Most people don't pause before taking a bite of a turkey burger to consider whether it will send them to the hospital. No one should have to consider eating ground turkey a game of Russian roulette. But an outbreak of Salmonella Heidelberg infections has been linked to ground turkey products produced by a Cargill Meat Solutions Corporation plant in Springdale, Arkansas.
A total of 107 persons infected with the outbreak strain of Salmonella Heidelberg have been reported from 31 states between February 27 and August 9, 2011. We are still getting contacts from people who think they may be part of the outbreak, so the outbreak numbers may grow.
The number of ill persons identified in each state is as follows: Alabama (1), Arkansas (1), Arizona (3), California (6), Colorado (2), Georgia (2), Illinois (13), Indiana (1), Iowa (2), Kansas (1), Kentucky (2), Louisiana (1), Massachusetts (3), Maryland (1), Michigan (12), Minnesota (2), Mississippi (1), Missouri (4), Nebraska (2), Nevada (1), New York (2), North Carolina (3), Ohio (10), Oklahoma (1), Oregon (1), Pennsylvania (5), South Dakota (3), Tennessee (2), Texas (14), Utah (1), and Wisconsin (4).
Among persons for whom information is available, illnesses began on or after February 27, 2011. According to news reports, Cargill may have known about Salmonella Heidelberg contamination of ground turkey from the Arkansas plant months before this date.
Of the 107 identified cases, 25 (39%) have been hospitalized. One death, a woman from Sacramento County, California, has been reported.
Investigation of the Outbreak
Outbreak investigations involve gathering epidemiological and microbiological evidence to determine the source of the outbreak.
The epidemiological evidence is as follows:
Among the 71 ill persons with available information, 40 (56%) reported consuming ground turkey. This proportion is significantly higher than results from a survey of healthy persons in which 11% of persons interviewed reported consuming ground turkey in the 7 days before they were interviewed.
The microbiological evidence is as follows:
Cultures of five ground turkey samples purchased from five retail locations between March 7 and June 27, 2011, yielded Salmonella Heidelberg with the outbreak strain. PFGE patterns from these Salmonella bacteria were added to the PulseNet database between April 11 and July 12, approximately a month after each sample was collected. Preliminary information indicates that all of these products originated from a common food-production establishment (Cargill Meat Solutions Corporation in Springdale, Arkansas). These products were obtained as part of routine sampling in the National Antimicrobial Resistance Monitoring System (NARMS)External Web Site Icon, and are not linked to illnesses.
This is a multi-drug resistant strain of Salmonella Heidelberg. As of August 5, 2011, investigators have collected antibiotic resistance information on isolates from four samples of ground turkey collected at retail and from nine ill persons infected with the outbreak strain of Salmonella Heidelberg. The isolatesfrom the ground turkey samples are resistant to antibiotics including ampicillin, streptomycin, tetracycline, and gentamicin. The sensitivity testing results, to date, indicate that isolates from humans are also resistant to ampicillin, streptomycin, and tetracycline, and some are resistant to gentamicin; however, the testing is not complete for all isolates. All human isolates are sensitive to several common antibiotics that are used in clinical practice such as ciprofloxacin, ceftriaxone, and trimethoprim-sulfamethoxazole. Antimicrobial resistance may increase the risk of hospitalization or possible treatment failure in infected individuals.
A sample of leftover unlabeled frozen ground turkey was collected by public health officials from the home of an ill person in Ohio infected with the outbreak strain of Salmonella Heidelberg. Culture of the ground turkey sample yielded the outbreak strain on July 29, 2011. In addition to the outbreak strain with the “initial” PGFE pattern, a second closely related PFGE pattern of Salmonella Heidelberg was identified in the contaminated leftover product. Since February 27, 2011, a total of 23 ill persons have been reported to PulseNet with this closely related PGFE pattern. Among the 8 such patients that have been interviewed to date, 6 (75%) report consumption of ground turkey in the week before their illness began. The closely related PGFE pattern was also found in a retail sample of ground turkey taken as part of NARMS surveillance. This retail sample originated from Cargill Meat Solutions Corporation establishment in Springdale, Arkansas. Based on these findings, the 23 ill persons with this second closely related PFGE pattern of Salmonella Heidelberg have been included in the total count of outbreak cases.
Cargill Ground Turkey Recall
In response to this outbreak, on August 3, 2011, Cargill Meat Solutions Corporation, a Springdale, Arkansas, establishment, recalled approximately 36 million pounds of ground turkey products that may be contaminated with a multi-drug resistant strain of Salmonella Heidelberg. The products subject to recall bear the establishment number "P-963" inside the USDA mark of inspection. Read more about the Cargill ground turkey recall and a Cargill lawsuit.