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Salmonellosis in the United States

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Salmonellosis annually causes, per CDC estimation, about 1.2 million illnesses, 23,000 hospitalizations, and 450 deaths in the United States every year.[1]

The shell of the egg may be contaminated with Salmonella by feces or environment, or its interior (yolk) may be contaminated by penetration of the bacteria through the porous shell or from a hen whose infected ovaries contaminate the egg during egg formation.[2][3]

Salmonella is found in 8% of the chicken parts tested by the USDA and 25% of ground chicken.[4] Antibiotic resistance has developed in some strains of salmonella.[4]

Regulation

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The United States has struggled to control salmonella infections, with the rate of infection rising from 2001 to 2011. The FDA and the USDA have separate jurisdiction over products which may be contaminated with salmonella, but the rules defining which agency inspects what is complex and difficult to summarize; for example, the FDA inspects shelled eggs while the USDA oversees egg products.[5]

In 1998, the USDA moved to close plants if salmonella was found in excess of 20 percent, which was the industry’s average at the time, for three consecutive tests.[6] Texas-based Supreme Beef Processors, Inc. sued on the argument that Salmonella is naturally occurring and ultimately prevailed when a federal appeals court affirmed a lower court.[6] These issues were highlighted in a proposed Kevin's Law (formally proposed as the Meat and Poultry Pathogen Reduction and Enforcement Act of 2003), of which components were included the Food Safety Modernization Act passed in 2011, but that law applies only to the FDA and not the USDA.[6] The USDA proposed a regulatory initiative in 2011 to Office of Management and Budget.[7]

In 2012, the USDA proposed to increase the line speed and reduce the number of inspectors of chickens.[8]

Hazard Analysis and Critical Control Point (HACCP) rules

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In 1996, the USDA Food Safety and Inspection Service finalized rules which required slaughter and processing plants to adopt Hazard Analysis and Critical Control Point rules, which included performance standards for acceptable percentage testing positive of salmonella. These included 20% for broilers (chickens), 8.7% for swine, and 7.5% for ground beef.[9] In 2011, updated performance standards went into effect, reducing the salmonella prevalence to 7.5%; however, meeting these standards was not strictly required for operation.[10] Plants not meeting the requirement were publicized online.[10] The agency originally began publishing the names of problem plants in 2008.[11]

Industry commentary

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In a 2013 fact sheet, the National Chicken Council observed that although salmonella on raw chicken has significantly declined, salmonellosis has not significantly declined, suggesting that salmonellosis infections have another cause.[12]

Epidemiology

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In 2010, an analysis of death certificates in the United States identified a total of 1,316 Salmonella-related deaths from 1990 to 2006. These were predominantly among older adults and those who were immunocompromised.[13]

Before 2006

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The U.S. government reported as many as 20% of all chickens were contaminated with Salmonella in the late 1990s, and 16.3% were contaminated in 2005.[14] In the mid- to late 20th century, Salmonella enterica serovar Enteritidis was a common contaminant of eggs. This is much less common now with the advent of hygiene measures in egg production, and the vaccination of laying hens to prevent Salmonella colonization. Various Salmonella serovars (strains) also cause severe diseases in animals.[citation needed]

2007

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In February 2007, the U.S. Food and Drug Administration issued a warning to consumers not to eat certain jars of Peter Pan or Great Value peanut butter, due to risk of contamination with Salmonella tennessee.[15]

2008

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Main article: 2008 United States salmonellosis outbreak

From April 10, 2008 to July 8, 2008, the rare Saintpaul serotype of S. enteritidis caused at least 1017 cases of salmonellosis in 41 states throughout the United States, the District of Columbia, and Canada. As of July 2008, the U.S. FDA suspected the contaminated food product was a common ingredient in fresh salsa, such as raw tomato, fresh jalapeño pepper, fresh serrano pepper, and fresh cilantro. It is the largest reported salmonellosis outbreak in the United States since 1985. New Mexico and Texas have been proportionally the hardest hit by far, with 49.7 and 16.1 reported cases per million, respectively. The greatest number of reported cases have occurred in Texas (384), New Mexico (98), Illinois (100), and Arizona (49).[16] At least 203 reported hospitalizations have been linked to the outbreak, it has caused at least one death, and it may have been a contributing factor in at least one additional death.[17] The CDC maintains "it is likely many more illnesses have occurred than those reported." If applying a previous CDC-estimated ratio of unreported salmonellosis cases to reported cases (38.6:1), an estimated 40,273 illnesses occurred from this outbreak.[18]

