Seattle-King County Public Health Friday announced it is investigating a salmonellosis outbreak caused by Salmonella Stanley, an uncommon strain of Salmonella bacteria.

Six persons infected with Salmonella Stanley were reported to Public Health during July 17–July 24.

On July 26-27, genetic fingerprinting results for four of the six cases became available, and all had the same genetic fingerprint, suggesting that they have some common source of infection; genetic fingerprinting for the other two cases is pending.

This fingerprint has only been seen twice before in King County where two to six cases of Salmonella Stanley have been reported annually over the past several years. Public Health is attempting to interview each case to gather information about possible risk factors for infection.

The source of the outbreak is still under investigation.

The median age of the cases is 21 years; three cases are female and three are male. None of the cases are known to have been hospitalized. Additional details on the investigation will be posted as they are available.

Salmonellosis is a bacterial infection that is often spread through the fecal-oral route, through contaminated food and water, or through contact with animals and their environments. Symptoms of salmonellosis include nausea, vomiting, diarrhea, headache, fever, chills, and abdominal cramping. Illness typically lasts several days and people can spread infection to others even after symptoms resolve.

To prevent Salmonella infection:

  • Wash hands with soap and water after going to the bathroom, changing diapers, touching animals, and before eating or preparing food.
  • Cook all meats thoroughly, especially poultry.
  • Wash cutting boards and counters used for meat or poultry preparation immediately after use to avoid cross contaminating other foods.

Here is an interesting research article on the likely source of the outbreak.

Characterization of Isolates of Salmonella enterica Serovar Stanley, a Serovar Endemic to Asia and Associated with Travel

Rene S. Hendriksen,a Simon Le Hello,b Valeria Bortolaia,a Chaiwat Pulsrikarn,d Eva Møller Nielsen,c Srirat Pornruangmong,d Phattharaporn Chaichana,d Christina Aaby Svendsen,a François-Xavier Weill,b and Frank M. Aarestrupa J Clin Microbiol. 2012 Mar; 50(3): 709–720. doi:  10.1128/JCM.05943-11 This article has been cited by other articles in PMC. Go to: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3295172/

Abstract

Salmonella enterica serovar Stanley (S. Stanley) is a common serovar in Southeast Asia and was the second most common serovar implicated in human salmonellosis in Thailand in the years 2002 to 2007. In contrast, this serovar is relatively uncommon in Europe. The objective of this study was to characterize a collection of S. Stanley strains isolated from Thai (n = 62), Danish (n = 39), and French (n = 24) patients to gain a broader understanding of the genetic diversity, population dynamics, and susceptibility to antimicrobials. All isolates were characterized by pulsed-field gel electrophoresis and antimicrobial susceptibility testing. The molecular mechanisms of resistance to extended-spectrum cephalosporins and plasmid-mediated resistance to quinolones were characterized by PCR and sequencing. Plasmid profiling, replicon typing, and microarray analysis were used to characterize the genetic mechanisms of antimicrobial resistance in 10 extended-spectrum cephalosporinase-producing isolates. Considerable
genetic diversity was observed among the isolates characterized with 91 unique XbaI pulsed-field gel electrophoresis (PFGE) patterns, including 17 distinct clusters consisting of two to seven indistinguishable isolates. We found some of the S. Stanley isolates isolated from patients in Europe were acquired during travel to Southeast Asia, including Thailand. The presence of multiple plasmid lineages carrying the extended-spectrum cephalosporinase-encoding blaCMY-2 gene in S. Stanley isolates from the central part of Thailand was confirmed. Our results emphasize that Thai authorities, as well as authorities in other countries lacking prudent use of antimicrobials, should improve the ongoing efforts to regulate antimicrobial use in agriculture and in clinical settings to limit the spread of multidrug-resistant Salmonella isolates and plasmids among humans and pigs in Thailand and abroad.

Salmonella is an organism that can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella often experience fever, diarrhea, nausea, vomiting and abdominal pain.

Grande Produce has announced a voluntary recall of a limited quantity of Papaya Maradol (with the brand name Caribeña labeled on cartons) distributed during the dates of July 10 and July 19 due to a potential health risk from Salmonella.

According to Grande Produce, a Maryland distribution center where the papayas were delivered has already notified retail customers to remove the recalled papayas from inventories, store shelves and the stream of commerce.  Recall effectiveness checks are already underway by Grande Produce.

The only papayas subject to the recall carry a “Caribeña” brand label on cartons and were shipped during the dates of July 10 to July 19.  No other papayas or fresh produce distributed by Grande Produce are subject to the recall.

