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Nichols M, Stapleton GS, Rotstein DS, Gollarza L, Adams J, Caidi H, Chen J, Hodges A, Glover M, Peloquin S, Payne L, Norris A, DeLancey S, Donovan D, Dietrich S, Glaspie S, McWilliams K, Burgess E, Holben B, Pietrzen K, Benko S, Feldpausch E, Orel S, Neises D, Kline KE, Tobin B, Caron G, Viveiros B, Miller A, Turner C, Holmes-Talbot K, Mank L, Nishimura C, Nguyen TN, Hale S, Francois Watkins LK. Outbreak of multidrug-resistant Salmonella infections in people linked to pig ear pet treats, United States, 2015-2019: results of a multistate investigation. LANCET REGIONAL HEALTH. AMERICAS 2024; 34:100769. [PMID: 38817954 PMCID: PMC11137515 DOI: 10.1016/j.lana.2024.100769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 04/17/2024] [Accepted: 05/02/2024] [Indexed: 06/01/2024]
Abstract
Background International distribution of contaminated foods can be a source of Salmonella infections in people and can contribute to the spread of antimicrobial-resistant bacteria across countries. We report an investigation led by the United States Centers for Disease Control and Prevention, the Food and Drug Administration (FDA), and state governmental officials into a multistate outbreak of salmonellosis linked to pig ear pet treats. Methods Pig ear treats and companion dogs were tested for Salmonella by state officials and the FDA. Products were traced back to the country of origin when possible. Cases were defined as outbreak illnesses in people associated with one of seven Salmonella serotypes genetically related to samples from pig ear pet treats, with isolation dates from June 2015 to September 2019. Whole genome sequencing (WGS) of isolates was used to predict antimicrobial resistance. Findings The outbreak included 154 human cases in 34 states. Of these, 107 of 122 (88%) patients reported dog contact, and 65 of 97 (67%) reported contact with pig ear pet treats. Salmonella was isolated from 137 pig ear treats, including some imported from Argentina, Brazil, and Colombia, and from four dogs. WGS predicted 77% (105/137) of human and 43% (58/135) of pig ear treat isolates were resistant to ≥3 antimicrobial classes. Interpretation This was the first documented United States multistate outbreak of Salmonella infections linked to pig ear pet treats. This multidrug-resistant outbreak highlights the interconnectedness of human health and companion animal ownership and the need for zoonotic pathogen surveillance to prevent human illness resulting from internationally transported pet food products. Funding Animal Feed Regulatory Program Standards award. Animal and product testing conducted by FDA Vet-LIRN was funded by Vet-LIRN infrastructure grants (PAR-22-063).
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Affiliation(s)
- Megin Nichols
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - G. Sean Stapleton
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - David S. Rotstein
- Office of Surveillance and Compliance, Center for Veterinary Medicine, United States Food and Drug Administration, Rockville, MD, USA
| | - Lauren Gollarza
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer Adams
- Association of Public Health Laboratories, Silver Spring, MD, USA
| | - Hayat Caidi
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jessica Chen
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - April Hodges
- Office of Surveillance and Compliance, Center for Veterinary Medicine, United States Food and Drug Administration, Rockville, MD, USA
| | - Mark Glover
- Office of Surveillance and Compliance, Center for Veterinary Medicine, United States Food and Drug Administration, Rockville, MD, USA
| | - Sarah Peloquin
- Veterinary Laboratory Investigation and Response Network, Office of Applied Science, Center for Veterinary Medicine, United States Food and Drug Administration, Laurel, MD, USA
| | - Lloyd Payne
- Office of Surveillance and Compliance, Center for Veterinary Medicine, United States Food and Drug Administration, Rockville, MD, USA
| | - Anne Norris
- Office of the Director, Strategic Communications, Center for Veterinary Medicine, United States Food and Drug Administration, Rockville, MD, USA
| | - Siobhan DeLancey
- Office of the Director, Strategic Communications, Center for Veterinary Medicine, United States Food and Drug Administration, Rockville, MD, USA
| | - Danielle Donovan
- Michigan Department of Health & Human Services, Lansing, MI, USA
| | - Steve Dietrich
- Michigan Department of Health & Human Services, Lansing, MI, USA
| | - Stevie Glaspie
- Michigan Department of Agriculture & Rural Development, MI, USA
| | | | | | - Beth Holben
- Michigan Department of Health & Human Services, Lansing, MI, USA
| | - Karen Pietrzen
- Michigan Department of Agriculture & Rural Development, MI, USA
| | - Scott Benko
- Michigan Department of Agriculture & Rural Development, MI, USA
| | | | - Sydney Orel
- Kansas Department of Agriculture Laboratory, Manhattan, KS, USA
| | - Daniel Neises
- Kansas Department of Health and Environment, Topeka, KS, USA
| | | | - Bradley Tobin
- Pennsylvania Department of Agriculture, Harrisburg, PA, USA
| | | | | | - Adam Miller
