2018 Salmonella Infections Linked to Contact with Live Poultry in Backyard Flocks, 2018 (Final Update)

Posted September 13, 2018 at 11:00 AM ET

These outbreak investigations are over. However, people can still get a Salmonella infection from live poultry, including those in backyard flocks. Read more information about Salmonella from live poultry and how people can reduce the chance they or their children will get an infection.

Final Outbreak Advisory

334
Cases

47
States

56
Hospitalizations

0
Deaths

CDC and multiple states investigated several multistate outbreaks of Salmonella infections linked to contact with live poultry in backyard flocks.
- People can get sick with Salmonella infections from touching live poultry or their environment. These birds can be carrying Salmonella bacteria but appear healthy and clean and show no signs of illness.
- Several different types of Salmonella bacteria have made people sick in these outbreaks: Salmonella Seftenberg, Salmonella Montevideo, Salmonella Infantis, Salmonella Enteritidis, Salmonella Indiana, and Salmonella Litchfield.
A total of 334 people were infected with the outbreak strains of Salmonella reported from 47 states.
- Illnesses started from February 15, 2018 to August 10, 2018.
- 56 ill people were hospitalized, and no deaths were reported.
- 21% of ill people were children younger than 5 years.
Epidemiologic, traceback, and laboratory findings linked these outbreaks to contact with live poultry, such as chicks and ducklings, which came from multiple hatcheries.
- In interviews, 132 (63%) of 211 ill people with information available reported contact with chicks or ducklings in the week before their illness started.
- People reported obtaining chicks and ducklings from several sources, including feed supply stores, websites, hatcheries, and from relatives.
Whole genome sequencing analysis was performed on 141 isolates from ill people in this outbreak. Twenty-eight isolates contained genes that predict resistance to at least one of the following antibiotics: ampicillin, streptomycin, sulfamethoxazole, tetracycline, gentamicin, ceftriaxone, amoxicillin-clavulanic acid, cefoxitin, ciprofloxacin, and fosfomycin. No resistance was identified in 113 isolates. Testing of 6 isolates using standard antibiotic susceptibility testing by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory confirmed these results. Some of these antibiotic-resistant infections may be difficult to treat with the commonly recommended antibiotics, and may require a different antibiotic choice.
These outbreak investigations are over. CDC will continue to work with state public health partners to monitor for the occurrence of Salmonella infections associated with contact with live poultry in backyard flocks.

Mail-order hatcheries should provide health-related information to owners and potential purchasers before they buy any birds (see example below). This should include information about preventing Salmonella infections from contact with live poultry.

A flier [PDF – 632 KB] describing the risk of Salmonella infections from contact with live poultry and prevention recommendations is available.

Mail-order hatcheries should put interventions in place to help prevent contamination and infection of poultry with Salmonella:

Best Management Practices Handbook: A Guide to the Mitigation of Salmonella Contamination at Poultry Hatcheries [PDF – 1.4 MB]

Mail-order hatcheries should participate in the voluntary USDA-NPIP U.S. Salmonella Monitored Program [PDF – 279 KB], in which mail-order hatcheries certify their flocks are monitored for Salmonella bacteria that may cause illness in humans. The intent of this program is to reduce the incidence of Salmonella in day-old poultry in the hatchery and give the poultry industry a better opportunity to reduce the incidence of Salmonella in their products.

Agricultural feed stores should take steps to prevent Salmonella infections from contact with live poultry:

Source the birds they sell from suppliers that have adopted the U.S. Department of Agriculture’s (USDA’s) best management practices to mitigate Salmonella contamination [PDF – 1.4 MB] and which voluntarily participate in the USDA’s National Poultry Improvement Plan (USDA-NPIP) U.S. Salmonella Monitored Program [PDF – 279 KB].
Provide health information to owners and potential purchasers of these birds before purchase (see sample flier below). This should include information about the risk of acquiring a Salmonella infection from contact with live poultry.
- A flier [PDF – 632 KB] describing the risk of Salmonella infections from contact with live poultry and prevention recommendations is available.
Place health information in clear view where birds are displayed.
Provide hand washing stations or hand sanitizer next to poultry display areas and tell customers to wash hands right after leaving these areas.
Display poultry out of reach of customers, especially children, so customers cannot easily touch birds.
Clean and sanitize the areas where birds are displayed between shipments of new birds. Be sure to remove debris first so that the disinfectant is applied to a surface that is generally clean. Apply the disinfectant on the surface for the proper contact time listed on the disinfectant label.
More information on displaying animals in public settings can be found in the 2017 Compendium of Measures to Prevent Diseases Associated with Animals in Public Settings.

Previous Outbreak Advisories

212
Cases

44
States

34
Hospitalizations

0
Deaths

Since the last update on June 8, 2018, 88 more ill people have been reported. The most recent illness began on June 21, 2018.
CDC and multiple states are investigating several multistate outbreaks of Salmonella infections linked to contact with live poultry in backyard flocks.
- People can get sick with Salmonella infections from touching live poultry or their environment. These birds can be carrying Salmonella bacteria but appear healthy and clean and show no signs of illness.
- Several different types of Salmonella bacteria have made people sick in this outbreak: Salmonella Seftenberg, Salmonella Montevideo, Salmonella Infantis, Salmonella Enteritidis, Salmonella Indiana, and Salmonella Litchfield.
As of July 13, 2018, 212 people infected with the outbreak strains of Salmonella have been reported from 44 states.
- Illnesses started from February 15, 2018 to June 21, 2018.
- 34 ill people have been hospitalized, and no deaths have been reported.
- 26% of ill people are children younger than 5 years.
Epidemiologic, traceback, and laboratory findings link these outbreaks to contact with live poultry, such as chicks and ducklings, which come from multiple hatcheries.
- In interviews, 100 (72%) of 138 ill people with information available reported contact with chicks or ducklings in the week before their illness started.
- People reported obtaining chicks and ducklings from several sources, including feed supply stores, websites, hatcheries, and from relatives.
WGS analysis to identify antibiotic resistance was performed for 118 isolates from ill people in this outbreak. Twenty-two isolates from ill people contained genes expected to cause resistance or decreased susceptibility to all or some of the following antibiotics: ampicillin, streptomycin, sulfamethoxazole, tetracycline, gentamicin, ceftriaxone, amoxicillin-clavulanic acid, cefoxitin, ciprofloxacin, and fosfomycin. Ninety-six isolates did not identify predicted resistance. Testing of 5 outbreak isolates using standard antibiotic susceptibility testing by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory confirmed these results. Some infections may be difficult to treat with commonly recommended antibiotics, and may require another kind of antibiotic.
This investigation is ongoing, and CDC will provide updates when more information is available.

Illustration showing several chickens with text reading Always wash your hands after handling live poultry

Tips to Stay Healthy With a Backyard Flock

Always wash hands thoroughly with soap and water right after touching live poultry or anything in their environment.
Don’t let children younger than 5 years handle or touch live poultry without adult supervision.
Set aside a pair of shoes to wear while taking care of your birds and keep the shoes outside of your home.

Read more about ways to stay healthy with backyard flocks. Read live poultry Q&A.

Illustration showing a chicken with text reading Don't play chicken with your health. Wash your hands after handling backyard poultry.

Seventy outbreaks of Salmonella infections have been linked to contact with backyard flocks since 2000 [PDF – 887 KB].

CLICK TO VIEW CASE COUNT MAPS

People infected with the outbreak strains of Salmonella, by state of residence, as of August 24, 2018

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