Investigations of Possible Multistate Outbreaks of Salmonella, Shiga Toxin–Producing Escherichia coli, and Listeria monocytogenes Infections — United States, 2016

Abstract

Problem/Condition Salmonella , Shiga toxin–producing Escherichia coli (STEC), and Listeria monocytogenes are the leading causes of multistate foodborne disease outbreaks in the United States. Responding to multistate outbreaks quickly and effectively and applying lessons learned about outbreak sources, modes of transmission, and risk factors for infection can prevent additional outbreak-associated illnesses and save lives. This report summarizes the investigations of multistate outbreaks and possible outbreaks of Salmonella , STEC, and L. monocytogenes infections coordinated by CDC during the 2016 reporting period. Period Covered 2016. An investigation was considered to have occurred in 2016 if it began during 2016 and ended on or before March 31, 2017, or if it began before January 1, 2016, and ended during March 31, 2016–March 31, 2017. Description of System CDC maintains a database of investigations of possible multistate foodborne and animal-contact outbreaks caused by Salmonella , STEC, and L. monocytogenes. Data were collected by local, state, and federal investigators during the detection, investigation and response, and control phases of the outbreak investigations. Additional data sources used for this report included PulseNet, the national molecular subtyping network based on isolates uploaded by local, state, and federal laboratories, and the Foodborne Disease Outbreak Surveillance System (FDOSS), which collects information from state, local, and territorial health departments and federal agencies about single-state and multistate foodborne disease outbreaks in the United States. Multistate outbreaks reported to FDOSS were linked using a unique outbreak identifier to obtain food category information when a confirmed or suspected food source was identified. Food categories were determined and assigned in FDOSS according to a classification scheme developed by CDC, the Food and Drug Administration (FDA), and the U.S. Department of Agriculture Food Safety and Inspection Service (FSIS) in the Interagency Food Safety Analytics Collaboration. A possible multistate outbreak was determined by expert judgment to be an outbreak if supporting data (e.g., temporal, geographic, demographic, dietary, travel, or food history) suggested a common source. A solved outbreak was an outbreak for which a specific kind of food or animal was implicated (i.e., confirmed or suspected) as the source. Outbreak-level variables included number of illnesses, hospitalizations, cases of hemolytic uremic syndrome (HUS), and deaths; the number of states with illnesses; date of isolation for the earliest and last cases; demographic data describing patients associated with a possible outbreak (e.g., age, sex, and state of residence); the types of data collected ...

Multistate reptile‐ and amphibian‐associated salmonellosis outbreaks in humans, United States, 2009–2018

“…These outbreaks are a reminder that contact with reptiles and amphibians remains an important source of salmonellosis in the United States. Consistent with historical outbreaks of Salmonella linked to animal contact, RAAS outbreaks in this analysis were longer in duration compared to foodborne Salmonella outbreaks (Marshall et al, 2020 ; Marus et al, 2019 ). Reptiles and amphibians can be colonized with multiple strains of Salmonella , appear healthy while colonized and shed Salmonella intermittently; people might be exposed long after obtaining their pet, which can result in prolonged outbreak durations (Goupil et al, 2012 ; Hoelzer et al, 2011 ; Whitten et al, 2015 ).…”

Antimicrobial Effects of Plant Compounds against Virulent <i>Escherichia coli</i> O157:H7 Strains Containing Shiga Toxin Genes in Laboratory Media and on Romaine Lettuce and Spinach

“…Escherichia coli O157:H7 is one of the most important foodborne pathogenic bacteria responsible for hemorrhagic colitis (HC) and hemolytic-uremic syndrome (HUS) in affected individuals. According to Marshall, et al [1], Salmonella, Shiga toxin-producing Escherichia coli (STEC), and Listeria monocytogenes are the leading causes of multistate foodborne disease outbreaks in the United States.…”

Free-Living Aquatic Turtles as Sentinels of Salmonella spp. for Water Bodies

“…Whether the turtles are the source of human cases or just a sentinel of environmental contamination is currently unknown. Reptileassociated salmonellosis remains a public health concern (4,7,8,28,35,93,94). The current investigation by the CDC of an ongoing outbreak of salmonellosis linking human infections with contact with infected wild birds or contaminated feeders should serve as a reminder of the significance of understanding salmonellae dynamics in wildlife (95).…”

“…There has also been a significant number of human cases of salmonellosis linked to animal (4,(7)(8)(9)(10)(11)(12)(13) and environmental exposure (14)(15)(16) and a geographic disparity in reported cases of salmonellosis in the United States (17)(18)(19). Georgia has the highest annual Salmonella prevalence among the states; and within the state, the southern Coastal Plain has the highest incidence (20).…”