Busy week – Food Poisoning Outbreaks – E. coli and Wagu, Listeria and Deli Meat and Salmonella and Cucumbers

E. coli: The Flathead City-County Health Department (FCCHD) and the Montana Department of Public Health and Human Services (DPHHS) continue to work together to investigate an E. coli O157:H7 outbreak originating in Flathead County.

On July 25^th, FCCHD and DPHHS received confirmatory testing results of clinical and food samples verifying ground beef as the exposure of concern. Specifically, the source of the outbreak was wagyu beef from one lot number. All cases reported eating undercooked or made-to-order burgers made with wagyu beef at one of multiple restaurants in Flathead County. The last known date of consumption was July 14, 2024.

The following restaurants are associated with the 14 cases of reported illness in this outbreak: Gunsight Saloon; Hops Downtown Grill; Tamarack Brewing Company; the Lodge at Whitefish Lake; and Harbor Grille. Furthermore, based on information provided through case investigation, one individual has died after exposure to wagyu beef consumed at Harbor Grille. 

Patients associated with this outbreak were sickened with Shiga toxin-producing E. coli O157 which can be caused by a person eating raw or undercooked animal products contaminated with this strain of bacteria. Symptoms of this type of E. coli infection can include severe stomach cramps, bloody diarrhea, vomiting, fever, and chills. Young children, older adults, and people with weakened immune systems are at higher risk for severe illness. In severe cases, the infection can also trigger a serious condition called hemolytic uremic syndrome (HUS). According to the Centers for Disease Control and Prevention (CDC), HUS can lead to kidney failure, permanent health conditions, and death. Symptoms of E. coli infection occur between one and ten days after exposure, with an average of three to four days after exposure. Individuals that may be experiencing these symptoms are encouraged to contact their healthcare provider.

Listeria: As of July 19, 2024, a total of 28 people infected with the outbreak strain of Listeria have been reported from 12 states – Georgia (2), Illinois (1), Massachusetts (2), Maryland (6), Minnesota (1), Missouri (2), North Carolina (1), New Jersey (2), New York (7), Pennsylvania (1), Virginia (2) and Wisconsin (1). Sick people’s samples were collected from May 29, 2024, to July 5, 2024. Of 28 people with information available, all have been hospitalized. One person got sick during their pregnancy and remained pregnant after recovering. Two deaths have been reported, 1 in Illinois and 1 in New Jersey.

Public health investigators used the PulseNet system to identify illnesses that may have been part of this outbreak. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause foodborne illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS). WGS showed that bacteria from sick people’s samples are closely related genetically. This means that people in this outbreak likely got sick from the same type of food. This means that these 28 people are likely linked, and according to the CDC, likely also linked to delis that sell meat.

State and local public health officials are interviewing people about the foods they ate in the month before they got sick. People are reporting eating a variety of meats sliced at deli counters. Of the 18 people able to be interviewed, 16 (89%) reported eating meats sliced at a deli, most commonly deli-sliced turkey, liverwurst, and ham. Meats were sliced at a variety of supermarket and grocery store delis.

CDC conducted an analysis comparing foods reported by people in this outbreak to foods reported by people who got sick with Listeria but were not part of an outbreak. The analysis showed that people in this outbreak were more likely to eat deli-sliced turkey and liverwurst. This information suggests that meats sliced at the deli are a likely source of this outbreak. 

Salmonella: As of July 2, a total of 449 people infected with one of the outbreak strains of Salmonella Africana and Salmonella Braenderup have been reported from 31 states and the District of Columbia. Of these illnesses, 215 people were infected with the newly added Salmonella Braenderup strain. 

Illnesses started on dates ranging from March 11, 2024, to June 4, 2024. Of 360 people with information available, 125 have been hospitalized and no deaths have been reported.

Public health investigators used the PulseNet system to identify illnesses that may have been part of this outbreak. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause foodborne illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS).WGS showed that bacteria from sick people’s samples are closely related genetically. This means that people in this outbreak likely got sick from the same type of food.

FDA’s traceback investigation identified Bedner Growers, Inc., in Florida as a supplier of cucumbers in this outbreak. This one grower does not account for all illnesses in this outbreak. FDA collected samples at the grower in Florida and identified Salmonella Braenderup in untreated canal water. WGS determined that the Salmonella found in the water is the same strain of Salmonella Braenderup that made people in this outbreak sick. Additional soil and water samples collected at Bedner Growers, Inc. were positive for other strains of Salmonella. CDC and FDA are looking to see if these strains have caused illness in people.

Republished with permission from Bill Marler and Marler Clark. Copyright (c) Marler Clark LLP, PS. All rights reserved.