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FSPCA - Food Safety Preventive Controls Alliance

Friday, July 31, 2020

Canada - Salmonella Outbreak Linked to Red Onions from the USA

According to a release from Canadian Government,  there have been 114 confirmed cases of Salmonella Newport illness linked to raw red onions imported into Canada from the US.

While this outbreak is in Canada, the report states that the "U.S. CDC is also investigating an outbreak of Salmonella Newport illnesses that have a similar genetic fingerprint to illnesses reported in this outbreak."

Onions have been rarely an issue regarding foodborne illness outbreaks.  In a 2015 study (below), inoculated Salmonella did not penetrate into the onion from the outer layers and the level of organism generally decline, more so at ambient temperatures versus refrigeration temperatures, although Salmonella was recoverable after  7 weeks of refrigerated storage.  With diced onions. Salmonella number did increase somewhat when the product was refrigerated.  "Populations of E. coli O157:H7 and Salmonella did not decline at 4uC and increased by 0.2 to 0.3 log CFU/g/h at ambient conditions in diced onions."  So based on this..if Salmonella did survive on the onions that were kept cool and then if those onions are diced, then there could be some growth if held at ambient temperature.  Hard to know exactly what happened.  My guess is that the Salmonella never read this research paper.

Reason for concern with the onions you bought from the store....unless those onions are part of the recalled onions, there is still very low risk when you peel the outer layers away and then rinse the onions under running water before use.


Government of Canada
https://www.canada.ca/en/public-health/services/public-health-notices/2020/outbreak-salmonella-infections-under-investigation.html
Public Health Notice: Outbreak of Salmonella infections linked to red onions imported from the United States
July 30, 2020 – Update

Since July 24, there have been 55 additional illnesses in Canada reported in the ongoing investigation. Investigators have determined that red onions imported from the United States (U.S.) are a likely source of the outbreak.

Until more is known about the outbreak, individuals in British Columbia, Alberta, Saskatchewan, Manitoba, and Ontario are advised to not eat any red onions imported to Canada from the U.S., including any food products that contain raw red onions imported from U.S.. Retailers and restaurants in these locations are also advised not to use, sell or serve red onions imported from the U.S.. Red onions grown in Canada are not affected by this advice.

Why should you take note

The Public Health Agency of Canada (PHAC) is collaborating with federal and provincial public health partners, the United States Centers for Disease Control and Prevention (U.S. CDC), and U.S. health officials to investigate an outbreak of Salmonella infections occurring in five provinces.

In Canada, based on the investigation findings to date, exposure to red onions imported from the U.S. has been identified as a likely source of the outbreak. Many of the ill individuals under investigation reported having eaten red onions before getting sick.

Through a collaborative investigation between public health and food safety partners in Canada and the U.S., traceback information indicates that the contaminated red onions are being imported to Canada from the U.S. and distributed in central and western Canada. Red onions grown in Canada are not associated with this outbreak. More information is needed to determine the cause of contamination in red onions imported from the U.S.. The outbreak is ongoing, as recent illnesses continue to be reported to the PHAC.

Given this new information, and until more is known about the outbreak, the Public Health Agency of Canada advises individuals in British Columbia, Alberta, Saskatchewan, Manitoba, and Ontario to not eat any red onions imported to Canada from the U.S., including any food products that contain raw red onions imported from U.S.. Retailers and restaurants in these locations are also advised not to use, sell or serve red onions imported from the U.S.. Red onions grown in Canada are not affected by this advice.

As the investigation is ongoing, it is possible that additional sources could be identified, and food recall warnings related to this outbreak may be issued. This public health notice will be updated as the investigation evolves.

Investigation summary

As of July 30, 2020, there have been 114 confirmed cases of Salmonella Newport illness linked to this outbreak in the following provinces: British Columbia (43), Alberta (55), Manitoba (13), Ontario (2), and Prince Edward Island (1). The individual from Prince Edward Island reported travelling to Alberta before becoming ill. Saskatchewan has not reported any confirmed illnesses related to this outbreak, but provincial public health authorities are investigating some Salmonella Newport illnesses in the province.

