Chicken products fingered in international Salmonella outbreak

A deadly nine-nation outbreak of Salmonella Mbandaka ST413 infections is most likely due to consumption of ready-to-eat (RTE) chicken products and/or fresh chicken meat, such as those used in sandwiches and wraps.

According to the European Centre for Disease Prevention and Control,  196 cases have been reported in nine countries, including seven member states of the European Union (EU), the United Kingdom (UK), and Israel since November 8, 2022.

Nineteen outbreak victims have been hospitalized, five of them with septicemia.

One person–a resident of the UK–has died.

Outbreak cases have been reported by the following countries:

  • Czechia (Czech Republic): 5 (none confirmed as yet)
  • Estonia: 3 (all confirmed)
  • Finland: 89 (42 confirmed and 47 possible)
  • France: 10 (all confirmed)
  • Germany: 2 (all confirmed)
  • Ireland: 1 (all confirmed)
  • Netherlands: 1 (all confirmed)
  • Israel: 4 (none confirmed as yet)
  • United Kingdom: 81 (all confirmed)

The UK was the first country to detect the outbreak, reporting a cluster of 31 cases from England (25), Scotland (3) and Wales (3) on May 20, 2022. Sample collection dates ranged between September 24, 2021 and April 23, 2022. Four of the patients were hospitalized, and one has died.

Finland followed on the UK’s heels with a report of nine cases on June 16, 2022.

The Finnish food safety authority has linked suspect products to an Estonian company, but this link could not be verified by traceback identification or microbiological analysis.

The European Centre for Disease Control (ECDC) is encouraging its member countries to sequence the genomes of Salmonella Mbandaka isolated from human sources and to interview those patients whose isolates match the outbreak strain.

Salmonella Mbandaka was first reported in 1948 in the Belgian Congo, where it was recovered from a patient suffering from salmonellosis.

The ST413 strain entered the Polish feed and poultry sector in the 1990s, and has been circulating in Poland and other EU countries since then.

The ECDC warns that new cases are likely to occur until the source of the outbreak has been identified and controlled.

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USDA has future plans to consider whether Salmonella in chicken should be dealt with

This story by Coral Beach first appeared on Food Safety News and is reposted here with permission

The USDA is beginning to consider whether or not to consider if Salmonella in poultry should be considered a problem.

The department’s Food Safety and Inspection Service (FSIS) today announced that it is “considering a regulatory framework” for a new strategy that would allow the agency to consider controlling Salmonella in poultry products. The goal, if things move forward, is to reduce human illnesses.

Every year at least 135,000 people are sickened by Salmonella, according to the Centers for Disease Control and Prevention. Of those illnesses, one-fourth are caused by the pathogen in chicken.

The potential framework described in the FSIS announcement has three prongs and an open ended time schedule.

Some who have been fighting for Salmonella to be declared an adulterant in poultry — making it illegal to sell chicken contaminated with it knowingly or unknowingly — are feeling lukewarm about the potential framework.

Bill Marler, a Seattle food safety attorney who three years ago filed a petition on behalf of several individuals and three consumer groups seeking to have Salmonella declared an adulterant, said the FSIS announcement reminded him of a 19970s TV commercial: “Where’s the beef?”

He said the proposal for a framework to consider studying the situation “dances around” the problem. He is concerned that the proposed framework is not bold enough. He is, however, glad to see some movement, any movement.

“This is the first public-facing document I’ve seen in more than 30 years that FSIS has put out there showing that they understand there is a problem,” Marler said.

Consumer Reports, one of the groups named in the petition filed by Marler, is also pleased at this first step by FSIS. The group said the announcement  “is an encouraging sign that the agency is stepping up its efforts to protect the public.

Salmonella contamination is all too common in poultry and poses a potentially deadly risk to consumers,” said Brian Ronholm, director of food policy at Consumer Reports. “It’s critical for the USDA to work expeditiously to adopt aggressive goals to sharply reduce Salmonella contamination and focus its efforts on reducing the strains that pose the biggest threat to human health.”

The citizen’s petition asked FSIS to declare 32 strains of Salmonella to be considered an adulterant. The FSIS is considering whether to review three of those strains.

Salmonella contamination is widespread in chicken in part because of the often crowded and filthy conditions in which they are raised, according to Consumer Reports. A recent CR investigation, for example, found almost one-third of ground chicken samples tested contained Salmonella

Consumer reports said the numbers are alarming and that the framework needs to go further.

“While the USDA currently requires producers to test poultry for Salmonella, a processing facility is allowed to have the bacteria in up to 9.8 percent of all whole birds it tests, 15.4 percent of all parts, and 25 percent of ground chicken. Producers that exceed these amounts are given what amounts to a warning, but not prevented from selling the meat,” according to the Consumer Reports statement.

