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Biological Hazard – Salmonellosis, multiple serotypes: Public Health Alert, Multi-state Outbreak, USA

2016/06/06

SALMONELLOSIS, MULTIPLE SEROTYPES – USA (02): LIVE POULTRY
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Published Date: 2016-06-05 23:15:42
Subject: PRO/AH/EDR> Salmonellosis, multiple serotypes – USA (02): live poultry
Archive Number: 20160605.4266428

Thursday 2 June 2016
Source: CDC Outbreak Reports [edited]

CDC is collaborating with public health, veterinary, and agriculture officials in many states, as well as the Department of Agriculture’s Animal and Plant Health Inspection Service (USDA-APHIS), to investigate 7 separate multistate outbreaks of human salmonellosis. Results from these investigations showed that contact with live poultry in backyard flocks was the likely source of these outbreaks.

Contact with live poultry (such as chicks, chickens, ducks, and ducklings) and their environment can make people sick with salmonellosis. Regardless of where they are purchased, live poultry may have salmonellae in their droppings and on their bodies (feathers, feet, and beaks) even when they appear healthy and clean. The germs can also get on cages, coops, hay, plants, and soil in the area where the birds live and roam. People, especially children, can be exposed to salmonellae by holding, cuddling, or kissing the birds and by touching things where the bird lives, such as cages or feed and water bowls.

Public health investigators are using the PulseNet system to identify illnesses that may be part of these outbreaks. PulseNet, coordinated by CDC, is the national subtyping network of public health and food regulatory agency laboratories. PulseNet performs DNA fingerprinting on Salmonella bacteria isolated from ill people by using techniques called pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS). CDC PulseNet manages a national database of these DNA fingerprints to identify possible outbreaks.

Investigation of the Outbreaks
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In 7 separate multistate outbreaks, a total of 324 people infected with the outbreak serotype strains of _Salmonella enterica_ were reported from 35 states. Among people who reported the date they became ill, illnesses started on dates ranging from 4 Jan 2016 to 11 May 2016. A list of the states and the number of cases in each can be found on the Case Count Map page.

In interviews, ill people answered questions about contact with animals and other exposures in the week before becoming ill; 217 (91%) of the 238 people interviewed reported contact with live poultry in the week before their illness. Ill people reported purchasing live baby poultry from several different suppliers, including feed supply stores, Co-Ops, hatcheries, and friends in multiple states. Ill people reported purchasing live poultry to produce eggs, learn about agriculture, have as a hobby, enjoy for fun, keep as pets, or to give as Easter gifts. Some of the places ill people reported contact with live poultry include at their home, someone else’s home, work, or school settings.

The CDC National Antimicrobial Resistance Monitoring System (NARMS) human surveillance program monitors antibiotic resistance in Salmonella and other bacteria isolated from clinical specimens submitted to NARMS by public health laboratories. CDC’s NARMS laboratory conducted antibiotic-resistance testing on clinical isolates collected from 3 people infected with one of the 7 outbreak strains. All 3 isolates were susceptible to all antibiotics tested. CDC’s NARMS laboratory continues to conduct antibiotic-resistance testing on additional clinical isolates collected from ill persons infected with one of the outbreak strains. Results will be reported when they become available.

NARMS is a U.S. public health surveillance system that tracks antibiotic resistance in foodborne and other enteric bacteria found in people, raw meat and poultry, and food-producing animals. NARMS is a partnership among the CDC, the U.S. Food and Drug Administration (FDA), the U.S. Department of Agriculture (USDA), and state and local health departments.

Summaries of the 7 Separate Multistate Outbreak Investigations
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Outbreak 1: _Salmonella enterica_ serotype Enteritidis Investigation

A total of 132 people infected with the outbreak strains of _S._ Enteritidis were reported from 15 states. The number of ill people identified in each state was as follows: California (6), Connecticut (4), Florida (8), Kentucky (15), Maryland (1), Michigan (25), Minnesota (1), North Carolina (3), New York (23), Ohio (18), Oklahoma (1), Pennsylvania (9), Rhode Island (2), Virginia (4), and Vermont (12).

Among people who reported the date they became ill, illnesses began between 4 Jan 2016 and 11 May 2016. Ill people ranged in age from younger than one year to 87, with a median age of 18. Of ill people, 58% were female. Among the 106 ill people with available information, 18 (17%) were hospitalized. One death was reported; Salmonellosis was not considered to be a contributing factor in this death.

