FoodCORE Year Eight Summary

Connecticut responded to a large norovirus outbreak at a university that was complicated by a water main break, making campus water unusable for washing hands. This investigation highlighted surge capacity provided by FoodCORE students to interview food workers.

Minnesota was part of a multistate outbreak of Salmonella Reading infections associated with raw turkey products that resulted in 358 cases in 42 states. Twenty one cases were identified in Minnesota and efforts by Minnesota Department of Health and the Minnesota Department of Agriculture led to the recall of raw ground turkey pet food that was associated with several Minnesota cases.

New York City was part of a multistate outbreak of Salmonella Concord infections associated with tahini products from Israel that resulted in eight cases in four states, including two NYC residents. NYC investigators collected records and food samples at a restaurant where ill people ate, and the outbreak strain was isolated from samples of tahini, which led to a recall. Using WGS, investigators were able to show that S. Concord cases were highly related, and that the Salmonella strain identified in the tahini products were closely related to clinical isolates from ill people.

Ohio published an article in CDC’s Morbidity and Mortality Weekly Report, ‘Multidrug-Resistant Campylobacter jejuni Outbreak Linked to Puppy Exposure – United States, 2016-2018.’  Using WGS, scientists were able to show that isolates associated with this outbreak were multidrug resistant. This led to important discussions on antibiotic stewardship practices in Ohio’s commercial dog breeding industry.

Oregon conducted extensive product traceback and environmental testing at a retail location during the multistate outbreak of Salmonella infections linked to kratom from several strains, which led to the first mandatory recall of kratom issued by the Food and Drug Administration. Several other recalls occurred in response to this outbreak, and Oregon continues to test leftover products from cases. As recently as February 2019, Oregon collected positive samples that led to an additional recall.

South Carolina was part of a multistate outbreak of Salmonella Braenderup infections linked to shell eggs that resulted in 45 cases in ten states. Increased capacity through FoodCORE allowed South Carolina investigators to obtain detailed egg exposure data that helped lead to a recall from Rose Acre Farms.

Tennessee investigated an outbreak of E.coli O157:H7 infections associated with consumption of raw milk purchased through a cow share program. This outbreak resulted in the hospitalization of seven children, six of them with hemolytic uremic syndrome. In addition to standard public notification methods including phone calls and press releases, Tennessee Department of Health used the Tennessee Health Alert Network for the first time to send mass text messages to cow share participants to conduct case finding, urge them to discard the contaminated products, and seek medical attention if they are ill.

Utah investigated 97 outbreaks in 2018, the highest amount the state has ever investigated in one year. One of these included the multistate, multi-serotype outbreak of Salmonella infections associated with kratom. The Utah Public Health Laboratory successfully isolated an outbreak strain of Salmonella from kratom product purchased in Utah, which provided laboratory evidence of product contamination.

Wisconsin was part of a multistate outbreak of Salmonella Montevideo infections linked to raw sprouts served at chain restaurants that resulted in ten cases in three states. To reduce the risk of becoming ill, Wisconsin Department of Health requested that the restaurant locations in Wisconsin remove sprouts from their menu until the investigation was complete. Wisconsin Department of Agriculture conducted trace back from implicated Wisconsin facilities and National Environmental Assessment Reporting System (NEARS) assessments for each location linked to a case. Environmental assessments provide the information needed to recommend effective short and long-term interventions that stop ongoing foodborne outbreaks and prevent them in the future.