By the FSIS’s own admission the number of illnesses caused by Salmonella in poultry has remained stagnant for decades. This is in the context that industry has reduced the amount of Salmonella found in poultry by 50 percent. Marler explained that anomaly in terms of a swimming pool.

“If you have a pool and you drain out half of the water you still have half a pool of water,” he said.

The water in the pool represents the amount of Salmonella in the chicken. There’s just too much of it left, even with the 50 percent of it gone, that makes people sick. That shows how much Salmonella is in chicken — too big of a bacterial load, as scientists say.

With the proposed FSIS framework the number of human illnesses caused by Salmonella in poultry would be decreased by 25 percent, meaning three out of four people who are sickened would still get sick. That is not acceptable in Marler’s opinion. 

The Center for Science in the Public Interest (CSPI) is pleased to see the attention to Salmonella in poultry but is cautiously optimistic.

“While the proposed framework represents a welcome shift in thinking by the agency, many important details are yet to be worked out, and the need for these changes is urgent,” CSPI said in a statement this morning.

“USDA’s announcement of this framework represents a landmark acknowledgment from an agency that has long refused to recognize that Salmonella in raw poultry poses unacceptable risks. Center for Science in the Public Interest first petitioned the USDA to ban certain strains of antibiotic-resistant Salmonella in 2011, and again in 2014, but was denied twice by the agency.”

STOP Foodborne Illness is also happy to see some action out of FSIS on the decade-old problem of Salmonella in chicken.

“Stop Foodborne Illness (STOP) applauds FSIS for taking the first step of developing meaningful, comprehensive controls for Salmonella in poultry that includes an enforceable final product standard. The proposed framework reflects many issues raised by STOP and its coalition partners in our joint petition filed in January 2021,” said Mitzi D. Baum, M.Sc. and CEO of STOP.

One key point in the proposed framework for the possible FSIS strategy for dealing with Salmonella in poultry is to have the industry work out the problem. The framework calls for birds to come into “the establishments” cleaner. That means that people who raise chickens would have to send healthy birds to slaughterhouses and processing plants.

By putting pressure on “the establishments” to accept cleaner birds the government believes the slaughterhouses and processors would put pressure on their suppliers, thus resolving the problem.

Marler says the most significant point in the proposed framework is that it recognizes that dealing with Salmonella pre-harvest is necessary. Right now there is no industry incentive to fix the problem.

Consumer Reports agrees that testing so-called incoming birds is a crucial step.

“Under the proposal announced by the USDA, poultry producers would be required to test flocks for Salmonella before slaughter and provide documentation on Salmonella levels or serotypes to processing plants,” according to Consumer Reports’ statement. “The requirement is meant to incentivize plants to implement measures to reduce the Salmonella load in the final poultry product. USDA is also considering the adoption of a final product standard to ensure that poultry contaminated with Salmonella likely to make people sick is not allowed on the market.”

The framework itself 

A key point from the FSIS announcement is that the agency will be seeking comment from stakeholders on all of the elements of the framework —  both at a public meeting and in written comments submitted to the meeting docket in the Federal Register — before moving forward with any proposed changes to regulations or other actions.

After analyzing recent data on human illness from the Centers for Disease Control and Prevention and FSIS sampling results from chicken and turkey products, the agency has decided to focus at this time on three serotypes: Enteritidis, Typhimurium, and Infantis, which together cause 33 percent of all Salmonella illnesses. The public petition requested that 32 types be considered adulterants.

Excerpts from the three components of the framework

Component 1: Requiring incoming flocks be tested for Salmonella before entering an establishment

FSIS is considering requiring establishments to characterize Salmonella as a hazard reasonably likely to occur at receiving and that incoming flocks be tested for Salmonella before entering an establishment. 

Under this approach, the flock would have to meet a predetermined target for Salmonella at receiving, which may be industry-wide or establishment-specific, and the establishment must demonstrate that its subsequent process will be effective in reducing Salmonella so that the product will meet the final product standard. 

Salmonella enters an establishment in and on the birds. The goal of this component is to incentivize the use of pre-harvest interventions that reduce the level of incoming Salmonella contamination or mitigate the risk of a particular serotype entering the establishment.

Under this approach, FSIS does not intend to require the industry to adopt any specific pre-harvest interventions but would allow flexibility for the industry to adopt the practices that are most effective at controlling Salmonella in each particular operation. Establishments would be encouraged to work with their suppliers and contractors to ensure they are implementing best practices in reducing the Salmonella hazard in breeding facilities, hatcheries, grow-out and throughout transport.

Component 2: Enhanced Establishment Process Control Monitoring and FSIS Verification 

To ensure that poultry slaughter establishments are effectively controlling Salmonella throughout their operations, FSIS may propose to modify its current regulations to prescribe enhanced establishment monitoring procedures, including revised locations for multipoint sampling and the use of a statistical approach to process control.