Individuals became sick between mid-June and mid-July 2020. Information is available for 102 illnesses. Out of 102 people, 16 individuals have been hospitalized. No deaths have been reported. Individuals who became ill are between 3 and 100 years of age. The majority of cases (56%) are female.

Individuals who became ill reported eating red onions at home, in menu items ordered at restaurants and in residential care settings.

The Canadian Food Inspection Agency (CFIA) is conducting a food safety investigation. If contaminated food products are identified, CFIA will take the necessary steps to protect the public, including recalling the product as required.

The U.S. CDC is also investigating an outbreak of Salmonella Newport illnesses that have a similar genetic fingerprint to illnesses reported in this outbreak. Investigators in Canada and the U.S. continue to collaborate to exchange information and identify commonalities in the outbreak information that may identify additional sources of illness or help to identify the cause of contamination in the red onions.

It is possible that more recent illnesses may be reported in the outbreak because there is a period of time between when a person becomes ill and when the illness is reported to public health officials. For this outbreak, the illness reporting period is between two and four weeks.

Who is most at risk

Anyone can become sick with a Salmonella infection, but children aged 5 years and under, older adults, pregnant women or people with weakened immune systems are at higher risk for contracting serious illness.

Most people who become ill from a Salmonella infection will recover fully after a few days. It is possible for some people to be infected with the bacteria and to not get sick or show any symptoms, but to still be able to spread the infection to others.

What should you do to protect your health

Individuals in British Columbia, Alberta, Saskatchewan, Manitoba, and Ontario are advised to not eat any red onions imported to Canada from the U.S., including any food products that contain raw red onions imported from U.S..

Retailers and restaurants in these locations are also advised not to use, sell or serve red onions imported from the U.S.. Red onions harvested in Canada are not affected by this advice.

Individuals are asked to check their homes for red onions, including whole, sliced, or chopped, as well as prepared foods that contain red onions as an ingredient, such as premade salads, sandwiches, wraps, or dips.

If you have red onions at home:

Look for a label showing where the red onion was grown. It may be printed on the package or on a sticker.

If the packaging or sticker shows that it is from the U.S., don't eat it. Throw it away and wash your hands.

If it isn't labeled, don't eat it. Throw it away and wash your hands.

If you don't know whether the red onion found in a premade salad, sandwich, wrap or dip contains red onion from the U.S., don't eat it. Throw it away and wash your hands.

Wash and sanitize drawers or shelves in areas (such as fridges and cupboards) where red onions were stored.

If you buy red onions at a store:

Look for a label showing where the red onion was grown. It may be printed on the package or on a sticker.

If the packaging shows that it is from the U.S., don't buy it.

If it is an unpackaged product, or is not labelled, ask the retailer whether the red onion comes from the U.S.

If you can't confirm that the red onion in stores is not from the U.S., don't buy it.

If you order salad or any other food item containing red onions at a restaurant or food establishment, ask the staff whether the red onions come from the U.S. If they did, or they don’t know, don’t eat it.

Restaurants and retailers should check the label on bags or boxes of red onions, or ask their suppliers about the source of their red onions.

Suppliers, distributors and others in the supply chain should not ship or sell red onions imported from the U.S.

If you have been diagnosed with a Salmonella infection or any other gastrointestinal illness, do not cook food for other people.

Contact your local public health authority to report any food safety concerns at restaurants or grocery stores, or if you suspect food poisoning from a restaurant or other food establishments.

Symptoms

Symptoms of a Salmonella infection, called salmonellosis, typically start 6 to 72 hours after exposure to Salmonella bacteria from an infected animal, person or contaminated product.

