CDC: Multidrug-Resistant Salmonella Infections Linked to Pig Ear Dog Treats

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Zoonotic diseases - those that are normally carried by non-human species, but which can spill over into human beings - have long been the primary focus of this humble blog.  They not only constitute a tremendous burden to human health, they are the likely origin of the next big public health crisis or pandemic.

Just a few zoonotic themed blogs from the past few weeks include:

San Diego County Fair: Cluster Of 4 Pediatric E. coli STEC cases (1 Fatal)

PLoS NTDS: Prioritizing Surveillance of Nipah Virus in India

Texas DSHS Cautions Residents On Avoiding Sick or Dead Wildlife

WHO WER: Plague Around The World

Epidemics: Systematic Review Of MERS-CoV Seroprevalence and RNA Prevalence in Dromedary Camels 

CDC FluView Week 21: 1 Novel (H1N1v) Flu Infection - Michigan

Two months ago, in CDC: The 8 Zoonotic Diseases Of Most Concern In The United States, we looked at a joint CDC, USDA, DOI report on the top (n=56) zoonotic diseases of national concern for the United States. Of these 56 diseases examined, 8 were selected as being of particular concern in the United States.

The zoonotic diseases of most concern in the U.S. are:

• Zoonotic influenza
• Salmonellosis
• West Nile virus
• Plague
• Emerging coronaviruses (e.g., severe acute respiratory syndrome and Middle East respiratory syndrome)
• Rabies
• Brucellosis
• Lyme disease

While zoonotic (i.e., swine, avian, etc.) influenza tops the list - due to its potential impact - coming in second place is Salmonellosis, which the CDC estimates causes about 1.2 million illnesses, 23,000 hospitalizations, and 450 deaths in the United States every year.  

Currently the CDC is following 5 outbreaks of Salmonella around the country; of which 3 are linked to animals (Note: The laboratory outbreak is from 2017)

Reports of Active Salmonella Outbreak Investigations

Outbreak Investigations Linked to Food

Papayas – Salmonella Uganda

Outbreak Investigations Linked to Animals 

Backyard Poultry – Salmonella Infections
Pet Hedgehogs – Salmonella Typhimurium
Pig Ear Dog Treats – Salmonella I 4,[5],12:i:-

Other Outbreaks

Clinical and Teaching Microbiology Laboratory Exposure – Salmonella Typhimurium

The most recent Salmonella outbreak was announced on Tuesday afternoon (July 3rd), and it involves pig ear dog treats, a popular pet product which has seen recalls in the past.

Outbreak of Multidrug-Resistant Salmonella Infections Linked to Contact with Pig Ear Dog Treats 

Published on July 3, 2019 at 2:45 PM ET

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDAexternal icon) are investigating a multistate outbreak of multidrug-resistant Salmonella I 4,[5],12:i:- infections linked to contact with pig ear dog treats. 

Latest Outbreak Information
 
At A Glance

• Reported Cases: 45
• States: 13
• Hospitalizations: 12
• Deaths: 0 
• Forty-five people infected with the outbreak strain of Salmonella I 4,[5],12:i:- have been reported from 13 states.
• Twelve ill people have been hospitalized. No deaths have been reported.
• Epidemiologic evidence indicates that contact with pig ear dog treats is the likely source of this outbreak.
• In interviews, 34 (89%) of 38 ill people reported contact with a dog before getting sick.
• Of 24 people with available information, 17 (71%) reported contact with pig ear dog treats or with dogs who were fed pig ear dog treats. 
• Officials from the Michigan Department of Agriculture and Rural Development gathered pig ear dog treats at retail locations where ill people reported buying the products. They sampled pig ears for Salmonella. Although the outbreak strain was not identified, other strains of Salmonella were. Investigators are checking to see if any human illnesses are linked to those strains. Retail locations where sampling occurred have removed pig ears from shelves.
• A common supplier of pig ear treats in this outbreak has not been identified. Pet owners can take steps to keep their families healthy while feeding pets.
• This investigation is ongoing, and CDC will provide updates when more information is available.

(Continue . . . )

At the same time the FDA issued the following announcement:

FDA Investigates Contaminated Pig Ear Pet Treats Connected to Human Salmonella Infections

July 3, 2019

The U.S. Food and Drug Administration is coordinating with the U.S. Centers for Disease Control and Prevention (CDC) and state agencies to investigate human cases of Salmonella enterica serotype I 4,[5],12:i:- with a suspected link to exposure to pig ear pet treats.

Fast Facts

• The U.S. Food and Drug Administration, together with the Centers for Disease Control and Prevention (CDC) and State partners, is investigating a suspected link between pig ear treats and human cases of salmonellosis.
• CDC reports that there are 45 cases of human infection with Salmonella enterica serotype I 4,[5],12:i:- in 13 states. Twelve people have been hospitalized.
• Pig ear treat samples collected from bulk bins in retail locations by the Michigan Department of Agriculture and Rural Development (MDARD) tested positive for several strains of Salmonella, but not the specific strain connected to this outbreak.
• CDC and FDA are working with state boards of health to determine if there are any cases of human or animal illness linked to the strains of Salmonella found in the tested treats.
• FDA is also working with impacted firms to remove these pig ears from the marketplace and identify other places where they may have been distributed.
• FDA is issuing this alert so that consumers can choose whether to remove pig ear treats from their homes or take steps to potentially prevent Salmonella infection.
• Salmonella can affect both human and animal health. People with symptoms of Salmonella infection should consult their healthcare providers. Consult a veterinarian if your pet has symptoms of Salmonella infection.
• This is an ongoing investigation and FDA will provide the public with new information as it becomes available.

(Continue . . . )

Even pet food products that haven't been identified as contaminated can carry Salmonella or Listeria bacteria, and so the CDC provides an informative Pet Food Safety website, one that warns:

Raw pet foods can make pets and people sick

CDC does not recommend feeding raw diets to pets. Germs like Salmonella and Listeria bacteria have been found in raw pet foods, even packaged ones sold in stores. These germs can make your pets sick. Your family also can get sick by handling the raw food or by taking care of your pet.

What about dry and canned pet food?

Dry and canned pet food also can be contaminated with germs. Before making any changes to your pet’s diet, talk with your veterinarian.

While zoonotic diseases with pandemic potential - like avian flu, MERS, Nipah, and Plague - get most of our attention, the largely invisible burden of `lesser' bacterial zoonotic threats - like Salmonella, Listeria, and E. coli - continue to take a significant toll on public health.

Luckily, practicing good hand hygiene and following some common sense precautions can substantially lower your risk of infection.