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Multistate Outbreak of Salmonella Braenderup Infections Linked to Rose Acre Farms Shell Eggs (Final Update)

Posted June 14, 2018 3:00 PM ET


This outbreak appears to be over. Consumers and restaurants should always handle and cook eggs safely to avoid foodborne illness from raw eggs. Wash hands and items that came into contact with raw eggs with soap and water.

Highlights

  • As of June 14, 2018, this outbreak appears to be over.
  • CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) investigated a multistate outbreak of Salmonella Braenderup infections linked to Rose Acre Farms shell eggs.
    • Forty-five people infected with the outbreak strain of Salmonella Braenderup were reported from 10 states.
    • Eleven people were hospitalized, and no deaths were reported.
  • Epidemiologic, laboratory, and traceback evidence indicated that shell eggs produced by Rose Acre Farms’ Hyde County, North Carolina farm were the likely source of this multistate outbreak.
    • On April 13, 2018, Rose Acre Farms of Seymour, Indiana, voluntarily recalled 206,749,248 shell eggs because they could have been contaminated with Salmonella bacteria. Visit the FDA website for a list of recalled products.
    • On April 16, 2018, Cal-Maine Foods, Inc. voluntarily recalled 23,400 dozen eggs purchased from Rose Acre Farms.
  • Consumers and restaurants should handle and cook eggs safely to avoid foodborne illness from raw eggs. It is important to handle and prepare all fresh eggs and egg products carefully.
    • Eggs should be cooked until both the yolk and white are firm. Scrambled eggs should not be runny.
    • Wash hands and items that came into contact with raw eggs—including countertops, utensils, dishes, and cutting boards—with soap and water.
    • Wash and sanitize drawers or shelves in refrigerators where recalled eggs were stored. Follow these five steps to clean your refrigerator.

Outbreak Summary

Introduction

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) investigated a multistate outbreak of Salmonella Braenderup infections.

Public health investigators used the PulseNet system to identify illnesses that were part of this outbreak. PulseNet is the national subtyping network of public health and food regulatory agency laboratories coordinated by CDC. DNA fingerprinting is performed on Salmonella bacteria isolated from ill people by using techniques called pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS). CDC PulseNet manages a national database of these DNA fingerprints to identify possible outbreaks. WGS gives a more detailed DNA fingerprint than PFGE.

As of June 13, 2018, 45 people infected with the outbreak strain of Salmonella Braenderup were reported from 10 states. A list of the states and the number of cases in each can be found on the Case Count Map page.

Illnesses started on dates ranging from November 16, 2017 to May 13, 2018. Ill people ranged in age from 1 to 90, with a median age of 60. Fifty-six percent were female. Eleven people were hospitalized, and no deaths were reported.

Testing of 3 clinical isolates using standard antibiotic susceptibility testing methods by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory did not show any resistance. Whole genome sequencing of 27 clinical and 7 environmental isolates also did not predict resistance to antibiotics on the NARMS panel.

Investigation of the Outbreak

Epidemiologic, laboratory, and traceback evidence indicated that shell eggs produced by Rose Acre Farms’ Hyde County, North Carolina farm were 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 (83%) of 36 people interviewed reported eating shell eggs. Nineteen (53%) reported eating various egg dishes at different restaurants. This latter percentage is significantly higher than results from a survey [PDF – 787 KB] of healthy people in which 38% of respondents reported eating any eggs away from home in the week before they were interviewed. These restaurants reported using shell eggs in the dishes eaten by ill people.

FDA traced the source of some of the shell eggs supplied to these restaurant locations to Rose Acre Farms’ Hyde County, North Carolina farm. FDA investigators inspected the farm and collected samples for testing. Laboratory testing identified the outbreak strain of Salmonella Braenderup in environmental samples taken at the farm.

On April 13, 2018, Rose Acre Farms of Seymour, Indiana, voluntarily recalled 206,749,248 shell eggs because they could have been contaminated with Salmonella bacteria. Recalled eggs were sold in grocery stores and to restaurants in Colorado, Florida, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Virginia, and West Virginia under multiple brand names, including Coburn Farms, Country Daybreak, Crystal Farms, Food Lion, Glenview, Great Value, Nelms, and Sunshine Farms. On April 16, 2018, Cal-Maine Foods, Inc. voluntarily recalled 23,400 dozen eggs purchased from Rose Acre Farms.

