CDC - 2106 Outbreak of Salmonella Linked to Cucumbers

CDC published a report regarding a 2016 outbreak of Salmonella enterica serotype Oslo.  The report links the outbreak to Persian or mini cucumbers.  "The investigation identified two Canadian Persian cucumber suppliers during the timeframe of interest, but a single grower was not identified."

"This is the fourth Salmonella outbreak since 2013 associated with cucumbers, with over 1,200 illnesses and 260 hospitalizations included in the previous three outbreaks (2–4). Two of these outbreaks were caused by cucumbers sourced from Mexico (2,4), whereas the other outbreak identified cucumbers sourced from Maryland as a major cause of illnesses (3). This outbreak supports the continued evaluation and sampling of produce by FDA with the Food Safety Modernization Act requirements intended to prevent and minimize contamination of produce with pathogens."

CDC - Morbidity and Mortality
https://www.cdc.gov/mmwr/volumes/65/wr/mm655051a3.htm?s_cid=mm655051a3_e
Outbreak of Salmonella Oslo Infections Linked to Persian Cucumbers — United States, 2016
Weekly / December 30, 2016 / 65(5051);1430–1433

CDC Update - Salmonella Cases Associated with Cucumbers Continue to Trickle In

 Since CDC's last report in November, 50 more people from 16 states have been reported becoming ill with a specific strain of Salmonella associated with cucumbers from one distributor in California.  The current total is 888 cases in 39 states. 

Cucumbers Recalled in GA and FL Due to Potential for Salmonella Contamination

A Florida produce company is recalling cucumbers after a random sampling and testing conducted by FDA produced a positive Salmonella result.  No illnesses have been reported.  Product was distributed in Florida and Georgia.


FDA Recall Notice
http://www.fda.gov/Safety/Recalls/ucm479661.htm
Recall: Firm Press Release
Thomas Produce Recalls Cucumbers because of Possible Health Risk
For Immediate Release


December 31, 2015
Contact
Consumers Richard Wilson   1-561-482-1111
Firm Press Release

Thomas Produce Company of Boca Raton, FL is recalling 174 bulk-packed containers of Cucumbers. This product has the potential to be contaminated with Salmonella, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella may experience fever, diarrhea (which may be bloody), nausea, vomiting, and abdominal pain.

This product was sold to distributors in Florida and Georgia between 12/15/2015 and 12/16/2015. All distributors that received this product have been notified as of the time of this press release.

Update on Salmonella Outbreak Associated with Cucumbers

CDC updated the information regarding the outbreak of Salmonella related to contaminated cucumbers that began in July.    There have been 838 cases of Salmonella reported in 38 states with 165 hospitalizations and 4 deaths.

  

  

 

CDC Recall Update

http://www.cdc.gov/salmonella/poona-09-15/index.html

Multistate Outbreak of Salmonella Poona Infections Linked to Imported Cucumbers 

Posted November 19, 2015 11:45 AM ET

 

 At A Glance

Case Count: 838 (http://www.cdc.gov/salmonella/poona-09-15/epi.html)

States: 38(http://www.cdc.gov/salmonella/poona-09-15/map.html)

Deaths: 4

Hospitalizations: 165

Recall: Yes

What's New?

• Since the last update on October 14, 2015, 71 more ill people have been reported from 23 states.
• Connecticut and New Hampshire were added to the list of states with ill people, bringing the total number of states to 38.
• The number of reported illnesses has declined substantially since the peak of illnesses in August and September; however, it has not returned to the number of reported illnesses that we would expect to see (about 5 every month). The investigation into the source of these illnesses is ongoing.

Number of Cucumber Related Salmonellosis Cases Rises

There have been an addition 61 cucumber linked cases of salmonellosis since the September 29 CDC outbreak update. This brings the total to 732 people.  With a relatively short shelf-life of 14 days, CDC anticipates that there should not be too many more, if any, additional cases.

 

It is surprising the lack of outrage in the media.  732 cases.  4 deaths.  Let's compare that to the Salmonella outbreak associated with Foster Farms raw chicken, a product that is supposed to be cooked.  In that outbreak , CDC reported that "a total of 634 persons infected with seven outbreak strains of Salmonella Heidelberg were reported from 29 states and Puerto Rico from March 1, 2013 to July 11, 2014.  38% of ill persons were hospitalized, and no deaths were reported."   Have we become desensitized?  Or are there less deep pockets to access?

 

Certainly the scope is huge.  35 states.  This demonstrates the impact of one initial supply hub in moving product across the county. 

 

It also shows the inability to track an outbreak related to produce.  3 months is a long time for such a short shelf-life product.

 

 

 

  

 

 

 

CDC Outbreak

http://www.cdc.gov/salmonella/poona-09-15/index.html

Multistate Outbreak of Salmonella Poona Infections Linked to Imported Cucumbers

Posted October 6, 2015 4:00 PM ET

 

What's New?

