The CDC has been tracking two salmonella outbreaks related to meat products. One has been declared over and the other is ongoing.

The ongoing outbreak linked to Citterio brand “Premium Italian-Style Salame Sticks” sold by Trader Joe’s and other grocers has had an additional person added to the patient list, bringing the total to 21. The sick people are spread across eight states, according to the Centers for Disease Control and Prevention.

Patients in the outbreak are infected with Salmonella I 4,[5],12:i:- and have had illness onset dates ranging from Sept. 18 through Oct. 3.

Sick people range in age from 2 to 75 years old, with a median age of 12. Most of the sick people, 81 percent are younger than 18 years old, and 62 percent are female. Of 18 people with information available, six have been hospitalized. No deaths have been reported.

The true number of sick people in an outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses. This is because many people recover without medical care and are not tested for Salmonella. In addition, recent illnesses may not yet be reported as it can take more than a month to determine if a sick person is part of an outbreak. 

State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Among 15 people interviewed, all reported eating salami sticks, and 14 reported eating or maybe eating Citterio brand Premium Italian-Style “Salame” Sticks. Thirteen people bought Citterio brand Premium Italian-Style “Salame” Sticks from Trader Joe’s, and one person bought them from a Wegman’s grocery store.

Whole genome sequencing analysis of bacteria from 14 people’s samples and one raw ground pork sample predicted resistance to one or more of the following antibiotics: ampicillin, kanamycin, streptomycin, sulfamethoxazole, and tetracycline. 

The CDC is continuing to advise people not to eat, sell, or serve Citterio brand Premium Italian-Style “Salame” Sticks regardless of wher they were purchased.

Antipasto products Salmonella outbreak over
The CDC has declared that the Salmonella outbreak associated with Fratelli Beretta uncured antipasto products has ended. Two outbreak strains were identified, Salmonella Infantis sickened 14 people and Salmonella Typhimurium infected 26 people.

The outbreak patients live in 17 states. Illnesses started on dates ranging from May 9 to Aug. 16. Sick people ranged in age from 1 to 91 years old, with a median age of 41, and 51 percent were male. Of 35 people with information available, 12 were hospitalized. No deaths were reported.

State and local public health officials interviewed people about the foods they ate in the week before they got sick. Of the 28 people interviewed, 26 reported eating a variety of Italian-style meats. Among 15 people who remembered the specific product or had shopper card records showing a purchase, 14 had Fratelli Beretta brand prepackaged Uncured Antipasto trays.

Public health investigators used the PulseNet system to identify illnesses that were part of this outbreak. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause foodborne illnesses. DNA fingerprinting is performed on bacteria using whole genome sequencing (WGS).

For each outbreak strain, WGS showed that bacteria from sick people’s samples are closely related genetically. This suggests that people in each outbreak got sick from eating the same food.

Antibiotic resistance testing for the antipasto outbreak using whole genome sequencing showed 96 percent of people tested had infections that were resistant to ampicillin. The testing of all samples showed resistance to chloramphenicol, streptomycin, sulfamethoxazole, and tetracycline for all samples. 

However, if antibiotics are needed, illnesses in this outbreak may be difficult to treat with ampicillin and may require a different antibiotic choice.

Testing for the Salmonella Infantis infections did not predict any antibiotic resistance.