The Public Health Agency of Canada is collaborating with provincial public health partners, the Canadian Food Inspection Agency and Health Canada to investigate an outbreak of Salmonella infections.

Based on the investigation findings to date, exposure to raw turkey and raw chicken products has been identified as the likely source of the outbreak. Many of the individuals who became sick reported eating different types of turkey and chicken products before their illnesses occurred.

Almost half of the illnesses included in this active investigation occurred in October and November 2018. These illnesses are genetically related to illnesses that date back to 2017. The outbreak appears to be ongoing, as illnesses continue to be reported to the Public Health Agency of Canada.
Salmonella bacteria are commonly found in raw or undercooked poultry like turkey or chicken. The bacteria are most-often transmitted to people when they improperly handle, eat or cook contaminated foods.

This outbreak is a reminder of the importance of using safe food handling practices if you are preparing, cooking, cleaning or storing raw turkey and raw chicken food products. These raw products can have bacteria that can easily be spread around food preparation areas and can make you sick if safe food-handling practices are not properly followed.

Canadians across the country are reminded to always handle raw turkey and raw chicken carefully, and to cook it thoroughly to prevent food-related illnesses like Salmonella. The Public Health Agency of Canada is not advising that consumers avoid eating properly cooked turkey or chicken products, nor is it advising retailers to stop selling raw turkey and raw chicken products.

This public health notice is being issued to inform Canadians of the investigation findings to date and to share important safe food-handling practices to help prevent further Salmonella infections. This notice will be updated as the investigation evolves.

As of December 21, 2018, there have been 22 confirmed cases of Salmonella Reading illness investigated in the following provinces: British Columbia (9), Alberta (7), Manitoba (5), and New Brunswick (1). Individuals became sick between April 2017 and mid-November 2018. Five individuals have been hospitalized. One individual has died. Individuals who became ill are between 0 and 93 years of age. The majority of cases (64%) are female.

The collaborative outbreak investigation was initiated due to an increase of Salmonella Reading illnesses that occurred in October and November 2018. Through the use of a laboratory method called whole genome sequencing, some Salmonella illnesses dating back to 2017 were identified to have the same genetic strain as the illnesses that occurred in October and November 2018. Almost half of the illnesses under investigation occurred in October and November 2018.

It is possible that more recent illnesses may be reported in the outbreak because there is a period of time between when a person becomes ill and when the illness is reported to public health officials. This period of time is called the case reporting delay. In national Salmonella outbreak investigations, the case reporting delay is usually between 5 and 6 weeks.

The United States Centers for Disease Control and Prevention (U.S. CDC) is also investigating similar Salmonella illnesses in several states that have been linked to raw turkey exposure. There have been some turkey products recalled in the U.S. that were associated with this outbreak. These products were not imported or distributed in the Canadian marketplace.

The CFIA is collaborating with the overall outbreak investigation and is liaising with the U.S. Department of Agriculture regarding their investigation into the potential turkey source. The CFIA will issue food recall warnings to inform Canadians if any products recalled in the U.S. were imported in Canada.

Summary

Public Health investigated an outbreak of salmonellosis (caused by Salmonella bacteria) associated with Burien Fresh Smoothies in Burien. The exact food or drink item that caused the illnesses has not been identified.

Illnesses

Since August 15, 2018, eleven people from six separate meal parties reported becoming ill after consuming food and beverage from Burien Fresh Smoothies from August 6–8, 2018. Two of the ill people were hospitalized and have since recovered. There is no indication that any employees of the restaurant have had any symptoms consistent with salmonellosis.

Public Health actions

As part of the Public Health investigation, Environmental Health investigators visited the restaurant on August 15, 2018. Investigators found that the restaurant was serving cooked pork prepared at the restaurant owner’s home, which is not an approved food safety practice. The restaurant was directed to immediately stop serving pork-based food items and to remove them from their menu.

However, on August 16, 2018, we identified a fourth ill person diagnosed with salmonellosis after eating at Burien Fresh Smoothies on August 7, 2018. This person did not eat any pork-based food items. On August 16, 2018, our Environmental Health investigators revisited the establishment and suspended its permit.

On August 17, 2018, an additional three ill people were identified (one person with lab-confirmed salmonellosis, two people with symptoms consistent with salmonellosis).

Burien Fresh Smoothies was allowed to reopen on August 20, after Public Health confirmed the restaurant completed a thorough cleaning and disinfection of their establishment, adopted safe food handling practices to minimize cross contamination risks, and discarded any remaining processed ready-to-eat food products. Additionally, Environmental Health investigators worked closely with Burien Fresh Smoothies owners to educate them about using only approved food sources. The restaurant will be allowed to sell pork-based foods once our food safety team determines the owners have secured an alternative approved source.Laboratory testing

Eight of the eleven people who got sick tested positive for Salmonella Braenderup with the same genetic fingerprint, suggesting that they have a common source of infection.

Food samples collected from the establishment tested negative for salmonella. We were not able to confirm which food or beverage caused these illnesses.

An additional 87 ill people from 16 states were included in this investigation since the last update on November 15, 2018. States with newly reported illnesses include: Michigan, Mississippi, and West Virginia.

As of December 12, 2018, 333 people infected with the outbreak strain of Salmonella Newport have been reported from 28 states.Illnesses started on dates ranging from August 5, 2018 to November 9, 2018.

91 people have been hospitalized. No deaths have been reported.

Epidemiologic, laboratory, and traceback evidence indicates that ground beef produced by JBS Tolleson, Inc. is a likely source of this outbreak.

On October 4, 2018, JBS Tolleson, Inc. recalled approximately 6.9 million pounds of beef products that may be contaminated with Salmonella Newport. On December 4, 2018, JBS Tolleson, Inc. recalled an additional 5.2 million pounds of beef products.