• Since the last update on September 29, 2015, 61 more ill people have been reported from 24 states. Given the 14-day shelf life of cucumbers and the gap between when someone gets sick and when that illness is reported to public health, it is not unexpected to continue to see illnesses reported after the recalls.
• A death has been reported from Oklahoma, bringing the total number of deaths to four.
• Maryland was added to the list of states with ill people, bringing the total number of states to 35.

Salmonella Oubreak Associated with Cucumbers....671 Affected and 3 Deaths

Update on Cucumber Salmonella Outbreak.....CDC now reports that

• Since the last update on September 22, 2015, 113 more ill people have been reported from 19 states. Given the 14-day shelf life of cucumbers, it is not unexpected to continue to see illnesses reported after the recalls.
• Alabama was added to the list of states with ill people, bringing the total number of states to 34.

This takes the total number of infected to 671 individuals, with 3 deaths.  Interesting, more than half of those infected, about 340, were children (<18 years old)

  

 

 

CDC Outbreak Notice

 http://www.cdc.gov/salmonella/poona-09-15/

Multistate Outbreak of Salmonella Poona Infections Linked to Imported Cucumbers

Read the Recall & Advice to Consumers, Restaurants, and Retailers >>(http://www.cdc.gov/salmonella/poona-09-15/advice.html)

CDC, multiple states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Salmonella Poona infections. This investigation is ongoing. CDC will provide updates when more information is available.

• 671 people infected with the outbreak strains of Salmonella Poona have been reported from 34 states, an increase of 113 cases since the last update on September 22.
• 131 ill people have been hospitalized, and three deaths have been reported from Arizona (1), California (1), and Texas (1).
• 51% of ill people are children younger than 18 years.

Cucumber Salmonella Outbreak - Cases Now at 558 with 3 Deaths

CDC's last repost on the Salmonella outbreak associated with cucumbers had the case count at 558, with 112 requiring hospitalization and 3 deaths.  This number of cases per day has begun to decrease since the two associated recalls were issued on September 4th and September 11th, however looking at the EPI curve, this duration of this outbreak is close to 3 months.

The cucumbers were said to be imported from Mexico and were then packed by US produce companies for shipment across the county...resulting in illnesses in 33 states.

In 2014, there was a Salmonella outbreak associated with cucumbers from Maryland and in 2013, an outbreak of E.coli O157:H7 associated with slice cucumber on sandwiches.

The pH of cucumbers is approximately 6.  While there are limited studies on the growth of Salmonella on cut cucumbers, evidence suggests that there may be a slow increase in numbers when the product is stored at non-refrigerated temperatures.  This may compound the primary issue, which is that cucumbers are grown on or near the ground, and if that ground is contaminated, such as occurs when using improperly treated manure as a fertilizer, then that contamination is transferred to the cucumbers (via direct contact, hands, splashing water, little critters, etc) could adhere to the surface of the cucumber.  Using contaminated irrigation water can lead to contamination of the cucumbers.  Finally, cucumbers can become contaminated during handling and rinsing / hydrocooling.  Point source contamination issues in the packing house can spread that contamination to  a large number of cucumbers.  More study is needed on cucumbers and contamination issues associated with growing, harvesting, storage and consumer handling.
 

CDC News Release

http://www.cdc.gov/salmonella/poona-09-15/

Multistate Outbreak of Salmonella Poona Infections Linked to Imported Cucumbers

Posted September 22, 2015 3:15 PM ET

 

Highlights

Read the Recall & Advice to Consumers, Restaurants, and Retailers >>(http://www.cdc.gov/salmonella/poona-09-15/advice.html)

CDC, multiple states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Salmonella Poona infections. This investigation is ongoing. CDC will provide updates when more information is available.

• 558 people infected with the outbreak strains of Salmonella Poona have been reported from 33 states, an increase of 140 cases since the last update on September 15.
• 112 ill people have been hospitalized, and three deaths have been reported from Arizona (1), California (1), and Texas (1).

Salmonella Outbreak Linked to Cucumbers Up to 341 Cases in 30 States

CDC reports that there are now 341 cases of salmonelloisis related to cucumbers.  The California company issued a recall last week, for cucumbers, but still has no idea of how the product became contaminated.  In a press release, they stated that they have ceased all operations.

CDC Website
http://www.cdc.gov/salmonella/poona-09-15/index.html
Multistate Outbreak of Salmonella Poona Infections Linked to Imported Cucumbers
Posted September 9, 2015 4:30 PM ET

Read the Recall & Advice to Consumers, Restaurants, and Retailers >>

• CDC, multiple states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Salmonella Poona infections.
• 341 people infected with the outbreak strains of Salmonella Poona have been reported from 30 states, an increase of 56 cases since the last update on September 4. 

