2013 Salmonella Outbreak Linked to Ground Beef

Introduction

CDC collaborated with public health officials in many states and the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS) to investigate a multistate outbreak of Salmonella Typhimurium infections linked to ground beef produced by Jouni Meats, Inc. and Gab Halal Foods. Public health investigators used DNA “fingerprints” of Salmonella bacteria obtained through diagnostic testing with pulsed-field gel electrophoresis (PFGE) to identify cases of illness that may be part of this outbreak. They used data from PulseNet, the national subtyping network made up of state and local public health laboratories and federal food regulatory laboratories that performs molecular surveillance of foodborne infections. This PFGE pattern has rarely been seen before in PulseNet and in the past typically caused 0-1 cases per month.

A total of 22 persons infected with the outbreak strain of Salmonella Typhimurium were reported from 6 states. The number of ill persons identified in each state was as follows: Arizona (1), Illinois (2), Iowa (1), Michigan (9), Pennsylvania (1), and Wisconsin (8).

Among persons for whom information was available, illness onset dates ranged from December 9, 2012 to February 20, 2013. Ill persons ranged in age from 2 years to 87 years, with a median age of 45 years. Fifty-five percent of ill persons were male. Among 14 persons with available information, 7 (50%) ill persons were hospitalized. No deaths were reported.

This particular outbreak appears to be over. While the use-by date of the recalled ground beef has passed, consumers might still have recalled ground beef in their homes if the ground beef was frozen at home. Consumers should check their freezers for recalled ground beef products and should not eat them.

Investigation of the Outbreak

Epidemiologic, laboratory, and traceback investigations conducted by officials in local, state, and federal public health, agriculture, and regulatory agencies linked this outbreak to ground beef produced by Jouni Meats, Inc. and Gab Halal Foods.

Initial investigations focused on seven ill persons in Michigan (6) and Arizona (1) who reported eating at the same restaurant before their illness began. All seven of these ill persons reported eating raw ground beef kibbeh (a dish typically made of finely ground red meat, usually beef, minced onions, and bulghur wheat) at this restaurant before becoming ill.

An additional nine ill persons were interviewed and answered questions about foods consumed and other exposures during the week before becoming ill. Although several of these ill persons reported eating beef prior to becoming ill, a likely source was not identified that linked these illnesses with the illnesses at the restaurant.

Results of antibiotic susceptibility testing indicated that this strain of Salmonella was susceptible to commonly prescribed antibiotics.

On January 24, 2013, Jouni Meats, Inc. recalled approximately 500 pounds of ground beef products. On January 25, 2013, Gab Halal Foods recalled approximately 550 pounds of ground beef products. While the use-by date has passed and these products are no longer available for retail sale, FSIS is concerned that some product may be frozen in consumers’ freezers. Consumers should not eat the recalled ground beef, and retailers and food service establishments should not serve it.

Salmonella is an important cause of human illness in the United States. More information about Salmonella infections, and steps people can take to reduce their risk of infection, can be found on the CDC Salmonella Web Page.

March 15, 2013

Final Case Count Update

A total of 22 persons infected with the outbreak strain of Salmonella Typhimurium were reported from 6 states. Since the last update, four new ill persons were reported from Wisconsin (3) and Pennsylvania (1).

Among persons for whom information was available, illness onset dates ranged from December 9, 2012 to February 20, 2013. Ill persons ranged in age from 2 years to 87 years, with a median age of 45 years. Fifty-five percent of ill persons were male. Among 14 persons with available information, 7 (50%) ill persons were hospitalized. No deaths were reported.

February 13, 2013

Case Count Update

A total of 18 persons infected with the outbreak strain of Salmonella Typhimurium have been reported from 5 states. Two new cases have been reported from Wisconsin since the last update.

Among persons for whom information is available, illness onset dates range from December 9, 2012 to January 7, 2013. Ill persons range in age from 2 years to 87 years, with a median age of 47 years. Fifty percent of ill persons are female. Among 14 persons with available information, 7 (50%) patients reported being hospitalized. No deaths have been reported.

Illnesses that occurred after January 24, 2013 might not be reported yet due to the time it takes between when a person becomes ill and when the illness is reported.

Initial Announcement

January 25, 2013

CDC is collaborating with public health officials in many states and the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS) to investigate a multistate outbreak of Salmonella Typhimurium infections. Public health investigators are using DNA “fingerprints” of Salmonella bacteria obtained through diagnostic testing with pulsed-field gel electrophoresis, or PFGE, to identify cases of illness that may be part of this outbreak. They are using data from PulseNet, the national subtyping network made up of state and local public health laboratories and federal food regulatory laboratories that performs molecular surveillance of foodborne infections.

A total of 16 individuals infected with the outbreak strain of Salmonella Typhimurium have been reported from 5 states. The number of ill people identified in each state with the outbreak strain is as follows: Arizona (1), Illinois (2), Iowa (1), Michigan (9), and Wisconsin (3).

Among 16 persons for whom information is available, illness onset dates range from December 9, 2012 to January 7, 2013. Ill persons range in age from 2 years to 87 years, with a median age of 48 years. Forty-three percent of ill persons are female. Among 13 persons with available information, 7 (53%) reported being hospitalized. No deaths have been reported. Preliminary results of antibiotic susceptibility testing indicate that this strain of Salmonella Typhimurium is susceptible to commonly prescribed antibiotics.

This PFGE pattern has rarely been seen before in PulseNet and in the past typically caused 0-1 case per month. The outbreak can be visually described with a chart showing the number of people who became ill each day or week. This chart is called an epi curve. Illnesses that occurred after January 3, 2013 might not be reported yet due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 2 to 3 weeks. For more details, please see Salmonella Outbreak Investigations: Timeline for Reporting Cases.

Investigation of the Outbreak

Epidemiologic and traceback investigations conducted by officials in local, state, and federal public health, agriculture, and regulatory agencies indicate that ground beef produced by Jouni Meats, Inc. and Gab Halal Foods are likely sources of this outbreak of Salmonella Typhimurium infections.

Initial investigations focused on six ill persons in Michigan and one ill person in Arizona who reported eating at the same restaurant before their illness began. All seven of these ill persons reported eating raw ground beef kibbeh (a dish typically made of finely ground red meat, usually beef, minced onions, and bulghur wheat) at this restaurant before becoming ill. Investigations are ongoing to determine if the additional nine ill persons may be linked to the recalled products.

CDC and state and local public health partners are continuing laboratory surveillance through PulseNet to identify additional ill persons and to interview ill persons about foods eaten before becoming ill. FSIS is continuing to work closely with CDC and state partners during this investigation. CDC will update the public on the progress of this investigation as information becomes available.