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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
From: Defibaugh-Chavez, Stephanie - FSISSent: Tuesday, October 29, 2013 11:32 AMTo: Leskowsky, Robert - FSIS; - FSIS; Atkinson, Richard - FSIS; Pihkala, Nora - FSIS; Shaw, William - FSIS; Vetter, Danah - FSIS; Robertson, Kis - FSISCc: Kissler, Bonnie - FSIS; Green, Alice - FSIS; Dessai, Uday - FSISSubject: Continued Intensified Sampling Update
Importance: High
Just a quick update for continued intensified sampling (Phase 2) results for the 5 establishments currently being sampled:
Total Collected # Neg # Pos % Pos # In progress M33901-P33901 35 23 0 0.0 12 M6137-P6137 63 47 4 7.8 12 P33900-V33900 35 27 0 0.0 8 P6137A 63 44 4 8.3 15 P7632 63 47 1 2.1 15
There are 9 positive samples so far just for the continued (Phase 2) sampling at these establishments. There is not any subtyping information (serotype/PFGE) available yet, but unofficially I have heard that there are two Heidelbergs identified, and PFGE is still pending for these isolates. I am hoping to get that info in the next two days and will send an update as soon as I do.
Please share within your program areas as necessary.
-Stephanie
Stephanie Defibaugh-Chávez, Ph.D.MicrobiologistScience Staff, Office of Public Health ScienceFood Safety and Inspection ServiceUnited States Department of Agriculture202-690-6042 (office)202-641-5540 (Blackberry)202-690-6364 (fax)email: [email protected]
Stay Connected with USDA: <http://www.facebook.com/usda> <http://www.twitter.com/usda> <http://www.youtube.com/usda>
From: - FSISSent: Tuesday, October 29, 2013 10:05 AMTo: Green, Alice - FSISSubject: RE: More Costco shopper records to request
The card number for , " " is incorrect as there is only 11 digits and Costco card numbers have 12.
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Compliance Investigator
USDA/FSIS/OIEA/CID
19110 Bothell Way NE, Suite #201
Bothell, WA 98011
Office:
Cell:
Fax: (425) 483-3492
fsis.usda.gov
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From: Green, Alice - FSIS Sent: Friday, October 25, 2013 1:28 PMTo: Atkinson, Richard - FSIS; - FSISCc: Khroustalev, Allison - FSISSubject: FW: More Costco shopper records to request
Please forgive me if I've missed any of these, but I didn't see them in the IR. Do these need to be requested from Costco?
Thank you!
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
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Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Peralta, Vi (CDPH-CID-DCDC-IDB) [mailto:[email protected]] Sent: Thursday, October 24, 2013 8:19 PMTo: Green, Alice - FSIS; Kimura, Akiko (CDPH-CID-DCDC); Higa, Jeffrey (CDPH-CID-DCDC-IDB)Subject: More Costco shopper records to request
Hi Alice,
I've had a chance to go through all the records....whew! Thank you!
These are all the ones for which we don't have any records yet (the last two are new).
Talk to you tomorrow morning!
PulseNet ID
CDC ID
Onset Date
Cluster pattern
SourceCounty
Reported Chicken Exposures from Interview
Store1
Costco Shopper Card #
7/28/2013
JF6X01.0041
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
San Diego
Foster Farms chicken livers (used as bait for fishing several time during week prior to illness onset) purchased from Stater Bros; Stater Bros brand chicken thighs; Sprouts natural chicken brand thighs
Costco
9/1/2013
JF6X01.0045
San Mateo
Foster Farm chicken tenderloins, frozen raw (Costco) consumed 8/26-8/28
Costco
8/29/2013
JF6X01.0022
San Diego
Costco/Kirkland thighs and maybe rotisserie chicken. Legs (Vons/Ralphs)
Costco
9/23/2013
JF6X01.0045
Santa Clara
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chicken bake 9/21/13 from Costco food court
Costco
and
9/14/2013
JF6X01.0258
Riverside
Maybe had Foster Farms breaded boneless skinless chicken, looks like strips (Costco). Maybe had pre-cooked rotisserie (Stater Bros)
Costco
9/11/2013
JF6X01.0258
San Francisco
Costco rotisserie chicken purchased and consumed 9/11/13
Costco
9/14/2013
JF6X01.0258
San Mateo
Buys Foster Farms chicken every week from Costco. Reports Foster Farms whole chicken, fresh raw, consumed 9/11/13. Foster Farms thighs, fresh raw, consumed within week before onset
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Costco
and
From: Green, Alice - FSIS [mailto:[email protected]] Sent: Thursday, October 24, 2013 1:06 PMTo: Peralta, Vi (CDPH-CID-DCDC-IDB); Kimura, Akiko (CDPH-CID-DCDC); Higa, Jeffrey (CDPH-CID-DCDC-IDB)Cc: Gieraltowski, Laura (CDC/OID/NCEZID); Schwensohn, Colin A. (CDC/OID/NCEZID); Nakao, Jolene H. (CDC/OID/NCEZID); Allen, Latasha - Commissioned Corps - FSIS; Robertson, Kis - FSISSubject: shopper records
Hi Vi-
I believe I've covered all the records in your request. There might be some duplicates-I wanted to include all versions of shopper histories in case some are more complete than others.
Please let me know if I've omitted any of the ones you gently reminded us about. J
Thanks much,
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
This electronic message contains information generated by the USDA solely for the intended recipients. Any unauthorized interception of this message or the use or disclosure of the information it contains may violate the law and subject the violator to civil or criminal penalties. If you believe you have received this message in error, please notify the sender and delete the email immediately.
From: Dessai, Uday - FSISSent: Tuesday, October 29, 2013 9:57 AMTo: Kissler, Bonnie - FSIS; Goldman, David - Commissioned Corps - FSIS; Kause, Janell - FSISCc: Green, Alice - FSIS; Robertson, Kis - FSIS; Bennett, Patty - FSIS; Douris, Aphrodite - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Holt, Kristin - FSISSubject: RE: Positive chicken sample for S. Heidelberg patient
Thanks Bonnie!
Kis and SDC - We may need to mention this at OPHSLT, unless we have additional information from David.
Thanks much!
Uday
From: Kissler, Bonnie - FSIS Sent: Tuesday, October 29, 2013 10:55 AMTo: Dessai, Uday - FSIS; Goldman, David - Commissioned Corps - FSIS; Kause, Janell - FSISCc: Green, Alice - FSIS; Robertson, Kis - FSIS; Bennett, Patty - FSIS; Douris, Aphrodite - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Holt, Kristin - FSISSubject: RE: Positive chicken sample for S. Heidelberg patient
CDC is planning a web update this week (could be as early as tomorrow). If we decide to move forward with a recall, CDC will likely wait until after the recall before doing the web update.
Bonnie KisslerSenior EpidemiologistUSDA, FSIS, OPHS, AESc/o Centers for Disease Control and Prevention
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1600 Clifton Road, NE, MS A-38Building 24, Room 10203Atlanta, GA 30329Office: 404.639.5012Blackberry: 404.661.6640Fax: 404.718.2126Email: [email protected] <mailto:[email protected]>
From: Dessai, Uday - FSIS Sent: Monday, October 28, 2013 3:17 PMTo: Dessai, Uday - FSIS; Goldman, David - Commissioned Corps - FSIS; Kause, Janell - FSISCc: Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Douris, Aphrodite - FSIS; Defibaugh-Chavez, Stephanie - FSISSubject: RE: Positive chicken sample for S. Heidelberg patient
Also here are summary points from SDC email from Friday:
About case-patient ( traceback and FSIS intensified sampling:
The specific product identified is a boneless skinless chicken thigh product. It was collected at P6137A but was produced from source materials that originated from P7632 (slaughtered on 9/9/2013). StephanieDC had suggested in her Friday’s email to consider recalling all chicken products (including parts and whole chicken!) produced from birds slaughtered on 9/9/2013 at P7632 . This was based on the fact that 11 total product –positives were produced from source materials that originated from P7632 (slaughtered on 9/9/2013 and includes a variety of parts and whole/rotisserie chicken.
Thanks much!
Uday
From: Dessai, Uday - FSIS Sent: Monday, October 28, 2013 8:57 AMTo: Goldman, David - Commissioned Corps - FSIS; Kause, Janell - FSISCc: Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Douris, Aphrodite - FSIS; Defibaugh-Chavez, Stephanie - FSISSubject: RE: Positive chicken sample for S. Heidelberg patient
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HI David
Stephanie, Alice and Aphrodite are looking at the following two issues and here are our initial thoughts:
1) OIEA has established a compelling link in the Foster Farms illness outbreak investigation. Here are the details from
This revolves around The case patient shopper data and intensified sampling conducted at the three Foster farms facilities in California was utilized. The linkages are detailed below:
· tested for positive for PFGE 045, and the like sample collected on the same date, sample form ID number 100583269, as one of the pack dates is PFGE 045, which is the same PFGE pattern.
· The product purchased by the case patient and the like sample, Foster Farms boneless, skinless thighs, were slaughtered at P-7632 on 9/9/2013 and were processed/packed at P-6137A on 9/9/2013.
· There are other multiple sample positives for PFGE 45 at p-7632 and P-6137A on 9/9/2013, both parts and whole birds.
· SDC will look into this further….
2) P6137A PFGE pattern JF6X01.0122 (5/10 subs positive), additional 2 being tested for PFGEs; case patient has PFGE type 45
· Although:
o during the specpgm_02 Sept sampling there was a single positive with pattern .0122 from the same establishment
o the fact that mixed PFGE patterns can be found in the same sample
o There may be overwhelming indirect evidences..
o We cannot make a conclusive claim that there is a link between the patient and chicken samples recovered from the patients home
----------
o A close examination of the two band difference between 0122 and 45 shows that - these are distinctly different PFGE types (on the gel)
o We are awaiting the final results from the additional 2 PFGEs
o We are analyzing the hospitalization rate for the two PFGE types
o Etc.
Thanks much!
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Uday
Yes, I would say that these two patterns are significantly different.
Aphrodite DourisMicrobiologistOutbreaks Section, Eastern LaboratoryFood Safety and Inspection ServiceThe United States Department of AgricultureRussell Research Center950 College Station RoadAthens, GA [email protected]: (706) 546-2330 FAX:(706)546-3144
Privileged Communications: This transmission (and/or the documents accompanying it) may contain confidential information belonging to the sender. The information is intended only for the use of the individual or entity named in the distribution. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error, please notify us by telephone to arrange for the return of the documents.
_____________________________________________From: Dessai, Uday - FSIS Sent: Friday, October 25, 2013 2:22 PMTo: Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg similarity matrix
Thx much Alice and Douris.
2 bands different (~ 200 and ~ 80 region) as I see it on the picture.
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Douris – does the ~ 200 region band constitute a real diffence ! ( I would imagin yes!)
Thanks
What remains to be done
<<6002696219 FF Invoice.pdf>> <<Originating Spreadsheet Special 102413.xlsx>> <<2013-10-22_Phase1-Heidelbergs.xlsx>>
Hello,
We have a compelling link in the Foster Farms illness outbreak investigation. This revolves around The case patient shopper data and intensified sampling conducted at the three Foster farms facilities in California was utilized. The linkages are detailed below:
· tested for positive for PFGE 045, and the like sample collected on the same date, sample form ID number 100583269, as one of the pack dates is PFGE 045, which is the same PFGE pattern.
· The product purchased by the case patient and the like sample, Foster Farms boneless, skinless thighs, were slaughtered at P-7632 on 9/9/2013 and were processed/packed at P-6137A on 9/9/2013.
· There are other multiple sample positives for PFGE 45 at p-7632 and P-6137A on 9/9/2013, both parts and whole birds.
I have attached invoice 6002696219 that shows the link in commerce between Foster Farms and the COSTCO store where the case patient purchased the product. I have also attached a spreadsheet titled “original Spreadsheet Special” that demonstrates the linkages between and the samples collected at Foster farms, and finally, I have attached the sample data spreadsheet that represents all samples collected at the three Foster farms facilities.
About the other CPs, are not as compelling:
Case patients – We could not make a connection between FSIS sampling dates for Est. 7632 & Est. 6137 for product comprising the load distributed to Costco, part of which may have been consumed by both case patients. Product from Est. 33900 was also included in the load to Costco.
Case patients – Product (Rotisserie Chicken) available on the purchase day consisted of seven Foster Farms invoices to Costco with several different slaughter and pack dates from Est. 7632, 6137, 6137A, and 33900. Positive test results, PFGE pattern 258, from FSIS sampling with slaughter dates of; 9/7, 9/9, 9/10, 9/11, and 9/17,
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taken at Est. 6137 and 6137A made up part of the product included on the invoices.
Case patient – OIEA is still waiting on California for membership card information.
Case patient - OIEA is still waiting on California for additional purchase dates.
Case patients – Product (Rotisserie Chicken) available on the day of purchase consisted of a single invoice from Foster Farms to Costco. Product represented on the invoice originated from Est. P-7632 and P-33900. Positive test results, PFGE pattern 258, from FSIS sampling with a slaughter date of 9/9 from Est. 7632 comprised part of the load.
The CCMS patient in NV:
OPHS spoke with complainant as did OIEA’s investigator. Review labs – CBC- WNL, Chemistry Profile – Elevated liver enzymes, Stool Sample negative for Salmonella, Shigella and Campy. He might give us some of the sample but not all of it. We are concerned about how we would do that.
Alice and SDC pl:
Isolate numbers
Types of parts, production/analysis dates and PFGEs
PFGE Types
P1
P2
P3
P4
P5
whole
Patient info
1?