Cucumbers from California Recalled for Potential Link to Salmonella Outbreak

A California company is recalling cucumbers because these cucumbers might be linked to a Salmonella outbreak.  It is reported that there are illnesses in 27 states.


FDA Recall Notice
http://www.fda.gov/Safety/Recalls/ucm461382.htm
Andrew and Williamson Fresh Produce Recalls Limited Edition Brand® Cucumbers Because of Possible Health Risk
Contact: Consumer: 619-661-6004

FOR IMMEDIATE RELEASE — September 4, 2015— Andrew and Williamson Fresh Produce (“A&W”) of San Diego, California is voluntarily recalling all cucumbers sold under the Limited Edition® label during the period from August 1, 2015 through September 3, 2015 because it may be contaminated with Salmonella.

A&W is currently working with health authorities to determine if, in fact, this product is the source of an outbreak of Salmonella with illnesses being reporting in as many as 27 states.

2014 Salmonella Outbreak Linked to Maryland Cucumbers

In a 2014 outbreak of Salmonella, cucumbers were linked to the outbreak that has resulted in 275 cases of illness.  The cucumbers were traced back to a farm on the Eastern Shore of Maryland.  While environmental samples were negative, the CDC report states, "Records and interviews indicated that the farm applied poultry litter approximately 120 days before harvest, but it was not available for testing."  So there is no definitive answer was found on how the product may have become contaminated.
CDC MMWR
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a3.htm?s_cid=mm6406a3_e
Outbreak of Salmonella Newport Infections Linked to Cucumbers — United States, 2014
Weekly
February 20, 2015 / 64(06);144-147

Kristina M. Angelo, DO1,2, Alvina Chu, MHS3, Madhu Anand, MPH4, Thai-An Nguyen, MPH2, Lyndsay Bottichio, MPH2, Matthew Wise, PhD2, Ian Williams, PhD2, Sharon Seelman, MS, MBA5, Rebecca Bell, PhD5, Marianne Fatica, PhD5, Susan Lance, DVM, PhD5, Deanna Baldwin6, Kyle Shannon3, Hannah Lee, MPH3, Eija Trees, PhD2, Errol Strain, PhD5, Laura Gieraltowski, PhD2 (Author affiliations at end of text)

In August 2014, PulseNet, the national molecular subtyping network for foodborne disease surveillance, detected a multistate cluster of Salmonella enterica serotype Newport infections with an indistinguishable pulse-field gel electrophoresis (PFGE) pattern (XbaI PFGE pattern JJPX01.0061).* Outbreaks of illnesses associated with this PFGE pattern have previously been linked to consumption of tomatoes harvested from Virginia's Eastern Shore in the Delmarva region and have not been linked to cucumbers or other produce items (1). To identify the contaminated food and find the source of the contamination, CDC, state and local health and agriculture departments and laboratories, and the Food and Drug Administration (FDA) conducted epidemiologic, traceback, and laboratory investigations. A total of 275 patients in 29 states and the District of Columbia were identified, with illness onsets occurring during May 20–September 30, 2014. Whole genome sequencing (WGS), a highly discriminating subtyping method, was used to further characterize PFGE pattern JJPX01.0061 isolates. Epidemiologic, microbiologic, and product traceback evidence suggests that cucumbers were a source of Salmonella Newport infections in this outbreak. The epidemiologic link to a novel outbreak vehicle suggests an environmental reservoir for Salmonella in the Delmarva region that should be identified and mitigated to prevent future outbreaks.

E. coli O157:H7 Outbreak Linked to Cucumbers (Colorado, 2013)

A 2013 outbreak of  E. coli O157:H7, where 9 individuals were infected, appears to be linked to eating sandwiches containing cucumbers.  All ill patrons ate at different shops of the same restaurant chain which all used the same lot of cucumbers.

From the report:

Prior to this outbreak, there have been no documented E. coli O157:H7 outbreaks associated with cucumbers in the United States, per a literature search conducted by CDPHE and by searching for outbreaks on CDC’s Foodborne Outbreak Online Database (http://wwwn.cdc.gov/foodborneoutbreaks/), which captures foodborne outbreak reports generated by local and state health departments and the CDC from 1998 through 2012. An outbreak of E. coli O157:H7 associated with consumption of cucumber salad (consisting of cucumbers, hard-boiled egg, and vinaigrette dressing) affected school-age children from England who were visiting France in 2002 (5). The investigators hypothesized that the cucumbers became contaminated in the growing field. There is evidence that cucumbers can support the growth of E. coli O157:H7 based on a 1993 study by Abdul-Raouf et al (6). The researchers inoculated sliced cucumbers with E. coli O157:H7 and found that the bacteria load increased when storage temperatures were at 21 degrees Celcius (69.8 degrees Fahrenheit). Mukherjee et al conducted microbiological analyses of fresh cucumbers produced by organic and conventional farmers in Minnesota and were not able to isolate E. coli O157:H7 but did find that cucumbers are often contaminated with coliforms, an indicator of fecal contamination (7).

