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Marler Blog Providing Commentary on Food Poisoning Outbreaks & Litigation

A Smorgasbord of Outbreaks and Recalls – We should do better

Looking at the Salmonella Tuna Scrape (they really need a better name for it) outbreak numbers yesterday, it got me spending some of my day at work today looking at CDC data over the last few years on outbreak surveillance, investigations, announcements and governemnt or business recalls. 

Looking at the data, it is fairly clear that most – but not all – outbreaks are not figured out until far into the epi curve or not until the outbreak is winding down.  It raises the question how we can arm, local, state and federal investigators with the tools to figure out outbreaks earlier and prevent more illnesses. 

In addition, I still have that nagging issue of recall effectiveness.  Again, many – but not all – recalls are not effective at stopping the consumption of the “recalled” tainted product – consumers consume it first.  What tools do pubic health officials, food manufacturers, retailers and consumers need to know so they know what has been recalled and what has not been?

Peanut Corporation of America Salmonella Outbreak 2009 - As of April 20, 2009, 714 persons infected with the outbreak strain of Salmonella Typhimurium have been reported from 46 states. The number of ill persons identified in each state is as follows: Alabama (2), Arizona (14), Arkansas (6), California (81), Colorado (18), Connecticut (11), Florida (1), Georgia (6), Hawaii (6), Idaho (17), Illinois (12), Indiana (11), Iowa (3), Kansas (2), Kentucky (3), Louisiana (1), Maine (5), Maryland (11), Massachusetts (49), Michigan (38), Minnesota (44), Missouri (15), Mississippi (7), Montana (2), Nebraska (1), New Hampshire (14), New Jersey (24), New York (34), Nevada (7), North Carolina (6), North Dakota (17), Ohio (102), Oklahoma (4), Oregon (15), Pennsylvania (19), Rhode Island (5), South Dakota (4), Tennessee (14), Texas (10), Utah (8), Vermont (4), Virginia (24), Washington (25), West Virginia (2), Wisconsin (5), and Wyoming (2). Additionally, one ill person was reported from Canada.  Infection may have contributed to nine deaths: Idaho (1), Minnesota (3), North Carolina (1), Ohio (2), and Virginia (2). Among the persons with confirmed, reported dates available, illnesses began between September 1, 2008 and March 31, 2009.  Recall: January 28, 2009 (red bar).

PCA_typhimurium_epi_042909.jpgJimmy John’s Salmonella Sprout Outbreak 2009 - As of May 7, 2009, 235 persons infected with the outbreak strain of Salmonella Saintpaul have been reported from 14 states. The number of ill persons identified in each state is as follows: Nebraska (111), Iowa (35), South Dakota (38), Michigan (19), Kansas (8), Pennsylvania (7), Minnesota (5), Ohio (3), Illinois (2), Virginia (2), West Virginia (2), Florida (1), North Carolina (1), and Utah (1).  Among the 234 persons with known illness onset dates, illnesses began between February 1 and April 15, 2009.  Recall: March 3, 2009 (red bar).

Sprout-2009-05-08_epi.jpgWright County Egg Salmonella Outbreak 2010 - In July 2010, CDC identified a nationwide sustained increase in the number of Salmonella Enteritidis isolates with PFGE pattern JEGX01.0004 uploaded to PulseNet.  From May 1 to November 30, 2010, a total of 3,578 illnesses were reported.  Based on the previous 5 years of reports to PulseNet, the CDC would expect approximately 1,639 total illnesses to occur during this same period. This means there are approximately 1,939 reported illnesses that are likely to be associated with this outbreak.  There was one death.  Recall: August 13, 2010 (red bar).

2010-Egg-120210_epi.jpgJimmy Johns Salmonella Sprout Outbreak 2010 - From November 1, 2010, through February 9, 2011, 140 individuals infected with the outbreak strain of Salmonella serotype I 4,[5],12:i:-, whose illnesses began (onset dates) since November 1, were reported from 26 states and the District of Columbia. The number of ill persons identified in each state and the District of Columbia with the outbreak strain is as follows: Arkansas (1), California (1), Colorado (1), Connecticut (1), District of Columbia (1), Georgia (1), Hawaii (1), Iowa (1), Illinois (70), Indiana (13), Kentucky (1), Louisiana (1), Massachusetts (2), Maryland (1), Missouri (23), Nebraska (1), Nevada (1), New Jersey (1), New York (2), North Carolina (1), Oregon (1), Pennsylvania (4), South Carolina (1), South Dakota (1), Tennessee (2), Virginia (2), and Wisconsin (4). Among 138 persons for whom information is available, reported illness onset dates range from November 1 to January 18, 2011.  Recall: December 29, 2010 (red bar).

