Minnesota probe links Salmonella outbreak to peanut butter

Robert Roos and Lisa Schnirring  Staff Writers

Jan 12, 2009 (CIDRAP News) – Minnesota officials today reported a genetic match between Salmonella found in an open container of King Nut peanut butter and a multistate outbreak that has sickened more than 400 people, confirming a link they first reported as likely on Jan 9.

Testing by the Minnesota Department of Agriculture (MDA) last week revealed Salmonella in a 5-pound container of King Nut peanut butter collected from a long-term care facility associated with one of 30 cases in Minnesota, according to state officials.

The finding led King Nut Cos., based in Solon, Ohio, on Jan 10 to recall its peanut butter because of possible Salmonella contamination. In a press release posted on the Food and Drug Administration (FDA) Web site, the company said it distributes peanut butter only to food service accounts, not to retail stores.

The MDA and the Minnesota Department of Health (MDH) issued a product advisory Jan 9 after finding the contamination. An MDH epidemiologic investigation pointed to the company's product as the likely cause of Salmonella infections in Minnesota residents. The state conducted more tests over the weekend (Jan 10 and 11) to verify the link between the contaminated product and illnesses, the agencies said in a news release about the latest findings today.

The outbreak involves Salmonella enterica serotype Typhimurium. The MDH is coordinating its investigation with the US Centers for Disease Control and Prevention (CDC), the FDA, and other states.

In an e-mail statement this afternoon, the CDC said the outbreak has sickened 410 people in 43 states and may have contributed to 3 deaths. The states with the most cases include California (55), Ohio (53), Massachusetts (40), Minnesota (30), and Michigan (20). Illness onset dates are known for 388 patients and range from Sep 15, 2008, to Jan 7; most began after Oct 1. Patients' ages range from less than 1 year to 98 years, and 48% are female. Hospitalization was reported in 18% of the patients.

The FDA, in posting King Nut's recall notice Jan 10, did not mention the widespread Salmonella outbreak. The CDC apparently did not mention the peanut butter findings in updates on the outbreak until the e-mail statement issued this afternoon.

Speaking today but before the latest Minnesota findings of a genetic match were announced, FDA spokesman Sebastian Cianci said the FDA did not publicly link the recall to the outbreak because it didn't have enough information. "What we have to establish is, is this the same strain of Salmonella that is appearing in the outbreak, or is it something not related to the outbreak?" he said.

Without definitive evidence in the form of DNA fingerprinting tying the food to the illnesses, he said, "There's a possibility there could be something else, so we have to go through our regulatory and scientific due diligence. If it were not linked, we might have two things to worry about."

"Basically it's a combination of making sure we're dealing with exactly the same organism and that individuals were exposed to that organism as well," he said. "If that's the case, then there's a very high likelihood that there's a causal association. That's when we make the call" to notify consumers.

Martin Kanan, president and chief executive officer of King Nut Co., said in the recall notice that the firm was very concerned about the contamination possibility. "We are very sorry this happened. We are taking immediate and voluntary action because the health and safety of those who use our products is always our highest priority," he said.

Kanan said the peanut butter is produced by Peanut Corporation of America (PCA) under the King Nut label. He said the same company also makes another brand that King Nut distributes, Parnell's Pride, though other companies also distribute that brand. He urged customers to stop using both brands.

Meanwhile, PCA in a Jan 10 statement voiced concern about an apparent Salmonella finding in one of its products and said it was working with federal officials and independent testing laboratories to investigate the possible contamination. PCA said it has a rigorous detection system for Salmonella and other contaminants and that Salmonella has never been found in any of its products.

However, PCA said the discovery of the pathogen in an open container in a nursing facility leaves open the possibility of cross-contamination. "To date, the only conclusive testing linking Salmonella to PCA's product was done on an open container of peanut butter in a large, institutional kitchen," the company said in its statement. "The history of the handling of that open container is unknown at this time."

PCA, based in Lynchburg, Va., has three processing plants, but makes peanut butter only at its Blakely, Ga., facility, according to the company's Web site.

News of the contaminated peanut butter comes nearly 2 years after the last nationwide Salmonella outbreak linked to peanut butter. Federal officials traced that outbreak to a Sylvester, Ga., plant that produced Peter Pan and other brands. That outbreak, which involved Salmonella enterica serovar Tennessee, sickened 425 people in 44 states.

See also:

Jan 12 MDH press release

http://www.health.state.mn.us/news/pressrel/2009/salmonella011209.html

Jan 9 MDH press release

Jan 10 FDA press release

Jan 10 PCA press release

Jan 9 CDC Salmonella outbreak update

PCA Web site