Local health officials in Michigan collected environmental samples from live poultry at feed stores; testing was performed at the state lab, and the outbreak strain of Salmonella Enteritidis was isolated.

Samples from live poultry and their environment were collected at the Minnesota patient’s home. Four of 6 samples (all from poultry purchased this spring) contained the outbreak strain of _S._ Enteritidis.

Outbreak 2: _Salmonella enterica_ serotype Muenster Investigation:

19 people infected with the outbreak strain of _S._ Muenster were reported from 7 states. The number of ill people identified in each state was as follows: Indiana (1), Kentucky (1), Michigan (4), Missouri (1), Ohio (7), Pennsylvania (2), and Tennessee (3).

In interviews, ill people answered questions about contact with animals in the week before they became ill. Of the 15 ill people who were interviewed, 12 (80%) reported contact with live poultry.

Among people who reported the date they became ill, illnesses began between 11 Mar 2016 and 9 May 2016. Ill people ranged in age from younger than one year to 71, with a median age of 3. Of ill people, 58 percent were male. Among the 14 ill people with available information, 6 (43%) were hospitalized. No deaths were reported.

Local health officials in Michigan collected environmental samples from live poultry at feed stores; testing was performed at the state lab, and the outbreak strain of Salmonella Muenster was isolated.

Outbreak 3: _Salmonella enterica_ serotype Hadar Investigation:

42 people infected with the outbreak strain of _S._ Hadar were reported from 15 states. The number of ill people identified in each state was as follows: Alabama (1), Arkansas (2), Colorado (2), Georgia (1), Massachusetts (1), Montana (6), North Carolina (7), North Dakota (1), Oregon (1), Pennsylvania (4), South Carolina (6), South Dakota (1), Texas (1), Virginia (5), and West Virginia (3).

In interviews, ill people answered questions about contact with animals in the week before they became ill. Of the 29 ill people who were interviewed, 27 (93%) reported contact with live poultry.

Among people who reported the date they became ill, illnesses began between 21 Mar 2016 and 6 May 2016. Ill people ranged in age from less than one year to 77, with a median age of 30. Of ill people, 53% were female. Among the 31 ill people with available information, 11 (35%) were hospitalized. No deaths were reported.

Outbreak 4: _Salmonella enterica_ serotype Indiana Investigation:

46 people infected with the outbreak strain of _S._ Indiana were reported from 13 states. The number of ill people identified in each state was as follows: Alabama (4), Arkansas (2), California (2), Colorado (1), Georgia (2), Mississippi (1), Montana (4), North Carolina (10), North Dakota (1), South Carolina (2), South Dakota (2), Virginia (7), and West Virginia (8).

In interviews, ill people answered questions about contact with animals in the week before they became ill. Of the 23 ill people who were interviewed, 18 (78%) reported contact with live poultry.

Among people who reported the date they became ill, illnesses began between 26 Mar 2016 and 9 May 2016. Ill people ranged in age from less than one year to 87, with a median age of 7. Of ill people, 66% were male. Among the 26 ill people with available information, 7 (27%) were hospitalized. No deaths were reported

Outbreak 5: _Salmonella enterica_ serotype Mbandaka Investigation:

12 people infected with the outbreak strain of _S._ Mbandaka were reported from 7 states. The number of ill people identified in each state was as follows: Alabama (4), Arkansas (1), Indiana (1), Michigan (2), North Carolina (2), Texas (1), and Virginia (1).

In interviews, ill people answered questions about contact with animals in the week before they became ill. Of the 10 ill people who were interviewed, 9 (90%) reported contact with live poultry.

Among people who reported the date they became ill, illnesses began between 13 Mar 2016 and 4 May 2016. Ill people ranged in age from younger than one year to 92, with a median age of 11. Of ill people, 64% were female. Among the 10 ill people with available information, 2 (20%) were hospitalized. No deaths were reported.

Outbreak 6: _Salmonella enterica_ serotype Infantis Investigation:

35 people infected with the outbreak strain of _S._ Infantis were reported from 16 states. The number of ill people identified in each state was as follows: Georgia (2), Iowa (1), Illinois (4), Indiana (4), Massachusetts (1), Maryland (1), Missouri (2), North Carolina (4), New York (3), Ohio (1), Pennsylvania (4), South Carolina (1), Texas (1), Virginia (2), Wisconsin (2), and West Virginia (2).

In interviews, ill people answered questions about contact with animals in the week before they became ill. Of the 18 ill people who were interviewed, 13 (72%) reported contact with live poultry.

