Epidemiology and Infection

Original Papers

Gastrointestinal

Nationwide outbreak of Salmonella Montevideo infections associated with contaminated imported black and red pepper: warehouse membership cards provide critical clues to identify the source

L. GIERALTOWSKIa1 c1, E. JULIANa2, J. PRINGLEa3, K. MACDONALDa4, D. QUILLIAMa2, N. MARSDEN-HAUGa4, L. SAATHOFF-HUBERa5, D. VON STEINa6, B. KISSLERa7, M. PARISHa8, D. ELDERa8, V. HOWARD-KINGa8, J. BESSERa3, S. SODHAa3, A. LOHARIKARa1, S. DALTONa3, I. WILLIAMSa3 and C. BARTON BEHRAVESHa3

a1 Epidemic Intelligence Service assigned to the Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA

a2 Rhode Island Department of Health, Providence, RI, USA

a3 Centers for Disease Control and Prevention, Atlanta, GA, USA

a4 Washington State Department of Health, Olympia, WA, USA

a5 Illinois Department of Public Health, Springfield, IL, USA

a6 Iowa Department of Health, De Moines, IA, USA

a7 Food Safety and Inspection Service, US Department of Agriculture, Atlanta, GA, USA

a8 Food and Drug Administration, Rockville, MD, USA

SUMMARY

In November 2009, we initiated a multistate investigation of Salmonella Montevideo infections with pulsed-field gel electrophoresis pattern JIXX01.0011. We identified 272 cases in 44 states with illness onset dates ranging from 1 July 2009 to 14 April 2010. To help generate hypotheses, warehouse store membership card information was collected to identify products consumed by cases. These records identified 19 ill persons who purchased company A salami products before onset of illness. A case-control study was conducted. Ready-to-eat salami consumption was significantly associated with illness (matched odds ratio 8·5, 95% confidence interval 2·1–75·9). The outbreak strain was isolated from company A salami products from an environmental sample from one manufacturing plant, and sealed containers of black and red pepper at the facility. This outbreak illustrates the importance of using membership card information to assist in identifying suspect vehicles, the potential for spices to contaminate ready-to-eat products, and preventing raw ingredient contamination of these products.

(Received March 07 2012)

(Revised July 11 2012)

(Accepted July 31 2012)

(Online publication August 30 2012)

Key words

  • Enteric bacteria;
  • epidemiology;
  • outbreaks;
  • Salmonella

Correspondence

c1 Author for correspondence: Dr L. Gieraltowski, 1600 Clifton Road NE, MS A38, Atlanta, GA 30329, USA. (Email: lax2@cdc.gov)

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