As of 18 July 2008, the FDA removed raw tomatoes and cilantro as potential carriers; however, fresh jalapeño and serrano peppers still remain.[19]

In December 2008 and January 2009, several Midwestern states, including Ohio (officially confirmed by state authorities), reported an outbreak of salmonellosis from Salmonella typhimurium that had sickened at least 50 people, due to contaminated dairy products such as cheeses.[citation needed]

2009

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Main article: Peanut Corporation of America

On January 17, 2009, the FDA announced they had traced the source of an outbreak of Salmonella typhimurium to a plant in Blakely, Georgia, owned by Peanut Corporation of America (PCA), and urged people to postpone eating commercially prepared or manufactured peanut butter-containing products and institutionally served peanut butter.[20] Salmonella was reported to be found in 46 states in the United States in at least 3,862 peanut butter-based products, such as crackers, energy bars, and peanut butter cookies from at least 343 food companies. Dog treats were affected, as well. At least 691 people in more than 46 states became sick, and the Salmonella claimed at least 9 lives as of March 25.[21][22][23][24][25]

Peanut butter and peanut paste manufactured by PCA were distributed to hundreds of firms for use as an ingredient in thousands of different products, such as cookies, crackers, cereal, candy, and ice cream, all of which were recalled. Some products were also sold directly to consumers in retail outlets, such as dollar stores.[20]

On March 14, 2009, expressing his own personal concern for the safety of his children who enjoy peanut butter, President Obama announced the establishment of the Food Safety Working Group, "an inter-agency effort to help overhaul the oversight system."[26] The announcement came days after the FDA, also responding, released its first "guidance" on dealing with Salmonella contamination.[citation needed]

2012

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See also: 2012 salmonella outbreak

An outbreak of salmonellosis caused by a rarer subspecies, Salmonella bareilly, was reported in multiple US states primarily on the East Coast. No deaths were reported, but many episodes of sickness and some hospitalizations were linked to the consumption of raw scraped ground tuna product.[27]

2024

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An outbreak of salmonellosis in nine states due to recalled eggs, with 65 people hospitalized, has been reported.[28]

