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J Food Prot. 2019 Sep;82(9):1615-1624. doi: 10.4315/0362-028X.JFP-19-048.

Multidrug-Resistant Salmonella I 4,[5],12:i:- and Salmonella Infantis Infections Linked to Whole Roasted Pigs from a Single Slaughter and Processing Facility.

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Epidemic Intelligence Service, Division of Scientific Education and Professional Development, CSELS.
Communicable Disease Epidemiology and Immunization Section, Public Health-Seattle & King County, 401 5th Avenue, Seattle, Washington 98104.
Outbreak Response and Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, NCEZID.
Enteric Diseases Laboratory Branch, Division of Foodborne, Waterborne, and Environmental Diseases, NCEZID, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, Georgia 30333.
Public Health Laboratories, Washington State Department of Health, 1610 N.E. 150th Street, Shoreline, Washington 98155.
Food Safety and Inspection Service, U.S. Department of Agriculture, 100 Alabama Street S.W., Atlanta, Georgia 30303.
Food Safety and Inspection Service, U.S. Department of Agriculture, 1400 Independence Avenue S.W., Washington, DC 20250.
Department of Epidemiology, School of Public Health, University of Washington, 1959 N.E. Pacific Street, Seattle, Washington 98195, USA.


We describe two outbreaks of multidrug-resistant (MDR) Salmonella I 4,[5],12:i:- infection, occurring in 2015 to 2016, linked to pork products, including whole roaster pigs sold raw from a single Washington slaughter and processing facility (establishment A). Food histories from 80 ill persons were compared with food histories reported in the FoodNet 2006 to 2007 survey of healthy persons from all 10 U.S. FoodNet sites who reported these exposures in the week before interview. Antimicrobial susceptibility testing and whole genome sequencing were conducted on selected clinical, food, and environmental isolates. During 2015, a total of 192 ill persons were identified from five states; among ill persons with available information, 30 (17%) of 180 were hospitalized, and none died. More ill persons than healthy survey respondents consumed pork (74 versus 43%, P < 0.001). Seventeen (23%) of 73 ill persons for which a response was available reported attending an event where whole roaster pig was served in the 7 days before illness onset. All 25 clinical isolates tested from the 2015 outbreak and a subsequent 2016 smaller outbreak (n = 15) linked to establishment A demonstrated MDR. Whole genome sequencing of clinical, environmental, and food isolates (n = 69) collected in both investigations revealed one clade of highly related isolates, supporting epidemiologic and traceback data that establishment A as the source of both outbreaks. These investigations highlight that whole roaster pigs, an uncommon food vehicle for MDR Salmonella I 4,[5],12:i:- outbreaks, will need further attention from food safety researchers and educators for developing science-based consumer guidelines, specifically with a focus on the preparation process.


I 4,[5],12:i:−; Food safety; Multidrug resistant; Pig; Pork; Swine

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