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CDC: Outbreak traced to raw turkey turns deadly; 35 states now report cases

BULLETIN: Federal officials are reporting an 82 percent increase in the number of confirmed Salmonella infections in a nationwide outbreak traced to raw turkey. The CDC also confirmed the first outbreak-related death today.
Since the initial outbreak report on July 19 — when 90 people from 26 states had been confirmed with the outbreak strain of Salmonella Reading — another 74 people have been added to the case count. As of Nov. 5, 164 people from 35 states are laboratory confirmed as outbreak patients, according to this afternoon’s update from the Centers for Disease Control and Prevention.
No recalls have been initiated in relation to the outbreak.
The outbreak’s hospitalization rate is higher than usually seen with salmonellosis. Of the 135 patients with the information currently available, 47 percent have been admitted to hospitals. One of the patients in California died.  
“In interviews, ill people report eating different types and brands of turkey products purchased from many different locations. Three ill people lived in households where raw turkey pet food was fed to pets,” said investigators from the CDC.
“The outbreak strain of Salmonella Reading has been identified in samples from raw turkey pet food in Minnesota, from live turkeys from several states, and from raw turkey products collected from ill people’s homes. The raw turkey samples collected from ill people’s homes are still being investigated to determine the source of the turkey. A single, common supplier of raw turkey products or of live turkeys has not been identified.”
The USDA’s Food Safety and Inspection Service has food safety jurisdiction over poultry and its investigators are working with the CDC and turkey producers, but the FSIS is deferring to the CDC when it comes to outbreak updates.  
Federal food safety officials say the fact that the outbreak strain of Salmonella Reading is present in live turkeys and many types of raw turkey products shows the bacteria could be widespread in the turkey industry.  
“CDC and USDA-FSIS have shared this information with representatives from the turkey industry and asked about steps that they may be taking to reduce Salmonella contamination,” according to the CDC update.
Routine government testing detected outbreak
Inspectors from FSIS who were conducting routine testing discovered Salmonella contamination in turkey products from 22 slaughter facilities and seven processing establishments. They performed whole genome sequencing on the bacteria samples and uploaded the results to the CDC’s pathogen database. Cross checks of isolates from infected people showed the Salmonella Reading strain detected in the slaughter and processing plants had the same DNA fingerprint.
The first patient with an infection from the outbreak became ill on Nov. 20, 2017, with the most recent documented illness beginning on Oct. 20 this year. The confirmed patients range in age from less than 1 year old to 91 years old.  
State and local health department investigators continue to interview ill people about the foods they ate and other exposures in the week before they became ill. Of 85 patients for whom the information is available, more than half — 44 — reported eating or handling raw turkey products before becoming sick. Three of those 85 worked in a facility that raises or processes turkeys, or lived with someone who did.
Health officials say some of the specific isolates of the outbreak strains are proving difficult to treat. The CDC is encouraging medical providers to review its information on antibiotic resistance among the bacteria causing the infections.  
“Whole genome sequencing showed 68 isolates from ill people and 84 isolates from food, animal, and environmental samples contained genes for resistance to all or some of the following antibiotics: ampicillin, streptomycin, sulfamethoxazole, tetracycline, kanamycin, gentamicin, nalidixic acid, ciprofloxacin, ceftriaxone, and fosfomycin,” according to the CDC.
“Testing of five outbreak isolates using standard antibiotic susceptibility testing by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory confirmed these results. Most of the infections in this outbreak are susceptible to the antibiotics that are commonly used for treatment, so this resistance likely will not affect the choice of antibiotic used to treat most people.”
Advice for consumers
Food that is contaminated with Salmonella bacteria usually does not look, smell or taste spoiled. Anyone can become sick with a Salmonella infection, but infants, children, seniors and people with weakened immune systems are at higher risk of serious illness because their immune systems are fragile, according to the CDC.
Anyone who has eaten any of the recalled products and developed symptoms of Salmonella infection should seek medical attention. Sick people should tell their doctors about the possible exposure to Salmonella bacteria because special tests are necessary to diagnose salmonellosis. Salmonella infection symptoms can mimic other illnesses, frequently leading to misdiagnosis.
Symptoms of Salmonella infection can include diarrhea, abdominal cramps, and fever within 12 to 72 hours after eating contaminated food. Otherwise healthy adults are usually sick for four to seven days. In some cases, however, diarrhea may be so severe that patients need to be hospitalized.  
Older adults, children, pregnant women and people with weakened immune systems, such as cancer patients, are more likely to develop a severe illness and serious, sometimes life-threatening conditions.
It is possible for some people to be infected with the bacteria and to not get sick or show any symptoms, but to still be able to spread the infection to others.
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