If the FDA, CDC, Jimmy Johns corporate and the seed supplier (ISS) went public in 2019, would 51 been sickened in 2020?

When the CDC declared the Jimmy John’s E. coli O103 outbreak over at a total of 51 people infected with the outbreak strain of E. coli O103 reported from 10 states, that included only 3 counted in Iowa.

According to the CDC, illnesses started on dates ranging from January 6, 2020, to March 15, 2020. Ill people ranged in age from 1 to 79 years, with a median age of 29 years. Fifty-five percent of ill people were female. Of 41 ill people with information available, 3 were hospitalized and no deaths were reported.  Here is the full report: https://www.cdc.gov/ecoli/2020/o103h2-02-20/index.html

A few months ago a report from the Iowa Department of Health report landed in my inbox showing that 22 from Iowa were sickened.

Here is the summary:

In December, 2019, 22 Iowans became ill with Escherichia coli (E.coli) O103 after consuming clover sprouts produced by Sprouts Unlimited Wholesale Foods, Inc (Sprouts Unlimited) and sold on sandwiches at Jimmy John’s restaurants. The Iowa Department of Public Health (IDPH) first identified this outbreak through routine surveillance on December 18, 2019 when four individuals reported consuming sandwiches sold at various Jimmy John’s locations.

Iowa’s food retail and manufacturing regulatory agency, the Iowa Department of Inspections and Appeals (DIA), notified Jimmy John’s district office of the findings. Based on the epidemiological information, Sprouts Unlimited voluntarily ceased further distribution of clover sprouts pending additional information.

On February 21, 2020, the Food and Drug Administration (FDA) issued a warning letter to Jimmy John’s with evidence that demonstrates Jimmy John’s engaged in a pattern of receiving and offering for sale adulterated fresh produce, specifically clover sprouts and cucumbers.

The FDA also issued a warning letter to Sprouts Unlimited on February 25, 2020 for supplying sprouts to Jimmy John’s which lead to this outbreak and for several violations observed during FDA’s inspection of Sprouts Unlimited on December 31, 2019.

Here is the full report: 2002IAEXW-1 Outbreak – Iowa DPH Final Report

Here is a bit of a visual – 2020 and 2019 Outbreak NCBI Tree

A bit(e) of pre-2019 history:

Jimmy John’s sprout related outbreaks and recalls pre-2020 • Multistate Salmonella Outbreak, Jimmy John’s Restaurants Sprouts 2018

8 Sickened – As of January 18, 2018, eight people infected with the outbreak strain of Salmonella Montevideo had been reported from Illinois, Wisconsin, and Minnesota. Illnesses started on dates ranging from December 20, 2017, to January 3, 2018. Ill people ranged in age from 26 to 50, with a median age of 34. All 8 were female. No hospitalizations and no deaths were reported. Evidence indicated that raw sprouts served at Jimmy John’s restaurants were a likely source of outbreak.

Federal, state, and local health and regulatory officials conducted traceback investigations from the six Jimmy John’s locations where ill people ate raw sprouts.

Multistate E. coli O121 Outbreak, Jimmy John’s Restaurants Alfalfa Sprouts 2014

19 Sickened – Public health officials in California, Idaho, Michigan, Montana, Utah, and Washington collaborated with their federal partners at the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) to investigate an outbreak of E. coli O121 that occurred in May 2014. A total of 19 people with the outbreak strain, identified by the CDC’s PulseNet PFGE Pattern Identification Numbers EXKX01.0011/EXKA26.0001, were reported. Among people for whom information was available, dates of illness onset ranged from May 1, 2014, to May 20, 2014. Ill people ranged from 11 years to 52 years old. Seven of 16 victims for whom information was available were hospitalized. None of the confirmed patients developed hemolytic uremic syndrome and no deaths were reported.

Epidemiologic and traceback investigations conducted by public health officials implicated raw clover sprouts produced by Evergreen Fresh Sprouts LLC of Hayden, Idaho as the likely source of this outbreak. Thirteen (81%) of 16 ill people reported eating raw clover sprouts in the week before becoming ill. Ill people in Washington and Idaho reported eating sprouts in sandwiches at several local food establishments including several Jimmy John’s locations, the Pita Pit, and Daanen’s Deli.

As part of the investigation the FDA performed a traceback analysis and determined that Evergreen Fresh Sprouts supplied sprouts to seven restaurants with outbreak associated cases. This analysis used documents collected directly from the distributors and the grower, Evergreen Fresh Sprouts, as well as documents collected by the states from the points of service.

The FDA conducted several inspections at the Evergreen Fresh Sprouts facility in May and June. During the inspections FDA investigators observed a number of unsanitary conditions, including condensate and irrigation water dripping from rusty valves, a rusty and corroded watering system in the mung bean room, tennis rackets were being used to scoop mung bean sprouts that had scratches, chips and frayed plastic; a pitchfork used to transfer mung bean sprouts had corroded metal, and a squeegee used to agitate mung bean sprouts inside a soak vat that had visible corroded metal and non-treated wood.

On June 26, 2014, the FDA and CDC held a meeting with the owner of Evergreen Fresh Sprouts to advise the firm of FDA’s concerns that the seed lot used to row clover sprouts linked to this outbreak might be contaminated and to encourage Evergreen Fresh Sprouts to discontinue using that seed lot. The owner of Evergreen Fresh Sprouts agreed to stop using the suspect lot of seeds.

Multistate E. coli O26 Outbreak, Jimmy John’s Restaurants Alfalfa Sprouts 2012

29 Sickened – A total of 29 individuals infected with the outbreak strain of E. coli O26 were reported from 11 states, including: Alabama (1), Arkansas (1), Iowa (5), Kansas (2), Michigan (10), Missouri (3), Ohio (3), Pennsylvania (1), Washington (1), Wisconsin (1), and West Virginia (1).