Among people who reported the date they became ill, illnesses began between 19 Feb 2016 and 9 May 2016. Ill people ranged in age from less than one year to 86, with a median age of 14. Of ill people, 56% were female. Among the 23 ill people with available information, 15 (65%) were hospitalized. No deaths were reported.

Outbreak 7: _Salmonella enterica_Braenderup Investigation:

38 people infected with the outbreak strain of _S._ Braenderup were reported from 14 states. The number of ill people identified in each state was as follows: Arkansas (1), Illinois (1), Indiana (1), Kentucky (5), Massachusetts (2), Maryland (1), Michigan (3), Missouri (4), New York (8), Ohio (7), Pennsylvania (1), Texas (1), Utah (1), and Wisconsin (2).

In interviews, ill people answered questions about contact with animals in the week before they became ill. Of the 24 ill people who were interviewed, 19 (79%) reported contact with live poultry.

Among people who reported the date they became ill, illnesses began between 27 Jan 2016 and 5 May 2016. Ill people ranged in age from less than one year to 84, with a median age of 34. Of ill people, 65% were female. Among the 24 ill people with available information, 7 (29%) were hospitalized. No deaths were reported.


Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[Small animals such as chicks, ducklings, mice, and baby turtles are common vehicles for salmonellosis for 2 reasons: they are small enough to handle, and they carry salmonellae. Two ways to minimize the risk: aggressive hand washing after contact and choosing other pets such as dogs or cats. – Mod.LL

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/106.]

See Also

Salmonellosis, multiple serotypes – USA: pet turtles 20160520.4230368
Salmonellosis, st. Enteritidis – USA: (MN, VA) packaged kale salad, alert, recall 20160517.4226922
Salmonellosis – USA (09): (MI) live poultry, multiple serotypes 20160505.4203696
Salmonellosis – USA (08): FDA, contaminated raw retail meat & poultry, resistance 20160501.4195399
Salmonellosis – USA (07): pet turtles 20160428.4190298
Salmonellosis – USA (06): (GA) laboratory worker 20160401.4132686
Salmonellosis, st Virchow – USA (03): nutrition shakes 20160325.4118915
Salmonellosis, st Poona – USA (02): Mexican cucumbers, fatal 20160320.4107406
Salmonellosis – USA (04): (CA) unpasteurized Mexican-style soft cheeses 20160318.4104009
Salmonellosis, st Montevideo – USA (02): pistachios, alert, expanded recall 20160316.4097252
Salmonellosis, st Montevideo – USA: pistachios, alert, recall 20160310.4083152
Salmonellosis – USA (03): (KY) restaurant 20160309.4080819
Salmonellosis – USA (02): (OH) restaurant, non-commercial mayonnaise 20160309.4078371
Salmonellosis, st Muenchen – USA: sprouts, alert, recall 20160224.4041875
Salmonellosis, st Virchow – USA (02): nutrition shakes 20160221.4037934
Salmonellosis – USA: (KY) restaurant 20160206.4000864
Salmonellosis, st Poona – USA: Mexican cucumbers, fatal 20160130.3980203
Salmonellosis, st Virchow – USA: nutrition shakes, alert, recall 20160130.3980251

2015
—-
Salmonellosis, serotype Paratyphi B – USA: raw nut butter, alert, recall 20151205.3842006
Salmonellosis, st. Poona – USA (08): Mexican cucumbers, fatal 20151122.3809130
Salmonellosis, multiple serotypes – USA: pet turtles 20151109.3779058
Salmonellosis – USA (16): (AZ) prison, salad 20150928.3670432
Salmonellosis – USA (17): (MI) nosocomial 20150930.3680871
Salmonellosis – USA (16): (AZ) prison, salad 20150928.3670432
Salmonellosis – Canada: live poultry 20150526.3386463
Salmonellosis, st Enteritidis – Ireland: poultry 20150506.3345864

2013
—-
Salmonellosis, multiple serotypes – USA: pet turtles 20130525.1737232
Salmonellosis – USA (03): multiple serotypes, live poultry contact 20130428.1678626
Salmonellosis – USA (02): (NM), live poultry contact 20130427.1676459
Salmonellosis, st Infantis – USA: (MN, CO) live poultry contact 20130424.1669381
Salmonellosis – USA: (SD) live chick contact 20130421.1662050
Salmonellosis, serotype Heidelberg – USA: chicken 20130217.1546450
………………………………………….sb/ll/msp/mpp

Source:
A ProMED-mail post
ProMED-mail is a program of the International Society for Infectious Diseases


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