Outbreak of Multidrug-Resistant Salmonella Infections Linked to Contact with Pig Ear Dog Treats

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Published on September 5, 2019 at 9:30 AM ET

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA)external icon are investigating a multistate outbreak of multidrug-resistant Salmonella infections linked to contact with pig ear dog treats.

Latest Outbreak Information
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At A Glance
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  • CDC and FDA are advising people not to buy or feed any pig ear dog treats, including any that may already be in homes.
  • People can get sick after handling the treats or caring for dogs who ate the treats. Dogs might get sick after eating them.
  • 16 ill people have been added to this investigation since the last update on July 31, 2019.
  • 143 people infected with the outbreak strains of Salmonella have been reported from 35 states.
    • Of 110 ill people with available information, 33 (30%) have been hospitalized. No deaths have been reported.
    • 26 illnesses (20%) are among children younger than 5 years.
  • Epidemiologic, laboratory and traceback evidence indicates that contact with pig ear dog treats from many different suppliers is the likely source of this outbreak. For this reason, CDC and FDA are advising people not to buy any pig ear dog treats or feed them to their dogs.
  • State health and regulatory officials in several states and the FDA have tested pig ear dog treats at various suppliers and identified many different strains of Salmonella.
  • This investigation is ongoing and CDC will provide updates when more information is available.
Advice to Dog Owners
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  • Do not feed any pig ear treats to your dog. Throw them away in a secure container so that your pets and other animals can’t eat them.
    • Even if some of the pig ears were fed to your dog and no one got sick, do not continue to feed them to your dog.
    • Wash containers, shelves, and areas that held any pig ears with hot, soapy water. Be sure to wash your hands after handling any of these items.
  • I fed pig ears to my dog. How do I know if I have a Salmonella infection?
    • People with a Salmonella infection may have diarrhea, fever, and stomach cramps. Most people recover without treatment. If you have symptoms of a Salmonella infection, talk to your healthcare provider.
  • How do I know if my dog has a Salmonella infection?
    • Some dogs with Salmonella infection may not look sick. Dogs with a Salmonella infection usually have diarrhea (which may be bloody). Sick animals may seem more tired than usual, and may vomit or have a fever.
    • If your dog has these signs of illness, or you are concerned that your pet may have Salmonella infection, please contact your pet’s veterinarian.
  • How can I report my dog’s illness if I think it’s related to pig ears?
  • Shop safely
    • Always wash your hands thoroughly with soap and water after touching unpackaged dog food or treats, including products in bulk bins or on store shelves.
  • Take extra care around young children
    • Children younger than 5 should not touch or eat dog food or treats.
    • Young children are at risk for illness because their immune systems are still developing and because they are more likely than others to put their fingers or other items into their mouths.
    • Adults should supervise handwashing for young children.
  • Always wash your hands thoroughly with soap and water right after handling dog food or treats. See our Pet Food Safety Infographic for more tips on staying healthy while caring for pets.

Advice to Pet Stores and Retailers Selling Pig Ears

  • Importers, suppliers, distributors, wholesalers, and other retailers should not sell any pig ear dog treats.
    • Remove pig ears from retail. This includes bulk bin and individually wrapped pig ears.
      • Throw them away in secure containers so that animals cannot get to them.
      • Retailers who choose not to immediately throw them away should securely and safely store packaged product until additional information is available.
    • Wash and sanitize any surfaces that have come in contact with pig ears. This includes bulk bins or shelves, other storage containers, and surfaces such as counters or displays.
    • Advise employees and customers to wash hands after handling pet treats and food.
    • For more information see FDA’s question and answers for retailers, distributors, importers, suppliers, and manufacturersexternal icon.

Recalls

Several companies recalled pig ear products because they might be contaminated with one or more of the outbreak strains of Salmonella. For more information on the recalls listed below please see FDA’s investigationexternal icon.

No single supplier, distributor or common brand of pig ear treats has been identified that could account for all the illnesses. More products could be recalled as testing identifies Salmonella.

Symptoms of Salmonella Infection
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  • Most people infected with Salmonella develop diarrhea, fever, and stomach cramps 6 hours to 4 days after being exposed to the bacteria.
  • The illness usually lasts 4 to 7 days, and most people recover without treatment.
  • In some people, the illness may be so severe that the patient needs to be hospitalized. Salmonella infection may spread from the intestines to the bloodstream and then to other places in the body.
  • Children younger than 5 years, adults 65 years and older, and people with weakened immune systems are more likely to have a severe illness.
Investigation Details

August 27, 2019

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA)external icon are investigating a multistate outbreak of multidrug-resistant Salmonella infections linked to contact with pig ear dog treats. Salmonella strains included are Cerro, Derby, London, Infantis, Newport, Rissen, and I 4,[5],12:i:-.

