OUTBREAK ALERT AND PRODUCT RECALL: Listeria monocytogenes in pre-cooked chicken

One person is dead and two more have been hospitalized in a multi-state outbreak of Listeria monocytogenes according to a report released last night and updated today by the US Centers for Disease Contol and Prevention (CDC).

All three outbreak victims were either living in a long-term care facility or were already hospitalized at the time they became infected.

Two of the cases, including the single fatality, are in Texas. The remaining case is in Delaware.

Victims range in age from 60 to 95, with a median age of 89 years old. Two of the three are male.

The CDC warns that the true number of infected people may be higher, and the outbreak may not be limited to Texas and Delaware.

The outbreak strain was recovered from two samples of precooked chicken products during routine sampling conducted by the US Department of Agriculture’s Food Safety and Inspection Service (FSIS).

One of the positive samples was produced by Tyson Foods Inc. in Dexter, MO. The producer of the second sample to test positive for the outbreak strain has not yet been named.

Tyson recalls 4,246 TONS of pre-cooked chicken products

Tyson has recalled approximately 8,492,832 pounds of ready-to-eat (RTE) chicken products produced between December 26, 2020 and April 13, 2021 and bearing the establishment number, EST. P-7089.

The recalled products include frozen, fully cooked chicken strips, diced chicken, chicken wing sections, and fully cooked pizza with chicken and were sold under multiple brand names, including: Tyson, Jet’s Pizza, Casey’s General Store, Marco’s Pizza, and Little Caesars.

These items were shipped nationwide to retailers and institutions, including hospitals, nursing facilities, restaurants, schools and Department of Defense locations. Please refer to the recall notice for a complete list of affected products.

Consumers and food handlers should take additional care when preparing dishes that included pre-cooked chicken, especially when the food will be offered to the elderly or to immunocompromised individuals, including pregnant women.

What businesses need to know

  • Do not serve or sell recalled products.
  • Long-term care facilities, hospitals, and other facilities that serve people at higher risk for severe Listeria illness should take extra precautions. Listeria is particularly harmful to people who are 65 years or older, pregnant, or have a weakened immune system.
  • All of the sick people in this outbreak ate foods served at a long-term care facility or hospital.
  • Follow USDA-FSIS guidelines to prevent the spread and growth of Listeria.

What consumers need to know

  • Do not eat any recalled products. Throw them away or return them to where you bought them.
  • Follow these five steps to clean your refrigerator, containers, and surfaces that may have touched the recalled products. Listeria can survive in the refrigerator and can easily spread to other foods and surfaces.
  • Call your healthcare provider right away if you have these symptoms after eating recalled products.
    • If you are pregnant: Fever and muscle aches. Your illness may be mild, but Listeria can cause pregnancy loss or premature birth. It can also cause serious illness or death in newborns.
    • If you are not pregnant: Headache, stiff neck, confusion, loss of balance, and convulsions, in addition to fever and muscle aches.

Salmonella Outbreak Linked to Onions—a Post-mortem

Reported cases: 1,642
Hospitalizations:
246
States affected:
48
Provinces affected:
7
Infectious agent: Salmonella Newport
Probable source: Red onions produced and packed by Thomson International, Inc. of Bakersfield, CA


Two months after the US Centers for Disease Control and Prevention (CDC) and the Public Health Agency of Canada (PHAC) declared this outbreak over, its root cause remains a mystery.

The US Food and Drug Administration (FDA) has plowed through more than 2,000 samples, testing finished products, swab and environmental samples from Thomson’s packing facility, and environmental samples from the vicinity of the fields where the onions were grown.

FDA labs recovered eleven different Salmonella serotypes from the various environmental samples, according to information obtained by eFoodAlert in response to a Freedom of Information Act request.

Although Salmonella Newport was found in two samples described as soil/sediment, neither sample yielded the outbreak strain recovered from patients.

