Purpose: In March 2012, an increase in the number of cases of Salmonella Bareilly was noted nationally and an investigation was begun to identify the vehicle and source of infections. Salmonella Bareilly is a rare serotype, accounting for 0.5% of all sporadic Salmonella infections.
Methods: The case definition for this outbreak included laboratory confirmed cases of Salmonella Bareilly, Pulsed-field gel electrophoresis (PFGE) Xbal pattern JAPX01.0042 or Salmonella Nchanga, PFGE Xbal pattern JRQX01.0004 with illness onset (or isolation date, if onset date was unknown) from January 28, 2012 through July 26, 2012. The Texas Department of State Health Services (DSHS) laboratory identified 14 cases of Salmonella Bareilly PFGE Xbal pattern JAPX01.0042. Cases were interviewed using hypothesis generating and supplemental questionnaires.
Results: Eleven of the 14 Texas cases reported eating sushi (P < 0.0001); of those 11, 10 different sushi restaurants were named. Two restaurant locations, with multiple cases, provided traceback information that was key to the investigation. The vehicle identified as causing infections in this outbreak was Nakaochi Scrape tuna used in sushi.
Significance: CDC identified a total of 425 cases in this multi-state cluster; 410 persons with Salmonella Bareilly and 15 persons with Salmonella Nchanga. A successful outcome – identification of the vehicle and source of the outbreak – occurred due to the cooperation and good communication among the laboratories; state, regional, and local health departments; restaurants; and regulatory partners.