A lawsuit was filed today in U.S. District Court against Hy-Vee, Inc. on behalf of Margaret Reiner, Tyler Rogers, and Kami Rogers who were all infected with Salmonella after eating Hy-Vee Pasta Salad. The three plaintiffs are represented by Marler Clark, the Nation’s Food Safety Law Firm, and Jardine, Logan, and O’Brien, a well-respected local firm.  Case No. is 0:18-cv-02379.

“Hy-Vee has always been a leader in food safety,” said Bill Marler, managing partner at Marler Clark. “We hope through the lawsuit to understand how this event happened and the do what we can to make sure something like this never happens again, added Marler.

On July 5, 2018, Ms. Reiner’s daughter, Kami Rogers, purchased pasta salad from a Hy-Vee store located at 1475 W. Service Drive, Winona, Minnesota. Ms. Reiner consumed the product the same day. Six days later, she began experiencing symptoms of diarrhea, body aches, and headaches. On July 19, her symptoms became so severe that she sought medical attention at Olmsted Medical Center where she tested positive for Salmonella. She remains under professional care through today.

Tyler Rogers consumed the same Hy-Vee Pasta Salad that his grandmother, Ms. Reiner. ate. He began experiencing symptoms on July 11, forcing him to miss three days of work. He continues to recover from his symptoms.

Kami Rogers consumed the Hy-Vee Pasta Salad on July 5th, 6th, and 7th.  She began experiencing symptoms on July 8th and four days later sought medical attention. Ms. Rogers consulted with her physicians regarding her symptoms through August 1, during which time she tested positive for Salmonella.

On July 17, the CDC and Hy-Vee announced an outbreak and recall of Hy-Vee Spring Pasta Salad for Salmonella contamination. To date, there are 79 cases across 9 states. 18 people have been hospitalized.

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 Arthritis or 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.

Perry County Memorial Hospital in Perryville says there have been over 30 cases of Salmonella diagnosed since August 6th. Patient ages range from two to 68.  Three cases have required acute hospital admission, two short-term hospital observation and treatment, and one case has been transferred to a Cape Girardeau hospital.  The others so far are recovering with medication and hydration at home.

The Perry County Health Department says many of the reports of illness come from people who attended the St. Vincent de Paul Parish Seminary Picnic in Perryville from August 3rd through 5th.

The health department has posted a questionnaire for those who attended the event in an attempt to determine the source of the illness and protect the community from further illness.

Sorry Tom Hanks and Meg Ryan

Food Safety News reports – Known for its Chirashi bowl, but called The Fremont Bowl for its Seattle location, a small, but popular Japanese restaurant was forced to close Friday by Public Health. Seattle-King County Public Health closed The Fremont Bowl, located at  4258 Fremont Ave N, Ste #4262, Seattle, WA 98103, at 10:45 a.m., Aug. 10, 2018, due to the following food safety violations:

  • Foodborne illness outbreak.
  • Failure to wash hands as required
  • Improper food temperature control
  • Risk of cross contaminations not eliminated
  • Inadequate fresh produce washing procedure followed

Public Health is investigating an outbreak of salmonellosis, which caused by Salmonella bacteria. At this time, the source of the illnesses has not been identified.

The agency learned on Aug. 8 of four people from three separate meal parties that have reported illness after eating at Fremont Bowl in Seattle from July 27-29, 2018.

Three of the four people who got sick tested positive for Salmonella by a healthcare provider. The fourth person ate at Fremont Bowl prior to becoming ill with symptoms consistent with salmonellosis.

One of the ill people was hospitalized and has since recovered.

Environmental Health investigators completed an inspection at Fremont Bowl on Aug. 9, finding potential risk factors, including inadequate hand washing, lack of temperature controls, and risk of cross-contamination. Fremont Bowl management was informed about corrective measures that were required.

Environmental Health investigators re-visited on Aug. 10  and closed the establishment because many of the corrective actions were not completed.

Fremont Bowl will not be allowed to reopen until Public Health confirms they achieve a thorough cleaning and disinfection of their establishment, adopt safe food handling practices to minimize cross-contamination risks, and any remaining processed ready-to-eat food products are discarded. Furthermore, employees will be required to attend food safety training before being allowed to handle food.

A Chirashi (means scattered) is a big bowl of rice mixed with your choice of fish, vegetables, and other ingredients.