Not one of the onions tested in FDA labs were Salmonella-positive.

Not one of the swab samples obtained from inside the Thomson packing facility were Salmonella-positive.

But this is not the whole story. To understand FDA’s findings, it’s important to know more about onions.

The onion

Onions can be grown from seeds, seedlings, or sets (immature onion bulbs). The crop is ready for harvest when at least one-half of the leaves are dead.

In order to ensure an adequate storage life, the onions must be left in the field to “cure” for at least 12–24 hours. This allows the outer skin to dry. Curing is complete when the neck of the onion (the top of the bulb) is dry and tight.

After curing, the onions are “topped” above the neck to remove the leaves, after which they are ready for eating or for extended storage.

Onions are closely related to garlic and, like garlic, onions produce certain essential oils that possess anti-bacterial properties. Although Salmonella can survive on onions, these essential oils complicate the process of detecting the bacteria.

Thomson’s onion operations

Onions are onions, whether grown in a small backyard or in a large commercial field. The same principles apply. The differences are those of scale.

Thomson’s onions are grown from seeds in two different parts of California. The company uses fields both near Bakersfield, where its packing house is located, and just outside Holtville, in California’s Imperial Valley, approximately 330 miles to the south.

When the onion crop is ready for harvest, Thomson’s crews use specialized equipment to dig beneath the bulbs and cut them out of the ground. The onions are left in the field to cure.

Once the onions have cured, a crew of farm laborers works its way through the field, trimming off the tops and bottoms of the onions, culling and discarding damaged onions, and placing the trimmed onions into buckets.

Culled onions and the trimmed-off tops and bottoms are left in the field to be plowed back into the soil when it is prepared for the next crop.

The full buckets are poured into burlap bags, which are left in the field for additional curing.

Once curing is complete, the onions are either shipped in bulk directly to customers or are transported to Thomson’s Bakersfield packing facility, where they are brushed clean and packed for distribution.

What FDA did not find

  • No “egregious” conditions or violations of the Produce Safety Rule
  • No direct evidence of the outbreak strain in bagged onions
  • No direct evidence of the outbreak strain in any environmental samples either at the packing facility or in and around the fields

What FDA found in Bakersfield

  • Cats in and near the onion packing lines
  • Pigeons flying or roosting inside the packing house
  • Apparent bird droppings on and near the onion packing line
  • A thick build-up of dirt and soil on the packing line even after the most recent cleaning/sanitizing activity
  • Rough, dirty weld points on the packing line
  • Inadequate documentation of cleaning/sanitizing activity
  • Swallow nests overhead within a few feet of an onion-packing line
  • Inconsistent cleaning/sanitation Standard Operating Procedures documentation
  • Inconsistent bacteriological testing of agricultural water for coliforms and E. coli.
  • Salmonella in animal scat, drain sediment, and environmental swab sample and on a water filter

What FDA found in Holtville

  • Worn and uneven areas on field packing equipment that could harbor bacteria
  • Indications of bird activity around the fields and equipment
  • Flock of birds (ibis) in field undergoing flood irrigation adjacent to field where onions had been grown
  • Salmonella, including Salmonella Newport, in several soil/sediment samples

And then there’s the water…

Information received under a Freedom of Information Act request is often heavily redacted, as anyone knows who watches The Rachel Maddow Show on MSNBC. This is what FDA’s investigation report had to say about the source of irrigation water used on the onion fields.

It would appear that irrigation water was drawn from a different source than was usual on at least one occasion. The details and date(s) on which this took place were redacted from the report, as was the diagram showing the flow of water from the source to the fields.

Why does this matter?

Irrigation water polluted by runoff from cattle feedlots has been linked to contaminated produce grown in the Salinas and Imperial Valleys in the past. A quick look at a Google map for the areas around Bakersfield and Holtville reveals the presence of feedlots in both vicinities.

