Attorneys in both the USA and Canada have launched Class Action suits against Diamond Pet Foods and Costco, in the latest development in this cross-border Salmonella saga.

The Canadian suit was filed on May 9, 2012 in the Superior Court of Quebec by the Consumer Law Group; the US suit was filed in the US District Court, Eastern District of New York on May 30, 2012 (Civil Action #CV12 2708).

Neither suit has received wide publicity yet, and the US suit, as of earlier today, boasted only two class members.

As of June 13, 2012, the CDC confirmed 20 cases of human salmonellosis in 13 states, all of them caused by a single strain of Salmonella Infantis – the same strain that was recovered from samples of dry pet food manufactured in the Gaston, South Carolina production facility of Diamond Pet Foods. Two cases also were confirmed by the Public Health Agency of Canada – one in Quebec and one in Nova Scotia.

It is rare that I choose to comment on the filing of law suits, class action or otherwise. But certain wording in the US filing by Samuel H. Rudman of Robbins Geller Rudman & Dowd LLP made me cringe. On page 2 of the filing, and again on page 10, the Complaint refers to “the Salmonella virus.”

Messrs. Robbins Geller Rudman & Dowd: Salmonella is NOT a virus. Salmonella is a bacterium. The two are very different – they have different survival and growth characteristics. Please get your terminology right!

It’s bad enough when a news reporter – whether in print, on the Internet, on radio or on television – makes this error and shows his or her ignorance. It’s doubly bad when a formal legal complaint makes the same error. It shows a lack of knowledge and lack of attention. It’s sloppy and does not engender confidence.

Messrs. Robbins Geller Rudman & Dowd: Please educate yourselves. Your clients – actual and potential – deserve your full attention.

Establishing the source of a foodborne disease outbreak takes a combination of teamwork and technology. And a healthy dose of luck.

All of these elements were indispensable to the detection and definition of the Salmonella Infantis outbreak that is linked to contaminated dry pet food manufactured by Diamond Pet Foods in Gaston, South Carolina.

We know the toll of confirmed human illnesses caused by contaminated dry pet food from Diamond Pet Foods’ Gaston facility – 22 cases as of June 13, 2012. These have been documented by CDC and the Public Health Agency of Canada.

Thirteen states are reporting outbreak illnesses, all of them caused by a single strain of Salmonella Infantis. The US reports come from Alabama (2), California (1), Connecticut (1), Illinois (1), Michigan (1), Missouri (3), North Carolina (3), New Jersey (1), New York (1), Ohio (2), Pennsylvania (2), South Carolina (1) and Virginia (1). Canada has confirmed two outbreak cases, one each in the provinces of Quebec and Nova Scotia.

Outbreak-related illnesses began as early as October 8, 2011; the most recent illness onset was May 11, 2012. Infected individuals cover the entire age spectrum – from less than one year old to 82 years old. Two-thirds (68%) of the  patients are female, and at least six of the outbreak victims were hospitalized.

In response to the outbreak and to the finding of Salmonella Infantis in samples of three different Diamond Pet Foods products by Michigan, Ohio and FDA, the company recalled a range of products that were manufactured in its Gaston, South Carolina facility between December 9, 2011 and April 7, 2012.

Let me repeat (in case you missed it). The outbreak began, as far as CDC is concerned, with an illness that developed on October 8, 2011. The earliest production date that was recalled was December 9, 2011.

I’ve been wondering about this disparity for quite some time. Yesterday, I had the opportunity to put the question to Dr. Casey Barton Behravesh, of the US Centers for Disease Control and Prevention (CDC) during a telephone interview. Here is what I learned:

The outbreak first came to light as a result of a routine retail-level pet food sampling program conducted by the state of Michigan. On April 2nd, the Michigan Department of Agriculture and Rural Development detected Salmonella in an unopened bag of Diamond Naturals Lamb Meal & Rice dry dog food, which had been collected March 14, 2012. The state profiled the Salmonella strain using Pulsed Field Gel Electrophoresis (PFGE), often referred to as “genetic fingerprinting.” As is routine, Michigan reported the PFGE result to CDC.

Whenever CDC receives this type of report, the agency looks back at recent reports of human illnesses – reporting human Salmonella illnesses to CDC is mandatory – and checks for matching PFGE profiles. In this instance, CDC found several reports, dating back to the beginning of 2012. The next step was to contact the people who had been infected, and interview them to determine whether an outbreak was underway. These interviews, most often, are carried out by state or local health authorities.

There are two dates that are highly relevant to CDC in this type of investigation. One is the date of onset – the first day that a person experiences symptoms. The other is the date that the microbe was actually recovered from the patient. Typically, these two dates are fairly close in time. But this outbreak wasn’t typical.

When the state or local health authorities contacted one of the people for whom the isolation date was reported as January 2012, they were told that this person actually had begun to experience symptoms on October 8, 2011. The individual also reported “dog contact,” but could not name a specific brand of dog food that was involved. The combination of “dog contact” AND the fact that the individual had been infected with the outbreak strain of Salmonella Infantis, convinced CDC to include this individual in the case count.