According to press reports, the Perry County Health Department, more than 30 cases of Salmonella infection have been reported in the past five days, nearly six times the number they usually see in a year.

Health department officials said they don’t have enough information yet to determine a source and that the investigation is ongoing.

“We are speaking with Department of Health and Senior Services in St. Louis, our counterparts up there,” said Sheila Hahs, the department’s RN communicable disease coordinator. “They have specialists who do all the calculations and figure out what caused what.”

Hahs said that the investigators are putting together a survey that will be used as part of the inquiry into the source of the outbreak.

“It depends on how many people come up symptomatic,” Hahs said. “This could go on for a while. We could be having secondary cases.”

On Thursday, Perry County Memorial Hospital reported that there had been at least 23 cases of Salmonella infection diagnosed since Monday in patients ranging in age from 2 to 68, both through the PCMH emergency department and local doctors’ offices. By Friday, that number had risen to 32.

Of these, three have required acute hospital admission, two were admitted for short-term observation and treatment, and one was transferred to a hospital in Cape Girardeau.  The others are reportedly recovering at home with medication and hydration.

All cases resulting in positive tests for Salmonella bacteria were reported to the health department.

“Laboratories are required to report communicable diseases such as this,” Hahs said. “There is a reportable list that all labs and doctors’ offices have and when one of them comes across as the diagnosis, then that has to be reported.”

Doctors at PCMH were able to make rapid diagnoses thanks to a recent equipment upgrade in the hospital’s laboratory department. The new testing units, installed in July, cut the waiting period on test results from days to hours.

“It’s something that we purchased earlier this year,” said PCMH vice-president of operations Chris Wibbenmeyer, who also oversees the hospital’s laboratory department. “We actually have four units that this testing can be ran on. It was testing that we didn’t have before.”

Wibbenmeyer said the timing of the upgrades, which include a new, highly specialized gastrointestinal test panel that can accurately and quickly identify 22 of the most common organisms that cause abdominal symptoms, proved lucky in light of the outbreak.

“It just so happens that us implementing this G.I. panel happened just shortly before this outbreak,” Wibbenmeyer said. “It’s worked really well because it speeds up the diagnostic time by days. That’s beneficial to everyone. It has other testing capabilities — it’s not just GI testing  — and in all of those areas, we’ve reported significant reductions in the turnaround time for results and have improved the timeliness of getting appropriate medications to the patients. It’s proven its worth over and over again.”

One Kansas resident tests positive with Salmonella after attending dinner

The Kansas Department of Health and Environment (KDHE) and Doniphan County Health Department (DCHD) are currently conducting an outbreak investigation associated with an election day Indian Taco Dinner at the Highland United Methodist Presbyterian Church in Highland, Kan., on Aug. 7.

KDHE and DCHD request that anyone who attended or consumed food from the election day Indian Taco Dinner on Aug. 7 completes an online survey at: https://tinyurl.com/Doniphan . We would like everyone who attended to complete the survey, whether they became ill or not.

Those unable to complete the online survey may call DCHD at 785-985-3591, or the KDHE Epidemiology Hotline at 877-427-7317.

Contact a health care provider if you think you got sick. Most people infected with Salmonella develop diarrhea, fever and stomach cramps usually 12 to 96 hours, but can be as long as seven days, after being exposed to the bacteria. The illness usually lasts four to seven days, and most people recover without treatment. In some people, the diarrhea may be so severe that the patient needs to be hospitalized. Salmonella infection may spread from the intestines to the bloodstream and then to other places in the body. Children younger than five years, adults older than 65 years, and people with weakened immune systems are more likely to have a severe illness.

Fifty-eight more ill people from nine states were added to this outbreak since the last update on July 18, 2018. Four more states reported ill people: Illinois, Kansas, North Dakota, and Tennessee.

Salmonella enterica subspecies IIIb has been added to this investigation because two people were infected with this strain of Salmonella and with the outbreak strain of Salmonella Sandiego at the same time. A search of the CDC PulseNet database found six additional people infected with the strain of Salmonella enterica subspecies IIIb and these cases have also been added to the outbreak.

A total of 79 people infected with the outbreak strains of Salmonella have been reported from nine states.

Illnesses started on dates ranging from June 21, 2018, to July 15, 2018.

On July 17, 2018, Hy-Vee, Inc. recalled its Spring Pasta Salad because it might be contaminated with Salmonella. Do not eat recalled Hy-Vee Spring Pasta Salad.

