Cargill Beef Sickens 33 People

Ground beef supplied to Hannaford Supermarkets by Cargill Meat Solutions (Wyalusing, PA) has been linked to 33 cases of Salmonella Enteritidis infections in seven states.

Earlier today, Cargill recalled 29,339 pounds of fresh ground beef products (14-lb chub packages of “Grnd Beef Fine 85/15” packed 3 chubs to approximately 42-lb cases). The recalled product was produced on May 25, 2012 and shipped to distribution centers in Connecticut, Maine and New York for further distribution.

The recalled meat was repackaged into consumer-size packages and sold under different brand names. We know so far that Hannaford, a regional supermarket chain in the US Northeast, sold the repackaged ground beef in its stores in Maine, Massachusetts, New Hampshire, New York and Vermont.

Illnesses were reported in Massachusetts, Maine, New Hampshire, New York, Rhode Island, Virginia and Vermont. Investigations by federal and state health and agriculture departments were able to tie five of the illnesses to Cargill’s ground beef epidemiologically and via traceback. Onset dates for those five illnesses ranged from June 6th to June 13th; two of the five victims were hospitalized.

Although the outbreak strain has not yet been recovered from an unopened package, the Vermont Department of Health found the strain in a sample of leftover product with no packaging information, according to USDA’s Food Safety and Inspection Service.

The “use by” date of the recalled ground beef has expired, however, consumers may still have some of this product in their freezers. If you purchased fresh ground beef in late May or early June from a supermarket in one of the affected states, please check your freezer for any remaining product.

Taco Bell Named In Multi-State Salmonella Outbreak

On January 19th, the US CDC reported a multi-state outbreak of 68 confirmed cases of Salmonella enteritidis gastroenteritis associated with eating food from “Restaurant A,” which the Investigation Announcement described as a Mexican-style fast food restaurant chain. Forty-three of the confirmed cases were reported by Texas, and 16 by Oklahoma. Outbreak illnesses also were reported by Kansas (2), Iowa (1), Michigan (1), Missouri (1), Nebraska (1), New Mexico (1), Ohio (1), and Tennessee (1).

Ever since the Investigation Announcement was released, CDC has ignored, dodged, and declined to answer repeated requests from the media – including an Open Letter published on eFoodAlert – to identify Restaurant A. In a recent interview with JoNel Aleccia of MSNBC, Dr. Robert Tauxe, CDC’s deputy director of the Division of Foodborne, Waterborne and Environmental Diseases, explained the agency’s policy.

“The longstanding policy,” Tauxe told Aleccia, “is we publicly identify a company only when people can use that information to take specific action to protect their health. On the other hand,” he added, “if there’s not an important public health reason to use the name publicly, CDC doesn’t use the name publicly.”

Fortunately, the state of Oklahoma takes a broader view than CDC of the public’s right to know the identity of Restaurant A.

I have just learned, courtesy of the Oklahoma State Department of Health Acute Disease Service, that “Restaurant A” is Taco Bell. Following is the summary I was given of Oklahoma’s participation in the outbreak investigation.

Oklahoma State Department of Health
Acute Disease Service

Summary of Supplemental Questionnaire Responses Specific to
Taco Bell Exposure of Oklahoma Outbreak-associated Cases
Multistate Salmonella Enteritidis Outbreak Investigation
November 2011 – January 2012

Summary Demographic information

16 cases in 5 Oklahoma counties
- Cleveland (10), Bryan (2), Lincoln (2), Pottawatomie (1), and Greer (1)
Onset date range: 10/21/2011 – 11/18/2011
- 1 onset date unknown but believes around Thanksgiving
Hospitalizations: 4
Gender distribution: 10 (63%) females and 6 (37%) males
Age range: 5 to 78 years (median 23 years)

Taco Bell exposure summary of Oklahoma cases from supplemental case-control questionnaire responses

Total Oklahoma cases: 16
Total interviewed: 12/16 (4 refused or were lost-to-follow-up)
Consumed food from Taco Bell: 8/11

CDC reported that it was unsuccessful in determining the food source for this outbreak; however, the agency took pains to add that ground beef was an unlikely source, due to the restaurant chain’s handling and cooking processes. Patrons of the Taco Bell chain can draw some comfort from CDC’s assessment that its outlets follow appropriate handling and cooking procedures for raw ground beef.

