Salmonella -tainted pine nuts sicken 42 in six states

Oct 27, 2011 (CIDRAP News) – Wegmans Food Markets yesterday recalled bulk Turkish pine nuts sold in most of its stores after health officials linked them to a Salmonella Enteritidis outbreak that has so far sickened 42 people in six states.

The recall involves 5,000 pounds of pine nuts sold at the company's stores in New York, Pennsylvania, New Jersey, Virginia, and Maryland between Jul 1 and Oct 18. It does not apply to a store in Northborough, Mass., that opened on Oct 16, according to a recall notice from the US Food and Drug Administration (FDA).

Wegmans said the recalled pine nuts were imported from Turkey by Sunrise Commodities, based in Englewood Cliffs, N.J. The US Centers for Disease Control and Prevention (CDC) said yesterday in an outbreak announcement that though the nuts were imported from Turkey, they may not have originated there. Federal and state officials are tracking the source of the pine nuts to determine if they were distributed to other retailers.

The CDC said epidemiologic and laboratory investigations by local, state, and federal agencies linked the illnesses to the pine nuts, which Wegmans also used as an ingredient in prepared foods such as Caprese salad sold at its stores.

Information from shopper cards helped health officials narrow the list of products suspected as the source of the outbreak early in the investigation, the CDC said. The review of sick patients' purchases, with their permission, found that they had purchased the same type of Turkish pine nuts from bulk bins at different Wegmans locations before they became ill.

Wegmans said it sent automated phone calls to customers whose shopping cards reflected Turkish pine nut purchases to notify them about the recall.

Lab tests by the Virginia Division of Consolidated Laboratory Services identified the outbreak strain in a sample of Turkish pine nuts from the home of a sick patient who had bought them at Wegmans, as well as from retail samples collected from Wegmans stores where sick patients had shopped.

Meanwhile, testing at the New York Department of Health's Wadsworth Center Laboratory on two samples of pesto containing the pine nuts collected from two sick people's homes yielded the Salmonella Enteritidis outbreak strain. Additional tests on bulk pine nuts are pending.

So far most of the people sickened in the outbreak are from New York (26), with cases matching the same genetic fingerprint reported from Pennsylvania (8), Virginia (4), New Jersey (2), Arizona (1), and Maryland (1).

The CDC and its partners are using PulseNet to identify additional cases and interview sick people about the food they ate before they became ill.

Illnesses began on or after Aug 20, the CDC said, noting that illnesses occurring after Sep 28 might not be reflected in the outbreak numbers yet, due to the time lag between diagnosis and reporting, which can average 2 to 3 weeks.

Patients range from younger than 1 to 94, with a median age of 43. Two patients were hospitalized, and no deaths have been reported. Fifty-seven percent of the patients are female.

The CDC advised consumers to check their homes, including refrigerators and freezers, for pine nuts that they may have purchased from Wegmans bulk bins and avoid eating foods such as pesto and salads that were prepared with the recalled nuts.

Symptoms of Salmonella infection include diarrhea, fever, and abdominal cramping, which usually occur 12 to 72 hours after infection, the CDC said. The illness lasts about 4 to 7 days. Though most people recover without treatment, diarrhea can be so severe that patients need to be hospitalized. The disease can be more severe in older people, infants, and those with impaired immune systems.

A review of the medical literature and a CDC foodborne illness outbreak database turned up no previous Salmonella outbreaks specifically linked to pine nuts. In January 2010, Hines Nut Company, based in Dallas, recalled pine nuts packaged under the Harris Teeter Farmers Market brand after routine tests by its supplier, Red River Foods, detected Salmonella during routine sampling, according to a FDA recall notice. No illnesses were reported.

See also:

Oct 26 FDA recall notice

Oct 26 CDC outbreak announcement

Jan 15, 2010, FDA recall notice

CDC Foodborne Outbreak Online Database

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