Multistate Outbreak of Drug-Resistant Salmonella Enteritidis Infections Linked to Raw, Frozen, Stuffed Chicken Entrees Produced by Barber Foods (Final Update)

Final Case Count Update

Since the last update on July 29, 2015, six more ill people were reported from five states.

A total of 15 people infected with the outbreak strains of Salmonella Enteritidis were reported from seven states. The number of ill people reported from each state was as follows: Connecticut (1), Illinois (2), Minnesota (8), New Hampshire (1), New York (1), Oklahoma (1), and Wisconsin (1).

Illness onset dates ranged from April 5, 2015 to July 27, 2015. Ill people ranged in age from 4 years to 82, with a median age of 32, and 60% were female. Among 10 people with available information, 4 (40%) were hospitalized, and no deaths were reported.

Case Count Update

Since the last update on July 16, 2015, two additional ill people have been reported from Illinois (1) and Minnesota (1). A total of nine people infected with a strain of Salmonella Enteritidis have been reported from Illinois (1), Minnesota (6), Oklahoma (1), and Wisconsin (1).

Illness onset dates range from April 5, 2015 to July 5, 2015. Ill people range in age from 4 years to 82 with a median age of 46, and 56% are female. Three of six people for whom information is available (50%) have been hospitalized, and no deaths have been reported.

Illnesses that occurred after July 14, 2015 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.

Investigation Update

In ongoing interviews, ill people answered questions about foods eaten and other exposures in the week before they became ill. Of eight people for whom information is known, seven (88%) reported eating a frozen, raw, stuffed chicken entrée produced by Barber Foods in the week before becoming ill.

The National Antimicrobial Resistance Monitoring System (NARMS) is a U.S. public health surveillance system that tracks antibiotic resistance in foodborne and other enteric bacteria found in people, raw meat and poultry, and food-producing animals. NARMS is a partnership among the CDC, the U.S. Food and Drug Administration (FDA), the U.S. Department of Agriculture (USDA), and state and local health departments.

The NARMS human surveillance program at CDC monitors antibiotic resistance in Salmonella and other bacteria isolated from clinical specimens submitted to NARMS by public health laboratories. CDC’s NARMS laboratory conducted antibiotic resistance testing on clinical isolates collected from four ill people infected with the outbreak strain. Of the four isolates tested, all (100%) were resistant to ampicillin and tetracycline. Antibiotic resistance may be associated with increased risk of hospitalization, development of a bloodstream infection, or treatment failure in patients.

CDC and state and local public health partners are continuing laboratory surveillance through PulseNet to identify additional ill people and to interview them. Updates will be provided when more information is available.

At this time, this outbreak has not been connected with an outbreak of Salmonella Enteritidis infections linked to raw, frozen, stuffed chicken entrees produced by Aspen Foods and sold under many different brands.

Case Count Update

Since the last update on July 13, 2015, one additional ill person has been reported from Oklahoma. A total of seven people infected with a strain of Salmonella Enteritidis have been reported from Minnesota (5), Oklahoma (1), and Wisconsin (1). Illness onset dates range from April 5, 2015 to June 23, 2015. Two people were hospitalized.

Investigation Update

CDC, several states, and the U.S. Department of Agriculture’s Food Safety and Inspection Service are currently investigating two separate outbreaks of Salmonella Enteritidis infections linked to raw, frozen, stuffed chicken entrees. The two outbreaks are caused by different strains of Salmonella Enteritidis. The likely source for the two outbreaks is different.

Epidemiologic, laboratory, and traceback information indicate that raw, frozen, stuffed chicken entrees produced by Barber Foods are the likely source of this outbreak. In interviews, ill people answered questions about foods eaten and other exposures in the week before they became ill. Of six people for whom information is known, five (83%) reported eating a frozen, raw, stuffed chicken entrée produced by Barber Foods in the week before becoming ill.

The Minnesota Department of Health (MDH) and Department of Agriculture (MDA) collected 15 samples of unopened frozen chicken entrees produced by Barber Foods from retail locations for laboratory testing. MDA isolated Salmonella from 14 of these samples; the outbreak strain was isolated from one sample. In addition, MDH and MDA collected two samples of unopened Barber Foods chicken Kiev from an ill person’s home for laboratory testing. MDA and MDH isolated the Salmonella outbreak strain from one of these samples. Laboratory testing is ongoing.

CDC and state and local public health partners are continuing laboratory surveillance through PulseNet to identify additional ill people and to interview them. Updates will be provided when more information is available.