What was the rationale for choosing December 9, 2011 as the earliest production date to include in the recall? I didn’t ask this question of Dr. Barton Behravesh, as recalls come under the auspices of FDA, not CDC. I suspect, though, that there was not enough firm evidence to convince Diamond Pet Foods (and, perhaps, FDA) that the October victim had been infected through handling a Diamond product. But, why December 9th, rather than January 3rd, which was the earliest production date of a batch that was proven to contain Salmonella?

I believe that the answer lies with the second outbreak victim, whose symptoms began on January 4, 2012. This person would have been using a batch of food that was manufactured prior to that date – perhaps several weeks prior to the January 4th illness onset date. It’s even possible that the victim was able to report the actual production code to investigators.

And what about reports of sick and dead pets? CDC doesn’t track those (unless they occur in a household where a human outbreak case is confirmed). Dr. Barton Behravesh referred me to FDA’s Center for Veterinary Medicine (CVM) for an answer to this question. She also declined to provide a specific answer to my question about which brands of Diamond Pet Foods products were used in households where outbreak cases had been confirmed – saying only that all of the brands reported by outbreak victims were included in the various Diamond recalls.

Veterinarians and pet owners are encouraged by CVM to report pet illnesses that may be related to pet food, treats or medications. Unfortunately, the data generated by these reports are not readily accessible to the public, and not easily searched, even within FDA. Thus, as has happened several times in the past, my request for statistics on pet illnesses related to Diamond Pet Foods brands was met with “You will need to submit a Freedom of Information Act request.”

Fortunately, someone beat me to the punch. I learned earlier today from an eFoodAlert reader that several “Incident Reports” were posted on the website of the VIN News Service on June 6th. According to these reports, various Diamond-manufactured brands were blamed by pet owners for causing the deaths of five dogs and one cat. Most of the deaths occurred in the first half of April. There is no way to confirm the cause of these deaths – or of many anecdotal reports of animal illnesses – because Salmonella testing was not carried out on most of these animals. Previously, FDA acknowledged two animal deaths – both dogs – in a household where a human outbreak case was confirmed.

As for the single production batch of Diamond Naturals Small Breed Adult Dog Lamb & Rice Formula Dry Food that was manufactured in Meta, Missouri and recalled by the company on May 18th, Dr. Barton Behravesh assured me that CDC has checked its database of PFGE Salmonella profiles, and no illnesses have been linked to this batch. Only one individual was reported ill with the same PFGE strain; however, that person was traveling outside the USA during the entire incubation period and is thought to have become infected while away from home.

Finally, Dr. Barton Behravesh urges pet owners and people who come into contact with companion animals to follow CDC’s advice to pet owners, below:

Advice to Consumers and Families with Pets

Contaminated dry pet food manufactured at Diamond Pet Foods’ Gaston, South Carolina production plant is responsible for 22 confirmed cases of human salmonellosis – 20 in the USA and 2 in Canada, according to an update released yesterday by CDC.

Thirteen states are reporting outbreak illnesses, all of them caused by a single strain of Salmonella Infantis. The US reports come from Alabama (2), California (1), Connecticut (1), Illinois (1), Michigan (1), Missouri (3), North Carolina (3), New Jersey (1), New York (1), Ohio (2), Pennsylvania (2), South Carolina (1) and Virginia (1). Canada has confirmed two outbreak cases, one each in the provinces of Quebec and Nova Scotia.

Outbreak-related illnesses began as early as October 2011; the most recent illness onset was May 11, 2012. Infected individuals cover the entire age spectrum – from less than one year old to 82 years old. Two-thirds (68%) of the  patients are female, and at least six of the outbreak victims were hospitalized.

In addition to the human illnesses, the contaminated dry pet food has taken its toll of dogs and cats. FDA acknowledged two lab-confirmed illnesses in dogs, and numerous pet owners have reported sick and companion animals. In addition to the two illnesses acknowledged by FDA, eFoodAlert readers have reported 49 sick dogs and cats that were fed a recalled Diamond Pet Foods product. Seven animals died.

It’s time to review how we arrived at this point.

The Outbreak Investigation (from CDC investigation report)

