Asking the Right Questions Quickly from the Beginning
During an already busy summer in 2014, several FoodCORE centers proved once again to be instrumental during the investigation of a multistate outbreak of Salmonella infections – this time involving multiple Salmonella serotypes. PulseNet initially detected several ill people with a rare DNA fingerprint of Salmonella Newport and multiple health departments, including six FoodCORE centers, immediately began working with their federal partners on the investigation. By the end of the investigation, illnesses with three Salmonella serotypes (Newport, Hartford, and Oranienburg) and multiple DNA fingerprints would be linked to sprouted chia powder, a food which has never before been identified as the cause of an outbreak. In all, 31 ill people were identified in 16 states and an additional 63 ill people were identified in CanadaExternal.
Laboratories at six of the ten FoodCORE centers identified sick people that were linked to the outbreak through complete and timely PFGE subtyping. Initial interview data from multiple states revealed that many of the ill people were “healthy eaters.” A routine interview from Wisconsin, conducted before the multistate outbreak was recognized, included questions about consuming smoothies. The ill person reported adding a chia product to their smoothie in the week before becoming sick. This information was shared by Wisconsin during the initial stages of the multistate investigation and provided one of the first clues about the source of the outbreak. As a result, other states began asking other ill people about eating any chia products before they became sick. To the investigators’ surprise, more ill people reported the same exposure to chia products.
While more interviews were conducted, investigators also collected food samples to test. Public health laboratories isolated Salmonella from five samples of leftover product collected from ill persons’ homes, as well as two samples of unopened product from retail locations. Armed with all this information, FoodCORE centers, other involved health departments, and federal partners in the U.S. and Canada were able to pinpoint organic sprouted chia powder as the source of the infections. By interviewing ill persons quickly and asking the right questions from the beginning, FoodCORE centers provided critical evidence that helped to solve this outbreak quickly. The investigation resulted in multiple recalls of chia products in both the U.S. and Canada, removing contaminated products from store shelves, which likely prevented additional illnesses.
FoodCORE’s Model Practice on Patient Interviewing Cdc-pdf[10 pages]