The bottom line

As soon as Thomson onions were identified by CDC and FDA as the probable source of the Salmonella Newport outbreak, the company shut down its harvesting and packing operations.

By the time FDA investigators arrived on the scene, there were no field or packing activities for them to observe. The investigators were able to carry out extensive sampling of the equipment surfaces, the environment, and the stored onions, but were unable see either the harvest or packing operations in action.

Although neither FDA nor the Canadian Food Inspection Agency were able to find the outbreak strain in any of the onion samples, all of the epidemiological evidence from both the CDC and the PHAC points to Thomson’s red onions as the source of the outbreak,

The presence of multiple Salmonella-positive environmental samples lends weight to this conclusion, although the actual source of the contamination likely will never be known.

Thomson Onion Salmonella Outbreak: Is CDC Missing in Action?

On July 21, 2020, the US Centers for Disease Control and Prevention (CDC) informed the public of an outbreak of Salmonella Newport infections.

On July 24th, the Public Health Agency of Canada (PHAC) informed the public of an outbreak of Salmonella Newport infections apparently caused by the same outbreak strain as CDC was finding in the United States.

At the time of the initial reports, neither agency had determined the source of the outbreak.

On July 30th, PHAC updated its outbreak advisory, informing Canadians that the outbreak was linked to consumtion of red onions imported from the United States. That same day, the Canadian Food Inspection Agency (CFIA) posted a recall notice for red onions imported by Sysco in Western Canada.

Using the Canadian data as its starting point, on July 31st, the US Food and Drug Administration (FDA) and CDC announced that the US outbreak was linked to consumption of red onions produced by Thomson International, Inc. of Bakersfield, California.

Thomson International is a family-owned business, incorporated in California.

On August 1st, Thomson recalled its entire harvest of red, yellow, white, and sweet yellow onions from the 2020 growing season – approximately 18,750 tons of onions. The onions were distributed across the United States and exported to Canada.

CDC issued status updates of the size and scope of the US outbreak on August 3rd, August 7th, August 18th and September 1st, and has not been heard from since.

PHAC issued status updates of the size and scope of the Canadian outbreak on August 2nd, August 7th, August 14th, August 21st, August 31st and September 14th.

By August 7th, FDA had initiated its on-site investigation of Thomson’s Bakersfield facility, looking for the source of the Salmonella Newport contamination. By August 11th, FDA personnel had submitted 370 samples to the agency’s lab for Salmonella testing, including 278 swab samples, 82 onion samples, and 10 miscellaneous environmental samples, according to information obtained by eFoodAlert in response to a Freedom of Information Act request.

Not a single sample contained Salmonella.

The FDA investigation is still in progress. However, with the growing season complete and the packing plant idle, the chances of finding the source of the Salmonella Newport diminish day by day.

As of the last report from CDC, 1012 individuals in 47 states have been infected with Salmonella Newport as a result of having consumed contaminated onions. Only Louisiana, Oklahoma and Vermont have not reported any outbreak cases. Although there have been no deaths associated with this outbreak, 136 (more than 13%) of the victims have required a hospital stay.

In Canada, there have been 506 confirmed cases of Salmonella Newport in seven provinces, and 71 people (14%) have been hospitalized.

Canada v. USA – A Performance Comparison

Why was CDC unable to determine the link between red onions and the Salmonella Newport outbreak until after PHAC had made the connection?

Why has CDC not provided an update to its outbreak status report in three weeks?

Why does Canada appear to have been much harder hit by this outbreak than the United States – 13.7 cases per million Canadians versus only 3.1 per million Americans? Is this due to some quirk of distribution, or have PHAC and its provincial partners done a better job of reporting than CDC and the various state health agencies?

Has the Covid-19 pandemic hit CDC so hard that it no longer has the resources to follow-up on illness outbreaks elsewhere?

 

IF CDC IS MISSING IN ACTION, WHAT DOES THIS MEAN FOR THE HEALTH AND SAFETY OF THE US POPULATION?