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Multistate Outbreak of Salmonella Anatum Infections Linked to Imported Hot Peppers - United States, May-July 2016.

Abstract Foodborne salmonellosis causes an estimated 1 million illnesses and 400 deaths annually in the United States (1). Salmonella Anatum is one of the top 20 Salmonella serotypes in the United States. During 2013-2015 there were approximately 300-350 annual illnesses reported to PulseNet, the national molecular subtyping network for foodborne disease surveillance. In June 2016, PulseNet identified a cluster of 16 Salmonella Anatum infections with an indistinguishable pulsed-field gel electrophoresis (PFGE) pattern from four states.* In April 2016, the same PFGE pattern had been uploaded to PulseNet from an isolate obtained from an Anaheim pepper, a mild to medium hot pepper. Hot peppers include many pepper varieties, such as Anaheim, jalapeño, poblano, and serrano, which can vary in heat level from mild to very hot depending on the variety and preparation. This rare PFGE pattern had been seen only 24 times previously in the PulseNet database, compared with common PFGE patterns for this serotype which have been seen in the database hundreds of times. Local and state health departments, CDC, and the Food and Drug Administration (FDA) investigated to determine the cause of the outbreak. Thirty-two patients in nine states were identified with illness onsets from May 6-July 9, 2016. Whole-genome sequencing (WGS) was performed to characterize clinical isolates and the Anaheim pepper isolate further. The combined evidence indicated that fresh hot peppers were the likely source of infection; however, a single pepper type or source farm was not identified. This outbreak highlights challenges in reconciling epidemiologic and WGS data, and the difficulties of identifying ingredient-level exposures through epidemiologic investigations alone.
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Journal Title mmwr. morbidity and mortality weekly report
Publication Year Start




PMID- 28662015
OWN - NLM
STAT- In-Process
DA  - 20170629
LR  - 20170629
IS  - 1545-861X (Electronic)
IS  - 0149-2195 (Linking)
VI  - 66
IP  - 25
DP  - 2017 Jun 30
TI  - Multistate Outbreak of Salmonella Anatum Infections Linked to Imported Hot
      Peppers - United States, May-July 2016.
PG  - 663-667
LID - 10.15585/mmwr.mm6625a2 [doi]
AB  - Foodborne salmonellosis causes an estimated 1 million illnesses and 400 deaths
      annually in the United States (1). Salmonella Anatum is one of the top 20
      Salmonella serotypes in the United States. During 2013-2015 there were
      approximately 300-350 annual illnesses reported to PulseNet, the national
      molecular subtyping network for foodborne disease surveillance. In June 2016,
      PulseNet identified a cluster of 16 Salmonella Anatum infections with an
      indistinguishable pulsed-field gel electrophoresis (PFGE) pattern from four
      states.* In April 2016, the same PFGE pattern had been uploaded to PulseNet from 
      an isolate obtained from an Anaheim pepper, a mild to medium hot pepper. Hot
      peppers include many pepper varieties, such as Anaheim, jalapeno, poblano, and
      serrano, which can vary in heat level from mild to very hot depending on the
      variety and preparation. This rare PFGE pattern had been seen only 24 times
      previously in the PulseNet database, compared with common PFGE patterns for this 
      serotype which have been seen in the database hundreds of times. Local and state 
      health departments, CDC, and the Food and Drug Administration (FDA) investigated 
      to determine the cause of the outbreak. Thirty-two patients in nine states were
      identified with illness onsets from May 6-July 9, 2016. Whole-genome sequencing
      (WGS) was performed to characterize clinical isolates and the Anaheim pepper
      isolate further. The combined evidence indicated that fresh hot peppers were the 
      likely source of infection; however, a single pepper type or source farm was not 
      identified. This outbreak highlights challenges in reconciling epidemiologic and 
      WGS data, and the difficulties of identifying ingredient-level exposures through 
      epidemiologic investigations alone.
FAU - Hassan, Rashida
AU  - Hassan R
FAU - Rounds, Joshua
AU  - Rounds J
FAU - Sorenson, Alida
AU  - Sorenson A
FAU - Leos, Greg
AU  - Leos G
FAU - Concepcion-Acevedo, Jeniffer
AU  - Concepcion-Acevedo J
FAU - Griswold, Taylor
AU  - Griswold T
FAU - Tesfai, Adiam
AU  - Tesfai A
FAU - Blessington, Tyann
AU  - Blessington T
FAU - Hardy, Cerise
AU  - Hardy C
FAU - Basler, Colin
AU  - Basler C
LA  - eng
PT  - Journal Article
DEP - 20170630
PL  - United States
TA  - MMWR Morb Mortal Wkly Rep
JT  - MMWR. Morbidity and mortality weekly report
JID - 7802429
EDAT- 2017/07/01 06:00
MHDA- 2017/07/01 06:00
CRDT- 2017/06/30 06:00
AID - 10.15585/mmwr.mm6625a2 [doi]
PST - epublish
SO  - MMWR Morb Mortal Wkly Rep. 2017 Jun 30;66(25):663-667. doi:
      10.15585/mmwr.mm6625a2.