Salmonella typhimurium infections associated with peanut products

January 01, 0001

Salmonella typhimurium infections associated with peanut products

Contaminated food ingredients can affect multiple products, each distributed through various channels and consumed in multiple settings. Beginning in November 2008, these US authors investigated a nationwide outbreak of salmonella infections. A case was defined as laboratory-confirmed infection with the outbreak strain of Salmonella typhimurium occurring between September 1, 2008, and April 20, 2009. They conducted two case-control studies, product "trace-back," and environmental investigations.

They found: "Among 714 case patients identified in 46 states, 166 (23%) were hospitalized and 9 (1%) died. In study 1, illness was associated with eating any peanut butter (matched odds ratio, 2.5), peanut butter-containing products (matched odds ratio, 2.2), and frozen chicken products (matched odds ratio, 4.6). Investigations of focal clusters and single cases associated with nine institutions identified a single institutional brand of peanut butter (here called brand X) distributed to all facilities. In study 2, illness was associated with eating peanut butter outside the home (matched odds ratio, 3.9) and two brands of peanut butter crackers (brand A: matched odds ratio, 17.2). Both cracker brands were made from brand X peanut paste. The outbreak strain was isolated from brand X peanut butter, brand A crackers, and 15 other products. A total of 3918 peanut butter-containing products were recalled between January 10 and April 29, 2009."

The authors concluded: "Contaminated peanut butter and peanut products caused a nationwide salmonellosis outbreak. Ingredient-driven outbreaks are challenging to detect and may lead to widespread contamination of numerous food products."

The question is how to prevent recurrence.


For the full abstract, click here.

N Engl J Med 365:601-610, 18 August 2011 © 2011 to the Massachusetts Medical Society
Salmonella Typhimurium Infections Associated with Peanut Products. Elizabeth Cavallaro, Kashmira Date, Carlota Medus, et al. Correspondence to Dr. Cavallaro: ecavallaro@cdc.gov

Category: D. Digestive. Keywords: Salmonella typhimurium, peanuts, peanut butter, case-control and outbreak investigation studies, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 30 August 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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