For this particular investigation, it is not clear how the cucumbers could have been contaminated. It is very unlikely that contamination occurred within the 3 implicated Jimmy John’s locations, as no major food handling violations were noted during the environmental assessments and no ill food handlers were discovered. It is more likely that the implicated stores received contaminated cucumbers. Our investigation found no evidence that would support that the cucumbers became contaminated at the Denver-based produce distributor (Colo-Pac Produce, Inc.) or during shipment to the implicated Jimmy John’s locations. 

But it is easy to see that cucumbers can be a source. They are on the ground when harvested, and if not washed sufficiently, that contamination can be transferred to the slice when cut.
  
  
 Marler Blog / Colorado Department of Public Health and Environment
http://www.marlerblog.com/files/2014/12/CDPHE-Final-Report-Dec.-4-2014.pdf-Adobe-Acrobat.pdf
 Outbreak #2013-00-006 - Escherichia coli O157:H7 Outbreak Associated with Cucumbers Consumed at a Sandwich Restaurant Chain – Colorado, October 2013

Summary
 CDPHE and several Denver metropolitan area public health departments investigated an outbreak of Escherichia coli O157:H7 (E. coli O157:H7) that occurred in October 2013. Nine cases were identified, including 1 probable case and 8 laboratory-confirmed cases with matching pulsed-field gel electrophoresis (PFGE) and multiple-locus variable number tandem repeat analysis (MLVA) patterns from E. coli O157:H7 isolated from stool. All 9 cases reported eating sandwiches at Denver-area Jimmy John’s locations in early October 2013. The outbreak investigation consisted of case finding and interviews, 2 separate case-control studies, environmental investigations, produce traceback, and laboratory testing. The results of this investigation indicate that consumption of Jimmy John’s sandwiches containing cucumbers imported from Mexico was the likely cause of the outbreak. To our knowledge, this is the first E. coli O157:H7 outbreak associated with cucumbers reported in the United States. Public health and food safety officials should be aware that cucumbers may be contaminated with E. coli O157:H7, which could cause sporadic E. coli O157:H7 infections as well as outbreaks. As of the date of this report, no other cases of E. coli O157:H7 with the PFGE pattern combination seen in this outbreak were reported in Colorado.

Cucumbers linked to 73 becoming ill from Salmonella

UPDATE 5/8/13  CDC  - 81 people  infected from 18 states with 29% hospitalized.
http://www.cdc.gov/salmonella/saintpaul-04-13/index.html

CDC is reporting that 73 people have become ill from eating cucumbers contaminated with Salmonella. The cucumbers are from one Mexican producer, and that producer has been put on an import alert by FDA.

According to the CDC report (below): A total of 73 persons infected with the outbreak strain of Salmonella Saintpaul have been reported from 18 states. The number of ill persons identified in each state is as follows: Arizona (9), California (28), Colorado (1), Idaho (2), Illinois (3), Louisiana (1), Massachusetts (1), Maryland (1), Minnesota (8), Nevada (1), New Mexic0 (2), North Carolina (1), Ohio (1), Oregon (2), South Dakota (2), Texas (6), Virginia (2), and Wisconsin (2).

Multistate Outbreak of Salmonella Saintpaul Infections Linked to Imported Cucumbers

Posted April 25, 2013 12:30 PM ET http://www.cdc.gov/salmonella/saintpaul-04-13/index.html

Highlights
· Read the Advice to Consumers »
· A total of 73 persons infected with the outbreak strain of Salmonella Saintpaul have been reported from 18 states.
o 27% of ill persons have been hospitalized, and no deaths have been reported.
· State public health officials are interviewing ill persons to obtain information regarding foods they might have eaten and other exposures in the week before illness.
o Preliminary information indicates that consumption of imported cucumbers is the likely source of infection for the ill persons.
· On April 24, 2013, the U.S. Food and Drug Administration placed Daniel Cardenas Izabal and Miracle Greenhouse of Culiacán, Mexico on Import Alert .
o Cucumbers from these two firms will be denied admission into the United States unless the suppliers show that they are not contaminated with Salmonella.
· Currently, there is no evidence that contaminated cucumbers supplied by Daniel Cardenas Izabal and Miracle Greenhouse are still on the market.
o Due to the time it takes between when a person becomes ill and when the illness is reported, additional ill persons may be identified.
o Consumers and retailers should always follow safe produce handling recommendations . 
· CDC and state and local public health partners are continuing laboratory surveillance through PulseNet to identify additional ill persons and to interview ill persons about foods eaten with before becoming ill.