NA
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NA
NA
NA
NA
NA
Product info
5 each (!)
OB/PFGE types
Note: Same or different PFGE types can be found in a given sample. And the prevalence of a PFGE type in the enriched medium, does not in any fashion or manner indicates absence of other PFGE types in the product.
From: Goldman, David - Commissioned Corps - FSIS
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Sent: Friday, October 25, 2013 3:35 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSISSubject: Re: Positive chicken sample for S. Heidelberg patient
Good idea(s). We do need to figure this one out--I think I heard that FDA will sequence these strains. I would appreciate a separate discussion so that I understand how much we can learn about the genetic profile and phenotypic expression from this sequencing.
David P. Goldman, M.D., M.P.H.
Captain, USPHS
Assistant Administrator
Office of Public Health Science
Food Safety and Inspection Service
USDA
Room 341-E, Whitten Bldg.
1400 Independence Ave, SW
Washington, DC 20250
202-720-2644 (o)
202-690-2980 (f)
On Oct 25, 2013, at 1:34 PM, "Dessai, Uday - FSIS" <[email protected]> wrote:
Good point SDC Just a thought: Looks like there is a lot happening I Heidelberg genome.. For instance in the heidelbergs associated with this O/B, the virulence factors may be (just may be) up regulated for some reason... Alice and team: is it possible to tabulate rate of hospitalization for different PFGE types (if numbers are available!) Thx
From: Defibaugh-Chavez, Stephanie - FSIS Sent: Friday, October 25, 2013 01:18 PM
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To: Green, Alice - FSIS; Goldman, David - Commissioned Corps - FSIS; Dessai, Uday - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Can we also follow-up with CDC to see if they included pattern 0041 in the cluster because of similarity to 0122? An alternative way of asking that is David’s original question of whether they would consider those two patterns the same strain. As Uday pointed out, sometimes lack of or additional bands in the lower molecular weight region (i.e. <100k bp) can be due to plasmid or just poor band resolution in that region. It would be nice to know how they would interpret this situation of finding these two specific patterns in connection with a leftover product and a case-patient clinical isolate.
Stephanie Defibaugh-Chávez, Ph.D.
Microbiologist
Science Staff, Office of Public Health Science
Food Safety and Inspection Service
United States Department of Agriculture
202-690-6042 (office)
202-641-5540 (Blackberry)
202-690-6364 (fax)
email: [email protected]
Stay Connected with USDA:
<image001.png> <http://www.facebook.com/usda/> <image002.gif> <http://www.twitter.com/usda/> <image003.png> <http://www.youtube.com/usda/>
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 1:13 PM To: Goldman, David - Commissioned Corps - FSIS; Dessai, Uday - FSIS Cc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
The health department picked up 3 packages of FF product. There were no other suspect products noted. I’ll seek guidance from OSEL on pattern similarity between patterns 41 and 122.
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Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 11:46 AM To: Dessai, Uday - FSIS Cc: Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: Re: Positive chicken sample for S. Heidelberg patient
Thanks for the latest on the PFGE similarity. I am confused about the leftover products--I just assumed that the health dept picked any "suspect" product (meaning something eaten by the case and so a possible exposure). Given that 2 of the samples were negative, what other possibility is there except that the positive product led to the illness? Is CA aware of other chicken exposures that might complicate the picture?
If need be, would CDC say that these 2 patterns are so close that they may represent the same pathogen in this instance?
David P. Goldman, M.D., M.P.H.
Captain, USPHS
Assistant Administrator
Office of Public Health Science
Food Safety and Inspection Service
USDA
Room 341-E, Whitten Bldg.
1400 Independence Ave, SW
Washington, DC 20250
202-720-2644 (o)
202-690-2980 (f)
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On Oct 25, 2013, at 12:33 PM, "Dessai, Uday - FSIS" <[email protected]> wrote:
Thx Alice!
The Two bands (I would imagine in low molecular weight region!) may need to be considered a method artifact in this instance – given both are very close and part of the OB.
Cheers!
Uday
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 12:26 PM To: Dessai, Uday - FSIS; Goldman, David - Commissioned Corps - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Hi Uday—
You are correct! I do want to emphasize that both are outbreak strains, and pattern 122 and pattern 41 are 94.4% similar, differing in only two bands.
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
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From: Dessai, Uday - FSIS Sent: Friday, October 25, 2013 11:20 AM To: Goldman, David - Commissioned Corps - FSIS; Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Hi Alice
It is interesting that although we have pattern O122 in the product, we are not sure of the three products, which one was consumed by the patient!
So we have diffferent patterns between patient and product and we are not sure which product (1/3 positive) was consumed – right!
Thx!
From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 12:11 PM To: Green, Alice - FSIS; Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: Re: Positive chicken sample for S. Heidelberg patient
Thanks Alice--just want to clarify; were all 5 subs pattern 122? If so, then are there more isolates to test? David Goldman, MD, MPH CAPT, USPHS Chief Medical Officer Assistant Administrator USDA-FSIS-OPHS 202-720-2644 -------------------------- Sent from my BlackBerry Wireless Handheld
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 12:08 PM To: Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS
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Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS; Goldman, David - Commissioned Corps - FSIS Subject: FW: Positive chicken sample for S. Heidelberg patient
FYI—
PFGE table for tested products is below.
is the appropriate lab contact ( Pictures have use-by date of 03-29-2014. Product is frozen Kirkland Signature boneless skinless chicken tenders (mis-stated as chicken breast in my previous email).
Thanks much,
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Higa, Jeffrey (CDPH-CID-DCDC-IDB) [mailto:[email protected]] Sent: Friday, October 25, 2013 10:57 AM To: Green, Alice - FSIS; Kissler, Bonnie - FSIS; Robertson, Kis - FSIS; Allen, Latasha - Commissioned Corps - FSIS; [email protected]; [email protected]; [email protected]; [email protected]; [email protected] Cc: Needham, Michael (CDPH-DFDRS FDB); Hernandez, Michael (CDPH-DFDRS); Kennelly, Pat (CDPH-FDB); Peralta, Vi (CDPH-CID-DCDC-IDB); Kimura, Akiko (CDPH-CID-DCDC); Gilliss, Debra (CDPH-CID-DCDC-IDB) Subject: Positive chicken sample for S. Heidelberg patient
Hello USDA and CDC colleagues,
On 10/9/2013, 3 open packages of Kirkland Signature Boneless, Skinless Chicken Tenderloins were
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collected from the home of S. Heidelberg pattern 0041 patient Our Food and Drug Lab tested chicken from all 3 packages. Chicken from one of packages was positive for Salmonella:
FDLB Sample ID
Product
Establishment #
Result
PulseNet Isolate #
184100913-P001
Kirkland Signature boneless, skinless Chicken tenderloins
P33901
negative for Salmonella
n/a
184100913-P002
Kirkland Signature boneless, skinless Chicken tenderloins
P6137A
(best by 3/29/2014)
· positive for Salmonella group B
· 5 of 10 subs positive
· PFGE pattern JF6X01.0122
CA2__CA2F13M00985PP2A1
184100913-P003
Kirkland Signature boneless, skinless Chicken tenderloins
P33901
negative for Salmonella
n/a
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Attached are pictures of the package for the positive chicken sample. The chicken isolate was pattern 0122 and the patient had pattern 0041. Unfortunately, all 3 packages were open and the specific package the patient had chicken from prior to illness onset could not be determined.
FDB, please correct me if any of the information above is inaccurate.
-Jeff
Jeffrey Higa, MPH
California Department of Public Health
Infectious Diseases Branch
Disease Investigations Section
19300 S. Hamilton Ave., Suite 140
Gardena, CA 90248
310-217-6906
310-217-6911 (fax)
[email protected] <mailto:[email protected]>
NOTICE of CONFIDENTIALITY: This E-mail is the property of the California Department of Public Health and contains information that may be PRIVILEGED, CONFIDENTIAL or otherwise exempt from disclosure by applicable law. It is intended only for the person(s) to whom it is addressed. If you receive this communication in error, please do not retain or distribute it. Please notify the sender immediately by E-mail at the address shown above and delete the original message.
From: Kissler, Bonnie - FSISSent: Tuesday, October 29, 2013 9:55 AMTo: Dessai, Uday - FSIS; Goldman, David - Commissioned Corps - FSIS; Kause, Janell - FSISCc: Green, Alice - FSIS; Robertson, Kis - FSIS; Bennett, Patty - FSIS; Douris, Aphrodite - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Holt, Kristin - FSISSubject: RE: Positive chicken sample for S. Heidelberg patient
CDC is planning a web update this week (could be as early as tomorrow). If we decide to move forward with a recall, CDC will likely wait until after the recall before doing the web update.
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Bonnie KisslerSenior EpidemiologistUSDA, FSIS, OPHS, AESc/o Centers for Disease Control and Prevention1600 Clifton Road, NE, MS A-38Building 24, Room 10203Atlanta, GA 30329Office: 404.639.5012Blackberry: 404.661.6640Fax: 404.718.2126Email: [email protected] <mailto:[email protected]>
From: Dessai, Uday - FSIS Sent: Monday, October 28, 2013 3:17 PMTo: Dessai, Uday - FSIS; Goldman, David - Commissioned Corps - FSIS; Kause, Janell - FSISCc: Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Douris, Aphrodite - FSIS; Defibaugh-Chavez, Stephanie - FSISSubject: RE: Positive chicken sample for S. Heidelberg patient
Also here are summary points from SDC email from Friday:
About case-patient ( traceback and FSIS intensified sampling:
The specific product identified is a boneless skinless chicken thigh product. It was collected at P6137A but was produced from source materials that originated from P7632 (slaughtered on 9/9/2013). StephanieDC had suggested in her Friday’s email to consider recalling all chicken products (including parts and whole chicken!) produced from birds slaughtered on 9/9/2013 at P7632 . This was based on the fact that 11 total product –positives were produced from source materials that originated from P7632 (slaughtered on 9/9/2013 and includes a variety of parts and whole/rotisserie chicken.
Thanks much!
Uday
From: Dessai, Uday - FSIS Sent: Monday, October 28, 2013 8:57 AMTo: Goldman, David - Commissioned Corps - FSIS; Kause, Janell - FSISCc: Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Douris, Aphrodite -
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FSIS; Defibaugh-Chavez, Stephanie - FSISSubject: RE: Positive chicken sample for S. Heidelberg patient
HI David
Stephanie, Alice and Aphrodite are looking at the following two issues and here are our initial thoughts:
1) OIEA has established a compelling link in the Foster Farms illness outbreak investigation. Here are the details from
This revolves around The case patient shopper data and intensified sampling conducted at the three Foster farms facilities in California was utilized. The linkages are detailed below:
· tested for positive for PFGE 045, and the like sample collected on the same date, sample form ID number 100583269, as one of the pack dates is PFGE 045, which is the same PFGE pattern.
· The product purchased by the case patient and the like sample, Foster Farms boneless, skinless thighs, were slaughtered at P-7632 on 9/9/2013 and were processed/packed at P-6137A on 9/9/2013.
· There are other multiple sample positives for PFGE 45 at p-7632 and P-6137A on 9/9/2013, both parts and whole birds.
· SDC will look into this further….
2) P6137A PFGE pattern JF6X01.0122 (5/10 subs positive), additional 2 being tested for PFGEs; case patient has PFGE type 45
· Although:
o during the specpgm_02 Sept sampling there was a single positive with pattern .0122 from the same establishment
o the fact that mixed PFGE patterns can be found in the same sample
o There may be overwhelming indirect evidences..
o We cannot make a conclusive claim that there is a link between the patient and chicken samples recovered from the patients home
----------
o A close examination of the two band difference between 0122 and 45 shows that - these are distinctly different PFGE types (on the gel)
o We are awaiting the final results from the additional 2 PFGEs
o We are analyzing the hospitalization rate for the two PFGE types
o Etc.
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Thanks much!
Uday
Yes, I would say that these two patterns are significantly different.
Aphrodite DourisMicrobiologistOutbreaks Section, Eastern LaboratoryFood Safety and Inspection ServiceThe United States Department of AgricultureRussell Research Center950 College Station RoadAthens, GA [email protected]: (706) 546-2330 FAX:(706)546-3144
Privileged Communications: This transmission (and/or the documents accompanying it) may contain confidential information belonging to the sender. The information is intended only for the use of the individual or entity named in the distribution. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error, please notify us by telephone to arrange for the return of the documents.
_____________________________________________From: Dessai, Uday - FSIS Sent: Friday, October 25, 2013 2:22 PMTo: Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg similarity matrix
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Thx much Alice and Douris.
2 bands different (~ 200 and ~ 80 region) as I see it on the picture.
Douris – does the ~ 200 region band constitute a real diffence ! ( I would imagin yes!)
Thanks
What remains to be done
<<6002696219 FF Invoice.pdf>> <<Originating Spreadsheet Special 102413.xlsx>> <<2013-10-22_Phase1-Heidelbergs.xlsx>>
Hello,
We have a compelling link in the Foster Farms illness outbreak investigation. This revolves around The case patient shopper data and intensified sampling conducted at the three Foster farms facilities in California was utilized. The linkages are detailed below:
· tested for positive for PFGE 045, and the like sample collected on the same date, sample form ID number 100583269, as one of the pack dates is PFGE 045, which is the same PFGE pattern.
· The product purchased by the case patient and the like sample, Foster Farms boneless, skinless thighs, were slaughtered at P-7632 on 9/9/2013 and were processed/packed at P-6137A on 9/9/2013.
· There are other multiple sample positives for PFGE 45 at p-7632 and P-6137A on 9/9/2013, both parts and whole birds.