The Spring Pasta Salad includes shell pasta, carrots, celery, cucumbers, green pepper, onion, and mayonnaise. The recalled pasta salad was sold in 1-pound (16 oz.) and 3-pound (48 oz.) plastic containers or may have been scooped at the deli counter into clear plastic containers. The recalled pasta salad was sold in all Hy-Vee grocery stores in Illinois, Iowa, Kansas, Minnesota, Missouri, Nebraska, South Dakota, and Wisconsin. The expiration dates for the recalled pasta salad range from June 22, 2018 to August 3, 2018.

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 Arthritis or 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.

The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) is issuing a public health alert due to concerns that products may be contaminated with Salmonella from whey powder that has been recalled by the producer of the ingredient. FSIS is issuing this public health alert out of the utmost of caution to ensure that consumers are aware that these products, which bear the USDA mark of inspection, should not be consumed.

The whey powder is an FDA-regulated product that is being voluntarily recalled by the producer, Associated Milk Producers, Inc. (AMPI). Additional FSIS-regulated products containing the recalled whey powder may be added to this public health alert as more information becomes available.

The product currently subject to the public health alert is produced by Pinnacle Foods, Inc., a Fayetteville, Ark. establishment and is listed below:

  • 15.25-oz. individual frozen microwavable dinners with “HUNGRY MAN CHIPOTLE BBQ SAUCED BONELESS CHICKEN WYNGZ” printed on the label and bearing a best buy date of 9/6/19.

The product bears establishment number “EST. P138” or “P-138” on the side of the carton. These products were shipped to retail locations in Massachusetts, Pennsylvania, and Virginia.

The problem was discovered on July 17, 2018, when Pinnacle Foods, Inc. was notified by their supplier that the recalled whey powder ingredient was used in the ranch dressing seasoning supplied to the firm. The ranch dressing seasoning was incorporated into mashed potatoes and packaged as a component with a boneless chicken dinner.

As of July 24, 2018, 77 people infected with the outbreak strain of Salmonella Adelaide were reported from nine states – Arkansas 1, Florida 1, Illinois 7, Indiana 14, Kentucky 1, Michigan 39, Missouri 11, Ohio 2 and Tennessee 1.  The CDC has determined that the outbreak in likely over.

Among ill people, 67% were female.

Out of 70 people with information available, 36 (51%) were hospitalized. No deaths were reported.

Illnesses started on dates ranging from April 30, 2018, to July 2, 2018. Ill people ranged in age from less than 1 year to 97, with a median age of 67.

Epidemiologic and traceback evidence indicated that pre-cut melon supplied by the Caito Foods, LLC of Indianapolis, Indiana was the likely source of this multistate outbreak. In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Thirty-six (64%) of 56 people interviewed reported eating pre-cut melon purchased from grocery stores, including cantaloupe, watermelon, or a fruit salad mix with melon. Twelve other people reported eating melon, but did not specify whether it was pre-cut. Information collected from stores where ill people shopped indicated that Caito Foods, LLC supplied pre-cut melon to these stores. On June 8, 2018, Caito Foods, LLC recalled fresh-cut watermelon, honeydew melon, cantaloupe, and fresh-cut fruit medley products containing one of these melons that were produced at the Caito Foods facility in Indianapolis, Indiana.

The recalls (hopefully, without illnesses) over the past week liked to whey powder tainted with Salmonellathat has food its way into popular snack items for chocolate cakes to Ritz and Gold Fish crackers is concerning, but a clear indicator that product testing and recalls appear to be working – that is a good thing.

Of even great concern are the outbreaks linked to Salmonellathat have sickened 100’s of people, putting dozens in the hospital.  From sprouts, shell eggs, cut fruit, cereal, pasta salad and turkey, the last few months have people questioning the safety of our food supply and asking questions about Salmonella.

As for the why the outbreaks, it could be better surveillance by state, local and national health authorities utilizing cutting edge tools such as PFGE and WGS.  It could be a lack of support for inspectors.  It is certainly possible that it is more imports with a greater supply chain with a great chance for contamination or temperature abuse. It also could be we are eating more mass produced fresh, ready to eat foods without a “kill step.”