As of August 26, 2019, a total of 143 people infected with the outbreak strains of Salmonella have been reported from 35 states. A list of the states and the number of cases in each can be found on the Map of Reported Cases page.

Illnesses started on dates ranging from June 10, 2015 to July 30, 2019. Ill people range in age from less than 1 year to 90 years, with a median age of 39 years. Sixty (46%) ill people are female. Of 110 ill people with information available, 33 (30%) have been hospitalized. No deaths have been reported.

Illnesses 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 2 to 4 weeks. Please see the Timeline for Reporting Cases of Salmonella Infection for more details.

Predicted antibiotic resistance based on whole genome sequencing (WGS) was determined for 92 isolates, 87 from ill people and 5 from pig ears. There was no antibiotic resistance predicted for 2 human isolates; the remaining 90 isolates had predicted antibiotic resistance or decreased susceptibility to one or more of the following antibiotics: amoxicillin-clavulanic acid, ampicillin, cefoxitin, ceftriaxone, chloramphenicol, ciprofloxacin, gentamicin, kanamycin, nalidixic acid, streptomycin, sulfisoxazole, tetracycline, and trimethoprim-sulfamethoxazole. Testing of 9 clinical isolates using standard antibiotic susceptibility testing methods by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory provided comparable results (kanamycin was not tested by this method). If antibiotics are needed, infections related to this outbreak may be difficult to treat with some commonly recommended antibiotics, and may require a different antibiotic choice.

Investigation of the Outbreak

Epidemiologic, laboratory, and traceback evidence indicates that contact with pig ear dog treats is the likely source of this outbreak.

In interviews, ill people answered questions about animal and pet food contact in the week before they became ill. Of 100 ill people, 88 (88%) reported contact with a dog before getting sick. Of 80 people with available information, 56 (70%) reported contact with pig ear treats or with dogs who were fed pig ears. Both of these proportions are significantly higher than the results from a survey pdf icon[PDF – 787 KB] of healthy people who reported contact with dogs (61%) or handling dog treats (16%), such as pig ears, in the week before interview.

Health and regulatory officials from Connecticut, Indiana, Kansas, Michigan, Pennsylvania, Rhode Island, and FDA collected pig ears from ill people’s homes, retail locations where ill people reported buying the products or from suppliers and distributors to those locations. Testing identified Salmonella in over 90 samples, with many different strains. A search of the CDC PulseNet database found that people had been infected with some of these strains, including Salmonella Infantis, Salmonella London, and Salmonella Newport. Some of these illnesses date back to 2015. These ill people were added to the outbreak investigation. Additional Salmonella serotypes Anatum, Brandenburg, Give, Livingstone, Panama, Seftenberg, Typhimurium, Uganda, and Worthington were identified. Investigators are working to determine if any human illnesses are linked to these strains.

Some of the tested pig ears were imported from Argentina, Brazil, and Colombia. Some product labels indicated that the pig ears were irradiated; this process should kill Salmonella. Salmonella identified in products labeled as irradiated indicate they may not have been irradiated or there was another issue that led to Salmonella contamination.

Several firms have recalled pig ears because they might be contaminated with one or more of the outbreak strains of Salmonella. On July 3, 2019, Pet Supplies Plus recalledexternal icon bulk pig ears stocked in open bins. On July 26, 2019, Lennox Intl Inc recalledexternal icon pig ears. On July 30, 2019 Lennox Intl Inc expanded their recallexternal icon. On August 16, Dog Goods USA LLC recalledexternal icon bulk and packaged Chef Toby Pig Ears. On September 3, 2019, Dog Goods USA LLC recalledexternal icon all 30-packs of Berkley & Jensen brand pig ears sold at BJ’s Wholesale Club stores. These recalls do not account for all of the illnesses in this outbreak.

Information collected to date about where ill people bought pig ears has not identified a single supplier, distributor, or common brand of pig ear treats. CDC and FDA recommend that people do not buy pig ear pet treats or feed them to dogs because they could be contaminated with Salmonella and could make people and dogs sick. CDC and FDA recommendations may change as more information becomes available.

This investigation is ongoing. CDC will provide updates when more information is available.

Pet owners can take steps to keep their families healthy while feeding pets.