I have attached invoice 6002696219 that shows the link in commerce between Foster Farms and the COSTCO store where the case patient purchased the product. I have also attached a spreadsheet titled “original Spreadsheet Special” that demonstrates the linkages between and the samples collected at Foster farms, and finally, I have attached the sample data spreadsheet that represents all samples collected at the three Foster farms facilities.
About the other CPs, are not as compelling:
Case patients – We could not make a connection between FSIS sampling dates for Est. 7632 & Est. 6137 for product comprising the load distributed to Costco, part of which may have been consumed by both case
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patients. Product from Est. 33900 was also included in the load to Costco.
Case patients – Product (Rotisserie Chicken) available on the purchase day consisted of seven Foster Farms invoices to Costco with several different slaughter and pack dates from Est. 7632, 6137, 6137A, and 33900. Positive test results, PFGE pattern 258, from FSIS sampling with slaughter dates of; 9/7, 9/9, 9/10, 9/11, and 9/17, taken at Est. 6137 and 6137A made up part of the product included on the invoices.
Case patient – OIEA is still waiting on California for membership card information.
Case patient - OIEA is still waiting on California for additional purchase dates.
Case patients – Product (Rotisserie Chicken) available on the day of purchase consisted of a single invoice from Foster Farms to Costco. Product represented on the invoice originated from Est. P-7632 and P-33900. Positive test results, PFGE pattern 258, from FSIS sampling with a slaughter date of 9/9 from Est. 7632 comprised part of the load.
The CCMS patient in NV:
OPHS spoke with complainant as did OIEA’s investigator. Review labs – CBC- WNL, Chemistry Profile – Elevated liver enzymes, Stool Sample negative for Salmonella, Shigella and Campy. He might give us some of the sample but not all of it. We are concerned about how we would do that.
Alice and SDC pl:
Isolate numbers
Types of parts, production/analysis dates and PFGEs
PFGE Types
P1
P2
P3
P4
P5
whole
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Patient info
1?
NA
NA
NA
NA
NA
NA
Product info
5 each (!)
OB/PFGE types
Note: Same or different PFGE types can be found in a given sample. And the prevalence of a PFGE type in the enriched medium, does not in any fashion or manner indicates absence of other PFGE types in the product.
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From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 3:35 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSISSubject: Re: Positive chicken sample for S. Heidelberg patient
Good idea(s). We do need to figure this one out--I think I heard that FDA will sequence these strains. I would appreciate a separate discussion so that I understand how much we can learn about the genetic profile and phenotypic expression from this sequencing.
David P. Goldman, M.D., M.P.H.
Captain, USPHS
Assistant Administrator
Office of Public Health Science
Food Safety and Inspection Service
USDA
Room 341-E, Whitten Bldg.
1400 Independence Ave, SW
Washington, DC 20250
202-720-2644 (o)
202-690-2980 (f)
On Oct 25, 2013, at 1:34 PM, "Dessai, Uday - FSIS" <[email protected]> wrote:
Good point SDC Just a thought: Looks like there is a lot happening I Heidelberg genome.. For instance in the heidelbergs associated with this O/B, the virulence factors may be (just may be) up regulated for some reason... Alice and team: is it possible to tabulate rate of hospitalization for different PFGE types (if numbers are available!)
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Thx
From: Defibaugh-Chavez, Stephanie - FSIS Sent: Friday, October 25, 2013 01:18 PM To: Green, Alice - FSIS; Goldman, David - Commissioned Corps - FSIS; Dessai, Uday - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Can we also follow-up with CDC to see if they included pattern 0041 in the cluster because of similarity to 0122? An alternative way of asking that is David’s original question of whether they would consider those two patterns the same strain. As Uday pointed out, sometimes lack of or additional bands in the lower molecular weight region (i.e. <100k bp) can be due to plasmid or just poor band resolution in that region. It would be nice to know how they would interpret this situation of finding these two specific patterns in connection with a leftover product and a case-patient clinical isolate.
Stephanie Defibaugh-Chávez, Ph.D.
Microbiologist
Science Staff, Office of Public Health Science
Food Safety and Inspection Service
United States Department of Agriculture
202-690-6042 (office)
202-641-5540 (Blackberry)
202-690-6364 (fax)
email: [email protected]
Stay Connected with USDA:
<image001.png> <http://www.facebook.com/usda/> <image002.gif> <http://www.twitter.com/usda/> <image003.png> <http://www.youtube.com/usda/>
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 1:13 PM To: Goldman, David - Commissioned Corps - FSIS; Dessai, Uday - FSIS Cc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
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The health department picked up 3 packages of FF product. There were no other suspect products noted. I’ll seek guidance from OSEL on pattern similarity between patterns 41 and 122.
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 11:46 AM To: Dessai, Uday - FSIS Cc: Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: Re: Positive chicken sample for S. Heidelberg patient
Thanks for the latest on the PFGE similarity. I am confused about the leftover products--I just assumed that the health dept picked any "suspect" product (meaning something eaten by the case and so a possible exposure). Given that 2 of the samples were negative, what other possibility is there except that the positive product led to the illness? Is CA aware of other chicken exposures that might complicate the picture?
If need be, would CDC say that these 2 patterns are so close that they may represent the same pathogen in this instance?
David P. Goldman, M.D., M.P.H.
Captain, USPHS
Assistant Administrator
Office of Public Health Science
Food Safety and Inspection Service
USDA
Room 341-E, Whitten Bldg.
1400 Independence Ave, SW
Washington, DC 20250
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202-720-2644 (o)
202-690-2980 (f)
On Oct 25, 2013, at 12:33 PM, "Dessai, Uday - FSIS" <[email protected]> wrote:
Thx Alice!
The Two bands (I would imagine in low molecular weight region!) may need to be considered a method artifact in this instance – given both are very close and part of the OB.
Cheers!
Uday
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 12:26 PM To: Dessai, Uday - FSIS; Goldman, David - Commissioned Corps - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Hi Uday—
You are correct! I do want to emphasize that both are outbreak strains, and pattern 122 and pattern 41 are 94.4% similar, differing in only two bands.
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
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Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Dessai, Uday - FSIS Sent: Friday, October 25, 2013 11:20 AM To: Goldman, David - Commissioned Corps - FSIS; Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Hi Alice
It is interesting that although we have pattern O122 in the product, we are not sure of the three products, which one was consumed by the patient!
So we have diffferent patterns between patient and product and we are not sure which product (1/3 positive) was consumed – right!
Thx!
From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 12:11 PM To: Green, Alice - FSIS; Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: Re: Positive chicken sample for S. Heidelberg patient
Thanks Alice--just want to clarify; were all 5 subs pattern 122? If so, then are there more isolates to test? David Goldman, MD, MPH CAPT, USPHS Chief Medical Officer Assistant Administrator USDA-FSIS-OPHS 202-720-2644 -------------------------- Sent from my BlackBerry Wireless Handheld
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From: Green, Alice - FSIS Sent: Friday, October 25, 2013 12:08 PM To: Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS; Goldman, David - Commissioned Corps - FSIS Subject: FW: Positive chicken sample for S. Heidelberg patient
FYI—
PFGE table for tested products is below.
is the appropriate lab contact ( Pictures have use-by date of 03-29-2014. Product is frozen Kirkland Signature boneless skinless chicken tenders (mis-stated as chicken breast in my previous email).
Thanks much,
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Higa, Jeffrey (CDPH-CID-DCDC-IDB) [mailto:[email protected]] Sent: Friday, October 25, 2013 10:57 AM To: Green, Alice - FSIS; Kissler, Bonnie - FSIS; Robertson, Kis - FSIS; Allen, Latasha - Commissioned Corps - FSIS; [email protected]; [email protected]; [email protected]; [email protected]; [email protected] Cc: Needham, Michael (CDPH-DFDRS FDB); Hernandez, Michael (CDPH-DFDRS); Kennelly, Pat (CDPH-FDB); Peralta, Vi (CDPH-CID-DCDC-IDB); Kimura, Akiko (CDPH-CID-DCDC); Gilliss, Debra (CDPH-CID-DCDC-IDB) Subject: Positive chicken sample for S. Heidelberg patient
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Hello USDA and CDC colleagues,
On 10/9/2013, 3 open packages of Kirkland Signature Boneless, Skinless Chicken Tenderloins were collected from the home of S. Heidelberg pattern 0041 patient ). Our Food and Drug Lab tested chicken from all 3 packages. Chicken from one of packages was positive for Salmonella:
FDLB Sample ID
Product
Establishment #
Result
PulseNet Isolate #
184100913-P001
Kirkland Signature boneless, skinless Chicken tenderloins
P33901
negative for Salmonella
n/a
184100913-P002
Kirkland Signature boneless, skinless Chicken tenderloins
P6137A
(best by 3/29/2014)
· positive for Salmonella group B
· 5 of 10 subs positive
· PFGE pattern JF6X01.0122
CA2__CA2F13M00985PP2A1
184100913-P003
Kirkland Signature boneless, skinless Chicken tenderloins
P33901
negative for Salmonella
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n/a
Attached are pictures of the package for the positive chicken sample. The chicken isolate was pattern 0122 and the patient had pattern 0041. Unfortunately, all 3 packages were open and the specific package the patient had chicken from prior to illness onset could not be determined.
FDB, please correct me if any of the information above is inaccurate.
-Jeff
Jeffrey Higa, MPH
California Department of Public Health
Infectious Diseases Branch
Disease Investigations Section
19300 S. Hamilton Ave., Suite 140
Gardena, CA 90248
310-217-6906
310-217-6911 (fax)
[email protected] <mailto:[email protected]>
NOTICE of CONFIDENTIALITY: This E-mail is the property of the California Department of Public Health and contains information that may be PRIVILEGED, CONFIDENTIAL or otherwise exempt from disclosure by applicable law. It is intended only for the person(s) to whom it is addressed. If you receive this communication in error, please do not retain or distribute it. Please notify the sender immediately by E-mail at the address shown above and delete the original message.
From: Dessai, Uday - FSISSent: Tuesday, October 29, 2013 8:13 AMTo: Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Green, Alice - FSISCc: Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
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HI Alice
Thanks for following up on this request. Nice work…
Here are some additional thinks to consider..
· While the medial age is around 20, do the distributions for each PFGE type look any different (some weighted, skewed toward older or younger populations)
· Also, does the extent of hospitalization vary significantly by the product type
This info may be important from the pathogen view point (some level of age and/or product signal) as well as nature of the product (processing to handling and consumption).
If (and only if) there are any type of trends etc, we might be able to focus on additional sampling in that direction and may want to provide additional information/guidance to consumers etc.
Thx mch!
Uday
From: Dessai, Uday - FSIS Sent: Tuesday, October 29, 2013 8:33 AMTo: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Green, Alice - FSISCc: Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: Re: Heidelberg Pct Hospitalized by PFGE
Yes, it has been difficult..However, I think product MPNs in the IIT will provide some insight into final product distributions..possibly!
From: Defibaugh-Chavez, Stephanie - FSIS Sent: Tuesday, October 29, 2013 08:25 AMTo: Dessai, Uday - FSIS; Robertson, Kis - FSIS; Green, Alice - FSIS Cc: Kissler, Bonnie - FSIS; Douris, Aphrodite - FSIS Subject: Re: Heidelberg Pct Hospitalized by PFGE
We have MPNs on the products we collected. Requesting MPNs on patient leftovers has never worked out because the
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
products are rarely stored in a manner that would make MPNs informative.
Stephanie -------------------------- Stephanie Defibaugh-Chavez, Ph.D. USDA-FSIS, Office of Public Health Science Science Division
Sent using BlackBerry
From: Dessai, Uday - FSIS Sent: Tuesday, October 29, 2013 08:16 AMTo: Robertson, Kis - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSIS Cc: Kissler, Bonnie - FSIS; Douris, Aphrodite - FSIS Subject: Re: Heidelberg Pct Hospitalized by PFGE
Ah, ha.. That is an important consideration!The illness rates at times may be impacted by the type of commodity, processing and handling etc..SDC and team - if/when implicated product is available, can we run some MPNs please..
Thx
From: Robertson, Kis - FSIS Sent: Tuesday, October 29, 2013 08:12 AMTo: Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSIS Cc: Kissler, Bonnie - FSIS; Douris, Aphrodite - FSIS Subject: RE: Heidelberg Pct Hospitalized by PFGE
I like this discussion.
An important consideration is that a big chunk of the 258 patients were victimized by the rotisserie chicken. If the level of contamination on the rotisserie was lower than the level on raw products, the severity of illness could be also be lower.
Kis Robertson, DVM, MPH, DACVPM
Commander, U.S. Public Health Service
Acting Director
USDA/FSIS/OPHS/Applied Epidemiology Staff
Stop 3766, PP 3, 9-210B
1400 Independence Avenue, SW
Washington, DC 20250
Office Phone: (202) 772-9000
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Blackberry phone: (202) 379-6648
Email: [email protected]
_____________________________________________From: Dessai, Uday - FSISSent: Tuesday, October 29, 2013 7:51 AMTo: Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSISCc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
On the dot SDC, I was also wondering about the same..
Alice, can you remind us if thediference is in the region below 80….
If it is, there must be a highly virulent mobile element/plasmid that is getting transfered within Heidelbeg populations under some sort of selection pressure..
We will need to look into this further (FDA collaboration…)
Thx
_____________________________________________From: Defibaugh-Chavez, Stephanie - FSISSent: Monday, October 28, 2013 6:51 PMTo: Green, Alice - FSIS; Dessai, Uday - FSISCc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
I think it’s interesting that although 258 and 45 are highly similar in PFGE pattern, they appear to have vastly different hospitalization rates (almost double for 45). To me, this particular difference in hospitalization rates indicates the likelihood of some sort of plasmid that is making some of these strains more virulent than others.