• March 14, 2012: Michigan Department of Agriculture and Rural Development (MDARD) collects an unopened bag of Diamond Naturals Lamb Meal & Rice dry dog food to test for Salmonella as part of a routine retail test.
• April 2, 2012: MDARD detects Salmonella in the dog food sample. The pulsed field gel electrophoresis (PFGE) pattern of the Salmonella matched the genetic profile of Salmonella Infantis that was recovered from cases of human illness.
• April 12-20, 2012: FDA carries out an inspection of the Diamond Pet Foods’ manufacturing facility in Gaston, South Carolina. The inspection finds significant deficiencies in the production facility. As part of its inspection, FDA samples finished products, ingredients, and the production environment for Salmonella testing. All environment and ingredient samples are negative; a sample of Diamond Puppy Formula dry dog food tests positive for Salmonella.
• April 26, 2012: Ohio Department of Agriculture issues health alert referencing the Chicken Soup for the Pet Lover’s Soul product recall.
• May 3, 2012: CDC releases its initial Outbreak Investigation announcement, advising the public that 14 individuals in 9 states were infected with the outbreak strain of Salmonella Infantis.
• May 4, 2012: Ohio announces two cases of human illnesses linked to the same strain of Salmonella Infantis. State public health officials isolated the outbreak strain from an opened bag of Diamond Brand Chicken Soup for the Pet Lover’s Soul Adult Light Formula dry dog food collected from the home of an ill person, and an unopened bag of the product collected from a retail store.
• May 9, 2012: The Public Health Agency of Canada issues a Public Health Notice reporting one outbreak case of Salmonella Infantis illness in the province of Quebec.
• May 11, 2012: CDC updates its outbreak case count to 15 confirmed cases in 9 states, and one case in Canada.
• May 18, 2012: The Public Health Agency of Canada reports a second confirmed outbreak illness, this time in the province of Nova Scotia.
• June 13, 2012: CDC updates its outbreak case count to 20 confirmed cases in 13 states, and two cases in Canada.

The Recalls (from Diamond Pet Foods recall notices and emails to its international customers)

• April 6, 2012: Diamond Pet Foods announces recall of Diamond Naturals Lamb & Rice (best before dates 03 Jan 2013 and 04 Jan 2013)
• April 13, 2012: In an email addressed to its “Dear Valued Customers” with the subject line “Diamond Recall Clarification and Action Plans”, Diamond advises its international customers that Colombia and Japan were the only two international countries affected by the April 6th recall. The entire email was recently posted on the Facebook page of the Nigerian distributor of Diamond Pet Foods products. The email was signed by David Jack, Vice President, International Diamond Pet Food Company.
• April 26, 2012: Diamond Pet Foods announces recall of Chicken Soup for the Pet Lover’s Soul Adult Light Formula (best before dates 27/JAN/2013 and 28/JAN/2013)
• April 30, 2012: Diamond Pet Foods announces recall of Diamond Puppy Formula (best by dates 11-Jan-2013, 6-Apr-2013, and 7-Apr-2013)
• May 4, 2012: Diamond Pet Foods recalls several brands of dry dog food manufactured at its Gaston facility between December 9, 2011 and April 7, 2012
• May 4, 2012: Dick van Patten’s Natural Balance Pet Foods announces recall of several products manufactured by Diamond Pet Foods.
• May 4, 2012: Canidae Pet Foods announces recall of several dry dog food products manufactured by Diamond Pet Foods.
• May 4, 2012: Apex Pet Foods announces recall of Apex Chicken and Rice Dog food (best before 24-Jan-2013), manufactured by Diamond Pet Foods.
• May 18, 2012: Health Canada’s Consumer Product Safety announces series of recalls of Diamond Pet Foods brands of dry pet food that were shipped to Canada.
• May 18, 2012: Diamond Pet Foods recalls Diamond Naturals Small Breed Adult Dog Lamb & Rice formula (Production code DSL 0801), manufactured in its Meta, Missouri facility.
• May 21 and May 29, 2012: Agri-Food and Veterinary Authority of Singapore advises consumers of the recall of the affected production batches of Country Value, Diamond Naturals, Premium Edge, Taste of the Wild and SolidGold dry pet foods that were exported to Singapore.

What Else Do We Know?

• We know that the outbreak of Salmonella Infantis illnesses is linked inextricably with Salmonella-contaminated dry pet food manufactured by Diamond Pet Foods in Gaston, South Carolina.
• We know that the Salmonella found by the state of Ohio in a sample of Diamond Naturals Small Breed Adult Lamb & Rice that was manufactured in Meta, Missouri is not related to the Salmonella that contaminated the Gaston products.
• We know – courtesy of Laura Alvey, Deputy Director of Communications for FDA’s Center for Veterinary Medicine – that FDA is currently conducting an inspection of Diamond’s Missouri production facility.
• We know that the recalled pet food was distributed in the USA and – directly or indirectly – in Canada, Colombia, France, Ireland, Japan, the Netherlands,  Singapore and Spain.
• We know, through direct email correspondence, that Diamond’s direct customers in the following countries did NOT receive recalled pet food: Australia, Czech Republic, Finland, Hungary, Ireland, New Zealand, Romania, Sweden, Switzerland, Turkey, the United Kingdom

What DON’T We Know?

• We don’t know how the Salmonella Infantis entered Diamond’s Gaston production plant and how it remained – present and undetected – in the production plant from at least January 2012 into April 2012.
• We don’t know how many dogs and cats were sickened – and how many died – because of the contaminated pet food.
• We don’t know – because Diamond Pet Foods refuses to tell us – to which countries the recalled pet foods were exported.
• We don’t know what steps Diamond has taken to ensure that this won’t happen again.