Grande Produce has ceased importation of papayas from the grower and is taking all precautionary measures to ensure the safety of its imported produce.  The company is also coordinating closely with the U.S. Food and Drug Administration and other regulatory agencies in their investigations and will provide any assistance possible.

The Loudoun County Health Department has identified more than 135 individuals who reported becoming ill after visiting the Chipotle Mexican Grill at 21031 Tripleseven Road, Sterling, VA 20165 between July 13 and 16, 2017. “Two ill patrons have tested positive for the same strain of norovirus. Based on symptoms reported and these preliminary laboratory results, the cause of the outbreak is believed to be norovirus, though the specific source of the norovirus has not yet been identified,” said Dr. David Goodfriend, director of the Health Department. “The Health Department is not aware of any customers becoming ill since the reopening of the facility last Wednesday.”

According to the Centers for Disease Control and Prevention (CDC), 1 in 6 Americans gets sick from contaminated food each year. Norovirus (sometimes called “stomach flu”) is the most common cause of foodborne illness. People infected with norovirus usually develop symptoms 12 to 48 hours after being exposed to norovirus and most people who are ill get better within one to three days. Frequent hand washing and staying home when sick are two of the most important means of preventing the spread of infection.

The public is encouraged to contact the Loudoun County Health Department at health@loudoun.gov with any questions or concerns.

And, then there is this:

I dropped an Op-ed on the Hill this morning.  Here is an excerpt:

This week the CDC reported that at least 47 people were stricken with Salmonella, with one death, likely linked to papayas imported from Mexico. In the summer of 2016 came reports of hepatitis A tainted scallops sickening 292 in Hawaii. In that outbreak two died of liver failure complications. And, also in 2016, 143 people, mostly in Virginia, were also stricken with hepatitis A. This time the culprit was hepatitis A-tainted strawberries imported from Egypt.

While most food we consume is still produced in the United States, we rely on imports for some of our most nutritionally important but more risky commodities. And, imported food is increasingly taking a larger “bite” out of our food consumption. We now import over 90 percent of our seafood, 50 percent of our fresh fruit and 20 percent of our vegetables. Canada, Mexico, China and India are our top food trading partners. In 2014, we imported nearly $50 billion of food from just those four countries. Imports from all countries have increased, and that is especially true for China and India.

A nationwide baked beans recall has been issued for three varieties of Bush’s Best Baked Beans because a canning defect could allow harmful bacterial growth.

Bush is voluntarily recalling certain 28 ounce cans of Brown Sugar Hickory Baked Beans, Country Style Baked Beans and Original Baked Beans because cans may have defective side seams. These side seam defects may affect can integrity and may cause the cans to leak or allow for harmful bacteria to grow inside the product. Bush Brothers found the issue as part of their quality control inspections.

The recalled products were distributed nationwide in retail stores.

Bush’s Best Baked Beans Recall Affected Products:

[July 22, 2017]: BUSH’S BEST BROWN SUGAR HICKORY BAKED BEANS Voluntary Recall – 28 ounce with UPC of 0 39400 01977 0 and Lot Codes 6097S GF and 6097P GF with Best By date of Jun 2019 
[July 22, 2017]: BUSH’S BEST COUNTRY STYLE BAKED BEANS Voluntary Recall – 28 ounce with UPC of 0 39400 01974 9 and Lot Codes 6077S RR, 6077P RR, 6087S RR, 6087P RR with the Best By date of Jun 2019 
[July 22, 2017]: BUSH’S BEST ORIGINAL BAKED BEANS Voluntary Recall  28 ounce with UPC of 0 39400 01614 4 and Lot Codes 6057S LC and 6057P LC with the Best By date of Jun 2019 
This event only affects the flavors and lot codes below. Lot codes are printed on the bottom of the can.

You should not use these products even if the beans do not look or smell spoiled. No illnesses or other adverse consequences have been reported to date in connection with this product.

The recall was initiated after product leakage from the side seams of cans of the above product was detected. Subsequent investigation indicated a temporary quality issue from Bush’s can supplier caused the problem. The problem was corrected and no other product is affected.

Illnesses in Iowa, 1, Kentucky, 1, Louisiana, 1, Maryland, 5, Massachusetts, 1, Minnesota, 1, New Jersey, 12, New York, 13, Pennsylvania, 4, Texas, 1, Utah, 1 and Virginia, 6.

The CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Salmonella Kiambu infections.