Stephanie Defibaugh-Chávez, Ph.D.
Microbiologist
Science Staff, Office of Public Health Science
Food Safety and Inspection Service
United States Department of Agriculture
202-690-6042 (office)
202-641-5540 (Blackberry)
202-690-6364 (fax)
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
email: [email protected]
Stay Connected with USDA:
<< OLE Object: Picture (Device Independent Bitmap) >> <http://www.facebook.com/usda> << OLE Object: Picture (Device Independent Bitmap) >> <http://www.twitter.com/usda> << OLE Object: Picture (Device Independent Bitmap) >> <http://www.youtube.com/usda>
_____________________________________________From: Green, Alice - FSISSent: Monday, October 28, 2013 6:08 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
Hi Uday—
Here is today’s update to the requested information.
Based on Aphrodite’s work last summer, patterns 258 and 45 are the most closely related in the cluster at 99% similar with one band differing. Patterns 122 and 672 are about 97% similar with one band difference. Pattern 22 is 90% or less similar to all other patterns.
California was keeping track of this information separately early on in the investigation. It is interesting to revisit now that the number of case-patients has increased. I am not detecting any clear patterns. Please let me know what you think. Thanks! J
Pattern % hospitalized (n) Median Age % Male 22 42% (21/50) 20 yrs (n=55) 45% 41 44% (14/32) 20 yrs (n=49) 43% 45 52% (28/54) 22 yrs (n=77) 54% 122 33% (8/24) 23 yrs (n=31) 52% 258 29% (22/76) 18 yrs (n=117) 56% 326 25% (4/16) 20 yrs (n=25) 50% 672 50% (1/2) 9 yrs (n=2) 50%
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
_____________________________________________From: Dessai, Uday - FSISSent: Monday, October 28, 2013 6:40 AMTo: Green, Alice - FSIS
(b) (6)
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Cc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
This is very neat Alice J!
Although the lower numbers will be heavily influenced by the denominator, we may be able to divide these into atleast two categories based on % hospitalizations. (note: qualifying criteria could be something like we should have atleast 10 total illnesses to be counted in the categories)
1) 35% and below – 122, 258, 326
2) 35% and above – 22, 41, 45, 122, 672 (just 2 cases – does not qualify))
The next part will be to see if PFGEs in these categories have any commonality/similarity etc. If not all, atleast hose at the extreme ends of hospitalization..
Also, in your table, do if we add the columns for demographics (age, sensitive population etc.. if available, would that be useful to see..!)
Again, nice work Alice J!
_____________________________________________From: Green, Alice - FSISSent: Friday, October 25, 2013 2:41 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: Heidelberg Pct Hospitalized by PFGE
Pattern % hospitalized (n) 22 42% (21/50) 41 44% (14/32) 45 52% (28/54) 122 33% (8/24) 258 29% (22/75) 326 25% (4/16) 672 50% (1/2)
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Dessai, Uday - FSIS
(b) (6)
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Sent: Tuesday, October 29, 2013 7:33 AMTo: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Green, Alice - FSISCc: Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: Re: Heidelberg Pct Hospitalized by PFGE
Yes, it has been difficult..However, I think product MPNs in the IIT will provide some insight into final product distributions..possibly!
From: Defibaugh-Chavez, Stephanie - FSIS Sent: Tuesday, October 29, 2013 08:25 AMTo: Dessai, Uday - FSIS; Robertson, Kis - FSIS; Green, Alice - FSIS Cc: Kissler, Bonnie - FSIS; Douris, Aphrodite - FSIS Subject: Re: Heidelberg Pct Hospitalized by PFGE
We have MPNs on the products we collected. Requesting MPNs on patient leftovers has never worked out because the products are rarely stored in a manner that would make MPNs informative.
Stephanie -------------------------- Stephanie Defibaugh-Chavez, Ph.D. USDA-FSIS, Office of Public Health Science Science Division
Sent using BlackBerry
From: Dessai, Uday - FSIS Sent: Tuesday, October 29, 2013 08:16 AMTo: Robertson, Kis - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSIS Cc: Kissler, Bonnie - FSIS; Douris, Aphrodite - FSIS Subject: Re: Heidelberg Pct Hospitalized by PFGE
Ah, ha.. That is an important consideration!The illness rates at times may be impacted by the type of commodity, processing and handling etc..SDC and team - if/when implicated product is available, can we run some MPNs please..
Thx
From: Robertson, Kis - FSIS Sent: Tuesday, October 29, 2013 08:12 AMTo: Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSIS Cc: Kissler, Bonnie - FSIS; Douris, Aphrodite - FSIS Subject: RE: Heidelberg Pct Hospitalized by PFGE
I like this discussion.
An important consideration is that a big chunk of the 258 patients were victimized by the rotisserie chicken. If the
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
level of contamination on the rotisserie was lower than the level on raw products, the severity of illness could be also be lower.
Kis Robertson, DVM, MPH, DACVPM
Commander, U.S. Public Health Service
Acting Director
USDA/FSIS/OPHS/Applied Epidemiology Staff
Stop 3766, PP 3, 9-210B
1400 Independence Avenue, SW
Washington, DC 20250
Office Phone: (202) 772-9000
Blackberry phone: (202) 379-6648
Email: [email protected]
_____________________________________________From: Dessai, Uday - FSISSent: Tuesday, October 29, 2013 7:51 AMTo: Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSISCc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
On the dot SDC, I was also wondering about the same..
Alice, can you remind us if thediference is in the region below 80….
If it is, there must be a highly virulent mobile element/plasmid that is getting transfered within Heidelbeg populations under some sort of selection pressure..
We will need to look into this further (FDA collaboration…)
Thx
_____________________________________________From: Defibaugh-Chavez, Stephanie - FSISSent: Monday, October 28, 2013 6:51 PMTo: Green, Alice - FSIS; Dessai, Uday - FSISCc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
I think it’s interesting that although 258 and 45 are highly similar in PFGE pattern, they appear to have vastly different hospitalization rates (almost double for 45). To me, this particular difference in hospitalization rates indicates the likelihood of some sort of plasmid that is making some of these strains more virulent than others.
Stephanie Defibaugh-Chávez, Ph.D.
Microbiologist
Science Staff, Office of Public Health Science
Food Safety and Inspection Service
United States Department of Agriculture
202-690-6042 (office)
202-641-5540 (Blackberry)
202-690-6364 (fax)
email: [email protected] <mailto:[email protected]>
Stay Connected with USDA:
<< OLE Object: Picture (Device Independent Bitmap) >> <http://www.facebook.com/usda> << OLE Object: Picture (Device Independent Bitmap) >> <http://www.twitter.com/usda> << OLE Object: Picture (Device Independent Bitmap) >> <http://www.youtube.com/usda>
_____________________________________________From: Green, Alice - FSISSent: Monday, October 28, 2013 6:08 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
Hi Uday—
Here is today’s update to the requested information.
Based on Aphrodite’s work last summer, patterns 258 and 45 are the most closely related in the cluster at 99% similar with one band differing. Patterns 122 and 672 are about 97% similar with one band difference. Pattern 22 is 90% or less similar to all other patterns.
California was keeping track of this information separately early on in the investigation. It is interesting to revisit now that the number of case-patients has increased. I am not detecting any clear patterns. Please let me know what you think. Thanks! :-)
Pattern % hospitalized (n) Median Age % Male 22 42% (21/50) 20 yrs (n=55) 45% 41 44% (14/32) 20 yrs (n=49) 43% 45 52% (28/54) 22 yrs (n=77) 54% 122 33% (8/24) 23 yrs (n=31) 52% 258 29% (22/76) 18 yrs (n=117) 56% 326 25% (4/16) 20 yrs (n=25) 50%
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
672 50% (1/2) 9 yrs (n=2) 50%
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
_____________________________________________From: Dessai, Uday - FSISSent: Monday, October 28, 2013 6:40 AMTo: Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
This is very neat Alice :-)!
Although the lower numbers will be heavily influenced by the denominator, we may be able to divide these into atleast two categories based on % hospitalizations. (note: qualifying criteria could be something like we should have atleast 10 total illnesses to be counted in the categories)
1) 35% and below – 122, 258, 326
2) 35% and above – 22, 41, 45, 122, 672 (just 2 cases – does not qualify))
The next part will be to see if PFGEs in these categories have any commonality/similarity etc. If not all, atleast hose at the extreme ends of hospitalization..
Also, in your table, do if we add the columns for demographics (age, sensitive population etc.. if available, would that be useful to see..!)
Again, nice work Alice :-)!
_____________________________________________From: Green, Alice - FSISSent: Friday, October 25, 2013 2:41 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: Heidelberg Pct Hospitalized by PFGE
(b) (6)
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Pattern % hospitalized (n) 22 42% (21/50) 41 44% (14/32) 45 52% (28/54) 122 33% (8/24) 258 29% (22/75) 326 25% (4/16) 672 50% (1/2)
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Defibaugh-Chavez, Stephanie - FSISSent: Tuesday, October 29, 2013 7:26 AMTo: Dessai, Uday - FSIS; Robertson, Kis - FSIS; Green, Alice - FSISCc: Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: Re: Heidelberg Pct Hospitalized by PFGE
We have MPNs on the products we collected. Requesting MPNs on patient leftovers has never worked out because the products are rarely stored in a manner that would make MPNs informative.
Stephanie -------------------------- Stephanie Defibaugh-Chavez, Ph.D. USDA-FSIS, Office of Public Health Science Science Division
Sent using BlackBerry
From: Dessai, Uday - FSIS Sent: Tuesday, October 29, 2013 08:16 AMTo: Robertson, Kis - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSIS Cc: Kissler, Bonnie - FSIS; Douris, Aphrodite - FSIS Subject: Re: Heidelberg Pct Hospitalized by PFGE
Ah, ha.. That is an important consideration!The illness rates at times may be impacted by the type of commodity, processing and handling etc..SDC and team - if/when implicated product is available, can we run some MPNs please..
Thx
(b) (6)
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
From: Robertson, Kis - FSIS Sent: Tuesday, October 29, 2013 08:12 AMTo: Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSIS Cc: Kissler, Bonnie - FSIS; Douris, Aphrodite - FSIS Subject: RE: Heidelberg Pct Hospitalized by PFGE
I like this discussion.
An important consideration is that a big chunk of the 258 patients were victimized by the rotisserie chicken. If the level of contamination on the rotisserie was lower than the level on raw products, the severity of illness could be also be lower.
Kis Robertson, DVM, MPH, DACVPM
Commander, U.S. Public Health Service
Acting Director
USDA/FSIS/OPHS/Applied Epidemiology Staff
Stop 3766, PP 3, 9-210B
1400 Independence Avenue, SW
Washington, DC 20250
Office Phone: (202) 772-9000
Blackberry phone: (202) 379-6648
Email: [email protected]
_____________________________________________From: Dessai, Uday - FSISSent: Tuesday, October 29, 2013 7:51 AMTo: Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSISCc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
On the dot SDC, I was also wondering about the same..
Alice, can you remind us if thediference is in the region below 80….
If it is, there must be a highly virulent mobile element/plasmid that is getting transfered within Heidelbeg populations under some sort of selection pressure..
We will need to look into this further (FDA collaboration…)
Thx
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
_____________________________________________From: Defibaugh-Chavez, Stephanie - FSISSent: Monday, October 28, 2013 6:51 PMTo: Green, Alice - FSIS; Dessai, Uday - FSISCc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
I think it’s interesting that although 258 and 45 are highly similar in PFGE pattern, they appear to have vastly different hospitalization rates (almost double for 45). To me, this particular difference in hospitalization rates indicates the likelihood of some sort of plasmid that is making some of these strains more virulent than others.
Stephanie Defibaugh-Chávez, Ph.D.
Microbiologist
Science Staff, Office of Public Health Science
Food Safety and Inspection Service
United States Department of Agriculture
202-690-6042 (office)
202-641-5540 (Blackberry)
202-690-6364 (fax)
email: [email protected] <mailto:[email protected]>
Stay Connected with USDA:
<< OLE Object: Picture (Device Independent Bitmap) >> <http://www.facebook.com/usda> << OLE Object: Picture (Device Independent Bitmap) >> <http://www.twitter.com/usda> << OLE Object: Picture (Device Independent Bitmap) >> <http://www.youtube.com/usda>
_____________________________________________From: Green, Alice - FSISSent: Monday, October 28, 2013 6:08 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
Hi Uday—
Here is today’s update to the requested information.
Based on Aphrodite’s work last summer, patterns 258 and 45 are the most closely related in the cluster at 99% similar with one band differing. Patterns 122 and 672 are about 97% similar with one band difference. Pattern 22 is 90% or less similar to all other patterns.
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
California was keeping track of this information separately early on in the investigation. It is interesting to revisit now that the number of case-patients has increased. I am not detecting any clear patterns. Please let me know what you think. Thanks! :-)
Pattern % hospitalized (n) Median Age % Male 22 42% (21/50) 20 yrs (n=55) 45% 41 44% (14/32) 20 yrs (n=49) 43% 45 52% (28/54) 22 yrs (n=77) 54% 122 33% (8/24) 23 yrs (n=31) 52% 258 29% (22/76) 18 yrs (n=117) 56% 326 25% (4/16) 20 yrs (n=25) 50% 672 50% (1/2) 9 yrs (n=2) 50%
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
_____________________________________________From: Dessai, Uday - FSISSent: Monday, October 28, 2013 6:40 AMTo: Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
This is very neat Alice :-)!
