Slow response in salmonella outbreak “likely contributor” to illness count, finds report

The group said officials should make detection of and response to salmonella outbreaks a priority by enhancing the surveillance system and the US Food and Drug Administration (FDA) should modify the retail section of the National Antimicrobial Resistance Monitoring System (NARMS) to help detection and response.

It added that the FDA, FSIS, CDC, and state authorities must engage with food companies in the early stages of an outbreak investigation to speed identification of contaminated foods.

The report analysed the response to amultistate outbreak of Salmonella Heidelberg linked to ground turkey in 2011 which sickened 136 people, causing 37 hospitalizations and one death in 34 states.

Based on CDC estimates, due to the under diagnosis of salmonella, the outbreak could have sickened 4,000people nationally.

Problem areas​

The report highlighted problems such as:

• infections from salmonella are not given enough attention by the public health system
• bacteria isolated from retail meat and poultry samples and uploaded onto PulseNet are not identified with the names of the brand and processing plants that produced the samples, nor by their purchase dates
• government officials often wait until they are relatively certain of a likely source of an outbreak before notifying a company that it may have produced the contaminated food.

PulseNet is the national network of labs that shares information on foodborne bacteria.

Delay in identification​

The US Centers for Disease Control and Prevention (CDC) and the US Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS) did not identify the contaminated food source until 22 weeks after the first person became ill and 10 weeks after CDC detected the outbreak.

The ground turkey processed at one of Cargill Meat Solutions plants led to a recall of 36 million pounds of the product, which is one of the nation’s biggest poultry recalls.

The performance standard for salmonella in raw ground turkey is currently 49.9%, meaning that it is lawful for nearly half of the samples tested by the Food Safety and Inspection Service to be contaminated with salmonella.

This standard is based on data collected 17 years ago that estimated the national prevalence of salmonella in raw ground turkey: Food Safety and Inspection Service, “Nationwide Raw ​Ground Turkey Microbiological Survey​​” 1996, cited the report.

Pew staff reviewed and analyzed public documents regarding the outbreak and the health community’s response to it, including timelines produced by CDC.

The group said the incidence of salmonella foodborne infections has not decreased significantly over the past 15 years to 2010.

“Efforts to reduce this pathogen face particular challenges because so many animals can carry it and it can be present in organs other than the intestines, complicating control strategies​,” said the report.

Craig Hedberg, Division of Environmental Health Sciences, University of Minnesota School of Public Health, and Ian Williams, chief of the Outbreak Response and Prevention Branch of the National Center for Emerging and Zoonotic Infectious Diseases at CDC, peer-reviewed the report.