As of July 21, 2017, 47 people infected with the outbreak strain of Salmonella Kiambu have been reported from 12 states. A list of the states and the number of cases in each can be found on the Case Count Map page. WGS showed that isolates from people infected with Salmonella Kiambu are closely related genetically. This close genetic relationship means that people in this outbreak are more likely to share a common source of infection.

Illnesses started on dates ranging from May 17, 2017 to June 28, 2017. Ill people range in age from less than 1 year to 95, with a median age of 27. Among ill people, 67% are female. Among 31 people with available information, 18 (58%) are of Hispanic ethnicity. Among 33 people with available information, 12 (36%) report being hospitalized. One death was reported from New York City.

Epidemiologic and laboratory evidence collected to date indicate that yellow Maradol papayas are a likely source of this multistate outbreak. This investigation is ongoing.

An illness cluster in Maryland was identified. An illness cluster is defined as two or more people who do not live in the same household who report eating at the same restaurant location, attending a common event, or shopping at the same location of a grocery store in the week before becoming ill. In Maryland, several ill people reported eating papayas purchased from the same location of a grocery store. Salmonella Kiambu and Salmonella Thompson were isolated from samples collected from ill people. Investigating illness clusters provides critical clues about the source of an outbreak. If several unrelated ill people ate or shopped at the same location of a restaurant or store within several days of each other, it suggests that the contaminated food item was served or sold there.

The Maryland Department of Health collected papayas from the grocery store associated with the illness cluster to test for Salmonella. One sample yielded the outbreak strain of Salmonella Kiambu and another sample yielded Salmonella Thompson. Both samples were from yellow Maradol papayas. WGS showed that the Salmonella Kiambu papaya isolate is closely related genetically to the Salmonella Kiambu isolates from ill people. This result provides more evidence that people in this outbreak got sick from eating contaminated yellow Maradol papayas. CDC is working to collect additional information to determine whether the recent Salmonella Thompson illness in Maryland is part of this multistate outbreak.

Based on the available evidence, CDC recommends that consumers not eat, restaurants not serve, and retailers not sell yellow Maradol papayas until we learn more.

The FDA, CDC, MDH and other state and local officials are investigating Salmonella Kiambu and Salmonella Thompson illnesses linked to Caribeña brand Maradol papayas from Mexico distributed by Grande Produce in San Juan, TX.

FDA and state partners continue to investigate the distribution of the papayas involved in this outbreak. It appears the distribution pattern of Caribeña brand Maradol papayas does not explain all of the illnesses, meaning other firms likely have distributed contaminated Maradol papayas as well. At this time, the farm(s) producing these papayas appear to only be in Mexico.

CDC reports 47 cases, 12 hospitalizations and one death from 12 states in the Salmonella Kiambu outbreak. The states involved are IA, KY, LA, MA, MD, MN, NJ, NY, PA, TX, UT and VA. CDC is working to collect additional information to determine whether the recent Salmonella Thompson illness in Maryland is part of this multistate outbreak.

On June 26, 2017, the CDC notified the FDA about a Salmonella Kiambu cluster detected by PulseNet. All 47 cases have the same pattern by pulsed-field gel electrophoresis (PFGE). Whole Genome Sequencing (WGS) analysis was conducted on ten patient samples in the outbreak cluster and all were highly related. This indicates that the patients were likely sickened by the same type of food.

MDH informed the FDA, CDC and state partners that several ill people shopped at the same Baltimore retail location and purchased papayas. Records and samples of green and yellow papaya were collected. On July 17, 2017, Maryland reported that three of ten samples had preliminarily tested positive for Salmonella. All positive samples were Caribeña brand yellow Maradol papayas from Mexico; none of the green papayas were positive. However, as noted above, Maradol papayas are green before they ripen and turn yellow, so consumers should not eat Caribeña brand papayas regardless of the color.

On July 19, 2017, MDH issued an advisory warning consumers not to eat Caribeña brand yellow Maradol papayas. Further WGS testing linked one of the papaya samples to the Salmonella Kiambu outbreak and another to Salmonella Thompson.

The Minneapolis Star-Tribune reports that a 5-year-old Wright County boy is fighting for his life after contracting a strain of E. coli that killed his younger sister earlier this week.

Kade and Kallan Maresh were sickened by a shiga toxin-producing bacteria on July 9, eventually sending them into acute kidney failure. State health officials are investigating the source for the E. coli that eventually led to hemolytic uremic syndrome (HUS), a complication of the bacterial infection.