As for the questions about Salmonella, here is a bit(e) of information:

Salmonella is a bacterium that causes one of the most common enteric (intestinal) infections in the United States – salmonellosis.  It has long been said that, in 1885, pioneering American veterinary scientist, Daniel E. Salmon, discovered the first strain of Salmonella. Actually, Theobald Smith, research-assistant to Dr. Salmon, discovered the first strain of SalmonellaSalmonella cholerae suis. But, being the person in charge, Dr. Salmon received credit for the discovery. In any case, today the number of known strains of the bacteria totals over two thousand.

The term Salmonella refers to a group or family of bacteria that variously cause illness in humans. Salmonella serotype typhimurium and Salmonella serotype enteritidis are the most common in the United States. Salmonella javiana is the fifth most common serotype in the United States and accounted for 3.4% of Salmonella isolates reported to the CDC during 2002. According to one study:

During the 1980s, S. Enteritidis emerged as an important cause of human illness in the United States. In 1976, the incidence of S. Enteritidis was 0.55 per 100,000 population and represented only 5% of all Salmonella isolates. By 1985, this proportion reached 10%, and the rate increased to 2.4 per 100,000 population. During the same time, total Salmonella infection rates rose from 10.7 per 100,000 in 1976 to 24.3 in 1985. The highest rates of S. Enteritidis were seen in the Northeast, although rates in the western region also increased during this time.

The number of outbreaks of S. Enteritidis infection also increased during the 1980s, particularly in the northeastern United States. Laboratory subtyping of S. Enteritidis isolates from outbreaks indicated that phage types (PT) 8 and 13a were the most common phage types in the United States. Although PT4 was common in Europe, where it coincided with a large increase in S. Enteritidis infections, it was seen in the United States only among persons with a history of foreign travel.

Of the Salmonella outbreaks that occurred from 1985 through 1999, “[f]ive hundred twenty-two (62%) outbreaks of S. Enteritidis infection were associated with food prepared at commercial food establishments (restaurants, caterers, delicatessens, bakeries, cafeteria, or market).”

Symptoms of a Salmonella Infection

Salmonella infections can have a broad range of illness, from no symptoms to severe illness. The most common clinical presentation is acute gastroenteritis. Symptoms include diarrhea, and abdominal cramps, often accompanied by fever of 100°F to 102°F (38°C to 39°C). Other symptoms may include bloody diarrhea, vomiting, headache and body aches. The incubation period, or the time from ingestion of the bacteria until the symptoms start, is generally 6 to 72 hours; however, there is evidence that in some situations the incubation can be longer than 10 days. People with salmonellosis usually recover without treatment within 3 to 7 days. Nonetheless, the bacteria will continue to be present in the intestinal tract and stool for weeks after recovery of symptoms—on average, 1 month in adults and longer in children.

Typhi and Paratyphi generally cause a bacteremic illness—Salmonella found in the blood—of long duration. This illness is called enteric, typhoid, or paratyphoid fever. Symptoms start gradually, and include fever, headache, malaise, lethargy, and abdominal pain. In children, it can present as a non-specific fever. The incubation period for S. Typhi is usually 8 to 14 days, but it can range from 3 to 60 days. For S. Paratyphi infections, the incubation period is similar to that of non-typhoidal Salmonella, 1 to 10 days.

Complications of a Salmonella Infection

In approximately 5% of non-typhoidal infections, patients develop bacteremia. In a small proportion of those cases, the bacteria can cause a focal infection, where it becomes localized in a tissue and causes an abscess, arthritis, endocarditis, or other severe illness. Infants, the elderly, and immune-compromised persons are at greater risk for bacteremia or invasive disease. Additionally, infection caused by antimicrobial-resistant non-typhoidal Salmonella serotypes appears to be more likely to cause bloodstream infections.

Overall, approximately 20% of cases each year require hospitalization, 5% of cases have an invasive infection, and one-half of 1% die. Infections in infants and in people 65 years of age or older are much more likely to require hospitalization or result in death. There is some evidence that Salmonella infections increase the risk of developing digestive disorders, including irritable bowel syndrome.

Although most persons that become ill with diarrhea caused by Salmonella recover without any further problems, a small number of persons develop a complication often referred to as reactive arthritis. The terminology used to describe this type of complication has changed over time. The term “Reiter’s Syndrome” was used for many years, but has now fallen into disfavor. The precise proportion of persons that develop reactive arthritis following a Salmonella infection is unknown, with estimates ranging from 2 to 15%. Symptoms of reactive arthritis include inflammation (swelling, redness, heat, and pain) of the joints, the genitourinary tract (reproductive and urinary organs), or the eyes.