- Rhode Island Department of Health, Providence, RI, USA
| | | | | | - Laurn Mank
- Connecticut Department of Public Health, Hartford, CT, USA
| | | | - Tu Ngoc Nguyen
- Connecticut Department of Public Health, Hartford, CT, USA
| | - Shelby Hale
- Ohio Department of Health, Columbus, OH, USA
| | - Louise K. Francois Watkins
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Morgan G, Saal M, Corr A, Jenkins C, Chattaway MA, Pinchbeck G, Williams N. Isolation of Salmonella species of public health concern from commonly fed dried meat dog treats. Vet Rec 2023; 192:e2642. [PMID: 36715168 DOI: 10.1002/vetr.2642] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/24/2022] [Accepted: 01/11/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND Dried non-heat-treated meat treats, such as ears, skin and tails, are popular supplementary dog foods. Previous studies have demonstrated Salmonella spp. contamination on treats, particularly in pig ears and chicken products. This small, exploratory, cross-sectional study investigated Salmonella spp. presence in dried treats available in the UK. METHODS A selection of dried treats from local pet shops and online retailers underwent bacterial culture for Salmonella spp. and subsequent antimicrobial susceptibility testing, with Salmonella serotype determined by whole genome sequencing. RESULTS Eighty-four samples were tested, with 16% being Salmonella spp. positive. Five Salmonella serotypes were identified, each associated with specific treat types. An antimicrobial-resistant phenotype was identified in 39% of isolates. All serotypes identified are known to cause human infection. LIMITATIONS This study was limited by a small sample size and limited number of retail sources. CONCLUSION Salmonella spp. of public health concern were present in some dried dog treats in this study. Dog owners, pet food retailers and veterinary professionals should be aware of the potential zoonotic disease risk associated with these treats, and appropriate hygiene measures, including thorough hand washing, should be utilised if they are fed.
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Affiliation(s)
- Genever Morgan
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, UK
| | - Mikhela Saal
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, UK
| | - Aoife Corr
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, UK
| | - Claire Jenkins
- Gastrointestinal Bacteria Reference Unit, United Kingdom Health Security Agency, London, UK
| | - Marie Anne Chattaway
- Gastrointestinal Bacteria Reference Unit, United Kingdom Health Security Agency, London, UK
| | - Gina Pinchbeck
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, UK
| | - Nicola Williams
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, UK
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Cavallo SJ, Daly ER, Seiferth J, Nadeau AM, Mahoney J, Finnigan J, Wikoff P, Kiebler CA, Simmons L. Human outbreak of Salmonella Typhimurium associated with exposure to locally made chicken jerky pet treats, New Hampshire, 2013. Foodborne Pathog Dis 2015; 12:441-6. [PMID: 25793722 DOI: 10.1089/fpd.2014.1889] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Pet treats and pet food can be contaminated with Salmonella and other pathogens, though they are infrequently implicated as the source of human outbreaks. In 2013, the New Hampshire Department of Health and Human Services investigated a cluster of Salmonella Typhimurium infections associated with contaminated locally made pet treats. Case-patients were interviewed with standardized questionnaires to assess food, animal, and social histories. Laboratory and environmental investigations were conducted, including testing of clinical specimens, implicated product, and environmental swabs. Between June and October 2013, a total of 43 ill persons were identified. Sixteen patients (37%) were hospitalized. Among 43 case-patients interviewed, the proportion exposed to dogs (95%) and pet treats (69%) in the 7 days prior to illness was statistically higher than among participants in a U.S. population-based telephone survey (61%, p<0.0001 and 16%, p<0.0001, respectively). On further interview, 38 (88%) reported exposure to Brand X Chicken Jerky, the maker of Brand X chicken jerky, or the facility in which it was made. Product testing isolated the outbreak strain from four of four Brand X Chicken Jerky samples, including an unopened package purchased at retail, opened packages collected from patient households, and unpackaged jerky obtained from the jerky maker. A site visit revealed inadequate processing of the chicken jerky, bare-hand contact with the finished product prior to packaging, and use of vacuum-sealed packaging, which may have enabled facultative anaerobic bacteria to proliferate. Seven (78%) of nine environmental swabs taken during the site visit also yielded the outbreak strain. Brand X Chicken Jerky was voluntarily recalled on September 9, 2013. Consumers should be made aware of the potential for locally made products to be exempt from regulation and for animals and animal food to carry pathogens that cause human illness, and be educated to perform hand hygiene after handling pet food or treats.
