Background information

In March 2013, the Centers for Disease Control reported on a multistate outbreak of foodborne illness related to Salmonella typhimurium in 6 states.  A total of 22 confirmed cases were listed in the report, which were indistinguishable by pulsed field gel electrophoresis (PFGE) and included 9 cases in the State of Michigan and 1 case in the State of Arizona.  The Arizona case consumed the suspect meal in Michigan during the same time period as the other Michigan cases.  Because of this outbreak two meat-processing establishments issued voluntary recalls because of the link of illnesses to their processing facilities.  Seven (7) of the Michigan cases and the 1 Arizona case consumed “Kibbeh” (a product made with raw ground beef and not further cooked), at the same restaurant “Ike’s” in Sterling Heights, Michigan.  All of the products were purchased on the same date, November 8, 2012 although one of the cases consumed the product as a leftover on the following day.  The other 6 cases consumed the product at the restaurant.  Further, 3 additional cases were epidemiologically linked to eating kibbeh at Ike’s Restaurant.

During the same time period, the United States Department of Agriculture, Agricultural Marketing Service (USDA/AMS) routinely sampled ground beef destined for their food commodity-purchasing program.  This sample, from a slaughter/processing plant in Minnesota, also matched the outbreak strain by PFGE.

The Cases

Case	First name	Last name	Meal date	Meal location	Meal item	Onset date
4302894840 60 yr. male			12/09/2012	Home, but purchased at Ike’s	Leftover kibbeh	12/11/2012
4298582187 87 yr. male			12/08/2012	Ike’s	kibbeh	12/11/2012
4318226832 17 yr. female			12/08/2012	Ike’s	kibbeh	?
4303040994 44 yr. female			12/08/2012	Ike’s	kibbeh	12/09/2012
4315648767 49 yr. female	Mary Ann	Thomas	12/08/2012	Ike’s	kibbeh	12/13/2012
4311129231 55 yr. female	Sara	Joseph	12/08/2012	Ike’s	kibbeh	12/12/2012
AZ Pl12354007 60 yr. female			12/08/2012	Ike’s	kibbeh	?

One case did not eat at Ike’s Restaurant, but the family had purchased ground beef from a meat market that was supplied by the same wholesaler as Gab Halal Foods and Jouni Halal Meats.

Case	First name	Last name	Meal date	Meal location	Meal item	Onset date
4330502377 2 yr. F			?	Home	Ground beef	12/18/2012

 

The Traceback

Ike’s Restaurant purchases ground beef from two suppliers: Gab Halal Foods also called Bob Berry & Sons and from Jouni Halal Meats.  The product is ground beef made from boneless peeled beef knuckles, which is from the primal cut sirloin.  Ike’s predominantly purchases from Gab Halal Foods and did purchase kibbeh meat on 12/06/2012- 10 pounds and on 12/08/2012-35 pounds.  However, on 12/07/2012 Gab Halal Foods was not able to provide meat for kibbeh and Ike’s purchased 25 pounds from Jouni Halal Meats.

The owner of Ike’s Restaurant stated that he does carry over kibbeh from one day to the next.  Nevertheless, since the last date of delivery from Gab Halal Foods was a 10-pound order on 12/06/2012 it is unlikely that this product would have been served on 12/08/2012 the date of consumption.  Gab Halal Foods and Jouni Halal Meats have the same wholesale supplier called Saad Wholesale Meats in Detroit, Michigan.

Saad Wholesale Meats receives beef products from American Foods Group (AFG), headquartered in Alexandria, Minnesota.  AFG has 10 beef slaughter plants in the United States and 2 of them are located in Minnesota: Dakota Premium in South St. Paul and Long Prairie Packing in Long Prairie.  As stated previously, USDA/AMS obtained a PFGE match for the outbreak strain during routine sampling of ground beef products.  The USDA/AMS does not provide detailed information on the location of the plant only that it is a plant located in Minnesota.  Additional handwritten notes received from the State of Michigan Department of Agriculture and Rural Development (MDARD) listed that USDA was in the process of conducting an EA (environmental assessment), or in-depth verification review in USDA terminology at Dakota Premium, USDA establishment 357.  Since the MDARD was in discussions with USDA, Food Safety Inspection Service (FSIS) on the impending recall by Jouni Halal Meats and Gab Halal Foods, this information was most likely provided by USDA/FSIS during a telephone conversation with an MDARD representative.  The following describes the products purchased by the companies involved:

Ike’s Restaurant purchased 10 pounds of kibbeh meat on 12/06/2012 and 35 pounds on 12/08/2012 from Gab Halal Foods.  Gab Halal Foods purchased 2-70 pound boxes of beef knuckles from Saad Wholesale Meats on 12/04/2012.  Saad Wholesale Meats purchased 14,721 pounds of beef knuckles from AFG delivery date of 11/28/2012 and 15,834 pounds of beef knuckles from AFG with a delivery date of 12/05/2012.

On 12/07/2012 Ike’s purchased 25 pounds of kibbeh meat from Jouni Halal Meats.  Jouni Halal Meats purchased 69 pounds of beef knuckles from Saad Wholesale Meats on 12/04/2012 and 158 pounds of beef knuckles on 12/07/2012.  Saad Wholesale Meats purchased 14,721 pounds of beef knuckles from AFG delivery date of 11/28/2012 and 15,834 pounds of beef knuckles from AFG with a delivery date of 12/05/2012.

In case 4330502377 ground beef was purchased (date unknown) for household consumption from Rababeh Meat Mkt. in Dearborn Heights, Michigan.  On 12/04/2012 Rababeh Meat Mkt. purchased 250 pounds of beef knuckles from Saad Wholesale Meats and on 12/07/2012 purchased 208 pounds of beef knuckles.  Saad Wholesale Meats purchased 14,721 pounds of beef knuckles from AFG delivery date 11/28/2012 and 15,834 pounds of beef knuckles from AFG with a delivery date of 12/05/2012.

Conclusion

In this investigation the most probable cause of the majority of the illness cases is the kibbeh meat from Ike’s Restaurant purchased on 12/08/2012.  The kibbeh meat came from two sources:  On 12/07/2012 Jouni Halal Meats and on 12/08/2012 Gab Halal Foods.  Either of these deliveries could have been served on 12/08/2012 as the owner of Ike’s Restaurant stated that product from previous day’s deliveries is used.

Both Gab Halal Foods and Jouni Halal Meats have the same source of beef knuckles used for grinding kibbeh meat and that is Saad Wholesale Meats.

Saad Wholesale Meats has one supplier for Halal beef knuckles and that is American Foods Group based in Alexandria, Minnesota.  Coincidently, USDA/AMS had PFGE match to the outbreak strain in a routine sample that was very likely obtained from Dakota Premium Meats, an AFG plant.  Based on this information more likely than not the meat that caused the foodborne illness outbreak was the kibbeh meat served at Ike’s Restaurant and received from Gab Halal Foods and Jouni Halal Meats.  Additionally one case was from ground beef purchased from Rababeh Meat Mkt.  All three establishments, Gab Halal Foods, Jouni Halal Meats and Rababeh Meat Mkt. received beef knuckles from Saad Wholesale Meats who purchases beef knuckles from American Foods Group, Alexandria, Minnesota.