More specifically, symptoms of reactive arthritis include pain and swelling in the knees, ankles, feet and heels. It may also affect wrists, fingers, other joints, or the lower back. Tendonitis (inflammation of the tendons) or enthesitis (inflammation where tendons attach to the bone) can occur. Other symptoms may include prostatitis, cervicitis, urethritis (inflammation of the prostate gland, cervix or urethra), conjunctivitis (inflammation of the membrane lining the eyelid) or uveitis (inflammation of the inner eye). Ulcers and skin rashes are less common. Symptoms can range from mild to severe.

One study showed that on average, symptoms developed 18 days after infection. A small proportion of those persons (15%) had sought medical care for their symptoms, and two thirds of persons with reactive arthritis were still experiencing symptoms 6 months later. Although most cases recover within a few months, some continue to experience complications for years. Treatment focuses on relieving the symptoms.

There are a lot of gaps in our knowledge surrounding this complication. Since there is no specific test for reactive arthritis, doctors rely on signs and symptoms of the patient in order to make the diagnosis. However, there are no clearly defined criteria or set of symptoms used to diagnose this condition. The role of genetics is also unclear. It is thought that the presence of a gene called human leukocyte antigen (HLA)-B27 predisposes a person to develop reactive arthritis, along with other autoimmune diseases; however, several studies have shown that many persons that develop reactive arthritis lack this genetic factor.

Diagnosis of Salmonella Infections

Salmonella bacteria can be detected in stool. In cases of bacteremia or invasive illness, the bacteria can also be detected in the blood, urine, or on rare occasions in tissues. The test consists of growing the bacteria in culture. A fecal, blood or other sample is placed in nutrient broth or on agar and incubated for 2-3 days. After that time, a trained microbiologist can identify the bacteria, if present, and confirm its identity by looking at biochemical reactions. Treatment with antibiotics before collecting a specimen for testing can affect bacterial growth in culture, and lead to a negative test result even when Salmonella causes the infection.

Treatment for Salmonella Infections

Salmonella infections usually resolve in 3 to 7 days, and many times require no treatment. Persons with severe diarrhea may require rehydration, often with intravenous fluids. Antimicrobial therapy (or treatment with antibiotics) is not recommended for uncomplicated gastroenteritis. In contrast, antibiotics are recommended for persons at increased risk of invasive disease, including infants younger than 3 months of age.

In situations in which antibiotics are needed, trimethoprim/sulfamethoxazole, ampicillin, or amoxicillin, are the best choices. Ceftriaxone, cefotaxime, or flouroquinolones are effective options for antimicrobial-resistant strains, although fluoroquinolones are not approved for persons less than 18 years of age. For persons with an infection in a specific organ or tissue (invasive disease), treatment with an expanded-spectrum cephalosporin is recommended, until it is known if the bacteria is susceptible to one of the more commonly used antibiotics listed above. For these rare situations, treatment with antibiotics for 4 weeks is generally recommended. For enteric fever, including S. Typhi infections, treatment for 14 days is recommended. The specific antibiotic chosen depends on the susceptibility of the bacteria and the response to treatment.

The Incidence of Salmonella Infections

In 2009, over 40,000 cases of Salmonella (13.6 cases per 100,000 persons) were reported to the Centers for Disease Control and Prevention (CDC) by public health laboratories across the nation, representing a decrease of approximately 15% from the previous year, but a 4.2% increase since 1996. Overall, the incidence of Salmonella in the United States has not significantly changed since 1996.

Only a small proportion of all Salmonella infections are diagnosed and reported to health departments. It is estimated that for every reported case, there are approximately 38.6 undiagnosed infections. The CDC estimates that 1.4 million cases, 15,000 hospitalizations, and 400 deaths are caused by Salmonella infections in the U.S. every year.

Salmonella can be grouped into more than 2,400 serotypes. The two most common serotypes in the U.S. are S. Typhimurium and S. Enteritidis. S. Typhi, the serotype that causes typhoid fever, is uncommon in the U.S. But, globally, typhoid fever continues to be a significant problem, with an estimated 12-33 million cases occurring annually. Moreover, outbreaks in developing countries have a high death-rate, especially when caused by strains of the bacterium that are resistant to antibiotic treatment.