At this time, this outbreak has not been connected with an outbreak of Salmonella Enteritidis infections linked to raw, frozen, stuffed chicken entrees produced by Aspen Foods. For the latest information about that outbreak investigation, please visit the outbreak webpage.

Case Count Update

Outbreak 1

Since the last update on July 8, 2015, two more ill people have been reported from Minnesota and Wisconsin. A total of six people infected with a strain of Salmonella Enteritidis have been reported from Minnesota (5) and Wisconsin (1). Illness onset dates range from April 5, 2015 to June 23, 2015. Two people were hospitalized.

Outbreak 2

No new illnesses have been identified since the last update on July 8, 2015. The Minnesota Department of Health identified three people infected with a different strain of Salmonella Enteritidis with illness onset dates ranging from May 9, 2015 to June 8, 2015. Two people were hospitalized.

Investigation Update

On July 12, 2015, Barber Foods expanded its recall to include 1.7 million pounds of frozen, raw stuffed chicken products that may be contaminated with Salmonella Enteritidis. The recall included Chicken Kiev as well as other types of frozen chicken products. The chicken products were produced between February 17, 2015 and May 20, 2015. The products subject to recall bear the establishment number “P-276” inside the USDA mark of inspection. The products were shipped to retail locations nationwide and Canada and sold under many different brand names. A list of recalled products is available. This recall expanded the initial Barber Foods recall of Chicken Kiev on July 2, 2015 and resulted from investigation of the first outbreak.

CDC and state and local public health partners are continuing laboratory surveillance through PulseNet to identify additional ill people and to interview them. Updates will be provided when more information is available.

July 8, 2015

The Minnesota Department of Health (MDH) and the Minnesota Department of Agriculture (MDA), along with CDC and the U.S. Department of Agriculture's Food Safety and Inspection Service (USDA-FSIS), are investigating two outbreaks of Salmonella Enteritidis infections linked to raw, frozen, breaded and pre-browned stuffed chicken entrees.

Public health investigators are using the PulseNet system to identify illnesses that may be part of these outbreaks. 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 a technique called pulsed-field gel electrophoresis, or PFGE. PulseNet manages a national database of these DNA “fingerprints” to identify possible outbreaks. Two DNA “fingerprints” (outbreak strains) are included in these outbreak investigations. The two strains represent the most common Salmonella Enteritidis strains in the PulseNet database. Because the two strains are so common, most of the illnesses identified as having matching PFGE patterns may not be related to this outbreak. Investigators are using additional laboratory methods, including whole genome sequencing, to help clarify which illnesses may be related to these outbreaks.

Investigation of the Outbreaks

In the first outbreak, MDH identified four people infected with a strain of Salmonella Enteritidis with illness onset dates ranging from April 5, 2015 to June 8, 2015. Two people were hospitalized. Epidemiologic and traceback evidence linked these illnesses to eating Barber Foods brand Chicken Kiev raw stuffed chicken breast. This investigation is ongoing.

In the second outbreak, MDH identified three people infected with a different strain of Salmonella Enteritidis with illness onset dates ranging from May 9, 2015 to June 8, 2015. Two people were hospitalized. The MDH and MDA investigation found that illnesses occurred after the people had eaten Antioch Farms brand Cordon Bleu raw stuffed chicken breast. This investigation is also ongoing.

On July 1, 2015, USDA-FSIS issued a public health alert due to concerns about illnesses caused by Salmonella that may be associated with raw, frozen, breaded and pre-browned, stuffed chicken products. In the alert, USDA-FSIS advises all consumers to safely prepare and cook these products to a temperature of 165°F.

As a result of the first outbreak investigation, on July 2, 2015, Barber Foods recalled approximately 58,320 pounds of Chicken Kiev because it may be contaminated with Salmonella Enteritidis. The product subject to recall includes a 2 lb.-4 oz. box containing six individually pouched pieces of "Barber Foods Premium Entrees Breaded-Boneless Raw Stuffed Chicken Breasts with Rib Meat Kiev" with use by/sell by dates of April 28, 2016, May 20, 2016, and July 21, 2016. The product was available for purchase at Sam’s Club retail stores in Illinois, Minnesota, and Wisconsin.

Illnesses in other states linked to either outbreak have not been identified but the investigation is ongoing. CDC and state and local public health partners are continuing laboratory surveillance through PulseNet to identify additional ill people and to interview them. Updates will be provided when more information is available.