The second component of this proposed framework builds on Hazard Analysis and Critical Control Point (HACCP), FSIS’ prevention-based approach to food safety. To ensure pathogen control throughout slaughter and processing operations, FSIS may modify the existing requirements for indicator organism testing for process control and establish additional parameters to better define the required analysis of the data. As part of the proposal, establishments may be required to test for indicator organisms (e.g., aerobic plate count [APC], Enterobacteriaceae).

Component 3: Enforceable Final Product Standard

FSIS is assessing whether certain levels or types of Salmonella in raw poultry products present an elevated risk of causing human illness such that they should be considered adulterants. As a result, the agency is considering implementing a final product standard or standards to ensure that product contaminated with Salmonella that is likely to make people sick is not sold to consumers. 

To protect public health, FSIS regulations should prevent products with high levels of contamination and/or specific serotypes from entering commerce. This goal would be accomplished by declaring Salmonella an adulterant. In doing so, FSIS would rely on criteria that were applied to STECs. These criteria are: consideration of serotypes associated with human illness; low infectious dose; severity of human illnesses; and typical consumer cooking practices.

(Editor’s note) The reference to STECs, or Sign toxin-producing E. coli, relates to how the beef industry was forced to clean up its meat when E. Coli was declared an adulterant.

Consistent with its approach to determining the status of certain STECs as adulterants in specific raw beef products, FSIS is considering whether there are specific Salmonella and raw poultry product pairs that have characteristics that distinguish them from other raw poultry products contaminated with Salmonella, such that Salmonella at certain levels and/or types of Salmonella should be considered as an adulterant when present in that specific raw poultry product. 

For example, FSIS will soon be releasing a proposal that Salmonella meets the criteria to be considered an adulterant in not-ready-to-eat (NRTE) breaded and stuffed raw chicken products, an action that will allow the Agency to better protect public health. 

At the same time, FSIS is exploring if a single product standard for Salmonella in all raw poultry products may be appropriate. From a consumer’s perspective, exposure to a quantity and/or serotype of Salmonella likely to make them sick is a key risk factor for the illness that may be consistent across product types. 

Seeking public comment

FSIS is soliciting input on all aspects of the draft framework, related to the three components as well as the cross-cutting issues. An online copy of the proposed framework is available at: www.fsis.usda.gov/inspection/inspection-programs/inspection-poultry-products/reducing-salmonella-poultry/proposed.

Reality of our world: Money trumps altruism in the quest for safer poultry

This is part two of a two-part opinion piece by Carl Custer. It first appeared in Food Safety News and is reposted here with permission.

In the previous article, I wrote about the decades-old public health problem of poultry-borne salmonellosis. This article will propose declaring the virulent strains that are pathogenic to humans as adulterants and the benefits of doing so.

Regulatory policies for other foodborne pathogens recognize consumer’s inability to handle them. The Code of Federal regulations, 9 CFR 311.2-39 describes a number of conditions for declaring meat carcasses adulterated, including: tuberculosis, arthritis, and odors. The poultry regulations 9 CFR, 381.80 et seq are similar. The Meat Inspection Regulations, 9 CFR 315.2 permit some meat products that are found adulterated under 311 to be passed for cooking – under the oversight of federal inspections, not in consumers’ kitchens. In 1995, the top administrator of the USDA’s Food Safety and Inspection Service (FSIS), Craig Reed, use that principle in his letter permitting lots of ground beef containing Escherichia coli O157:H7 to be cooked in a federal establishment – not in consumers’ kitchens.

Treatment of raw meat and poultry by cooking, irradiation, or high pressure processing would eliminate consumer exposure to those pathogens. However, one of the primary sources of foodborne pathogens now is contaminated produce. A growing body of scientific literature indicates a major source of these pathogens is food animal production via air 2, water 1, and manure 4. (These are only three recent papers of many). The 2018 meeting of the International Association for Food Protection (IAFP) in Salt Lake City had more than 20 sessions addressing preharvest contamination of soil, water and produce. There is also a large body of scientific literature on preharvest interventions in animals including isolation, competitive exclusion, probiotics, prebiotics, and vaccination. 

Interventions cost and thus, producers need incentives. Incentives include altruism, regulations, customer specifications, and litigation. A 2018 IAFP Round Table “RT9: Do Lawsuits Play a Productive Role in Advancing Food Safety?” suggested that customer specifications and regulations produced faster results; lawsuits were too far in the future. The COSTO and Walmart speakers said customer specifications are effective. Regulation has had some effect on E. coli O157:H7 in beef, but certainly not eliminated it in either commerce or preharvest.6 One can only speculate what the results would be if FSIS had not declared it an adulterant in 1994. We know more each year what the effect is of not declaring outbreak strains of Salmonella as adulterants.