Perhaps now that the Salmonella Enteritidis has hit the fan, CDC will deign to confirm the identity of the mysterious Restaurant A.

An Open Letter To The U.S. CDC

Last week, CDC released two “Final Update” reports on Salmonella outbreak investigations within a 48-hour period.

The first report, released on January 17th, summarized the results of an investigation into a 10-month long outbreak of Salmonella Typhimurium associated with exposure to clinical and teaching microbiology laboratories. The second report, released on January 19th, presented the results of an investigation into a 2-month long multi-state outbreak of Salmonella Enteritidis infections linked to a restaurant chain.

These two outbreaks had very little in common with each other; the outbreak settings were different, the scope and duration of the outbreaks were different, and the source of the infections was different. Nevertheless, the two outbreaks have one very important thing in common.

CDC, in conjunction with at least some of its public health partners at the state and local level, has chosen to withhold important information from the public.

What information has CDC withheld, and why should this information be released? Here is a list of questions that I sent to my media contact at CDC on January 18th, the day after the Salmonella Typhimurium outbreak report was released.

Is there a specific reason why CDC is not specifying the identity of the commercial strain of Salmonella Typhimurium that is associated with this outbreak (by the ATCC or NCTC strain number – not the commercial supplier)? Can you provide me with the strain number ID?
Does CDC have any hypothesis as to the trigger for this outbreak? Most of the commercial strains have been in use in various labs for many years. What may have happened to initiate the increase in cases? What determined the start date? With a baseline rate for the outbreak strain of 0 to 4 reports/week, how were the start and ending date established for this outbreak?
Were the outbreak cases all tied to the same commercial source of the S. Typhimurium “Strain X”?
Were the outbreak cases tied to the use of a specific format of the commercial source (for example, Bacti-discs or pre-filled inoculation loops)?
Have any cases involving this same strain been reported to CDC since the last “outbreak” case on June 29, 2011? If so, how has CDC differentiated those cases from the outbreak cases (keeping in mind the baseline of 0-4 cases per week mentioned in the CDC report).
Were the bulk of the cases linked to student labs or to clinical labs?

To these questions, I would now add, “Were the clinical lab cases tied mainly to in-hospital labs, or to free-standing commercial clinical labs? If the latter, was any single commercial lab chain disproportionately involved?”

When the Salmonella Enteritidis restaurant chain outbreak report hit the internet, I again contacted my CDC media liaison and asked, “Can you please explain why CDC has not revealed the name of the restaurant chain implicated in the above-mentioned outbreak? Even better, can you identify the chain by name?”

I realize that both outbreaks are “over” and that at least some of this information now is academic. Nevertheless, I question CDC’s actions in withholding information that could influence purchasing decisions on the part of consumers and of medical and lab professionals.

CDC reported on January 19th that Restaurant Chain A’s handling and cooking processes likely ruled out ground beef as a source of the Salmonella Enteritidis outbreak. This is favorable to the restaurant chain, and would give consumers comfort that the restaurants belonging to this fast food chain are following appropriate food-handling procedures – if only CDC had released the name of the chain.

As for the lab-related outbreak, if I was still running a microbiology lab, I would certainly want to know whether a specific packaging or format of commercially available control culture was more prone to contaminating the lab surroundings than others. I would opt to avoid this format, if I had the information and the choice. Likewise, as a medical doctor, I would opt to avoid a commercial clinical lab chain that was prone to in-lab contamination.

If either of these outbreaks had been traced to a specific packaged food, the offending food would have been named. There is no logical reason for restaurant-linked outbreaks to be handled differently. There is no logical reason for a lab-related outbreak to be handled differently.

I would appreciate receiving substantive answers to my questions.

Sincerely yours,

Phyllis Entis, MSc., SM(NRCM)
eFoodAlert