Of the 27 ill people with available information, 23 (85%) reported consuming sprouts at Jimmy John’s restaurants in the seven days preceding illness. Among 29 ill people, illness onset dates ranged from December 25, 2011, to March 3, 2012. Ill people ranged in age from 9 years to 57 years old, with a median age of 26 years; 89% of the patients were female. Among the 29 ill persons, seven (24%) were hospitalized. None developed HUS, and no deaths were reported.

Preliminary traceback information identified a common lot of clover seeds used to grow clover sprouts served at Jimmy John’s restaurant locations where ill persons ate. FDA and states conducted a traceback that identified two separate sprouting facilities; both used the same lot of seed to grow clover sprouts served at these Jimmy John’s restaurant locations. On February 10, 2012, the seed supplier initiated a notification process for sprouting facilities that received the implicated lot of clover seed to stop using it.

Results of the epidemiologic and traceback investigations indicated eating raw clover sprouts at Jimmy John’s restaurants was the likely cause of this outbreak.

Sprouters Northwest, Jimmy John’s Restaurants Clover Salmonella Sprouts Outbreak 2010

7 Sickened – Sprouters Northwest of Kent, WA, issued a product recall after the company’s clover sprouts had been implicated in an outbreak of Salmonella Newport in Oregon and Washington. At least some of the cases had consumed clover sprouts while at a Jimmy John’s restaurant. Concurrent with this outbreak, a separate outbreak of Salmonella, serotype I 4,5,12,i- ; involving alfalfa sprouts served at Jimmy John’s restaurants was under investigation. The recall of Northwest Sprouters products included: clover; clover and onion; spicy sprouts; and deli sprouts. The Sprouters Northwest products had been sold to grocery stores and wholesale operations in Washington, Oregon, Idaho, Alaska, British Columbia, Saskatchewan, and Alberta. The FDA inspection found serious sanitary violations.

Multistate Salmonella Outbreak, Tiny Greens Organic Farm, Jimmy John’s Restaurants Alfalfa Sprouts 2010

140 Sickened – On December 17, the Illinois Department of Health announced that an investigation was underway into an outbreak of Salmonella, serotype I4,[5],12:i:-. Many of the Illinois patients had eaten alfalfa sprouts at various Jimmy John’s restaurants in the Illinois counties of Adams, Champaign, Cook, DuPage, Kankakee, Macon, McHenry, McLean, Peoria, and Will counties. The sprouts were suspected to be the cause of the illnesses. On Dec. 21 that year Jimmy John Liautaud, the owner of the franchised restaurant chain, requested that all franchisees remove all sprouts from the menu as a “precautionary” measure. On Dec. 23, the Centers for Disease Control revealed that outbreak cases had been detected in other states and that the outbreak was linked with eating alfalfa sprouts from a nationwide sandwich chain. On Dec. 26, preliminary results of the investigation indicated a link to eating Tiny Greens’ Alfalfa Sprouts at Jimmy John’s restaurant outlets. The FDA subsequently advised consumers and restaurants to avoid Tiny Greens Brand Alfalfa Sprouts and Spicy Sprouts produced by Tiny Greens Organic Farm of Urbana, Illinois. The Spicy Sprouts contained alfalfa, radish, and clover sprouts. On January 14, 2011, it was revealed that the FDA had isolated Salmonella serotype I4,[5],12:i:- from a water runoff sample collected from Tiny Greens Organic Farm; the Salmonella isolated was indistinguishable from the outbreak strain. The several FDA inspections of the sprout growing facility revealed factors that likely led to contamination of the sprouts.

CW Sprouts, Inc., SunSprout Sprouts, “restaurant chain (Chain A),” a.k.a. Jimmy John’s Salmonella Outbreak 2009

256 Sickened – In February, Nebraska Department of Health and Human Services officials identified six isolates of Salmonella Saintpaul. Although this is a common strain of Salmonella, during 2008, only three cases had been detected in Nebraska and only four subtypes of this outbreak strain had been identified in 2008 in the entire USA. As additional reports were made, a case control study was conducted; alfalfa sprout consumption was found to be significantly related to illness. The initial tracebacks of the sprouts indicated that although the sprouts had been distributed by various companies, the sprouts from the first cases originated from the same sprouting facility in Omaha, NE. Forty-two of the illnesses beginning on March 15 were attributed to sprout growing facilities in other states; these facilities had obtained seed from the same seed producer, Caudill Seed Company of Kentucky. The implicated seeds had been sold in many states. On April 26, the FDA and CDC recommended that consumers not eat raw alfalfa sprouts, including sprout blends containing alfalfa sprouts. In May, FDA alerted sprout growers and retailers that a seed supplier, Caudill Seed Company of Kentucky, was withdrawing all alfalfa seeds with a specific three-digit prefix. Many of the illnesses occurred at “restaurant chain (Chain A),” according to the CDC, which generally does not identify specific business.

Jimmy John’s Restaurant Alfalfa Sprouts and Iceberg Lettuce E. coli Outbreak 2008

28 Sickened – Several University of Colorado students from one sorority became ill with symptoms of bloody diarrhea and cramping. Additional illnesses were reported.E. coli O157:NM(H-) was determined to be the cause. Consumption of alfalfa sprouts at the Jimmy

John’s Restaurants in Boulder County and Adams County were risk factors for illness. In addition, the environmental investigation identified Boulder Jimmy John’s food handlers who were infected with E. coli and who had worked while ill. The health department investigation found several critical food-handling violations, including inadequate handwashing. The fourteen isolates from confirmed cases were a genetic match to one another.

BTW, here is Jimmy Johns post 2018 and pre 2020 sprout “warning” sign:

Here is the one I would have suggested: