Every year, Salmonella is estimated [PDF - 1 page] to cause one million illnesses in the United States, with 19,000 hospitalizations and 380 deaths . Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection.
Salmonellosis, the illness caused by the bacteria, usually lasts four to seven days. Although, most persons recover without treatment, in some persons, the diarrhea may be so severe that the patient needs to be hospitalized. More »
Multistate Outbreak of Salmonella Braenderup Infections Linked to Nut Butter Manufactured by nSpired Natural Foods, Inc.
Posted August 21, 2014 3:30 PM ET
Latest Case Count Map
Latest Epi Curve
August 21, 2014
CDC is collaborating with public health officials in several states and the U.S. Food and Drug Administration (FDA) to investigate a multistate outbreak of Salmonella Braenderup infections. Results from this ongoing investigation indicate that almond and peanut butter manufactured by nSpired Natural Foods, Inc. is the likely source of this outbreak.
Public health investigators are using the PulseNet system to identify cases of illness that may be part of this outbreak. PulseNet, the national subtyping network of public health and food regulatory agency laboratories coordinated by CDC, receives DNA "fingerprints" of Salmonellabacteria obtained through diagnostic testing using pulsed-field gel electrophoresis, or PFGE.Whole genome sequencing, a highly discriminatory subtyping method, was also used to define the outbreak strain. Whole genome sequencing helped clarify which illnesses were related to the outbreak.
As of August 20, 2014, a total of four ill persons infected with the outbreak strain of SalmonellaBraenderup have been reported from four states since January 1, 2014. The number of ill persons identified in each state is as follows: Connecticut (1), Iowa (1), Tennessee (1), and Texas (1).
Illness onset dates range from January 22, 2014, to May 16, 2014. Ill persons range in age from 3 years to 83 years, with a median age of 36 years. Seventy-five percent of ill persons are female. Among three ill persons with available information, one (33%) reported being hospitalized. No deaths have been reported.
This outbreak can be visually described with a chart showing the number of persons who became ill each day. This chart is called an epidemic curve or epi curve. Illnesses that occurred after July 30, 2014 might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 2 to 4 weeks. The recalled peanut and almond butter products have a long shelf life and may still be in people’s homes, and illnesses may continue to be reported. Please see the Timeline for Reporting Cases of Salmonella Infectionfor more details.
Investigation of the Outbreak
During routine inspections at an nSpired Natural Foods facility in Ashland, Oregon, in January and July 2014, FDA isolated Salmonella Braenderup from environmental samples. PFGE and whole genome sequencing were performed on the environmental isolates by FDA to further characterize the bacteria.
A subsequent search of the PulseNet database identified ill persons with the same PFGE “fingerprint” of Salmonella Braenderup. CDC performed whole genome sequencing on these clinical isolates and determined that the bacteria from the ill persons were related to the environmental isolates taken from the firm.
To date, three of the four ill persons were interviewed and answered questions about foods eaten and other exposures during the week before becoming ill. All three (100%) of them reported eating peanut or almond butter, and all three (100%) reported eating a brand of peanut or almond butter produced by nSpired Natural Foods, Inc.
On August 19, 2014, nSpired Natural Foods, Inc. voluntarily recalled certain lots of almond and peanut butters because of potential contamination with Salmonella. The recalled brands include Arrowhead Mills, MaraNatha, and specific private label almond and peanut butters.
CDC and state and local public health partners are continuing laboratory surveillance through PulseNet to identify additional ill persons and to interview ill persons about foods eaten before becoming ill. FDA is continuing to work closely with CDC and state partners in this investigation.
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