New product, old problem(s): multistate outbreak of <i>Salmonella</i> Paratyphi B variant L(+) tartrate(+) infections linked to raw sprouted nut butters, October 2015

Marshall, Katherine E.; Booth, Hillary; Harrang, J.; Lamba, Katherine; Folley, A.; Ching-Lee, Myra; Hannapel, Elizabeth J.; Greene, Vernon L.; Classon, Andrew; Whitlock, Laura; Shade, L.; Viazis, Stelios; Nguyen, Thai-An; Neil, Karen P.

doi:10.1017/s0950268818002716

Cited by 6 publications

(6 citation statements)

References 22 publications

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“…Investigators can conduct open-ended interviews to ask questions about exposure to other foods and animals, although these are time-consuming for both interviewers and patients. However, open-ended interviews and other approaches (e.g., examination of shopper card records) have been used with success to identify new outbreak sources and solve outbreaks ( 11 , 15 , 16 ). Finally, a suspected outbreak source was identified in 28% of multistate investigations in 2016; however, sources were not confirmed because of insufficient traceback or laboratory data.…”

Section: Discussionmentioning

confidence: 99%

“…Epidemiologic data included 1) a higher than expected proportion of patients with exposure to the same food or animal before illness onset and 2) two or more unrelated patients who ate at the same restaurant, shopped at the same grocery store, or attended the same event. To determine whether a higher than expected proportion of patients was exposed to a particular food or animal, investigators frequently used techniques such as a binomial model to compare the proportion of patients associated with an outbreak with healthy persons who participated in the FoodNet Population Survey ( 10 , 11 ). Traceback data included shipping, purchase, or other information that suggested a common point of contamination in the distribution chain of food products or animals ( 12 ).…”

Section: Methodsmentioning

confidence: 99%

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

Marshall¹,

Nguyen²,

Ablan³

et al. 2020

MMWR Surveill. Summ.

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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 ...

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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

Marshall¹,

Nguyen²,

Ablan³

et al. 2020

MMWR Surveill. Summ.

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“…Processors relying on refrigeration must take care to confirm that refrigeration conditions are < 4°C and/or limit the soaking time at lower temperatures to prevent Salmonella growth. Investigations surrounding the 2015 Salmonella Paratyphi B outbreak linked to "sprouted" nut butters reported that the company conducted their soaking process under refrigeration but they did not apply a validated kill step (12). This situation demonstrates that refrigerated soaking may be an important control to prevent the growth of Salmonella; however, this approach was insufficient to eliminate risk associated with contaminated starting ingredients.…”

Section: Resultsmentioning

confidence: 99%

“…Three outbreaks have been linked to the consumption of "sprouted" products, specifically sprouted chia seed powder, cashew nut cheese, and raw sprouted nut butters (11,12,19). In response to the chia powder outbreak, Health Canada and the Canadian Food Inspection Agency conducted an investigation to determine the level of Salmonella contamination in the implicated product (sprouted chia powder) and a co-manufactured product (sprouted flax powder).…”

Section: Introductionmentioning

confidence: 99%

Salmonella Growth during the Soaking Step of ‘Sprouted’ Grain, Nut, and Seed Production

Emch¹,

Burroughs²,

Gaspar-Hernandez³

et al. 2021

FPT

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Food companies are marketing products with "sprouted," "activated," or "awakened" ingredients. The label implies that germination of grains, nuts, and seeds confers improved health benefits; however, the "sprouting" process consists of a simple overnight soak in water often at ambient temperature, followed immediately by drying and further processing. Our objective was to quantify Salmonella growth during soaking of grains, nuts, and seeds commonly included in "sprouted" products. Raw grains (buckwheat, millet, quinoa, rice), nuts (almond, cashew, hazelnut, peanut, pecan, walnut), and seeds (flax, hemp, pumpkin, sunflower) were inoculated with Salmonella to achieve ~3 log CFU/g after drying. Inoculated samples (20 g) were soaked in water (20 mL) with incubation at 7 or 25°C for 24 h. Salmonella bacteria were enumerated using serial dilution and spread plating on Hektoen enteric agar (37°C, 24 h). Salmonella was capable of significant growth (> 3 log CFU/g) in all 15 grains, nuts, and seeds during ambient temperature soaking, reaching an average concentration of 7.05 log CFU/g. High salt concentrations (> 10%) and refrigeration (< 7°C) were verified to prevent growth of Salmonella during soaking. This study demonstrates the risk of ambient temperature "sprouting" practices and presents practical strategies to improve safety of these products.

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“…Among these, 17 were identified as the Java biotype, while 10 belonged to the sensu stricto type. Multilocus sequence typing (MLST) analysis revealed four different sequence types (ST) within these strains: ST42 (11), ST86 (10), ST2814 (5), and ST135 (1). ST42, ST2814, and ST135 corresponded to the Java biotype, while ST86 represented sensu stricto.…”

Section: Salmonella Paratyphi B Isolates In Jiangsumentioning

confidence: 99%

Emergence of Rarely Reported Extensively Drug-Resistant Salmonella Enterica Serovar Paratyphi B among Patients in East China

Peng,

Feng,

et al. 2024

Antibiotics

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Background: In recent years, global concern over increasing multidrug resistance (MDR) among various Salmonella serotypes has grown significantly. However, reports on MDR Salmonella Paratyphi B remain scarce, let alone the extensively drug-resistant (XDR) strains. Methods: In this retrospective study, we investigated the isolates of Salmonella Paratyphi B in Jiangsu Province over the past decade and carried out antimicrobial susceptibility tests, then the strains were sequenced and bioinformatics analyses were performed. Results: 27 Salmonella Paratyphi B strains were identified, of which the predominant STs were ST42 (11), ST86 (10), and ST2814 (5). Among these strains, we uncovered four concerning XDR Salmonella Paratyphi B ST2814 strains (4/5) which were previously unreported. These alarmingly resistant isolates showed resistance to all three major antibiotic classes for Salmonella treatment and even the last resort treatment tigecycline. Bioinformatics analysis revealed high similarity between the plasmids harbored by these XDR strains and diverse Salmonella serotypes and Escherichia coli from China and neighboring regions. Notably, these four plasmids carried the ramAp gene responsible for multiple antibiotic resistance by regulating the AcrAB-TolC pump, predominantly originating from China. Additionally, a distinct MDR ST42(1/11) strain with an ICE on chromosome was also identified. Furthermore, phylogenetic analysis of global ST42/ST2814 isolates highlighted the regional specificity of these strains, with Jiangsu isolates clustering together with domestic isolates and XDR ST2814 forming a distinct branch, suggesting adaptation to local antibiotic pressures. Conclusions: This research underscores the pressing need for closely monitoring the MDR/XDR Salmonella Paratyphi B, particularly the emerging ST2814 strains in Jiangsu Province, to effectively curb its spread and protect public health. Moreover, surveillance should be strengthened across different ecological niches and genera to track resistance genes and horizontal gene transfer elements under the concept of “ONE HEALTH”.

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New product, old problem(s): multistate outbreak of Salmonella Paratyphi B variant L(+) tartrate(+) infections linked to raw sprouted nut butters, October 2015

Cited by 6 publications

References 22 publications

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

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

Salmonella Growth during the Soaking Step of ‘Sprouted’ Grain, Nut, and Seed Production

Emergence of Rarely Reported Extensively Drug-Resistant Salmonella Enterica Serovar Paratyphi B among Patients in East China

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