Parents Joseph and Tyffani Maresh said the toxin from the bacteria attacked their 3-year-old daughter’s kidneys and her neurological system. “Her brain and heart were being damaged,” the family said. “Our sweet sweet little girl lost the battle. … Kade is still fighting.” Kallan would have turned 4 next month. “We were able to give Kallan a bath and put her favorite jammies on her,” her parents wrote in a journal entry on Sunday. “We got to hold her free of tubes and snuggle and kiss her. She is the most amazing little girl in the world. Our hearts are aching with the deepest sadness.”

Deaths resulting from HUS, which causes kidneys to stop working and red cells to be destroyed, are very rare, said Joni Scheftel, supervisor of the zoonotic diseases unit at the Minnesota Department of Health. Children and the elderly are most at risk, she said.

In an “abundance of precaution,” the animals at a petting zoo the children recently visited were taken off display, she said.

But the children could have been infected with E. coli from any number of other sources that health officials are investigating, she said.

Health officials may be able to zero in on the source by next week once lab results are in, Scheftel said. So far, no other similar cases have been reported, she said.

See www.fair-safety.com

The Food Standards Agency of Scotland (FSAS) has announced that Macsween of Edinburgh Ltd has recalled a number of its products, including products manufactured for Lidl and Marks & Spencer, as a precautionary measure, because of concerns over the company’s procedures in place to control Clostridium botulinum.

FSAS reports that manufacturing controls that could potentially affect the safety of the products could not be demonstrated satisfactorily by the manufacturer. The issue relates to controlling factors to prevent the growth and toxin production of Clostridium botulinum. Botulinum toxin may cause a serious form of food poisoning called botulism and can be fatal.  A recall from customers is being carried out as a precautionary measure.

The recall concerns a wide variety of Haggis (Haggis is a savoury pudding containing sheep‘s pluck (heart, liver and lungs); minced with onionoatmealsuetspices, and salt, mixed with stock, traditionally encased in the animal’s stomach), as well as Black and White Pudding (White pudding is similar to black pudding, but does not include blood; both consists of pork meat and fat, suet, bread and oatmeal formed into a large sausage).

According to Food Safety News, the E. coli outbreak in southwest Utah that has already killed two is growing, and public health officials there have warned people to avoid consuming raw milk or recently purchased ground beef.

Officials with the Southwest Utah Public Health Department initially reported six victims in a July 3 health alert. As of Tuesday, 11 victims had been confirmed. The first victim was a 3-year-old boy who died in June. He and the other fatality, a 6-year-old girl, were not related but they lived in the same apartment building in Hildale.

The source of the outbreak in Hildale, UT, remains under investigation, according to health department spokesman David Heaton who is quoted in local media reports.

Heaton told the Salt Lake Tribune newspaper on Tuesday that the public alert about raw milk and “recently purchased ground beef” is a standard warning and that there is not a confirmed link to such products. He also told the newspaper there could be multiple sources for the E. coli, or the original patient could have contaminated food or surfaces, resulting in additional people becoming infected.

Many news outlets have noted a bit too often that the E. coli outbreaks victims come from Hildale, which is the headquarters of the Fundamentalist Church of Jesus Christ of Latter Day Saints, which broke off from the main Mormon church in 1913 and continues the practice of polygamy. The original Church of Jesus Christ of Latter Day Saints discontinued plural marriages in 1890.

My response is that all of us – regardless of politics or religion – need to do all we can to combat E. coli.

Vaccinations urged for all people not immune.

According to the San Diego County Health and Human Services Agency, 228 cases of hepatitis A have been reported in 2017, with 161 people hospitalized during the outbreak.  There have been 5 deaths. Public health investigators continue to evaluate cases, but most of those who have become ill are either homeless and/or illicit drug users. Hepatitis A is most commonly spread person-to-person through the fecal-oral route. The disease can be prevented by getting vaccinated. So far, officials said no common food, drink or drug source has been identified as the cause.

In addition, the number of hepatitis A cases over last year in Macomb, Oakland, Wayne and St. Clair counties has increased tenfold, spawning a Michigan Department of Health and Human Services investigation. 190 cases have been reported between August 1, 2016 and June 26, 2017, which has resulted in 10 deaths so far. Officials said it represents a significant health threat, with links to either illicit drug use, sexual activity or close contact among household members.

Symptoms of hepatitis A include jaundice, fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine and light-colored stools. Symptoms usually appear over several days and last less than two months. However, some people can be ill for as long as six months. Hepatitis A can also sometimes cause liver failure and death.