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Poultry Giblet-Associated Salmonellosis -- Maine

In November 1982 and October 1983, two unrelated outbreaks of foodborne salmonellosis caused by improperly cooked poultry giblets occurred in Maine. The two restaurants involved were located 50 miles apart but were part of the same restaurant chain. Reports of the outbreaks follow.

Outbreak 1: One hundred twelve culture-confirmed cases of Salmonella enteritidis serotype enteritidis were identified following exposure to this restaurant over the Thanksgiving weekend, November 25-27, 1982. A univariate analysis was unable to differentiate five of 42 foods associated with illness (roasted turkey, chef's dressing, giblet gravy, mashed potatoes, and apple cider) (p = 0.0001). Further analyses of food histories associated the giblet gravy most strongly with illness (p 0.0001). All items served with the turkey dinner had been used by the time the investigation was initiated. Food from five "doggy" bags was retrieved following the outbreak, but the contents contained a nonsegregated mixture of the turkey dinner. Nevertheless, turkey from two bags was positive for Salmonella, as were mashed potatoes from the third bag.

A review of the method used to prepare the giblet gravy revealed that, 3 days before Thanksgiving, the giblets had been removed from forty-three 22- to 24-pound turkeys, which had been thawed at room temperature for 36 hours before cooking. The giblets were refrigerated, with instructions reportedly given to boil them the day before Thanksgiving at the time the stock was being prepared. However, when each of the 18 foodhandlers was questioned individually, no one admitted to cooking the giblets or recalled seeing the giblets being boiled. The uncooked giblets were ground in a blender and added to a thickened, hot stock mixture. The gravy was not returned to a boil after addition of the ground giblets, so the thickened mixture would not scorch. The mixture was stored on the counter behind the stove at room temperature throughout Thanksgiving Day. Leftover gravy was used for turkey luncheon specials offered November 26 and 27.

Outbreak 2: Seven persons, all of whom were culture-positive for Salmonella serotype heidelberg, became ill after eating at the second restaurant on October 17, 1983. In univariate analysis of the latter outbreak, eating liver pate was associated with illness (p = 0.003). No pate remained for laboratory analysis, since the restaurant had been alerted to the problem by a customer and had stopped making the pate 2 days before the investigation. The pate was prepared October 15. Four 5-pound containers of frozen chicken livers had been defrosted under refrigerated conditions for 4 days before use. They were sauteed in a 20-quart vessel and ground in a food processor. After addition of seasoning and diced boiled eggs, the mixture was poured into a large storage pan and refrigerated. The pate was served in a small crock on the salad bar, which was replenished from the refrigerated storage container as needed from October 16 to October 19. Reported by KF Gensheimer, MD, Maine Dept of Human Svcs; Enteric Diseases Br, Div of Bacterial Diseases, Center for Infectious Diseases, CDC.

Editorial Note

Editorial Note: Poultry products are a frequent source of Salmonella infections, and reported outbreaks from turkey increase markedly during the Thanksgiving and Christmas holiday seasons (1). Culture surveys of poultry flocks and market poultry have demonstrated that salmonellae may be recovered frequently (2), a fact that is often not known or is overlooked during rushed holiday preparations.

The outbreaks described here were unusual in that they involved giblets that had been stored under refrigeration for several days and that, because they had oxidized, appeared to have been cooked. Domestic and commercial foodhandlers should be aware of the misleading appearance of giblets and other poultry organs that have been refrigerated for prolonged periods.

References

  1. Horwitz MA, Gangarosa EJ. Foodborne disease outbreaks traced to poultry, United States, 1966-1974. J Milk Food Technol 1976;39:859-63.

  2. Zecha BC, McCapes RH, Dungan WM, Holte RJ, Worcester WW, Williams JE. The Dillon Beach Project--a five-year epidemiological study of naturally occurring salmonella infection in turkeys and their environment. Avian Dis 1977; 21:141-59.



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