Multistate Outbreak of Salmonella Wandsworth Infections Linked to Veggie Booty (FINAL UPDATE)

Posted July 18, 2007

Outbreak Summary

Public health officials in OutbreakNet (the network of epidemiologists and other public health officials, facilitated by CDC, who investigate outbreaks of foodborne, waterborne, and other enteric illnesses nationwide) are investigating a multi-state outbreak of Salmonella Wandsworth infections. Salmonella Wandsworth is a rare strain of Salmonella.

Interviews comparing foods eaten by ill and well persons show that consumption of Robert’s American Gourmet brand Veggie Booty was statistically associated with illness and therefore the most likely source of the outbreak.

As of July 18 at 11AM ET, 65 persons infected with Salmonella Wandsworth have been reported to CDC from 20 states: California, Colorado, Connecticut, Georgia, Illinois, Indiana, Massachusetts, Maryland, Minnesota, New Hampshire, New Jersey, New York, Oregon, Pennsylvania, Tennessee, Texas, Vermont, Virginia, Washington, and Wisconsin. Among the patients for whom clinical information is available, all had diarrhea, 76% had bloody stools, and six patients were hospitalized. No deaths have been attributed to these infections. Onset dates, which are known for 64 patients, ranged from February 26, 2007 to June 27, 2007. Most (91%) of cases have occurred in children aged 10 months to 3 years. During the initial phase of the outbreak, the number of cases gradually increased, with only 8 cases reported to PulseNet (the nationwide network of public health laboratories that sub-type bacteria) from 6 states before May 1, 2007. Health department and CDC investigators worked for weeks conducting interviews with parents of ill children to develop theories about possible sources of infection.

A multi-state case-control study demonstrated a strong association between illness and consumption of Veggie Booty, a snack of puffed rice and corn with a vegetable coating. CDC OutbreakNet staff shared this information with colleagues at the Food and Drug Administration (FDA) on June 27. After being informed about the outbreak by FDA, the company that manufactures the product issued a voluntary recall on June 28. None of the 65 known illnesses from Salmonella Wandsworth began after the product was recalled. Persons are advised to discard any product in their possession.

OutbreakNet officials at CDC and in state and local health departments, FDA, and the marketing and manufacturing companies are working collaboratively to learn more about production of Veggie Booty to determine how it may have become contaminated. The Minnesota Department of Agriculture Laboratory (MDAL) has isolated the outbreak strain of Salmonella Wandsworth from sealed bags of Veggie Booty obtained from retail stores. The outbreak strain has also been isolated from sealed bags of Veggie Booty by the FDA laboratory and the New York State Department of Health Wadsworth Center Laboratory. Preliminary testing suggests that the seasoning mix used in Veggie Booty may be the source of the contamination.

MDAL also isolated Salmonella Typhimurium, a different strain of Salmonella, from a sealed bag of Veggie Booty collected at the same time as the bags positive for Salmonella Wandsworth. PulseNet identified 10 persons who had illness caused by this strain of Salmonella Typhimurium between June 1, 2007 and June 27, 2007. OutbreakNet officials have interviewed 8 of the 10 ill persons with this strain of Salmonella Typhimurium and determined that all eight consumed Veggie Booty during the week before their illnesses began.

On July 2, the company expanded the recall to include Super Veggie Tings Crunchy Corn Sticks. This was done due to the company’s concern that Veggie Booty and Super Veggie Tings share ingredients that could be contaminated. Persons should discard any Super Veggie Tings in their possession. CDC is not aware of any human illnesses associated with the consumption of Super Veggie Tings.

Persons who think they may have become ill from eating Veggie Booty or Super Veggie Tings are advised to consult their health care provider. Infection with Salmonella is diagnosed by culture of a stool sample.

Most persons infected with Salmonella develop diarrhea, often with fever and abdominal cramps, 12 to 72 hours after infection. The illness usually lasts 4 to 7 days, and most persons recover without treatment. However, sometimes the illness is so severe that the patient needs to be hospitalized. The elderly, infants, and those with impaired immune systems are more likely to have severe illness.

Final Case Count Map

Persons infected with the outbreak strain of Salmonella Wandsworth, by state of residence, as of July 18, 2007 (n=65)

Map updated July, 18, 2007

Case Counts Details:
*New York City case count- 8 cases
New York State case counts- 7 cases

Advice to Consumers

I have a bag of Robert’s American Gourmet Veggie Booty &/or Super Veggie Tings and I/my children ate some of it, but no one is sick. What should I do?

Do not eat any more of the Veggie Booty or Super Veggie Tings. Throw away the bag(s). If anyone in your family develops diarrheal illness with bloody diarrhea, fever, or symptoms lasting more than three days, he or she should consult a healthcare provider.

I/my household member ate Robert’s American Gourmet Veggie Booty &/or Super Veggie Tings and I/my household member is ill with diarrhea. I still have the bag. What should I do?

Do not eat any more of the Veggie Booty or Super Veggie Tings. If the diarrheal illness is severe, with bloody diarrhea, fever, or symptoms lasting more than three days, you should consult a healthcare provider. Salmonella infection is diagnosed by culture of a stool specimen. Call your local health department as well, as they may wish to investigate your case further.

What about Robert’s American Gourmet Super Veggie Tings Crunch Corn Sticks?

Robert’s American Gourmet Food, Inc. expanded its product recall on July 2, 2007 to include all lots and sizes of Super Veggie Tings Crunchy Corn Sticks due to the company’s concern that Veggie Booty and Super Veggie Tings share ingredients that could be contaminated. Persons should discard any bags of either product in their possession.

Has Super Veggie Tings Crunchy Corn Sticks been associated with illness?

CDC is not aware of any human illness associated with Super Veggie Tings Crunchy Corn Sticks. The voluntary recall by the company was a precautionary measure.

I/my household member ate another snack product from the Robert’s American Gourmet brand that is not Veggie Booty or Super Veggie Tings, and I/my household member is ill with diarrhea. I still have the bag. What should I do?

There is no evidence that this illness has been caused by the snack food you are describing. If the illness is severe, with bloody diarrhea, fever, or symptoms lasting more than three days, you should consult a healthcare provider.

I/my household member ate a snack food that is not the Robert’s American Gourmet brand, and I/my household member is ill with diarrhea. I still have the bag. What should I do?

There is no evidence that your illness has been caused by the snack food you are describing. If the illness is severe, with bloody diarrhea, fever, or symptoms lasting more than three days, you should consult a healthcare provider.