outbreak likely made the notable list due to the number of patients affected and potentially due to the pathogen identified.
Cyclospora Linked to Fresh Express Salad Mix
Another outbreak involving the parasite Cyclospora followed. This time, Fresh Express Salad Mix sold at McDonalds Restaurants was involved. This outbreak affected 511 people across 16 states and resulted in 24 hospitalizations. An FDA investigation looked at the distribution and supplier information for the carrots and romaine used in the product, but no single source of contamination could be identified. This is likely the reason it made the notable list. No deaths were reported for this outbreak.
Salmonella Sandiego Linked to Spring Pasta Salad
A Salmonella Sandiego outbreak linked to Spring Pasta Salad sold at Hy-Vee grocery stores was responsible for 101 illnesses across 10 states that resulted in 25 hospitalizations. This outbreak likely made the notable list due to the number of cases reported and the number of states involved.
Salmonella Reading Linked to Raw Turkey Products
A Salmonella Reading outbreak was linked to Jennie-O Turkey products. This outbreak was responsible for 216 cases across 38 states. A significant 84 case patients were sick enough to require hospitalization and 1 death has been linked to this outbreak. This outbreak was linked to the multi-drug resistant pathogen, which likely launched it to the notable list. This, in addition to the death and number of states affected earned its spot on the notable list.
Salmonella Linked to Kosher Chicken
A Salmonella outbreak involving kosher chicken or Empire Kosher brand chicken was linked to 25 case patients across 6 states. Of those 25, 11 were sick enough to require hospitalization. There was 1 death reported in connection with this outbreak. The death and novel product, kosher chicken, may have been the reason this outbreak made it to the notable list.
Salmonella Enteritidis Linked to Shell Eggs
A outbreak of Salmonella Enteritidis was linked to Gravel Ridge Farms shell eggs. This outbreak was linked to 44 cases across 11 states that resulted in 12 hospitalizations. No deaths were reported for this outbreak. A recall was initiated for Grave Ridge Farms shell eggs. The number of hospitalizations and states involved most likely moved this outbreak to the notable list.
E. coli O26 Linked to Ground Beef
An E. coli O26 outbreak was linked to Cargill Meat Solutions ground beef. This outbreak was responsible for 18 case patients across 4 states resulting in 6 hospitalizations and 1 death. The strain of E. coli indicated, and the resulting death likely put this outbreak on the notable list.
Listeria Monocytogenes Linked to Deli Ham
A Listeria monocytogenes outbreak was linked to Johnson County Hams, Inc under several other brand names. This outbreak was linked to 4 case patients across 2 states. All 4 linked cases were serious enough to require hospitalization. There was 1 death connected to this outbreak. A recall was initiated on all linked products. The seriousness of the illness and the connected death placed this outbreak on the notable list.
Salmonella Newport Linked to Ground Beef
The Salmonella Newport outbreak linked to JBS Tolleson was responsible for a huge beef recall. The historic nature of the amount of beef recalled along with the number of case patients affects landed this outbreak on the notable list. There were 333 cases across 28 states that were linked to the outbreak. This resulted in 91 hospitalizations. No deaths were connected to this outbreak.
Salmonella Infantis Linked to Raw Chicken Products
A Salmonella Infantis outbreak was linked to raw chicken. No specific chicken source could be identified, as the outbreak strain was found in samples taken from a variety of raw chicken sources, including raw chicken pet food, raw chicken products, and live chicken. There were 92 case patients across 29 states linked to this outbreak. There were 21 hospitalizations, though no deaths were reported.
E. coli O157:H7 Linked to Romaine Lettuce
E. coli and romaine lettuce unite again in another outbreak in November. As the growing season returned to the Yuma growing region, so did the linked illnesses. This outbreak was narrowed to Adam Bros. Farming, Inc, though it could have come from any of the following California counties: Monterey, San Benito, and Santa Barbara. There were 59 cases across 15 states linked to this outbreak. This resulted in 23 hospitalizations. The recurrence of the linked food product and the number of states and hospitalizations likely promoted this outbreak to the notable list.
Listeria Monocytogenes Linked to Pork Products
Long Phung Food Products Vietnamese style pork products was linked to a Listeria monocytogenes outbreak. This outbreak involved 4 cases, all of which required hospitalization and was spread across 4 states. No deaths were reported in connection with this outbreak. The severity of illness and the type of food product likely put this outbreak on the notable list.
Salmonella Agbeni Linked to Dunkin Hines Cake Mix
A Salmonella Agbeni outbreak was linked to Dunkin Hines Cake Mix resulting in 5 cases across 3 states. No hospitalizations or deaths were reported for this outbreak. This outbreak likely made the notable list due to the novel food source.
Salmonella Concord Linked to Tahini Products
The year ended as it began, with Salmonella. A Salmonella Concord outbreak was linked to imported Tahini products resulting in 5 linked cases across 3 states. No hospitalizations or deaths were reported for this outbreak. This outbreak likely made the notable list due to the novel food source or because it was imported into the United States. No specific source could be identified despite the widespread contamination of the product.
For many reasons we hope that next year brings safer food handling and manufacturing practices and fewer outbreaks and recalls. For the latest information on outbreaks, food safety news, and recalls, bookmark MakeFoodSafe.com as your source for 2019.
Happy New Year from our family to yours!
By: Heather Van Tassell, Contributing Writer (Non-Lawyer)