In 2018, during an investigation of antibiotic-susceptible Newport infections that led to a U.S. ground beef recall a genetically distinct group of MDR Newport isolates was identified. Isolates were classified as the outbreak strain if they fell within the MDR clade (0–11 alleles by core genome multilocus sequence typing [cgMLST]); isolates were identified using PulseNet, the national subtyping network for foodborne bacterial disease surveillance. A case was defined as isolation of the outbreak strain from a patient during June 2018–March 2019. After interviews conducted by state and local health departments, some patients were reinterviewed using a standardized hypothesis-generating questionnaire or supplementary questionnaires that included questions about travel and antibiotic treatment. Food exposures were reported for the 7 days before illness onset. Exposures among patients who did not travel internationally were compared with those expected among a nationally representative sample of healthy persons included in the U.S. Foodborne Diseases Active Surveillance Network population survey (2006–2007), after stratification by sex and ethnicity.
During June 2018–March 2019, 255 cases were identified in 32 U.S. states. Overall, 29% (60/209) of patients for whom information was available were hospitalized, 6% (4/70) were admitted to an intensive care unit, 4% (10/255) had Salmonella bacteremia, and two died. The median patient age was 36 years (range = <1–90 years), 58% (145/250) were female, and 65% (143/221) were Hispanic. Overall, 43% (89/206) with information on travel reported visiting Mexico in the 7 days preceding illness onset. Travelers to Mexico mostly reported visiting friends or family (67%, 24/36) and collectively reported visiting 16 of the 32 states within Mexico. Patients who did not visit Mexico were residents of 26 U.S. states.
Among patients who traveled to Mexico with information on food consumption, 87% (41/47) reported eating beef, and 63% (29/46) reported eating soft cheese; among those, 79% (23/29) recalled obtaining the cheese in Mexico. Of several types of artisanal cheese reported, the most frequently recalled cheese was queso fresco, a cheese that is typically made with raw, unpasteurized milk from cows or goats (3). Among patients who did not travel to Mexico, 29% (20/70) reported eating Mexican-style soft cheese, and 93% (68/73) reported eating beef (Table 1). The percentage who ate Mexican-style soft cheese was similar to the percentage in the nationally representative sample of healthy persons (p-value = 0.54), whereas the percentage who ate beef was higher than that among healthy persons (p<0.01).
 As of March 21, 2019, 403 people infected with the outbreak strain of Salmonella Newport were reported from 30 states. https://www.cdc.gov/salmonella/newport-10-18/index.html