Jimmy-Johns-2010-021011_epi.jpgCargill Ground Turkey Salmonella Outbreak 2011 - A total of 136 persons infected with the outbreak strain of Salmonella Heidelberg were reported from 34 states with illness onset dates between February 27 and September 13, 2011. The number of ill persons identified in each state was as follows: Alabama (1), Arkansas (1), Arizona (3), California (7), Colorado (4), Connecticut (1), Georgia (2), Illinois (16), Indiana (2), Iowa (2), Kansas (3), Kentucky (2), Louisiana (1), Massachusetts (4), Maryland (1), Michigan (12), Minnesota (2), Mississippi (2), Missouri (7), Nebraska (2), Nevada (1), New Jersey (1), New York (3), North Carolina (4), Ohio (12), Oklahoma (2), Oregon (1), Pennsylvania (8), South Dakota (3), Tennessee (2), Texas (18), Utah (1), Vermont (1), and Wisconsin (4).  One death was reported.  Among persons for whom information was available, illnesses began on or after February 27, 2011.  Recall: August 3, 2011 (red bar).

CargillRecall.jpg

Pine Nuts Salmonella Outbreak 2011 - A total of 43 individuals infected with the outbreak strain of Salmonella Enteritidis were reported from 5 states. The number of ill persons identified in each state with the outbreak strain was as follows: Maryland (1), New Jersey (2), New York (28), Pennsylvania (8), and Virginia (4).  Among 43 persons for whom information was available, illnesses began on or after August 20, 2011.  Recall:  October 26, 2011 (red bar).

Pine Nuts - 111711epi.jpgDog Food Salmonella Outbreak 2012 - A total of 22 individuals infected with the outbreak strain of Salmonella Infantis have been reported. Twenty ill persons have been reported from 13 states. The five new cases are from: Alabama (1), California (1), Illinois (1), New York (1), and South Carolina (1).  Additionally, two ill persons have been reported from Canada.  Among persons for whom information is available, illnesses began between October 2011 and May 11, 2012.  Recall:  April 2, 2012 (red bar).

Dog-Food061312-epi.jpgSo, readers and subscribers, what are the solutions to getting on top of outbreaks earlier and making recalls actually recalls? 

The goal of course it to avoid the outbreak and the recall in the first place.

One other pet peeve, many of the people who are sickened in an outbreak are never told by local, state or federal health authorities that they are part of an outbreak.  Why is that?

  • Glen Neal

    Hi Bill
    Two things
    1) An epidemic curve should dip post recall – remove the cause: remove the effect. Any curve that climbs post recall indicates the wrong perp has been collared.
    2) To Illness onset (x-axis) add the delay to seek medical attention, submit a specimen, lab detection, reporting and investigation – that is at least 7 days worth of time lapse and this is key limiting factor to interupting transmission.
    Agree it would be great to sort them out sooner.
    Cheers
    Glen

  • mommm!!!

    I don’t think it means that the wrong product has been collared. I think it means that it wasn’t effectively advertised to the public. I have a very hard time finding recalls of food, which is why I’m so glad to have found this place.
    I think the food manufacturers have too many laws of protection in place, of course, protecting themselves, not the consumers. I think that the merry go round of authoritative positions between government agencies like the USDA and private group or corporations like the beef groups or major food conglomerates is another major problem. There also seems to be no recourse for the consumer. I mean, you can’t even get so much as a refund most times on recalled foods. Also, giant food companies that are repeat offenders are still operating. They have adopted a “too big to fail” strangle hold on us that really needs to go. There’s no threat of going out of business when they come up dirty time and time again. Yet, if a restaurant is deemed unclean to a certain point, it is shut down and publicly shamed.

  • gary

    I think there should be a self-reporting website where anyone in the US can report diarrhea, vomiting, fever etc. Report what you ate, where you ate. The constantly vigilant food poisoning supercomputer bot, Ralf, statistically analyzes all data all the time and makes a determination when analyses are significantly relevant that humans should be bothered with the probability there is an outbreak. This should all be between individuals and Ralf. No reliance on health care professionals except they can report too on behalf of patients, no CDC, no FDA . Ralf can do 16 quadrillion calculations per second, so he’s starved for data, bring it on.
    ,

  • Melanie

    As a (human, not metal and plastic) epidemiologist, I have to say: GARY, YOU ARE HILARIOUS!