Multistate outbreak of Salmonella Mbandaka infections linked to sweetened puffed wheat cereal – United States, 2018

Abstract

In May of 2018, PulseNet, the national molecular subtyping network for enteric pathogens, detected a multistate cluster of illnesses caused by an uncommon molecular subtype of Salmonella serovar Mbandaka. A case was defined as an illness in a person infected with the outbreak strain of Salmonella Mbandaka with illness onset on or after 3 March 2018 and before 1 September 2018. One-hundred thirty-six cases from 36 states were identified; 35 hospitalisations and no deaths were reported. Ill people ranged in age from <1 year to 95 years (median: 57 years). When standardised questionnaires did not generate a strong hypothesis, opened-ended interviews were performed. Sixty-three of 84 (75%) ultimately reported consuming or possibly consuming a specific sweetened puffed wheat cereal in the week before illness onset. Environmental sampling performed at the cereal manufacturing facility yielded the outbreak strain. The outbreak strain was also isolated from open cereal samples from ill people's homes and from a sealed retail sample. Due to these findings, the brand owner of the product issued a voluntary recall of the cereal on 14 June 2018. Additional investigation of the manufacturing facility identified persistent environmental contamination with Salmonella Mbandaka that was closely genetically related to other isolates in the outbreak. This investigation highlights the ability of Salmonella to survive in low-moisture environments, and the potential for prolonged outbreaks linked to products with long shelf lives and large distribution areas.

Persistence of microbiological hazards in food and feed production and processing environments

“…A drying tower was identified as the source of contamination (Jones et al, 2019). Also, a S. Mbandaka outbreak (2018), linked to sweetened puffed wheat cereal, where the thorough investigation of the manufacturing facility identified persistent environmental contamination with strains closely related genetically to the outbreak strain (Keaton et al, 2022). At last, a S. Agona outbreak (2008), associated with toasted oats cereal, where the outbreak isolates were linked by PFGE and WGS to a 1998 S. Agona outbreak associated with cereal manufactured in the same facility, indicating a persistent source of contamination (Hoffmann et al, 2020;Russo et al, 2013).…”

“…Also, a S . Mbandaka outbreak (2018), linked to sweetened puffed wheat cereal, where the thorough investigation of the manufacturing facility identified persistent environmental contamination with strains closely related genetically to the outbreak strain (Keaton et al., 2022). At last, a S .…”

“…A typical example is the 2018 sweetened puffed wheat cereal outbreak in Illinois, caused by S . Mbandaka that originated from drains and the external surfaces of food processing equipment (Keaton et al., 2022).…”

Genomic Features and Phylogenetic Analysis of Antimicrobial-Resistant Salmonella Mbandaka ST413 Strains

“…This clone was involved in a multi-country outbreak linked to the consumption of poultry meat in EU/EEA, Israel, and the UK, which resulted in 196 human cases, 19 hospitalizations, five septicaemic infections, and one death [ 7 ]. Likewise, this serovar was also related to multistate outbreaks in the United States [ 9 ]. Another emergent concern to public health is the multidrug-resistant (MDR) profiles exhibited by S. Mbandaka isolates from poultry farms in different countries, which involves tetracycline, fluoroquinolones, aminoglycosides, sulphonamides, and third-generation cephalosporins [ 10 , 11 ].…”

A Food Poisoning Caused by Salmonella Enterica (S. Enteritidis) ST11 Carrying Multi-Antimicrobial Resistance Genes in 2019, China

“…7 Previous research had shown that America is frequently affected by Salmonella outbreaks since there have been incidents related to Salmonella contamination in onions, sweetened puffed wheat, and packaged leafy greens. [8][9][10] In China, retail meat in supermarkets and open-air markets in Guangxi, and two universities in Xiamen were also reported Salmonella food contamination and poisoning. 11,12 Salmonella is a gram-negative bacterium that primarily affects children, pregnant women, and the elderly.…”