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Affiliation(s)
- Steffany J Cavallo
- 1 Division of Public Health Services, New Hampshire Department of Health and Human Services , Concord, New Hampshire
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Stull JW, Peregrine AS, Sargeant JM, Weese JS. Pet husbandry and infection control practices related to zoonotic disease risks in Ontario, Canada. BMC Public Health 2013; 13:520. [PMID: 23714625 PMCID: PMC3668296 DOI: 10.1186/1471-2458-13-520] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 05/23/2013] [Indexed: 11/28/2022] Open
Abstract
Background Many human infections are transmitted through contact with animals (zoonoses), including household pets. Despite this concern, there is limited knowledge of the public’s pet husbandry and infection control practices. The objective of this study was to characterize zoonotic disease related-husbandry and infection preventive practices in pet-owning households in Ontario, Canada. Methods A self-administered questionnaire was distributed to individuals at two multi-physician clinics in Waterloo, Ontario, Canada during 2010. One adult from each household was invited to participate in the study. Results Four hundred one pet-owners completed the questionnaire. Households reported ownership of dogs (68%), cats (48%), fish (13%), exotic mammals (7%), such as hamsters, and reptiles and birds (each 6%). Across all species, individuals at higher risk of infections (i.e. < 5yrs, ≥ 65yrs, immunocompromised) were often (46-57%) present in households. Children < 16 yrs of age had close pet contact, as households reported dogs (13%) and cats (30%) usually slept in a child’s bed and dogs often licked a child’s face (24%). Household husbandry practices that increase zoonotic disease risk were frequently identified; some fed high-risk foods (i.e. raw eggs, raw meat, or raw animal product treats) to their dogs (28%) or cats (3%); 14% of reptile-owning households allowed the pet to roam through the kitchen or washed it in the kitchen sink. Reported hand washing by children was high for all species (> 76% washed hands sometimes or greater after touching the pet, its feces, or housing), although fewer reported children always washed their hands (3-57%; by species). With a few exceptions, practices were not associated with the presence of higher risk members in the household or recall of having previously received zoonotic disease education. Conclusions The results suggest there is a need for education on zoonotic disease prevention practices for pet-owning households with individuals at higher risk of infection and those with high-risk species (e.g., reptiles). Further research is needed to determine the role of education in altering higher risk pet practices.
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Affiliation(s)
- Jason W Stull
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario, N1G2W1 Canada.
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Hoelzer K, Moreno Switt AI, Wiedmann M. Animal contact as a source of human non-typhoidal salmonellosis. Vet Res 2011; 42:34. [PMID: 21324103 PMCID: PMC3052180 DOI: 10.1186/1297-9716-42-34] [Citation(s) in RCA: 280] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Accepted: 09/07/2010] [Indexed: 12/25/2022] Open
Abstract
Non-typhoidal Salmonella represents an important human and animal pathogen world-wide. Most human salmonellosis cases are foodborne, but each year infections are also acquired through direct or indirect animal contact in homes, veterinary clinics, zoological gardens, farm environments or other public, professional or private settings. Clinically affected animals may exhibit a higher prevalence of shedding than apparently healthy animals, but both can shed Salmonella over long periods of time. In addition, environmental contamination and indirect transmission through contaminated food and water may complicate control efforts. The public health risk varies by animal species, age group, husbandry practice and health status, and certain human subpopulations are at a heightened risk of infection due to biological or behavioral risk factors. Some serotypes such as Salmonella Dublin are adapted to individual host species, while others, for instance Salmonella Typhimurium, readily infect a broad range of host species, but the potential implications for human health are currently unclear. Basic hygiene practices and the implementation of scientifically based management strategies can efficiently mitigate the risks associated with animal contacts. However, the general public is frequently unaware of the specific disease risks involved, and high-risk behaviors are common. Here we describe the epidemiology and serotype distribution of Salmonella in a variety of host species. In addition, we review our current understanding of the public health risks associated with different types of contacts between humans and animals in public, professional or private settings, and, where appropriate, discuss potential risk mitigation strategies.
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Affiliation(s)
- Karin Hoelzer
- Department of Food Science, 410 Stocking Hall, Cornell University, Ithaca, NY 14853, USA.
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