P1-128 Identifying Turkish Pine Nuts Linked to an Outbreak of Salmonella Enteritidis: Using Product Traceback in Conjunction with Laboratory Data

Monday, July 23, 2012
Exhibit Hall (Rhode Island Convention Center)
Kari Irvin, U.S. Food and Drug Administration, College Park, MD
Johnson Nsubuga, U.S. Food and Drug Administration-CORE, College Park, MD
David Rotstein, U.S. Food and Drug Administration-CORE, College Park, MD
J. Douglas Park, U.S. Food and Drug Administration-CORE, College Park, MD
Ernest Levins, U.S. Food and Drug Administration-CORE, College Park, MD
Stelios Viazis, U.S. Food and Drug Administration, College Park, MD
Jeshua Pringle, Centers for Disease Control and Prevention, Atlanta, GA
Seth Levine, Virginia Department of Health, Richmond, VA
Matthew Ettinger, Virginia Department of Agriculture and Consumer Services, Richmond, VA
Denise Toney, Div. Consolidated Labs, Richmond, VA
Jessica Egan, New York State Department of Health, Troy, NY
Deena Reyes, New York State Department of Health, Troy, NY
Erin Sawyer, New York State Department of Agriculture and Markets, Albany, NY
Peter Olsen, New York State Department of Agriculture and Markets, Albany, NY
Carla Tuite, U.S. Food and Drug Administration-CORE, College Park, MD
Introduction:    In October 2011, CDC notified FDA of an outbreak of a rare strain of SalmonellaEnteritidis infections that was linked to consumption of bulk Turkish pine nuts (TPN), or products prepared with bulk TPN, purchased at Grocery Store Chain A.  Forty-three individuals from 5 states (MD, NJ, NY, PA, and VA) were identified. 

Purpose:    To determine the supply chain of TPN to Grocery Store Chain A and product lots potentially associated with illnesses.

Methods:   Case clusters identified by CDC were included in the traceback investigation based on the following criteria:  geographic distribution, case exposure dates, and laboratory findings.  FDA and state partners collected shipment records at the points of service, distribution centers, and importer.   The records were reviewed and analyzed to determine product identifying information along the supply chain.  Federal and state partners tested regulatory and retail samples of TPN collected along the supply chain.

Results:    Grocery Store Chain A received bulk TPN solely from Distribution Center B.  Distribution Center B received product from a single Importer C, which is supplied by two foreign suppliers (D and E) located in Turkey.  Two intact samples of TPN collected along the supply chain, one open retail sample, and multiple open samples from consumer homes tested positive for the same strain of Salmonella Enteritidis found in clinical cases.  Records collected provided the following information for traceback identification of TPN lots associated with illness:   1) purchase dates, 2) shipment frequency to points of service, and 3) availability of lots stored in distribution center and importer warehouses.  The overall investigation of TPN led to the implication of 3 lots by traceback investigation and 1 lot by positive laboratory results.

Significance:    The traceback investigation performed by FDA and state partners along with laboratory sampling led to the voluntary recall of 21,000 lbs. of TPNs by Importer C.  FDA placed Foreign Suppliers D and E on import alert.