Although the lower numbers will be heavily influenced by the denominator, we may be able to divide these into atleast two categories based on % hospitalizations. (note: qualifying criteria could be something like we should have atleast 10 total illnesses to be counted in the categories)
1) 35% and below – 122, 258, 326
2) 35% and above – 22, 41, 45, 122, 672 (just 2 cases – does not qualify))
The next part will be to see if PFGEs in these categories have any commonality/similarity etc. If not all, atleast hose at the extreme ends of hospitalization..
Also, in your table, do if we add the columns for demographics (age, sensitive population etc.. if available, would that be useful to see..!)
Again, nice work Alice :-)!
(b) (6)
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
_____________________________________________From: Green, Alice - FSISSent: Friday, October 25, 2013 2:41 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: Heidelberg Pct Hospitalized by PFGE
Pattern % hospitalized (n) 22 42% (21/50) 41 44% (14/32) 45 52% (28/54) 122 33% (8/24) 258 29% (22/75) 326 25% (4/16) 672 50% (1/2)
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Dessai, Uday - FSISSent: Tuesday, October 29, 2013 7:18 AMTo: Robertson, Kis - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSIS; Bennett, Patty - FSISCc: Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: Re: Heidelberg Pct Hospitalized by PFGE
TeamI have included patty on this distribution. Thx
From: Dessai, Uday - FSIS Sent: Tuesday, October 29, 2013 08:16 AMTo: Robertson, Kis - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSIS Cc: Kissler, Bonnie - FSIS; Douris, Aphrodite - FSIS Subject: Re: Heidelberg Pct Hospitalized by PFGE
Ah, ha.. That is an important consideration!The illness rates at times may be impacted by the type of commodity, processing and handling etc..SDC and team - if/when implicated product is available, can we run some MPNs please..
(b) (6)
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Thx
From: Robertson, Kis - FSIS Sent: Tuesday, October 29, 2013 08:12 AMTo: Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSIS Cc: Kissler, Bonnie - FSIS; Douris, Aphrodite - FSIS Subject: RE: Heidelberg Pct Hospitalized by PFGE
I like this discussion.
An important consideration is that a big chunk of the 258 patients were victimized by the rotisserie chicken. If the level of contamination on the rotisserie was lower than the level on raw products, the severity of illness could be also be lower.
Kis Robertson, DVM, MPH, DACVPM
Commander, U.S. Public Health Service
Acting Director
USDA/FSIS/OPHS/Applied Epidemiology Staff
Stop 3766, PP 3, 9-210B
1400 Independence Avenue, SW
Washington, DC 20250
Office Phone: (202) 772-9000
Blackberry phone: (202) 379-6648
Email: [email protected]
_____________________________________________From: Dessai, Uday - FSISSent: Tuesday, October 29, 2013 7:51 AMTo: Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSISCc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
On the dot SDC, I was also wondering about the same..
Alice, can you remind us if thediference is in the region below 80….
If it is, there must be a highly virulent mobile element/plasmid that is getting transfered within Heidelbeg populations under some sort of selection pressure..
We will need to look into this further (FDA collaboration…)
Thx
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
_____________________________________________From: Defibaugh-Chavez, Stephanie - FSISSent: Monday, October 28, 2013 6:51 PMTo: Green, Alice - FSIS; Dessai, Uday - FSISCc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
I think it’s interesting that although 258 and 45 are highly similar in PFGE pattern, they appear to have vastly different hospitalization rates (almost double for 45). To me, this particular difference in hospitalization rates indicates the likelihood of some sort of plasmid that is making some of these strains more virulent than others.
Stephanie Defibaugh-Chávez, Ph.D.
Microbiologist
Science Staff, Office of Public Health Science
Food Safety and Inspection Service
United States Department of Agriculture
202-690-6042 (office)
202-641-5540 (Blackberry)
202-690-6364 (fax)
email: [email protected] <mailto:[email protected]>
Stay Connected with USDA:
<< OLE Object: Picture (Device Independent Bitmap) >> <http://www.facebook.com/usda> << OLE Object: Picture (Device Independent Bitmap) >> <http://www.twitter.com/usda> << OLE Object: Picture (Device Independent Bitmap) >> <http://www.youtube.com/usda>
_____________________________________________From: Green, Alice - FSISSent: Monday, October 28, 2013 6:08 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
Hi Uday—
Here is today’s update to the requested information.
Based on Aphrodite’s work last summer, patterns 258 and 45 are the most closely related in the cluster at 99% similar
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
with one band differing. Patterns 122 and 672 are about 97% similar with one band difference. Pattern 22 is 90% or less similar to all other patterns.
California was keeping track of this information separately early on in the investigation. It is interesting to revisit now that the number of case-patients has increased. I am not detecting any clear patterns. Please let me know what you think. Thanks! :-)
Pattern % hospitalized (n) Median Age % Male 22 42% (21/50) 20 yrs (n=55) 45% 41 44% (14/32) 20 yrs (n=49) 43% 45 52% (28/54) 22 yrs (n=77) 54% 122 33% (8/24) 23 yrs (n=31) 52% 258 29% (22/76) 18 yrs (n=117) 56% 326 25% (4/16) 20 yrs (n=25) 50% 672 50% (1/2) 9 yrs (n=2) 50%
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
_____________________________________________From: Dessai, Uday - FSISSent: Monday, October 28, 2013 6:40 AMTo: Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
This is very neat Alice :-)!
Although the lower numbers will be heavily influenced by the denominator, we may be able to divide these into atleast two categories based on % hospitalizations. (note: qualifying criteria could be something like we should have atleast 10 total illnesses to be counted in the categories)
1) 35% and below – 122, 258, 326
2) 35% and above – 22, 41, 45, 122, 672 (just 2 cases – does not qualify))
The next part will be to see if PFGEs in these categories have any commonality/similarity etc. If not all, atleast hose at the extreme ends of hospitalization..
Also, in your table, do if we add the columns for demographics (age, sensitive population etc.. if available, would that be useful to see..!)
Again, nice work Alice :-)!
(b) (6)
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
_____________________________________________From: Green, Alice - FSISSent: Friday, October 25, 2013 2:41 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: Heidelberg Pct Hospitalized by PFGE
Pattern % hospitalized (n) 22 42% (21/50) 41 44% (14/32) 45 52% (28/54) 122 33% (8/24) 258 29% (22/75) 326 25% (4/16) 672 50% (1/2)
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Dessai, Uday - FSISSent: Tuesday, October 29, 2013 7:17 AMTo: Robertson, Kis - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSISCc: Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: Re: Heidelberg Pct Hospitalized by PFGE
Ah, ha.. That is an important consideration!The illness rates at times may be impacted by the type of commodity, processing and handling etc..SDC and team - if/when implicated product is available, can we run some MPNs please..
Thx
From: Robertson, Kis - FSIS Sent: Tuesday, October 29, 2013 08:12 AMTo: Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSIS Cc: Kissler, Bonnie - FSIS; Douris, Aphrodite - FSIS Subject: RE: Heidelberg Pct Hospitalized by PFGE
(b) (6)
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
I like this discussion.
An important consideration is that a big chunk of the 258 patients were victimized by the rotisserie chicken. If the level of contamination on the rotisserie was lower than the level on raw products, the severity of illness could be also be lower.
Kis Robertson, DVM, MPH, DACVPM
Commander, U.S. Public Health Service
Acting Director
USDA/FSIS/OPHS/Applied Epidemiology Staff
Stop 3766, PP 3, 9-210B
1400 Independence Avenue, SW
Washington, DC 20250
Office Phone: (202) 772-9000
Blackberry phone: (202) 379-6648
Email: [email protected]
_____________________________________________From: Dessai, Uday - FSISSent: Tuesday, October 29, 2013 7:51 AMTo: Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSISCc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
On the dot SDC, I was also wondering about the same..
Alice, can you remind us if thediference is in the region below 80….
If it is, there must be a highly virulent mobile element/plasmid that is getting transfered within Heidelbeg populations under some sort of selection pressure..
We will need to look into this further (FDA collaboration…)
Thx
_____________________________________________From: Defibaugh-Chavez, Stephanie - FSIS
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Sent: Monday, October 28, 2013 6:51 PMTo: Green, Alice - FSIS; Dessai, Uday - FSISCc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
I think it’s interesting that although 258 and 45 are highly similar in PFGE pattern, they appear to have vastly different hospitalization rates (almost double for 45). To me, this particular difference in hospitalization rates indicates the likelihood of some sort of plasmid that is making some of these strains more virulent than others.
Stephanie Defibaugh-Chávez, Ph.D.
Microbiologist
Science Staff, Office of Public Health Science
Food Safety and Inspection Service
United States Department of Agriculture
202-690-6042 (office)
202-641-5540 (Blackberry)
202-690-6364 (fax)
email: [email protected] <mailto:[email protected]>
Stay Connected with USDA:
<< OLE Object: Picture (Device Independent Bitmap) >> <http://www.facebook.com/usda> << OLE Object: Picture (Device Independent Bitmap) >> <http://www.twitter.com/usda> << OLE Object: Picture (Device Independent Bitmap) >> <http://www.youtube.com/usda>
_____________________________________________From: Green, Alice - FSISSent: Monday, October 28, 2013 6:08 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
Hi Uday—
Here is today’s update to the requested information.
Based on Aphrodite’s work last summer, patterns 258 and 45 are the most closely related in the cluster at 99% similar with one band differing. Patterns 122 and 672 are about 97% similar with one band difference. Pattern 22 is 90% or less similar to all other patterns.
California was keeping track of this information separately early on in the investigation. It is interesting to revisit now that the number of case-patients has increased. I am not detecting any clear patterns. Please let me know what you think. Thanks! :-)
Pattern % hospitalized (n) Median Age % Male 22 42% (21/50) 20 yrs (n=55) 45%
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
41 44% (14/32) 20 yrs (n=49) 43% 45 52% (28/54) 22 yrs (n=77) 54% 122 33% (8/24) 23 yrs (n=31) 52% 258 29% (22/76) 18 yrs (n=117) 56% 326 25% (4/16) 20 yrs (n=25) 50% 672 50% (1/2) 9 yrs (n=2) 50%
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
_____________________________________________From: Dessai, Uday - FSISSent: Monday, October 28, 2013 6:40 AMTo: Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
This is very neat Alice :-)!
Although the lower numbers will be heavily influenced by the denominator, we may be able to divide these into atleast two categories based on % hospitalizations. (note: qualifying criteria could be something like we should have atleast 10 total illnesses to be counted in the categories)
1) 35% and below – 122, 258, 326
2) 35% and above – 22, 41, 45, 122, 672 (just 2 cases – does not qualify))
The next part will be to see if PFGEs in these categories have any commonality/similarity etc. If not all, atleast hose at the extreme ends of hospitalization..
Also, in your table, do if we add the columns for demographics (age, sensitive population etc.. if available, would that be useful to see..!)
Again, nice work Alice :-)!
_____________________________________________From: Green, Alice - FSIS
(b) (6)
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Sent: Friday, October 25, 2013 2:41 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: Heidelberg Pct Hospitalized by PFGE
Pattern % hospitalized (n) 22 42% (21/50) 41 44% (14/32) 45 52% (28/54) 122 33% (8/24) 258 29% (22/75) 326 25% (4/16) 672 50% (1/2)
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Robertson, Kis - FSISSent: Tuesday, October 29, 2013 7:12 AMTo: Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSISCc: Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
I like this discussion.
An important consideration is that a big chunk of the 258 patients were victimized by the rotisserie chicken. If the level of contamination on the rotisserie was lower than the level on raw products, the severity of illness could be also be lower.
Kis Robertson, DVM, MPH, DACVPMCommander, U.S. Public Health ServiceActing DirectorUSDA/FSIS/OPHS/Applied Epidemiology StaffStop 3766, PP 3, 9-210B1400 Independence Avenue, SWWashington, DC 20250Office Phone: (202) 772-9000Blackberry phone: (202) 379-6648Email: [email protected]
_____________________________________________From: Dessai, Uday - FSIS
(b) (6)
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Sent: Tuesday, October 29, 2013 7:51 AMTo: Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSISCc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
On the dot SDC, I was also wondering about the same..Alice, can you remind us if thediference is in the region below 80….If it is, there must be a highly virulent mobile element/plasmid that is getting transfered within Heidelbeg populations under some sort of selection pressure..
We will need to look into this further (FDA collaboration…)
Thx
_____________________________________________From: Defibaugh-Chavez, Stephanie - FSIS Sent: Monday, October 28, 2013 6:51 PMTo: Green, Alice - FSIS; Dessai, Uday - FSISCc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
I think it’s interesting that although 258 and 45 are highly similar in PFGE pattern, they appear to have vastly different hospitalization rates (almost double for 45). To me, this particular difference in hospitalization rates indicates the likelihood of some sort of plasmid that is making some of these strains more virulent than others.
Stephanie Defibaugh-Chávez, Ph.D.MicrobiologistScience Staff, Office of Public Health ScienceFood Safety and Inspection ServiceUnited States Department of Agriculture202-690-6042 (office)202-641-5540 (Blackberry)202-690-6364 (fax)email: [email protected]
Stay Connected with USDA: << OLE Object: Picture (Device Independent Bitmap) >> <http://www.facebook.com/usda> << OLE Object: Picture (Device Independent Bitmap) >> <http://www.twitter.com/usda> << OLE Object: Picture (Device Independent Bitmap) >> <http://www.youtube.com/usda>
_____________________________________________From: Green, Alice - FSIS Sent: Monday, October 28, 2013 6:08 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Hi Uday—
Here is today’s update to the requested information.
