127 infected with Salmonella Braenderup and 16 with Salmonella Worthington
On August 29, 2012 the CDC announced that local, state and federal agencies were conducting an investigation into the source of an apparent outbreak of Salmonella serotype Braenderup. Results of their collaborative efforts implicated mangoes as the likely source of the outbreak. By October 11, 2012, the day the CDC declared the outbreak to be over a total of 127 persons infected with the outbreak strain of Salmonella Braenderup had been reported from 15 states. The number of ill persons identified in each state was as follows: California (99), Delaware (1), Hawaii (4), Idaho (1), Illinois (2), Maine (1), Michigan (1), Montana (1), Nebraska (1), New Jersey (1), New York (3), Oregon (1), Texas (2), Washington (8), and Wisconsin (1).
Among persons for whom information is available, illness onset dates ranged from July 3, 2012 to September 1, 2012. Ill persons ranged in age from less than 1 year to 86 years, with a median age of 33 years. Fifty-six percent of ill persons were female. Among 101 persons with available information, 33 (33%) reported being hospitalized, and no deaths were reported.
The CDC also noted that in August 2012 public health officials investigated an outbreak of Salmonella Worthington in 16 patients residing in 3 states. Ill persons were reported from similar states and during the same time period as seen in the Salmonella Braenderup outbreak. Eighty-nine percent of ill persons with Salmonella Worthington who were interviewed reported consuming mangoes in the week before their illnesses began. One person counted as an outbreak case in the Salmonella Braenderup outbreak was co-infected with Salmonella Worthington, a finding that suggested a possible connection between the two outbreaks.
Product traceback initially led investigators to mangoes distributed by Splendid Products of Burlingame, California. The company issued a recall of certain lots of Daniella brand mangoes on August 29th which was followed by an FDA warning to consumers the next day. The mangoes were sold between July 12, 2012 and August 29, 2012 at various stores throughout the United States. FDA investigators traced the mangoes to Agricola Daniella, a mango supplier with multiple farms and a single packing house located in Sinaloa, Mexico. Three other distributors were identified, Coast Citrus Distributors, Inc. of San Diego, Food Source Inc. of Edinburg, Texas, and GM Produce Sales of Hidalgo, Texas. Recalls of mangoes by firms supplied by these distributors were issued.
The FDA issued a second warning on September 13th after FDA laboratories had isolated Salmonella in mangoes from Agricola Daniella. Agricola was place on “Import Alert” which meant their mangoes would be denied admission into the United States until such time they could show they were not contaminated with Salmonella.
The causal link between one of our clients, Dorothy Pearce’s, Salmonella infection and Daniella mangoes is clear. On August 8, 2012 Mrs. Pearce purchased mangoes at the Haggen Grocery Store located in Stanwood, Washington. Public health investigators at the Snohomish Health District confirmed that this store received a shipment of Daniella mangoes from Charlie’s Produce. Mrs. Pearce experienced symptom onset on August 20, 2012. Her stool specimen collected on August 22nd was positive for Salmonella at PACLAB Network Laboratories. The Washington Department of Health (WDOH) Public Health Laboratory (PHL) serotyped her isolate as Salmonella Braenderup. The WDOH PHL conducted Pulsed Field Gel Electrophoresis (PFGE) on Mrs. Pearce’s isolate (Specimen ID#21096). Results showed that Mrs. Pearce was infected with JBPX01.0101, the strain associated with the Daniella mango outbreak. Mrs. Pearce spent 10 days in the hospital and still has not yet regained her pre-illness 92 year old vigor.