Symptoms include:

fever

chills

diarrhea

abdominal cramps

headache

nausea

vomiting

These symptoms usually last for 4 to 7 days. In healthy people, salmonellosis often clears up without treatment, but sometimes antibiotics may be required. In some cases, severe illness may occur and hospitalization may be required. People who are infected with Salmonella bacteria can be infectious from several days to several weeks. People who experience symptoms, or who have underlying medical conditions, should contact their health care provider if they suspect they have a Salmonella infection.

What is the Government of Canada doing

The Government of Canada is committed to protecting the health of Canadians from enteric disease outbreaks.

The Public Health Agency of Canada leads the human health investigation into an outbreak and is in regular contact with its federal, provincial and territorial partners to monitor the situation and to collaborate on steps to address an outbreak.

Health Canada provides food-related health risk assessments to determine whether the presence of a certain substance or microorganism poses a health risk to consumers.

The Canadian Food Inspection Agency conducts food safety investigations into the possible food source of an outbreak.

The Government of Canada will continue to update Canadians if new information related to this investigation becomes available.

Epidemiological information

Figure 1 is an epidemiological curve for this outbreak, which shows the numbers of new cases by week. Outbreak investigators use this information to show when illnesses begin, when they peak and when they trail off. It can take several weeks from the time a person becomes ill to when the illness is reported and testing confirms a link to the outbreak. Data are available for 113 cases.

Figure 1: Number of people infected with Salmonella Newport
Figure 1: Number of people infected with Salmonella Newport Figure 1 - Text Description



Journal of Food Protection
https://meridian.allenpress.com/jfp/article/78/1/42/174435/Survival-or-Growth-of-Inoculated-Escherichia-coli
Survival or Growth of Inoculated Escherichia coli O157:H7 and Salmonella on Yellow Onions (Allium cepa) under Conditions Simulating Food Service and Consumer Handling and Storage  
VANESSA M. LIEBERMAN; IRENE Y. ZHAO; DONALD W. SCHAFFNER; MICHELLE D. DANYLUK; LINDA J. HARRIS 

J Food Prot (2015) 78 (1): 42–50.
https://doi.org/10.4315/0362-028X.JFP-14-281
Article history

Whole and diced yellow onions (Allium cepa) were inoculated with five-strain cocktails of rifampin-resistant Escherichia coli O157:H7 or Salmonella and stored under conditions to simulate food service or consumer handling. The inoculum was grown in broth (for both whole and diced onion experiments) or on agar plates (for whole onion experiments). Marked circles (3.3 cm in diameter) on the outer papery skin of whole onions were spot inoculated (10 μl in 10 drops) at 7 log CFU per circle, and onions were stored at 4°C, 30 to 50% relative humidity, or at ambient conditions (23°C, 30 to 50% relative humidity). Diced onions were inoculated at 3 log CFU/g and then stored in open or closed containers at 4°C or ambient conditions. Previously inoculated and ambient-stored diced onions were also mixed 1:9 (wt/wt) with refrigerated uninoculated freshly diced onions and stored in closed containers at ambient conditions. Inoculated pathogens were recovered in 0.1% peptone and plated onto selective and nonselective media supplemented with 50 μg/ml rifampin. Both E. coli O157:H7 and Salmonella populations declined more rapidly on onion skins when the inoculum was prepared in broth rather than on agar. Agar-prepared E. coli O157:H7 and Salmonella declined by 0.4 and 0.3 log CFU per sample per day, respectively, at ambient conditions; at 4°C the rates of reduction were 0.08 and 0.06 log CFU per sample per day for E. coli O157:H7 and Salmonella, respectively. Populations of E. coli O157:H7 and Salmonella did not change over 6 days of storage at 4°C in diced onions. Lag times of 6 to 9 h were observed with freshly inoculated onion at ambient conditions; no lag was observed when previously inoculated and uninoculated onions were mixed. Growth rates at ambient conditions were 0.2 to 0.3 log CFU/g/h for E. coli O157:H7 and Salmonella in freshly inoculated onion and 0.2 log CFU/g/h in mixed product. Diced onions support pathogen growth and should be kept refrigerated.

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