Based on Aphrodite’s work last summer, patterns 258 and 45 are the most closely related in the cluster at 99% similar with one band differing. Patterns 122 and 672 are about 97% similar with one band difference. Pattern 22 is 90% or less similar to all other patterns.
California was keeping track of this information separately early on in the investigation. It is interesting to revisit now that the number of case-patients has increased. I am not detecting any clear patterns. Please let me know what you think. Thanks! :-)
Pattern % hospitalized (n) Median Age % Male 22 42% (21/50) 20 yrs (n=55) 45% 41 44% (14/32) 20 yrs (n=49) 43% 45 52% (28/54) 22 yrs (n=77) 54% 122 33% (8/24) 23 yrs (n=31) 52% 258 29% (22/76) 18 yrs (n=117) 56% 326 25% (4/16) 20 yrs (n=25) 50% 672 50% (1/2) 9 yrs (n=2) 50%
Alice
Alice L. Green, MS, DVM Public Health and Epidemiology LiaisonOffice of Public Health Science | Food Safety and Inspection Service | U.S. Department of AgricultureButler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected]
_____________________________________________From: Dessai, Uday - FSIS Sent: Monday, October 28, 2013 6:40 AMTo: Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
This is very neat Alice :-)!Although the lower numbers will be heavily influenced by the denominator, we may be able to divide these into atleast two categories based on % hospitalizations. (note: qualifying criteria could be something like we should have atleast 10 total illnesses to be counted in the categories)1) 35% and below – 122, 258, 3262) 35% and above – 22, 41, 45, 122, 672 (just 2 cases – does not qualify))
The next part will be to see if PFGEs in these categories have any commonality/similarity etc. If not all, atleast hose at the extreme ends of hospitalization..Also, in your table, do if we add the columns for demographics (age, sensitive population etc.. if available, would that be useful to see..!)
Again, nice work Alice :-)!
(b) (6)
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
_____________________________________________From: Green, Alice - FSIS Sent: Friday, October 25, 2013 2:41 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: Heidelberg Pct Hospitalized by PFGE
Pattern % hospitalized (n) 22 42% (21/50) 41 44% (14/32) 45 52% (28/54) 122 33% (8/24) 258 29% (22/75) 326 25% (4/16) 672 50% (1/2)
Alice L. Green, MS, DVM Public Health and Epidemiology LiaisonOffice of Public Health Science | Food Safety and Inspection Service | U.S. Department of AgricultureButler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected]
From: Dessai, Uday - FSISSent: Tuesday, October 29, 2013 6:51 AMTo: Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSISCc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
On the dot SDC, I was also wondering about the same..Alice, can you remind us if thediference is in the region below 80….If it is, there must be a highly virulent mobile element/plasmid that is getting transfered within Heidelbeg populations under some sort of selection pressure..
We will need to look into this further (FDA collaboration…)
Thx
_____________________________________________From: Defibaugh-Chavez, Stephanie - FSIS
(b) (6)
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Sent: Monday, October 28, 2013 6:51 PMTo: Green, Alice - FSIS; Dessai, Uday - FSISCc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
I think it’s interesting that although 258 and 45 are highly similar in PFGE pattern, they appear to have vastly different hospitalization rates (almost double for 45). To me, this particular difference in hospitalization rates indicates the likelihood of some sort of plasmid that is making some of these strains more virulent than others.
Stephanie Defibaugh-Chávez, Ph.D.MicrobiologistScience Staff, Office of Public Health ScienceFood Safety and Inspection ServiceUnited States Department of Agriculture202-690-6042 (office)202-641-5540 (Blackberry)202-690-6364 (fax)email: [email protected]
Stay Connected with USDA: << OLE Object: Picture (Device Independent Bitmap) >> <http://www.facebook.com/usda> << OLE Object: Picture (Device Independent Bitmap) >> <http://www.twitter.com/usda> << OLE Object: Picture (Device Independent Bitmap) >> <http://www.youtube.com/usda>
_____________________________________________From: Green, Alice - FSIS Sent: Monday, October 28, 2013 6:08 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
Hi Uday—
Here is today’s update to the requested information.
Based on Aphrodite’s work last summer, patterns 258 and 45 are the most closely related in the cluster at 99% similar with one band differing. Patterns 122 and 672 are about 97% similar with one band difference. Pattern 22 is 90% or less similar to all other patterns.
California was keeping track of this information separately early on in the investigation. It is interesting to revisit now that the number of case-patients has increased. I am not detecting any clear patterns. Please let me know what you think. Thanks! :-)
Pattern % hospitalized (n) Median Age % Male 22 42% (21/50) 20 yrs (n=55) 45% 41 44% (14/32) 20 yrs (n=49) 43% 45 52% (28/54) 22 yrs (n=77) 54% 122 33% (8/24) 23 yrs (n=31) 52% 258 29% (22/76) 18 yrs (n=117) 56% 326 25% (4/16) 20 yrs (n=25) 50% 672 50% (1/2) 9 yrs (n=2) 50%
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Alice
Alice L. Green, MS, DVM Public Health and Epidemiology LiaisonOffice of Public Health Science | Food Safety and Inspection Service | U.S. Department of AgricultureButler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected]
_____________________________________________From: Dessai, Uday - FSIS Sent: Monday, October 28, 2013 6:40 AMTo: Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
This is very neat Alice :-)!Although the lower numbers will be heavily influenced by the denominator, we may be able to divide these into atleast two categories based on % hospitalizations. (note: qualifying criteria could be something like we should have atleast 10 total illnesses to be counted in the categories)1) 35% and below – 122, 258, 3262) 35% and above – 22, 41, 45, 122, 672 (just 2 cases – does not qualify))
The next part will be to see if PFGEs in these categories have any commonality/similarity etc. If not all, atleast hose at the extreme ends of hospitalization..Also, in your table, do if we add the columns for demographics (age, sensitive population etc.. if available, would that be useful to see..!)
Again, nice work Alice :-)!
_____________________________________________From: Green, Alice - FSIS Sent: Friday, October 25, 2013 2:41 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: Heidelberg Pct Hospitalized by PFGE
Pattern % hospitalized (n) 22 42% (21/50) 41 44% (14/32) 45 52% (28/54) 122 33% (8/24) 258 29% (22/75) 326 25% (4/16) 672 50% (1/2)
(b) (6)
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Alice L. Green, MS, DVM Public Health and Epidemiology LiaisonOffice of Public Health Science | Food Safety and Inspection Service | U.S. Department of AgricultureButler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected]
From: Dessai, Uday - FSISSent: Tuesday, October 29, 2013 4:40 AMTo: Green, Alice - FSISSubject: RE: Positive chicken sample for S. Heidelberg patient
Thank you very very much Alice.
I could not make time yesterday to review the table carefully.
I am going to look at this later in the AM today.
Talk to you later.
Uday
From: Green, Alice - FSIS Sent: Monday, October 28, 2013 3:18 PMTo: Dessai, Uday - FSISSubject: RE: Positive chicken sample for S. Heidelberg patient
Uday--
Just wanted you to know that I will get you the additional information you requested before I leave today. Thanks! J
Alice
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(b) (6)
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Dessai, Uday - FSIS Sent: Monday, October 28, 2013 2:17 PMTo: Dessai, Uday - FSIS; Goldman, David - Commissioned Corps - FSIS; Kause, Janell - FSISCc: Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Douris, Aphrodite - FSIS; Defibaugh-Chavez, Stephanie - FSISSubject: RE: Positive chicken sample for S. Heidelberg patient
Also here are summary points from SDC email from Friday:
About case-patient ( traceback and FSIS intensified sampling:
The specific product identified is a boneless skinless chicken thigh product. It was collected at P6137A but was produced from source materials that originated from P7632 (slaughtered on 9/9/2013). StephanieDC had suggested in her Friday’s email to consider recalling all chicken products (including parts and whole chicken!) produced from birds slaughtered on 9/9/2013 at P7632 . This was based on the fact that 11 total product –positives were produced from source materials that originated from P7632 (slaughtered on 9/9/2013 and includes a variety of parts and whole/rotisserie chicken.
Thanks much!
Uday
From: Dessai, Uday - FSIS Sent: Monday, October 28, 2013 8:57 AMTo: Goldman, David - Commissioned Corps - FSIS; Kause, Janell - FSIS
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Cc: Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Douris, Aphrodite - FSIS; Defibaugh-Chavez, Stephanie - FSISSubject: RE: Positive chicken sample for S. Heidelberg patient
HI David
Stephanie, Alice and Aphrodite are looking at the following two issues and here are our initial thoughts:
1) OIEA has established a compelling link in the Foster Farms illness outbreak investigation. Here are the details from
This revolves around The case patient shopper data and intensified sampling conducted at the three Foster farms facilities in California was utilized. The linkages are detailed below:
· tested for positive for PFGE 045, and the like sample collected on the same date, sample form ID number 100583269, as one of the pack dates is PFGE 045, which is the same PFGE pattern.
· The product purchased by the case patient and the like sample, Foster Farms boneless, skinless thighs, were slaughtered at P-7632 on 9/9/2013 and were processed/packed at P-6137A on 9/9/2013.
· There are other multiple sample positives for PFGE 45 at p-7632 and P-6137A on 9/9/2013, both parts and whole birds.
· SDC will look into this further….
2) P6137A PFGE pattern JF6X01.0122 (5/10 subs positive), additional 2 being tested for PFGEs; case patient has PFGE type 45
· Although:
o during the specpgm_02 Sept sampling there was a single positive with pattern .0122 from the same establishment
o the fact that mixed PFGE patterns can be found in the same sample
o There may be overwhelming indirect evidences..
o We cannot make a conclusive claim that there is a link between the patient and chicken samples recovered from the patients home
----------
o A close examination of the two band difference between 0122 and 45 shows that - these are distinctly different PFGE types (on the gel)
o We are awaiting the final results from the additional 2 PFGEs
o We are analyzing the hospitalization rate for the two PFGE types
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o Etc.
Thanks much!
Uday
Yes, I would say that these two patterns are significantly different.
Aphrodite DourisMicrobiologistOutbreaks Section, Eastern LaboratoryFood Safety and Inspection ServiceThe United States Department of AgricultureRussell Research Center950 College Station RoadAthens, GA [email protected]: (706) 546-2330 FAX:(706)546-3144
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_____________________________________________From: Dessai, Uday - FSIS Sent: Friday, October 25, 2013 2:22 PMTo: Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg similarity matrix
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Thx much Alice and Douris.
2 bands different (~ 200 and ~ 80 region) as I see it on the picture.
Douris – does the ~ 200 region band constitute a real diffence ! ( I would imagin yes!)
Thanks
What remains to be done
<<6002696219 FF Invoice.pdf>> <<Originating Spreadsheet Special 102413.xlsx>> <<2013-10-22_Phase1-Heidelbergs.xlsx>>
Hello,
We have a compelling link in the Foster Farms illness outbreak investigation. This revolves around The case patient shopper data and intensified sampling conducted at the three Foster farms facilities in California was utilized. The linkages are detailed below:
· tested for positive for PFGE 045, and the like sample collected on the same date, sample form ID number 100583269, as one of the pack dates is PFGE 045, which is the same PFGE pattern.
· The product purchased by the case patient and the like sample, Foster Farms boneless, skinless thighs, were slaughtered at P-7632 on 9/9/2013 and were processed/packed at P-6137A on 9/9/2013.
· There are other multiple sample positives for PFGE 45 at p-7632 and P-6137A on 9/9/2013, both parts and whole birds.
I have attached invoice 6002696219 that shows the link in commerce between Foster Farms and the COSTCO store where the case patient purchased the product. I have also attached a spreadsheet titled “original Spreadsheet Special” that demonstrates the linkages between and the samples collected at Foster farms, and finally, I have attached the sample data spreadsheet that represents all samples collected at the three Foster farms facilities.
About the other CPs, are not as compelling:
Case patients – We could not make a connection between FSIS sampling dates for Est. 7632 & Est.
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6137 for product comprising the load distributed to Costco, part of which may have been consumed by both case patients. Product from Est. 33900 was also included in the load to Costco.
Case patients – Product (Rotisserie Chicken) available on the purchase day consisted of seven Foster Farms invoices to Costco with several different slaughter and pack dates from Est. 7632, 6137, 6137A, and 33900. Positive test results, PFGE pattern 258, from FSIS sampling with slaughter dates of; 9/7, 9/9, 9/10, 9/11, and 9/17, taken at Est. 6137 and 6137A made up part of the product included on the invoices.
Case patient – OIEA is still waiting on California for membership card information.
Case patient - OIEA is still waiting on California for additional purchase dates.
Case patients – Product (Rotisserie Chicken) available on the day of purchase consisted of a single invoice from Foster Farms to Costco. Product represented on the invoice originated from Est. P-7632 and P-33900. Positive test results, PFGE pattern 258, from FSIS sampling with a slaughter date of 9/9 from Est. 7632 comprised part of the load.
The CCMS patient in NV:
OPHS spoke with complainant as did OIEA’s investigator. Review labs – CBC- WNL, Chemistry Profile – Elevated liver enzymes, Stool Sample negative for Salmonella, Shigella and Campy. He might give us some of the sample but not all of it. We are concerned about how we would do that.
Alice and SDC pl:
Isolate numbers
Types of parts, production/analysis dates and PFGEs
PFGE Types
P1
P2
P3
P4
P5
whole
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Patient info
1?
NA
NA
NA
NA
NA
NA
Product info
5 each (!)
OB/PFGE types
Note: Same or different PFGE types can be found in a given sample. And the prevalence of a PFGE type in the enriched medium, does not in any fashion or manner indicates absence of other PFGE types in the product.