Personally, as I said to the Los Angeles Times some time ago, “I think that anything that can poison or kill a person should be listed as an adulterant [in food].”  Ignoring Salmonella in meat makes little, if any, sense. Even after the Court’s twisted opinion in Supreme Beef v. USDA, where it found Salmonella “not an adulterant per se, meaning its presence does not require the USDA to refuse to stamp such meat ‘inspected and passed,” our government’s failure to confront the reality of Salmonella, especially antibiotic-resistant Salmonella, is inexcusable.  The Wisconsin Supreme Court in Kriefall v Excel called it as it saw it:

The E. coli strain that killed Brianna and made the others sick is a “deleterious substance which may render [meat] injurious to health.” There is no dispute about this. Thus, under the first part of 21 U.S.C. § 601(m)(1), meat that either “bears or contains” E. coli O157:H7 (the “deleterious substance”) is “adulterated.” That E. coli O157:H7 contamination can be rendered non-“injurious to health” by cooking thoroughly, as discussed below, does not negate this; Congress used the phrase “may render,” not “in every circumstance renders.” Moreover, if the E. coli bacteria is not considered to be “an added substance,” because it comes from some of the animals themselves and is not either applied or supplied during the slaughtering process (although we do not decide this), it cannot be said that the E. coli strain “does not ordinarily render [the meat on or in which it appears] injurious to health.” Accordingly, meat contaminated by E. coli O157:H7 is also “adulterated” under the second part of § 601(m)(1).

Now, why would Salmonella be different? According to the CDC, it is estimated that 1.4 million cases of salmonellosis occur each year in the U.S. Of those cases, 95 percent are related to foodborne causes.  Approximately 220 of each 1000 cases result in hospitalization, and 8 of every 1000 cases result in death.  About 500 to 1,000 deaths – 31 percent of all food-related deaths – are caused by Salmonella infections each year. So, where do we stand with the existing USDA/FSIS law on adulteration?  Here is the law:

21 U.S.C. § 601(m)(4) – SUBCHAPTER I – INSPECTION REQUIREMENTS; ADULTERATION AND MISBRANDING – CHAPTER 12 – MEAT INSPECTION – TITLE 21—FOOD AND DRUGS

(m) The term “adulterated” shall apply to any carcass, part thereof, meat or meat food product under one or more of the following circumstances:

(1) if it bears or contains any poisonous or deleterious substance which may render it injurious to health; but in case the substance is not an added substance, such article shall not be considered adulterated under this clause if the quantity of such substance in or on such article does not ordinarily render it injurious to health; …

(3) if it consists in whole or in part of any filthy, putrid, or decomposed substance or is for any other reason unsound, unhealthful, unwholesome, or otherwise unfit for human food;

(4) if it has been prepared, packed, or held under insanitary conditions whereby it may have become contaminated with filth, or whereby it may have been rendered injurious to health; …

Hmmm. It is hard to read the above and not think that the words in bold equate to all E. coli and Salmonella (frankly, all pathogens in food).  I know, I am just a lawyer, but don’t ya think that when food with animal feces (and a dash of E. coli O157:H7) in it is considered an adulterant, that other animal feces (with dashes of other pathogens, like Salmonella) in them, should be considered adulterated too?  But, hey, that is just me. Another odd governmental fact is that the FDA does not seem to make a distinction between pathogens it considers adulterants or not.  FDA’s enabling legislation – Sec. 402. [21 USC §342] of the Food, Drug & Cosmetic Act also defines “Adulterated Food” as food that is: 

(a) Poisonous, insanitary, or deleterious ingredients.

(1) If it bears or contains any poisonous or deleterious substance which may render it injurious to health; but in case the substance is not an added substance such food shall not be considered adulterated under this clause if the quantity of such substance in such food does not ordinarily render it injurious to health;

(2) If it bears or contains any added poisonous or added deleterious substance … that is unsafe within the meaning of section 406;

(3) if it consists in whole or in part of any filthy, putrid, or decomposed substance, or if it is otherwise unfit for food;

(4) if it has been prepared, packed, or held under insanitary conditions whereby it may have become contaminated with filth, or whereby it may have been rendered injurious to health …

It would be interesting, and perhaps entertaining, to have House and Senate hearings focusing on what should and should not be considered adulterants in our food.  I can see panels of scientists from various fields, FDA, USDA and FSIS officials, beef and produce industry representatives and consumers discussing this.  I would pay to watch it.

Salmonella:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Salmonella outbreaks. The Salmonella lawyers of Marler Clark have represented thousands of victims of Salmonella and other foodborne illness outbreaks and have recovered over $650 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Salmonella lawyers have litigated Salmonella cases stemming from outbreaks traced to a variety of foods, such as cantaloupe, tomatoes, ground turkey, salami, sprouts, cereal, peanut butter, and food served in restaurants.  The law firm has brought Salmonella lawsuits against such companies as Cargill, ConAgra, Peanut Corporation of America, Sheetz, Taco Bell, Subway and Wal-Mart.

If you or a family member became ill with a Salmonella infection, including Reactive Arthritisor Irritable bowel syndrome (IBS), after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Salmonella attorneys for a free case evaluation.

As of December 7, 2018, this outbreak investigation is over.

A total of 25 people infected with the outbreak strain of Salmonella I 4,[5],12:i:- were reported from six states.

Eleven people were hospitalized, including one death reported from New York.

Kosher chicken products were contaminated with Salmonella I 4,[5],12:i:- and made people sick.

In interviews, ill people reported eating kosher chicken, and when asked about the specific brand eaten, several people reported Empire Kosher brand.

The outbreak strain was also identified in samples of raw chicken collected from two facilities, including one facility that processes Empire Kosher brand chicken.