Investigation Details

Posted June 2, 2021

June 2, 2021

CDC, public health and regulatory officials in several states, and the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS) are collecting different types of data to investigate a multistate outbreak of Salmonella Enteritidis infections linked to raw frozen breaded stuffed chicken products.

Epidemiologic Data

As of June 2, 2021, a total of 17 people infected with the outbreak strain of Salmonella Enteritidis have been reported from 6 states (see map). Illnesses started on dates ranging from February 21, 2021 to May 7, 2021 (see timeline).

Sick people range in age from 3 to 83 years, with a median age of 52 years, and 60% are female. Of 13 people with information available, 8 (62%) have been hospitalized; no deaths have been reported.

The true number of sick people in an outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses. This is because many people recover without medical care and are not tested for Salmonella. In addition, recent illnesses may not yet be reported as it usually takes 2 to 4 weeks to determine if a sick person is part of an outbreak.

State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Of the 12 people interviewed, 10 (83%) reported preparing and eating frozen breaded stuffed chicken products. People reported buying many different brands of raw frozen breaded stuffed chicken products from multiple stores. When asked about how the products were prepared at home, seven people reported undercooking, microwaving, or air frying the product.

Laboratory Data

Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause foodborne illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS).

WGS showed that bacteria from sick people’s samples are closely related genetically. This means that people in this outbreak likely got sick from the same source.

The Minnesota Department of Agriculture collected for testing five raw frozen breaded stuffed chicken products from a grocery store where an ill person purchased these products. The outbreak strain was identified in two samples of Kirkwood’s Chicken Cordon Bleu.

WGS of bacteria from 11 people’s samples did not predict any antibiotic resistance. Standard antibiotic susceptibility testing by the laboratory is currently underway.

Public Health Actions

On June 2, 2021, USDA-FSIS issued a Public Health Alertexternal icon about this outbreak.

Use an oven to cook raw chicken products thoroughly to 165°F. Never use a microwave or an air fryer to cook raw chicken products. Carefully read the labels on frozen chicken products to know if they are raw. They may still contain raw chicken even if they are breaded, browned, or stuffed. Never eat raw or undercooked chicken.

Previous Updates

CDC, public health and regulatory officials in several states, and the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS) are collecting different types of data to investigate a multistate outbreak of Salmonella Hadar infections linked to raw ground turkey. Epidemiologic, laboratory, and traceback data show that ground turkey has been making people sick.

Epidemiologic Data

As of April 12, 2021, 28 people infected with the outbreak strain of Salmonella Hadar have been reported from 12 states (see map). Illnesses started on dates ranging from December 28, 2020, to March 4, 2021 (see timeline).

Sick people range in age from less than 1 to 92 years, with a median age of 49, and 68% are female. Of 19 people with information available, 2 have been hospitalized. No deaths have been reported.

The true number of sick people in an outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses. This is because many people recover without medical care and are not tested for Salmonella. In addition, recent illnesses may not yet be reported as it usually takes 2 to 4 weeks to determine if a sick person is part of an outbreak.

State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Of the 10 people interviewed, 6 (60%) reported eating ground turkey. This percentage was significantly higher than results from a survey of healthy people in which 13% of respondents reported eating ground turkey in the week before they were interviewed. This suggests that people in this outbreak got sick from eating ground turkey.

Laboratory and Traceback Data

Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause foodborne illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS). WGS showed that bacteria from sick people’s samples are closely related genetically. This means that people in this outbreak likely got sick from the same food.

USDA-FSIS collected an unopened package of ground turkey from a sick person’s freezer for testing. Testing results showed that the ground turkey contained the outbreak strain of Salmonella. The traceback investigation found that the ground turkey purchased by the sick person was produced by Plainville Brands, LLC.

Not all illnesses can be linked to ground turkey produced by Plainville Brands, LLC. Sick people reported buying many different brands of ground turkey from multiple stores, and USDA-FSIS’s traceback investigation identified several turkey processing facilities. The outbreak strain was also identified in samples of several turkey products collected by state and regulatory officials for routine testing.

WGS predicted that Salmonella bacteria from 26 people’s samples and 16 turkey samples are resistant to one or both of the antibiotics streptomycin and tetracycline. CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory is currently conducting standard antibiotic resistance testing. Most people with Salmonella illness recover without antibiotics. However, if antibiotics are needed for people with severe illnesses, this resistance likely will not affect the choice of antibiotic used to treat most people.

Public Health Actions

On April 10, USDA-FSIS issued a public health alertexternal icon for approximately 211,406 pounds of raw ground turkey products produced by Plainville Brands, LLC. On April 12, CDC issued a Food Safety Alert, advising people not to eat, sell, or serve ground turkey products that are linked to illnesses.

USDA-FSIS is working to determine if additional turkey products are linked to illnesses. CDC advises people to always follow the four food safety steps when handling raw turkey.