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From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 3:35 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSISSubject: Re: Positive chicken sample for S. Heidelberg patient
Good idea(s). We do need to figure this one out--I think I heard that FDA will sequence these strains. I would appreciate a separate discussion so that I understand how much we can learn about the genetic profile and phenotypic expression from this sequencing.
David P. Goldman, M.D., M.P.H.
Captain, USPHS
Assistant Administrator
Office of Public Health Science
Food Safety and Inspection Service
USDA
Room 341-E, Whitten Bldg.
1400 Independence Ave, SW
Washington, DC 20250
202-720-2644 (o)
202-690-2980 (f)
On Oct 25, 2013, at 1:34 PM, "Dessai, Uday - FSIS" <[email protected]> wrote:
Good point SDC Just a thought: Looks like there is a lot happening I Heidelberg genome.. For instance in the heidelbergs associated with this O/B, the virulence factors may be (just may be) up regulated for some reason... Alice and team: is it possible to tabulate rate of hospitalization for different PFGE types (if numbers are available!)
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Thx
From: Defibaugh-Chavez, Stephanie - FSIS Sent: Friday, October 25, 2013 01:18 PM To: Green, Alice - FSIS; Goldman, David - Commissioned Corps - FSIS; Dessai, Uday - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Can we also follow-up with CDC to see if they included pattern 0041 in the cluster because of similarity to 0122? An alternative way of asking that is David’s original question of whether they would consider those two patterns the same strain. As Uday pointed out, sometimes lack of or additional bands in the lower molecular weight region (i.e. <100k bp) can be due to plasmid or just poor band resolution in that region. It would be nice to know how they would interpret this situation of finding these two specific patterns in connection with a leftover product and a case-patient clinical isolate.
Stephanie Defibaugh-Chávez, Ph.D.
Microbiologist
Science Staff, Office of Public Health Science
Food Safety and Inspection Service
United States Department of Agriculture
202-690-6042 (office)
202-641-5540 (Blackberry)
202-690-6364 (fax)
email: [email protected]
Stay Connected with USDA:
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From: Green, Alice - FSIS Sent: Friday, October 25, 2013 1:13 PM To: Goldman, David - Commissioned Corps - FSIS; Dessai, Uday - FSIS Cc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
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The health department picked up 3 packages of FF product. There were no other suspect products noted. I’ll seek guidance from OSEL on pattern similarity between patterns 41 and 122.
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 11:46 AM To: Dessai, Uday - FSIS Cc: Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: Re: Positive chicken sample for S. Heidelberg patient
Thanks for the latest on the PFGE similarity. I am confused about the leftover products--I just assumed that the health dept picked any "suspect" product (meaning something eaten by the case and so a possible exposure). Given that 2 of the samples were negative, what other possibility is there except that the positive product led to the illness? Is CA aware of other chicken exposures that might complicate the picture?
If need be, would CDC say that these 2 patterns are so close that they may represent the same pathogen in this instance?
David P. Goldman, M.D., M.P.H.
Captain, USPHS
Assistant Administrator
Office of Public Health Science
Food Safety and Inspection Service
USDA
Room 341-E, Whitten Bldg.
1400 Independence Ave, SW
Washington, DC 20250
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202-720-2644 (o)
202-690-2980 (f)
On Oct 25, 2013, at 12:33 PM, "Dessai, Uday - FSIS" <[email protected]> wrote:
Thx Alice!
The Two bands (I would imagine in low molecular weight region!) may need to be considered a method artifact in this instance – given both are very close and part of the OB.
Cheers!
Uday
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 12:26 PM To: Dessai, Uday - FSIS; Goldman, David - Commissioned Corps - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Hi Uday—
You are correct! I do want to emphasize that both are outbreak strains, and pattern 122 and pattern 41 are 94.4% similar, differing in only two bands.
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
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Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Dessai, Uday - FSIS Sent: Friday, October 25, 2013 11:20 AM To: Goldman, David - Commissioned Corps - FSIS; Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Hi Alice
It is interesting that although we have pattern O122 in the product, we are not sure of the three products, which one was consumed by the patient!
So we have diffferent patterns between patient and product and we are not sure which product (1/3 positive) was consumed – right!
Thx!
From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 12:11 PM To: Green, Alice - FSIS; Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: Re: Positive chicken sample for S. Heidelberg patient
Thanks Alice--just want to clarify; were all 5 subs pattern 122? If so, then are there more isolates to test? David Goldman, MD, MPH CAPT, USPHS Chief Medical Officer Assistant Administrator USDA-FSIS-OPHS 202-720-2644 -------------------------- Sent from my BlackBerry Wireless Handheld
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From: Green, Alice - FSIS Sent: Friday, October 25, 2013 12:08 PM To: Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS; Goldman, David - Commissioned Corps - FSIS Subject: FW: Positive chicken sample for S. Heidelberg patient
FYI—
PFGE table for tested products is below.
is the appropriate lab contact Pictures have use-by date of 03-29-2014. Product is frozen Kirkland Signature boneless skinless chicken tenders (mis-stated as chicken breast in my previous email).
Thanks much,
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Higa, Jeffrey (CDPH-CID-DCDC-IDB) [mailto:[email protected]] Sent: Friday, October 25, 2013 10:57 AM To: Green, Alice - FSIS; Kissler, Bonnie - FSIS; Robertson, Kis - FSIS; Allen, Latasha - Commissioned Corps - FSIS; [email protected]; [email protected]; [email protected]; [email protected]; [email protected] Cc: Needham, Michael (CDPH-DFDRS FDB); Hernandez, Michael (CDPH-DFDRS); Kennelly, Pat (CDPH-FDB); Peralta, Vi (CDPH-CID-DCDC-IDB); Kimura, Akiko (CDPH-CID-DCDC); Gilliss, Debra (CDPH-CID-DCDC-IDB) Subject: Positive chicken sample for S. Heidelberg patient
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Hello USDA and CDC colleagues,
On 10/9/2013, 3 open packages of Kirkland Signature Boneless, Skinless Chicken Tenderloins were collected from the home of S. Heidelberg pattern 0041 patient Our Food and Drug Lab tested chicken from all 3 packages. Chicken from one of packages was positive for Salmonella:
FDLB Sample ID
Product
Establishment #
Result
PulseNet Isolate #
184100913-P001
Kirkland Signature boneless, skinless Chicken tenderloins
P33901
negative for Salmonella
n/a
184100913-P002
Kirkland Signature boneless, skinless Chicken tenderloins
P6137A
(best by 3/29/2014)
· positive for Salmonella group B
· 5 of 10 subs positive
· PFGE pattern JF6X01.0122
CA2__CA2F13M00985PP2A1
184100913-P003
Kirkland Signature boneless, skinless Chicken tenderloins
P33901
negative for Salmonella
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n/a
Attached are pictures of the package for the positive chicken sample. The chicken isolate was pattern 0122 and the patient had pattern 0041. Unfortunately, all 3 packages were open and the specific package the patient had chicken from prior to illness onset could not be determined.
FDB, please correct me if any of the information above is inaccurate.
-Jeff
Jeffrey Higa, MPH
California Department of Public Health
Infectious Diseases Branch
Disease Investigations Section
19300 S. Hamilton Ave., Suite 140
Gardena, CA 90248
310-217-6906
310-217-6911 (fax)
[email protected] <mailto:[email protected]>
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From: Defibaugh-Chavez, Stephanie - FSISSent: Monday, October 28, 2013 5:59 PMTo: Kissler, Bonnie - FSIS; Green, Alice - FSIS; Vetter, Danah - FSIS; Atkinson, Richard - FSISSubject: FYI...
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Came across this today:http://fosterfarms.com/docs/Foster_Farms_Overview.pdf
Stephanie Defibaugh-Chávez, Ph.D.MicrobiologistScience Staff, Office of Public Health ScienceFood Safety and Inspection ServiceUnited States Department of Agriculture202-690-6042 (office)202-641-5540 (Blackberry)202-690-6364 (fax)email: [email protected]
Stay Connected with USDA: <http://www.facebook.com/usda> <http://www.twitter.com/usda> <http://www.youtube.com/usda>
From: Defibaugh-Chavez, Stephanie - FSISSent: Monday, October 28, 2013 5:51 PMTo: Green, Alice - FSIS; Dessai, Uday - FSISCc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
I think it’s interesting that although 258 and 45 are highly similar in PFGE pattern, they appear to have vastly different hospitalization rates (almost double for 45). To me, this particular difference in hospitalization rates indicates the likelihood of some sort of plasmid that is making some of these strains more virulent than others.
Stephanie Defibaugh-Chávez, Ph.D.MicrobiologistScience Staff, Office of Public Health ScienceFood Safety and Inspection ServiceUnited States Department of Agriculture202-690-6042 (office)202-641-5540 (Blackberry)202-690-6364 (fax)email: [email protected]
Stay Connected with USDA: <http://www.facebook.com/usda> <http://www.twitter.com/usda> <http://www.youtube.com/usda>
_____________________________________________From: Green, Alice - FSIS Sent: Monday, October 28, 2013 6:08 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
Hi Uday—
Here is today’s update to the requested information.
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Based on Aphrodite’s work last summer, patterns 258 and 45 are the most closely related in the cluster at 99% similar with one band differing. Patterns 122 and 672 are about 97% similar with one band difference. Pattern 22 is 90% or less similar to all other patterns.
California was keeping track of this information separately early on in the investigation. It is interesting to revisit now that the number of case-patients has increased. I am not detecting any clear patterns. Please let me know what you think. Thanks! :-)
Pattern % hospitalized (n) Median Age % Male 22 42% (21/50) 20 yrs (n=55) 45% 41 44% (14/32) 20 yrs (n=49) 43% 45 52% (28/54) 22 yrs (n=77) 54% 122 33% (8/24) 23 yrs (n=31) 52% 258 29% (22/76) 18 yrs (n=117) 56% 326 25% (4/16) 20 yrs (n=25) 50% 672 50% (1/2) 9 yrs (n=2) 50%
Alice
Alice L. Green, MS, DVM Public Health and Epidemiology LiaisonOffice of Public Health Science | Food Safety and Inspection Service | U.S. Department of AgricultureButler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected]
_____________________________________________From: Dessai, Uday - FSIS Sent: Monday, October 28, 2013 6:40 AMTo: Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSISSubject: RE: Heidelberg Pct Hospitalized by PFGE
This is very neat Alice :-)!Although the lower numbers will be heavily influenced by the denominator, we may be able to divide these into atleast two categories based on % hospitalizations. (note: qualifying criteria could be something like we should have atleast 10 total illnesses to be counted in the categories)1) 35% and below – 122, 258, 3262) 35% and above – 22, 41, 45, 122, 672 (just 2 cases – does not qualify))
The next part will be to see if PFGEs in these categories have any commonality/similarity etc. If not all, atleast hose at the extreme ends of hospitalization..Also, in your table, do if we add the columns for demographics (age, sensitive population etc.. if available, would that be useful to see..!)
Again, nice work Alice :-)!
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_____________________________________________From: Green, Alice - FSIS Sent: Friday, October 25, 2013 2:41 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: Heidelberg Pct Hospitalized by PFGE
Pattern % hospitalized (n) 22 42% (21/50) 41 44% (14/32) 45 52% (28/54) 122 33% (8/24) 258 29% (22/75) 326 25% (4/16) 672 50% (1/2)
Alice L. Green, MS, DVM Public Health and Epidemiology LiaisonOffice of Public Health Science | Food Safety and Inspection Service | U.S. Department of AgricultureButler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected]
From: Gieraltowski, Laura (CDC/OID/NCEZID) [[email protected]]Sent: Monday, October 28, 2013 3:51 PMTo: Green, Alice - FSIS; Nakao, Jolene H. (CDC/OID/NCEZID); Defibaugh-Chavez, Stephanie - FSIS; Kissler, Bonnie - FSIS; Robertson, Kis - FSISCc: Schwensohn, Colin A. (CDC/OID/NCEZID); Wise, Matthew E. (CDC/OID/NCEZID)Subject: RE: NARMS chicken sample postive for S. Heidelberg
Alice –
I just talked to Jeff and he is going to follow-up with Vi. CDC is willing to try to interview these patients and it sounds like the local health department is willing to let us. We’ll let you know when we receive the patient contact information and if we’re able to reach any of them.
Thanks,
Laura
From: Green, Alice - FSIS [mailto:[email protected]] Sent: Monday, October 28, 2013 4:42 PMTo: Nakao, Jolene H. (CDC/OID/NCEZID); Gieraltowski, Laura (CDC/OID/NCEZID); Defibaugh-Chavez, Stephanie - FSIS; Kissler, Bonnie - FSIS; Robertson, Kis - FSIS
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Cc: Schwensohn, Colin A. (CDC/OID/NCEZID); Wise, Matthew E. (CDC/OID/NCEZID)Subject: RE: NARMS chicken sample postive for S. Heidelberg
A check-in question—has CA been in touch with CDC regarding possible assistance with several Alameda/Berkeley interviews of case-patients with recent illness onsets? This was mentioned to me as a possibility last week and I wanted to follow up.
Thanks much,
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Nakao, Jolene H. (CDC/OID/NCEZID) [mailto:[email protected]] Sent: Monday, October 28, 2013 3:02 PMTo: Green, Alice - FSIS; Gieraltowski, Laura (CDC/OID/NCEZID); Defibaugh-Chavez, Stephanie - FSIS; Kissler, Bonnie - FSIS; Robertson, Kis - FSISCc: Schwensohn, Colin A. (CDC/OID/NCEZID)Subject: RE: NARMS chicken sample postive for S. Heidelberg
Yes! J
Apologies again, Alice. I need to put you on all of my list distribution emails.