The FSIS has the legal means to prevent these adulterants from entering commerce. The Meat and Poultry Inspection Acts 8-9 empower FSIS inspectors to conduct ante mortem and post mortem inspection of all animals before processing them into food. Traditionally, that has been visual inspection but not always. FSIS’s 2013 “Compliance Guide For Residue Prevention” uses laboratory results to compile a list, “The Residue Repeat Violator List.” It is composed of suppliers who have had more than one residue violation in the preceding 12 months. Thus, animals from a producer on that list present a “hazard reasonably likely to occur.” The HACCP (Hazard Analysis and Critical Control Point) rules require establishments to have controls to prevent any product with violative residues from entering commerce. Failure to do so is a violation of 9 CFR 417.6. FSIS can sample carcasses or live animals and the laboratory will report any violation to Field Operations for action. 

The principle used for residues could be applied to outbreak strains of certain bacterial pathogens also. These strains are adulterants as defined by both the Inspection Acts and the Code of Federal Regulations. FSIS routinely samples carcasses and products for pathogenic bacteria. When an outbreak strain is detected and traced back to an establishment, the establishment can identify the producer and that producer would be put on a “Adulterant Carrier List.” Future animals from that producer and their products must either be treated to inactivate any adulterants or tested (ICMSF Case 15) until the producer has implemented validated controls and verified their effectiveness to prevent future contamination. If the establishment cannot identify the producer, then all product from that establishment would be treated or tested under ICMSF Case 15 to prevent any adulterants from entering commerce.

This would be a harsh rule and FSIS would likely be sued by the industry. The outcome should be similar to Texas Food Industry Ass’n v. Espy7 where E. coli O157:H7 was found to be an adulterant in ground beef because consumers would eat the product rare. So why not Salmonella? The difference would be that FSIS could use the half century of scientific findings that cross contamination within consumer’s kitchens is a major source of foodborne illnesses, not just undercooking. Thus poultry and other meat products would be included.

The outcome of FSIS promulgating such a regulatory policy would be that preharvest control of pathogenic bacteria in food animal production would begin to be addressed. This action would begin to reduce the environmental contamination that reaches produce fields via waterways and even highways5.

Assays for pathogens have advanced rapidly in the past decade3. Methods are more rapid, sensitive, and specific. The FSIS, processors, and producers can use these methods to rapidly verify that interventions are working and adulterants are not being found in products.

It would be wonderful if altruism was the incentive for preventing adulterants from entering commerce. Alas, we do not live in that world. But let us take USC 602 to heart and apply it to preharvest control.

 References

1. Alegbeleye OO, Singleton I, Sant’Ana AS. 2018. Sources and contamination routes of microbial pathogens to fresh produce during field cultivation: A review. Food Microbiology. 73: 177-208. https://doi.org/10.1016/j.fm.2018.01.003

2. Berry ED, Wells JE, Bono JL, Woodbury BL, Kalchayanand N, Norman KN, Suslow TV, López-Velasco G, Millner PD. 2015. Effect of proximity to a cattle feedlot on Escherichia coli O157:H7 contamination of leafy greens and evaluation of the potential for airborne transmission. Appl Environ Microbiol 81:1101–1110. doi:10.1128/AEM.02998-14.

3. Besser, John M. 2018. Salmonella epidemiology: A whirlwind of change. Food Microbiology 71:55-59.

4. Heredia, Norma, Santos, García. 2018. Animals as sources of food-borne pathogens: A review. Animal Nutrition. In Press  https://doi.org/10.1016/j.aninu.2018.04.006

5. Seedorf J, Schmidt RG.. 2017.  The simulated air flow pattern around a moving animal transport vehicle as the basis for a prospective biosecurity risk assessment. Heliyon 3:00358

6. Swaggerty, Christina L., Ester Grilli, Andrea Piva, Nicolae Corcionivoschi, Steven C. Ricke, Todd R. Callaway. 2018. The First 30 Years of Shiga Toxin–Producing Escherichia coli in Cattle Production: Preharvest Intervention Strategies.  Food and Feed Safety Systems and Analysis- Chapter 8. Pages 133–151 https://doi.org/10.1016/B978-0-12-811835-1.00008-7

7. Texas Food Industry Ass’n v. Espy, 870 F. Supp. 143 (W.D. Tex. 1994) US District Court for the Western District of Texas – 870 F. Supp. 143 (W.D. Tex. 1994) December 13, 1994

8. 21 U.S. Code § 455. Inspection in official establishments (Poultry Inspection)

9. 21 U.S. Code § 603 – Examination of animals prior to slaughter; use of humane methods (Meat Inspection)