Salmonella are found in the intestinal tract of wild and domesticated animals and humans. Some serotypes of Salmonella, such as S. Typhi and S. Paratyphi are only found in humans. For ease of discussion, it is generally useful to group Salmonellae into two broad categories: typhoidal, which includes S. Typhi and S. Paratyphi, and non-typhoidal, which includes all other serotypes.

The Prevalence of Salmonella in Food and Elsewhere

Eating contaminated food, especially food from animal origins, causes most Salmonella infections. One study found that 87% of all confirmed cases of Salmonella were foodborne, with 10 percent from person-to-person infection and 3% caused by pets. As explained in a comprehensive report issued by the USDA’s Economic Research Service:

Salmonella contamination occurs in a wide range of animal and plant products. Poultry products and eggs are frequently contaminated with S. enteritidis, while beef products are commonly contaminated with S. typhimurium. Other food sources of Salmonella may include raw milk or other dairy products and pork. Salmonella outbreaks also have been traced to contaminated vegetables, fruits, and marijuana.

Another study went into even greater detail in explaining the prevalence of Salmonella and the sources of human infection, stating as follows:

A food item was implicated in 389 (46%) outbreaks of S. Enteritidis infection from 1985 through1999; in 86 (22%) of these, more than one food item was implicated. Of the 371 outbreaks for which information was available, 298 (80%) were egg associated. This proportion ranged from 10 (71%) of 14 in 1985 to 19 (95%) of 20 in 1997. Of outbreaks caused by a single vehicle for which information was known, 243 (83%) of 294 were egg-associated, as were 55 (71%) of 77 outbreaks in which more than one food item was implicated.

Among single foods implicated in egg-associated outbreaks, 67 (28%) of 243 were foods that contained raw eggs (e.g., homemade ice cream, Caesar salad dressing, tiramisu, egg nog). Sixty-five (27%) of the outbreaks implicated traditional egg dishes such as omelets, French toast, pancakes, and foods that use egg batter, such as crab cakes, chile rellenos, egg rolls, and Monte Cristo sandwiches. Sixty-three (26%) outbreaks implicated dishes known to contain eggs, such as lasagna, ziti, and stuffing, which would have been expected to have been fully cooked but probably did not reach temperatures sufficient to kill S. Enteritidis. Thirty-six (15%) outbreaks implicated egg dishes that were “lightly cooked” (e.g., hollandaise sauce, meringue, cream pies). The food vehicles in 12 (5%) outbreaks were reported to contain eggs but could not be classified because information on how the dishes were prepared was not provided.

Seventy-three (20%) of the 371 confirmed outbreaks for which information was provided involved vehicles that did not contain eggs. Twenty (27%) of these outbreaks were associated with poultry (chicken or turkey), 8 (11%) with beef, and 6 (8%) with foods containing shrimp (3 outbreaks), bologna (1), pork (1), and pepper loaf (1). Other implicated foods included potatoes (3), beans (3), desserts (3), salad (3), macaroni and cheese (1), cheese sauce (1), goat cheese (1), chili (1), and a pureed diet (1). In 22 (30%) of the non–egg-associated outbreaks, more than one food was implicated. In four of these outbreaks, cross-contamination with raw eggs was suspected.

In sum, food remains the most common vehicle for the spread of Salmonella, and eggs are the most common food implicated. As one authority points out, “Studies showed that the internal contents of eggs can be contaminated with [Salmonella], and this contamination has been identified as a major risk factor in the emergence of human illness.” Part of this risk stems from the variety of ways that Salmonella can contaminate an egg. For example, the FDA has documented the following:

Bacteria can be on the outside of a shell egg. That’s because the egg exits the hen’s body through the same passageway as feces is excreted. That’s why eggs are required to be washed at the processing plant. All USDA graded eggs and most large volume processors follow the washing step with a sanitizing rinse at the processing plant. It is also possible for eggs to become infected by Salmonella Enteritidis fecal contamination through the pores of the shells after they’re laid. SE also can be inside an uncracked, whole egg. Contamination of eggs may be due to bacteria within the hen’s reproductive tract before the shell forms around the yolk and white. SE doesn’t make the hen sick.

Chicken is also a major cause of Salmonella. Beginning in 1998, the publisher of Consumer Reports magazine has conducted surveys and tested chicken at retail for Salmonella and Campylobacter. Its 2009 study found 14% of broiler chickens at grocery stores to contain Salmonella. A USDA Baseline Data Collection Program report done in 1994 documented Salmonella contamination on 20.0% of broiler-chicken carcasses. However, in 2009 the same USDA data collection survey showed the prevalence of Salmonella in broiler chickens at 7.5%. Additionally, turkey carries a lower risk with a prevalence of 1.66%.

