CDC that Hepatitis A outbreak investigations were also underway in Russell County, Kentucky and Clark County, Nevada. Taco Bell green onions would soon be implicated in these outbreaks as well.
This outbreak was clearly linked to Taco Bell restaurants in the northeastern United States. As of December 14, 2006, Thursday, 71 persons with illness associated with the Taco Bell restaurant outbreak have been reported to CDC from 5 states: New Jersey (33), New York (22), Pennsylvania (13), Delaware (2), and South Carolina (1). States with Taco Bell restaurants where persons confirmed to have the outbreak strain have eaten are New Jersey, New York, Pennsylvania, and Delaware. (The patient from South Carolina ate at a Taco Bell restaurant in Pennsylvania). Other cases of illness are under investigation by state public health officials. Among these 71 ill persons, 53 (75%) were hospitalized and 8 (11%) developed a type of kidney failure called hemolytic-uremic syndrome (HUS).
Food items include a variety of different ingredients. By comparing foods consumed by ill and well persons, investigators can show statistical links between illness and consumption of particular food ingredients. Public health investigators have identified a few ingredients that were consumed more often by ill persons than well persons and were statistically linked with illness: lettuce, cheddar cheese, and ground beef. This analysis also indicates that onions of any type are not linked to this outbreak. The investigators have also gathered additional information about the locations of involved restaurants, the patterns of distribution of food ingredients, and the characteristics and preparation of food ingredients. Evaluation of all these data indicates that shredded lettuce consumed at Taco Bell restaurants in the northeastern United States was the most likely source of the outbreak.
In both outbreaks, the FDA worked with CDC and state partners to conduct a traceback investigation. The tracebacks focused on produce that ill individuals reported eating and that had been implicated in previous outbreaks of salmonellosis. The extensive traceback effort was initiated to determine if a common source or supplier could be identified to help focus the epidemiologic investigations. No common food source was identified in either traceback. The FDA also sampled and tested produce items and did not find either outbreak strain. As with previous outbreaks in which contaminated produce may be the factor, produce tracebacks present substantial challenges because of the short shelf life of the product and the industry’s comingling of product from multiple sources.
Salmonella Hartford Outbreak
A total of 75 individuals infected with a matching strain of Salmonella Hartford have been reported from 15 states since April 1, 2010. The number of ill people identified in each state with this strain is as follows: CO (1), GA (1), IL (5), IN (11), KY (23), MA (2), MI (3), MT (1), NC (1), NH (1), NY (1), OH (19), PA (1), SC (1) and WI (4). Among those for whom information is available about when symptoms started, illnesses began between April 30, 2010 and July 18, 2010. Case-patients range in age from <1 to 80 years old, and the median age is 39 years. Fifty-seven percent of patients are female. Among the 47 patients with available hospitalization information, 15 (32 %) were hospitalized.
Salmonella Baildon Outbreak
A total of 80 individuals infected with a matching strain of Salmonella Baildon have been reported from 15 states since May 1, 2010. The number of ill people identified in each state with this strain is as follows: CT (1), GA (1), IA (1), IL (20), IN (4), KY (5), MA (1), MI (4), MN (5), NJ (6), NY (2), OH (6), OR (1), WA (1) and WI (22). Among those for whom information is available about when symptoms started, illnesses began between May 11, 2010 and July 19, 2010. Case-patients range in age from 1 to 82 years old, and the median age is 47 years. Seventy-four percent of patients are female. Among the 68 patients with available hospitalization information, 27 (40 %) were hospitalized.