Raw Fish Salmonella and Falafel E. coli Outbreaks - How large will the become? - Food Poison Journal

Raw Fish Salmonella Outbreak: As of October 19, 2022, a total of 33 people infected with the outbreak strain of Salmonella Litchfield have been reported from 3 states . Illnesses started on dates ranging from June 14, 2022, to September 18, 2022.

Sick people range in age from 1 to 67 years, with a median age of 32, and 59% are female. Of 26 people with information available, 13 have been hospitalized. No deaths have been reported.

The true number of sick people in this 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 usually takes 3 to 4 weeks 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. Of the 16 people interviewed, 12 (75%) reported eating raw fish, sushi, or poke. This percentage was significantly higher than the 7.9% of respondents who reported eating raw fish in the FoodNet Population Survey—a survey that helps estimate how often people eat various foods linked to diarrheal illness. This difference suggests that people in this outbreak got sick from eating raw fish. Of 11 people who remembered details of their meal, 9 (82%) reported raw salmon.  Several sick people in the outbreak were identified as a part of three illness clusters at restaurants. An illness cluster is defined as two or more people who do not live in the same household who report eating food from the same retail location before getting sick. If several unrelated sick people ate food from the same retail location, it suggests that the contaminated food item was served or sold there. FDA's investigation traced the source of fresh, raw salmon eaten by sick people in these illness clusters back to Mariscos Bahia, Inc.

Public health investigators are using the PulseNet system to identify illnesses that may be 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 a method called whole genome sequencing (WGS). WGS showed that bacteria from sick people's samples are closely related genetically. This suggests that people in this outbreak got sick from the same food.

FDA collected an environmental sample that included multiple swabs at Mariscos Bahia, Inc., in Pico Rivera, California. Salmonella was identified from multiple environmental swabs collected at the facility and WGS analysis is ongoing. WGS completed to date indicates that Salmonella detected in at least one of the swabs from the facility is the outbreak strain.

CDC is advising restaurants not to sell or serve salmon, tuna, Chilean sea bass, swordfish, or halibut received on or after June 14, 2022, from Mariscos Bahia, Inc. The fish was distributed to restaurants fresh, not frozen. Fish distributed from Mariscos Bahia's locations in Pico Rivera, California, and Phoenix, Arizona, are included.

Falafel E. coli Outbreak: The FDA, along with CDC and state and local partners, are investigating a multistate outbreak of E. coli O121:H19 infections linked to Earth Grown frozen falafel.

Based on epidemiologic information provided by CDC and interviews conducted by state and local public health officials, of 18 people interviewed, 15 reported shopping at ALDI stores. Among these 15 people who reported shopping at ALDI stores, 6 reported eating Earth Grown brand frozen falafel purchased from ALDI in the week before getting sick.

On October 6, 2022, ALDI removed any remaining Earth Grown frozen falafel from stores.
FDA's investigation is ongoing. Updates to this advisory will be provided as they become available.
Recommendation

On October 6, 2022, the manufacturer of Earth Grown frozen falafel, Cuisine Innovations, initiated a voluntary recall. Recalled products include Earth Grown vegan traditional falafel and garlic & herb falafel distributed and sold exclusively by ALDI. Additional information on recalled products is available in the firm's recall notice.

Consumers, restaurants, and retailers should not eat, sell, or serve recalled Earth Grown Traditional Falafel or Garlic & Herb Falafel sold exclusively by ALDI after June 24, 2021. 

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