As of June 14, 2018, this outbreak appears to be over.

Previous Outbreak Announcements

May 10, 2018

Case Count Update

Since the last update on April 16, 2018, 12 more ill people were added to this outbreak.

As of May 10, 2018, 35 people infected with the outbreak strain of Salmonella Braenderup have been reported from 9 states. A list of the states and the number of cases in each can be found on the Case Count Map page. Illnesses started on dates ranging from November 16, 2017 to April 14, 2018. Ill people range in age from 1 to 90 years, with a median age of 65. Fifty percent of ill people are female. Of 28 people with information available, 11 (39%) have been hospitalized and no deaths have been reported.

Illnesses that occurred after March 23, 2018, might not yet be reported due to the time it takes between when a person becomes ill with Salmonella and when the illness is reported. This takes an average of two to four weeks.

WGS analysis did not identify antibiotic resistance in bacteria isolated from 22 ill people. Testing of three clinical isolates using standard antibiotic susceptibility testing methods by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory also did not show any resistance.

Investigation Update

State and local health officials continue to interview ill people to ask about the foods they ate and other exposures they had before they became ill. Twenty-two (88%) of 25 people interviewed reported eating shell eggs. Sixteen (64%) reported eating various egg dishes at different restaurants. This percentage is significantly higher than results from a survey[787 KB of healthy people in which 38% of respondents reported eating any eggs away from home in the week before they were interviewed. These restaurants reported using shell eggs in the dishes eaten by ill people.

This investigation is ongoing, and CDC will provide more information as it becomes available.

Initial Announcement

April 16, 2018

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Salmonella Braenderup infections.

Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. PulseNet is the national subtyping network of public health and food regulatory agency laboratories coordinated by CDC. DNA fingerprinting is performed on Salmonella bacteria isolated from ill people by using techniques called pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS). CDC PulseNet manages a national database of these DNA fingerprints to identify possible outbreaks. WGS gives a more detailed DNA fingerprint than PFGE.

As of April 16, 2018, 23 people infected with the outbreak strain of Salmonella Braenderup have been reported from 9 states. A list of the states and the number of cases in each can be found on the Case Count Map page. WGS performed on bacteria isolated from ill people showed that they were closely relatedly genetically. This means that people in this outbreak are more likely to share a common source of infection.

Illnesses started on dates ranging from November 16, 2017, to March 22, 2018. Ill people range in age from 5 to 90, with a median age of 65. Fifty-five percent are male. Six people have been hospitalized, and no deaths have been reported.

This outbreak can be illustrated with a chart showing the number of people who became ill each day. This chart is called an epidemic curve, or epi curve. Illnesses that occurred after February 25, 2018, might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of two to four weeks. Please see the Timeline for Reporting Cases of Salmonella Infection for more details.

WGS analysis did not predict antibiotic resistance in isolates from 14 ill people. Standard antibiotic resistance testing by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory is currently underway.

Investigation of the Outbreak

Epidemiologic, laboratory, and traceback evidence indicates that shell eggs produced by Rose Acre Farms are 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. Seventeen (100%) of 17 people interviewed reported eating shell eggs. Eleven (65%) reported eating various egg dishes at different restaurants. This percentage is significantly higher than results from a survey [787 KB] of healthy people in which 38% of respondents reported eating any eggs away from home in the week before they were interviewed. These restaurants reported using shell eggs in the dishes eaten by ill people.

FDA traced the source of some of the shell eggs supplied to these restaurant locations to Rose Acre Farms’ Hyde County, North Carolina farm. FDA investigators inspected the farm and collected samples for testing. Laboratory testing identified the outbreak strain of Salmonella Braenderup in environmental samples taken at the farm.

On April 13, 2018, Rose Acre Farms of Seymour, Indiana, voluntarily recalled 206,749,248 shell eggs because they could be contaminated with Salmonella bacteria. Recalled eggs were sold in grocery stores and to restaurants in Colorado, Florida, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Virginia, and West Virginia under multiple brand names, including Coburn Farms, Country Daybreak, Crystal Farms, Food Lion, Glenview, Great Value, Nelms, and Sunshine Farms.

This investigation is ongoing and we will provide updates when they are available.

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