On August 28, 2024, the US Centers for Disease Control and Prevention (CDC) revealed that Listeria monocytogenes-contaminated deli meats were responsible for 57 illnesses in 18 states.

All 57 outbreak victims were hospitalized.

Nine people are dead.

The first reported victim in this outbreak (the “index case”) became ill on May 29, 2024. By July 19, 2024, the date on which the investigation began, the CDC was aware of 28 confirmed outbreak cases, including two deaths. That number increased to 34 cases just one week later.

Epidemiological and traceback data all pointed an accusatory finger in the direction of meats sliced at deli counters. Of the 44 people able to be interviewed, 41 (93%) reported eating deli meats. Thirty-nine of the 41 (95%) reported eating meats sliced at a deli. Of the 41 people who answered if they ate liverwurst, 25 (61%) reported deli-sliced liverwurst before getting sick, and 19 reported Boar’s Head brand.

As part of the outbreak investigation, the Maryland Department of Health and Baltimore City Health Department collected an unopened Boar’s Head liverwurst product from a retail store. Lab tests recovered and identified the outbreak strain of Listeria monocytogenes from the liverwurst sample.

The recalls

On July 26, 2024, Boar’s Head Provisions Co., Inc. (based in Jarratt, VA) recalled all of its liverwurst products currently on the market, as well as several other deli products that had been manufactured on the same date as the sample of liverwurst from which the outbreak strain was recovered. The company expanded its recall four days later to include all outstanding products —approximately 7 million pounds of deli meats.

The recalled deli meats were distributed to retail locations throughout the USA and some were exported to the Cayman Islands, Dominican Republic, Mexico, and Panama.

The California Department of Public Health has posted a list of all retail outlets in the state where the recalled products were sold. These include large grocery chains, such as Albertson’s, Pavilions, Sprouts, Safeway, and Von’s, as well as numerous small chains and independent deli stores.

Elsewhere, consumers must rely on supermarket recall notices. The following is a list of supermarket chains that have posted notices on their websites. Follow the links to access the recall notices.

• BigY
• Defense Commissary Agency
• Fry’s Food Stores
• H-E-B
• Kroger stores
• Lowes Foods
• Price Chopper
• Schnucks
• ShopRite
• Sprouts Farmers Market
• Target

This list is far from comprehensive. For example, stores belonging to the Alberton’s group have not posted recall notices for Boar’s Head products.

Scope of the outbreak

Most of the reported outbreak victims live in the eastern half of the continental USA.

Confirmed cases have been documented in Arizona (1), Florida (3), Georgia (2), Illinois (1), Indiana (1), Maryland (8), Massachusetts (3), Minnesota (1), Missouri (3), New Jersey (5), New Mexico (1), New York (17), North Carolina (1), Pennsylvania (2), South Carolina (2), Tennessee (1), Virginia (4), and Wisconsin (1).

Both South Carolina victims died. The other seven deaths occurred in Florida, Illinois, New Jersey, New Mexico, New York, Tennessee, and Virginia.

According to the CDC, the true number of outbreak cases is likely higher than the 57 reported cases. People who suffer mild illnesses may not seek medical attention and their infections go unreported.

Comparison to past outbreaks

Since 2018, the CDC has reported on five Listeria monocytogenes outbreaks (including the current one) linked to consumption of deli meats or deli-sliced meats.

The current Boar’s Head outbreak accounts for more illnesses, hospitalizations, and deaths than all four previous deli-related outbreaks combined.

How did we get here?

As a manufacturer of meat and poultry products, Boar’s Head falls under the jurisdiction of the US Department of Agriculture’s Food Safety and Inspection Service (FSIS).

Unlike companies regulated by the US Food and Drug Administration (FDA), FSIS-regulated processors are inspected daily. In the case of Boar’s Head, the FSIS contracted with the Virginia Department of Agriculture and Consumer Services (VDACS) to perform those inspections.

In January 2014, FSIS issued a 143-page guidance document, “FSIS Compliance Guideline: Controlling Listeria monocytogenes in Post-lethality Exposed Ready-to-Eat Meat and Poultry Products.” The document was intended to assist processors in navigating the requirements of the agency’s Listeria rule.

In this document, the FSIS warns that, “Facilities maintenance personnel should be informed that Listeria thrives in moisture and that it is important that they vigilantly look for leaking roofs, drips, standing water, and condensation.”

Between August 1, 2023, and August 2, 2024, the VDACS inspector recorded a total of 69 instances of non-compliance, including multiple cleaning and sanitation issues, maintenance and repair issues, clogged drains, incomplete documentation, accumulation of black mold, live and dead insects, thick coatings of dust, multiple instances of condensation, leaking hot water pipe, and green algal growth in standing water.

During that same time period, the VDACS inspector submitted just twelve samples to the FSIS laboratory for analysis, none of which were positive for Listeria monocytogenes. It is unclear whether these were finished product or environmental samples.

What’s next?

Production has been shut down at the Jarratt facility until the source of the contamination can be identified and corrected.

The following statement appears on the Boar’s Head website:

We deeply regret the impact this recall has had on affected families. No words can fully express our sympathies and the sincere and deep hurt we feel for those who have suffered losses or endured illness.

We are conducting an extensive investigation, working closely with the USDA and government regulatory agencies, as well as with the industry’s leading food safety experts, to determine how our liverwurst produced at our Jarratt, Virginia facility was adulterated and to prevent it from happening again.

Production has been paused at our Jarratt, Virginia facility since we initiated the expanded recall in late July. We will not resume operations at this facility until we are confident that it meets USDA regulatory standards and Boar’s Head’s highest quality and safety standards.

Since last week’s release of the most recent data, multiple players have called for a congressional investigation into the actions of the company and the FSIS. Senator Blumenthal is among those who have called for a federal probe.

“The outbreak of listeria in Boar’s Head meat products should have been caught, could have been stopped by the United States Department of Agriculture,” Blumenthal was quoted by 12News Connecticut as saying. “I want an investigation as to why those lax inspection procedures caused these deaths and sicknesses.”

Interested in learning more about food safety and the history of foodborne disease outbreaks and investigations?

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