References

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  1. ^ "Salmonella Homepage | CDC". www.cdc.gov. 2018-11-13. Retrieved 2018-11-16.
  2. ^ Gantois, Inne; Richard Ducatelle; Frank Pasmans; Freddy Haesebrouck; Richard Gast; Tom J. Humphrey; Filip Van Immerseel (July 2009). "Mechanisms of egg contamination by Salmonella Enteritidis". FEMS Microbiology Reviews. 33 (4): 718–738. doi:10.1111/j.1574-6976.2008.00161.x. PMID 19207743. Eggs can be contaminated on the outer shell surface and internally. Internal contamination can be the result of penetration through the eggshell or by direct contamination of egg contents before oviposition, originating from infection of the reproductive organs. Once inside the egg, the bacteria need to cope with antimicrobial factors in the albumen and vitelline membrane before migration to the yolk can occur
  3. ^ Humphrey, T. J. (January 1994). "Contamination of egg shell and contents with Salmonella enteritidis: a review". International Journal of Food Microbiology. 21 (1–2): 31–40. doi:10.1016/0168-1605(94)90197-X. PMID 8155476. Salmonella enteritidis can contaminate the contents of clean, intact shell eggs as a result of infections of the reproductive tissue of laying hens. The principal site of infection appears to be the upper oviduct. In egg contents, the most important contamination sites are the outside of the vitelline membrane or the albumen surrounding it. In fresh eggs, only a few salmonellae are present. As albumen is an iron-restricted environment, growth only occurs with storage-related changes to vitelline membrane permeability, which allows salmonellae to invade yolk contents.
  4. ^ a b Simon, Bernice Yeung,Michael Grabell,Irena Hwang,Mollie. "America's Food Safety System Failed to Stop a Salmonella Epidemic. It's Still Making People Sick". ProPublica. Retrieved 2021-11-03.{{cite web}}: CS1 maint: multiple names: authors list (link)
  5. ^ "Who Inspects What? A Food Safety Scramble | Food Safety News". 2010-12-16. Retrieved 2016-09-18.
  6. ^ a b c "Salmonella Lurks From Farm to Fork « News21 2011 National Project". foodsafety.news21.com. Retrieved 2016-09-18.
  7. ^ "Ground Turkey Recall Shows We Still Need Kevin's Law | Food Safety News". 2011-08-12. Retrieved 2016-09-18.
  8. ^ "USDA Defends Controversial Measure To Speed Up Poultry Inspection Lines". The Huffington Post. 2012-08-07. Retrieved 2016-09-18.
  9. ^ "Progress Report on Salmonella Testing of Raw Meat and Poultry Products". www.fsis.usda.gov. Retrieved 2016-09-18.
  10. ^ a b "Tougher USDA standards for poultry pathogens to take effect". Retrieved 2016-09-18.
  11. ^ "USDA names chicken plants with Salmonella problems". Retrieved 2016-09-18.
  12. ^ "FACT SHEET: Salmonella - The National Chicken Council". 2013-06-28. Retrieved 2016-09-18.
  13. ^ Cummings, PL; Sorvillo F; Kuo T (November 2010). "Salmonellosis-related mortality in the United States, 1990–2006". Foodborne Pathogens and Disease. 7 (11): 1393–9. doi:10.1089/fpd.2010.0588. PMID 20617938.
  14. ^ Burros, Marian (March 8, 2006). "More Salmonella Is Reported in Chickens". The New York Times. Retrieved 2007-05-13.
  15. ^ "FDA Warns Consumers Not to Eat Certain Jars of Peter Pan Peanut Butter and Great Value Peanut Butter". FDA. 2007-02-14. Archived from the original on 2008-02-23. Retrieved 2019-08-04.
  16. ^ "Cases infected with the outbreak strain of Salmonella Saintpaul, United States, by state". For some states, such as California, the CDC has recently revised the tally of identified illness downward.
  17. ^ August 8, 2008: Investigation of Outbreak of Infections Caused by Salmonella Saintpaul | Salmonella CDC
  18. ^ Voetsch; et al. (2004-04-15). "FoodNet Estimate of the Burden of Illness Caused by Nontyphoidal Salmonella Infections in the United States". Clinical Infectious Diseases. 38: S127–S134. doi:10.1086/381578. PMID 15095181.
  19. ^ Elizabeth Landau (2008-07-18). "FDA lifts warning on tomatoes". CNN.
  20. ^ a b Recall of Products Containing Peanut Butter: Salmonella Typhimurium, U.S. Food and Drug Administration.
  21. ^ Recall of Peanut-Containing Products: Salmonella Typhimurium (Current Update), U.S. Food and Drug Administration
  22. ^ "Multistate Outbreak of Salmonella Typhimurium Infections Linked to Peanut Butter, 2008-2009 (FINAL UPDATE) - Salmonella - CDC". cdc.gov.
  23. ^ "More peanut products recalled, U.S. probe continues". Reuters. 2009-01-19.
  24. ^ NBC News: [1]
  25. ^ "Peanut Plant Had History of Health Lapses". The New York Times. 2009-01-27. Retrieved 2010-05-23.
  26. ^ Weise, Elizabeth (March 2009). "Salmonella outbreaks lead to food-safety changes". USA Today.
  27. ^ [3] "Multistate Outbreak of Salmonella Bareilly Infections Associated with a Raw Scraped Ground Tuna Product"
  28. ^ https://www.msn.com/en-us/health/nutrition/salmonella-outbreak-linked-to-recalled-eggs-from-wisconsin-farm-state-says/ar-AA1q8Ukv?ocid=BingNewsVerp
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