2015 Multistate Outbreak of <i>Salmonella</i> Paratyphi B Variant L(+) tartrate(+) and <i>Salmonella</i> Weltevreden Infections Associated with Imported Frozen Raw Tuna

Blankenship, Joseph

Tuesday, August 2, 2016

America's Center - St. Louis

Joseph Blankenship, U.S. Food and Drug Administration, College Park, MD

Rachel Goeriz, U.S. Food and Drug Administration, College Park, MD

Asma Madad, U.S. Food and Drug Administration, College Park, MD

Terrance Jackson, U.S. Food and Drug Administration, College Park, MD

Monique Salter, U.S. Food and Drug Administration, College Park, MD

Tyann Blessington, U.S. Food and Drug Administration, College Park, MD

Sheila Merriweather, U.S. Food and Drug Administration, College Park, MD

Karl Klontz, U.S. Food and Drug Administration, College Park, MD

Errol Strain, U.S. Food and Drug Administration, College Park, MD

Herminio Francisco, U.S. Food and Drug Administration, Irvine, CA

Heidi DeBeck, U.S. Food and Drug Administration, Minneapolis, MN

Rashida Hassan, Centers for Disease Control and Prevention, Atlanta, GA

Karen Neil, Centers for Disease Control and Prevention, Atlanta, GA

Matthew Wise, Centers for Disease Control and Prevention, Atlanta, GA

Alida Sorenson, Minnesota Department of Agriculture, St. Paul, MN

Patrick Kennelly, California Department of Public Health, Sacramento, CA

Michael Needham, California Department of Public Health, Sacramento, CA

Introduction: In 2015, FDA, CDC, and state and local officials investigated a multistate outbreak of Salmonella Paratyphi B variant L(+) tartrate(+) and Salmonella Weltevreden infections linked to consumption of frozen raw tuna used as a sushi ingredient.

Purpose: To describe outbreak response activities and discuss conclusions drawn from the investigation.

Methods: A case was defined as infection with the outbreak strains of Salmonella Paratyphi B variant L(+) tartrate(+) or Salmonella Weltevreden occurring between 3/1/2015 – 7/31/2015. Investigators analyzed case-patient interview data to identify common foods. Records documenting the import and distribution of tuna to restaurants associated with illnesses were collected to determine the source of the tuna used to make sushi reported by case-patients. Investigators collected and analyzed product samples.

Results: Sixty-nine cases were reported from 11 states. Raw tuna in sushi was consumed by 98% (46/47) of case-patients interviewed. Investigators traced frozen raw tuna (ground or chunk) used at 8 restaurants linked to 16 illnesses. Distribution records identified Importer A as a common source of frozen raw tuna that had been distributed to 7 of the 8 restaurants. Minnesota investigators recovered outbreak strains of Salmonella Paratyphi B variant L(+) tartrate(+) and Salmonella Weltevreden from intact samples of frozen raw tuna distributed by Importer A. Traceback analysis determined that the contaminated tuna was sourced from Indonesia. Importer A voluntarily recalled product it had received from Indonesia and distributed from 5/9/2014 – 7/9/2015.

Significance: Frozen raw tuna imported from Indonesia was implicated as the source of this outbreak. Since 2007, four Salmonella outbreaks have been linked to raw imported tuna, highlighting the risks associated with raw seafood consumption and raising the possibility that seafood harvest/processing practices used by foreign firms may have contributed to contamination of tuna products intended for raw consumption.

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P2-68 2015 Multistate Outbreak of Salmonella Paratyphi B Variant L(+) tartrate(+) and Salmonella Weltevreden Infections Associated with Imported Frozen Raw Tuna