While Salmonella comes from animal feces, fruits and vegetables can become contaminated. A common source is raw sprouts, which have been the subject of at least 30 reported outbreaks of foodborne illnesses since 1996. The U.S. Department of Health and Human Services cautions against consuming raw sprouts under any circumstances: “Unlike other fresh produce, seeds and beans need warm and humid conditions to sprout and grow. These conditions are also ideal for the growth of bacteria, including Salmonella, Listeria, and E. coli.”

Prevention

In general, safe cooking and preparation of food can kill existing Salmonella bacteria and prevent it from spreading. Additionally, safe choices at the grocery store can greatly reduce the risk of Salmonella.

  • Always wash your hands before you start preparing food.
  • Cook poultry until it reaches an internal temperature of 165 ºF.
  • Cook beef and pork until they reach 160ºF. High quality steaks (not needle or blade tenderized) can be safely cooked to 145ºF.
  • Cook eggs until they reach 160ºF or until the yoke is solid. Pasteurized eggs are available in some grocery stores.
  • Do not eat or drink foods containing raw eggs. Examples include homemade eggnog, hollandaise sauce, and undercooked French toast.
  • Never drink raw (unpasteurized) milk.
  • Avoid using the microwave for cooking raw foods of animal origin. Microwave-cooked foods do not reach a uniform internal temperature, resulting in undercooked areas and survival of Salmonella.
  • If you are served undercooked meat, poultry, or eggs in a restaurant don’t hesitate to send your food back to the kitchen for further cooking.
  • Avoid cross-contamination. That means that you should never allow foods that will not be cooked (like salads) to come into contact with raw foods of animal origin (e.g., on dirty countertops, kitchen sinks, or cutting boards). Wash hands, kitchen work surfaces, and utensils with soap and water immediately after they have been in contact with raw foods of animal origin.
  • Wash hands with soap after handling reptiles, amphibians or birds, or after contact with pet feces. Infants and persons with compromised immune systems should have no direct or indirect contact with such pets.
  • Reptiles, amphibians or birds, or any elements of their housing (such as water bowls) should never be allowed in the kitchen.
  • Avoid eating in animal barns, and wash your hands with soap and water after visiting petting zoos or farm settings.
  • Always wash your hands after going to the bathroom. The hands of an infected person who did not wash his or her hands adequately after using the bathroom may also contaminate food.

Steps for proper hand washing:

  • Wet your hands with clean warm running water;
  • Apply soap;
  • Rub your hands making lather for 20 seconds. Make sure that you scrub your hands entirely (not just the fingertips);
  • Rinse your hands under warm running water;
  • If possible, turn the faucet off using a paper towel;
  • Dry your hands using paper towels or an air dryer;
  • Do not use an alcohol-based (waterless) sanitizer instead of washing your hands when cooking or when hands are visibly soiled. Hand sanitizers are only effective when there is no visible organic matter (like dirt, food, or other matter) on the hands.

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 $600 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.

Additional Resources

The U.S. Food and Drug Administration is working with Mondelēz International, Inc., Pepperidge Farm Inc. and Flowers Foods, Inc. to initiate voluntarily recalls of certain products due to a potential risk that one of the ingredients may have been contaminated with Salmonella. Recalled foods include a variety of Mondelēz’s Ritz cheese sandwiches and Ritz Bits cheese products, certain Pepperidge Farm’s Goldfish, and Flowers Foods’ Swiss Rolls sold under various brand names. Additional information about each specific recall is available on our website. We recommend people discard or return any recalled product to the store where it was purchased.

There is no evidence at this time that anyone was sickened from one of these products, or that these products are contaminated. These recalls are being initiated because of a potential risk, and out of an abundance of caution. We are investigating this potential risk and closely monitoring whether there are any reported cases of food related illness associated with any of these products.

We believe these products may contain a common whey ingredient supplied by Associated Milk Producers Inc., that may have been contaminated with Salmonella. As there are likely other food products made by other manufacturers that also use this common ingredient, there may be other recalls initiated in the coming days. We are also aware that our partners at the U.S. Department of Agriculture are working with Pinnacle Foods Inc. on a public health alert regarding certain Hungry Man products that may also contain this ingredient.