Jolene
From: Green, Alice - FSIS [mailto:[email protected] <mailto:[email protected]> ] Sent: 28 October 2013 15:52To: Gieraltowski, Laura (CDC/OID/NCEZID); Defibaugh-Chavez, Stephanie - FSIS; Kissler, Bonnie - FSIS;
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Robertson, Kis - FSISCc: Nakao, Jolene H. (CDC/OID/NCEZID); Schwensohn, Colin A. (CDC/OID/NCEZID)Subject: RE: NARMS chicken sample postive for S. Heidelberg
J That reminds me...does CDC have an updated linelist for this cluster?
Thanks much,
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Gieraltowski, Laura (CDC/OID/NCEZID) [mailto:[email protected] <mailto:[email protected]> ] Sent: Monday, October 28, 2013 2:23 PMTo: Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Kissler, Bonnie - FSIS; Robertson, Kis - FSISCc: Nakao, Jolene H. (CDC/OID/NCEZID); Schwensohn, Colin A. (CDC/OID/NCEZID)Subject: Re: NARMS chicken sample postive for S. Heidelberg
Thanks, Alice. This isolate was uploaded to PulseNet today.
From: Green, Alice - FSIS [mailto:[email protected] <mailto:[email protected]> ] Sent: Monday, October 28, 2013 03:20 PM Eastern Standard TimeTo: Defibaugh-Chavez, Stephanie - FSIS <[email protected] <mailto:[email protected]> >; Kissler, Bonnie - FSIS <[email protected] <mailto:[email protected]> >; Robertson, Kis - FSIS <[email protected] <mailto:[email protected]> > Cc: Gieraltowski, Laura (CDC/OID/NCEZID); Nakao, Jolene H. (CDC/OID/NCEZID); Schwensohn, Colin A. (CDC/OID/NCEZID) Subject: FW: NARMS chicken sample postive for S. Heidelberg
FYI.
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Lofy, Kathy H (DOH) [mailto:[email protected] <mailto:[email protected]> ] Sent: Monday, October 28, 2013 1:22 PMTo: Green, Alice - FSISCc: Melius, Beth J (DOH); Stewart, Laurie K (DOH)Subject: NARMS chicken sample postive for S. Heidelberg
Hi Alice,
I want to let you know that routine meat testing in Washington for the NARMS program detected S. Heidelberg in a chicken sample. The label of this chicken sample is attached. It appears this chicken sample was processed at plant P-6137A (CA FF plant). The PulseNet PFGE pattern is not yet in our Washington database but I believe the pattern is XbaI JF6X01.0122. The isolate number is WA_19012.
Let us know if you need additional information.
Thanks
Kathy
Kathy Lofy, M.D.
Medical Epidemiologist
Washington State Department of Health
Office of Communicable Disease Epidemiology
Phone: 206-418-5500
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Public Health--Always Working for a Safer and Healthier Washington
This electronic message contains information generated by the USDA solely for the intended recipients. Any unauthorized interception of this message or the use or disclosure of the information it contains may violate the law and subject the violator to civil or criminal penalties. If you believe you have received this message in error, please notify the sender and delete the email immediately.
From: Gieraltowski, Laura (CDC/OID/NCEZID) [[email protected]]Sent: Monday, October 28, 2013 3:50 PMTo: Nakao, Jolene H. (CDC/OID/NCEZID); Schwensohn, Colin A. (CDC/OID/NCEZID); Barton Behravesh, Casey (CDC/OID/NCEZID); Wise, Matthew E. (CDC/OID/NCEZID); Williams, Ian (CDC/OID/NCEZID)Cc: Kissler, Bonnie - FSIS; Green, Alice - FSISSubject: Foster Farms response on their website
FYI
http://www.fosterfarms.com/docs/Foster_Farms_Overview.pdf
Laura B. Gieraltowski, PhD, MPHLCDR, US Public Health ServiceDoctoral EpidemiologistOutbreak Response and Prevention Branch Division of Foodborne, Waterborne and Environmental Diseases
National Center for Emerging and Zoonotic Infectious Diseases
Centers for Disease Control and Prevention1600 Clifton Road, MS A-38Atlanta, GA 30329 Phone: (404)639-3868 Fax: (404)718-2126
From: Nakao, Jolene H. (CDC/OID/NCEZID) [[email protected]]Sent: Monday, October 28, 2013 3:02 PMTo: Green, Alice - FSIS; Gieraltowski, Laura (CDC/OID/NCEZID); Defibaugh-Chavez, Stephanie - FSIS; Kissler, Bonnie - FSIS; Robertson, Kis - FSISCc: Schwensohn, Colin A. (CDC/OID/NCEZID)Subject: RE: NARMS chicken sample postive for S. HeidelbergAttachments: CDC MLL S Heidelberg 2013 clusters_comprehensive, 10-28-13.xlsx
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Yes! J
Apologies again, Alice. I need to put you on all of my list distribution emails.
Jolene
From: Green, Alice - FSIS [mailto:[email protected]] Sent: 28 October 2013 15:52To: Gieraltowski, Laura (CDC/OID/NCEZID); Defibaugh-Chavez, Stephanie - FSIS; Kissler, Bonnie - FSIS; Robertson, Kis - FSISCc: Nakao, Jolene H. (CDC/OID/NCEZID); Schwensohn, Colin A. (CDC/OID/NCEZID)Subject: RE: NARMS chicken sample postive for S. Heidelberg
J That reminds me...does CDC have an updated linelist for this cluster?
Thanks much,
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Gieraltowski, Laura (CDC/OID/NCEZID) [mailto:[email protected]] Sent: Monday, October 28, 2013 2:23 PMTo: Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Kissler, Bonnie - FSIS; Robertson, Kis - FSISCc: Nakao, Jolene H. (CDC/OID/NCEZID); Schwensohn, Colin A. (CDC/OID/NCEZID)Subject: Re: NARMS chicken sample postive for S. Heidelberg
Thanks, Alice. This isolate was uploaded to PulseNet today.
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
From: Green, Alice - FSIS [mailto:[email protected] <mailto:[email protected]> ] Sent: Monday, October 28, 2013 03:20 PM Eastern Standard TimeTo: Defibaugh-Chavez, Stephanie - FSIS <[email protected] <mailto:[email protected]> >; Kissler, Bonnie - FSIS <[email protected] <mailto:[email protected]> >; Robertson, Kis - FSIS <[email protected] <mailto:[email protected]> > Cc: Gieraltowski, Laura (CDC/OID/NCEZID); Nakao, Jolene H. (CDC/OID/NCEZID); Schwensohn, Colin A. (CDC/OID/NCEZID) Subject: FW: NARMS chicken sample postive for S. Heidelberg
FYI.
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Lofy, Kathy H (DOH) [mailto:[email protected] <mailto:[email protected]> ] Sent: Monday, October 28, 2013 1:22 PMTo: Green, Alice - FSISCc: Melius, Beth J (DOH); Stewart, Laurie K (DOH)Subject: NARMS chicken sample postive for S. Heidelberg
Hi Alice,
I want to let you know that routine meat testing in Washington for the NARMS program detected S. Heidelberg in a chicken sample. The label of this chicken sample is attached. It appears this chicken sample was processed at plant P-6137A (CA FF plant). The PulseNet PFGE pattern is not yet in our Washington database but I believe the pattern is XbaI JF6X01.0122. The isolate number is WA_19012.
Let us know if you need additional information.
Thanks
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Kathy
Kathy Lofy, M.D.
Medical Epidemiologist
Washington State Department of Health
Office of Communicable Disease Epidemiology
Phone: 206-418-5500
Public Health--Always Working for a Safer and Healthier Washington
This electronic message contains information generated by the USDA solely for the intended recipients. Any unauthorized interception of this message or the use or disclosure of the information it contains may violate the law and subject the violator to civil or criminal penalties. If you believe you have received this message in error, please notify the sender and delete the email immediately.
From: Dessai, Uday - FSISSent: Monday, October 28, 2013 2:47 PMTo: Green, Alice - FSISSubject: Re: Positive chicken sample for S. Heidelberg patient
Thx Alice..
From: Green, Alice - FSIS Sent: Monday, October 28, 2013 03:18 PMTo: Dessai, Uday - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Uday--
Just wanted you to know that I will get you the additional information you requested before I leave today. Thanks! J
Alice
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Dessai, Uday - FSIS Sent: Monday, October 28, 2013 2:17 PMTo: Dessai, Uday - FSIS; Goldman, David - Commissioned Corps - FSIS; Kause, Janell - FSISCc: Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Douris, Aphrodite - FSIS; Defibaugh-Chavez, Stephanie - FSISSubject: RE: Positive chicken sample for S. Heidelberg patient
Also here are summary points from SDC email from Friday:
About case-patient ( traceback and FSIS intensified sampling:
The specific product identified is a boneless skinless chicken thigh product. It was collected at P6137A but was produced from source materials that originated from P7632 (slaughtered on 9/9/2013). StephanieDC had suggested in her Friday’s email to consider recalling all chicken products (including parts and whole chicken!) produced from birds slaughtered on 9/9/2013 at P7632 . This was based on the fact that 11 total product –positives were produced from source materials that originated from P7632 (slaughtered on 9/9/2013 and includes a variety of parts and whole/rotisserie chicken.
Thanks much!
Uday
From: Dessai, Uday - FSIS Sent: Monday, October 28, 2013 8:57 AMTo: Goldman, David - Commissioned Corps - FSIS; Kause, Janell - FSISCc: Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Douris, Aphrodite - FSIS; Defibaugh-Chavez, Stephanie - FSIS
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Subject: RE: Positive chicken sample for S. Heidelberg patient
HI David
Stephanie, Alice and Aphrodite are looking at the following two issues and here are our initial thoughts:
1) OIEA has established a compelling link in the Foster Farms illness outbreak investigation. Here are the details from
This revolves around The case patient shopper data and intensified sampling conducted at the three Foster farms facilities in California was utilized. The linkages are detailed below:
· tested for positive for PFGE 045, and the like sample collected on the same date, sample form ID number 100583269, as one of the pack dates is PFGE 045, which is the same PFGE pattern.
· The product purchased by the case patient and the like sample, Foster Farms boneless, skinless thighs, were slaughtered at P-7632 on 9/9/2013 and were processed/packed at P-6137A on 9/9/2013.
· There are other multiple sample positives for PFGE 45 at p-7632 and P-6137A on 9/9/2013, both parts and whole birds.
· SDC will look into this further….
2) P6137A PFGE pattern JF6X01.0122 (5/10 subs positive), additional 2 being tested for PFGEs; case patient has PFGE type 45
· Although:
o during the specpgm_02 Sept sampling there was a single positive with pattern .0122 from the same establishment
o the fact that mixed PFGE patterns can be found in the same sample
o There may be overwhelming indirect evidences..
o We cannot make a conclusive claim that there is a link between the patient and chicken samples recovered from the patients home
----------
o A close examination of the two band difference between 0122 and 45 shows that - these are distinctly different PFGE types (on the gel)
o We are awaiting the final results from the additional 2 PFGEs
o We are analyzing the hospitalization rate for the two PFGE types
o Etc.
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Thanks much!
Uday
Yes, I would say that these two patterns are significantly different.
Aphrodite DourisMicrobiologistOutbreaks Section, Eastern LaboratoryFood Safety and Inspection ServiceThe United States Department of AgricultureRussell Research Center950 College Station RoadAthens, GA [email protected]: (706) 546-2330 FAX:(706)546-3144
Privileged Communications: This transmission (and/or the documents accompanying it) may contain confidential information belonging to the sender. The information is intended only for the use of the individual or entity named in the distribution. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error, please notify us by telephone to arrange for the return of the documents.
_____________________________________________From: Dessai, Uday - FSIS Sent: Friday, October 25, 2013 2:22 PMTo: Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg similarity matrix
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Thx much Alice and Douris.
2 bands different (~ 200 and ~ 80 region) as I see it on the picture.
Douris – does the ~ 200 region band constitute a real diffence ! ( I would imagin yes!)
Thanks
What remains to be done
<<6002696219 FF Invoice.pdf>> <<Originating Spreadsheet Special 102413.xlsx>> <<2013-10-22_Phase1-Heidelbergs.xlsx>>
Hello,
We have a compelling link in the Foster Farms illness outbreak investigation. This revolves around The case patient shopper data and intensified sampling conducted at the three Foster farms facilities in California was utilized. The linkages are detailed below:
· tested for positive for PFGE 045, and the like sample collected on the same date, sample form ID number 100583269, as one of the pack dates is PFGE 045, which is the same PFGE pattern.
· The product purchased by the case patient and the like sample, Foster Farms boneless, skinless thighs, were slaughtered at P-7632 on 9/9/2013 and were processed/packed at P-6137A on 9/9/2013.
· There are other multiple sample positives for PFGE 45 at p-7632 and P-6137A on 9/9/2013, both parts and whole birds.
I have attached invoice 6002696219 that shows the link in commerce between Foster Farms and the COSTCO store where the case patient purchased the product. I have also attached a spreadsheet titled “original Spreadsheet Special” that demonstrates the linkages between and the samples collected at Foster farms, and finally, I have attached the sample data spreadsheet that represents all samples collected at the three Foster farms facilities.
About the other CPs, are not as compelling:
Case patients – We could not make a connection between FSIS sampling dates for Est. 7632 & Est. 6137 for product comprising the load distributed to Costco, part of which may have been consumed by both case patients. Product from Est. 33900 was also included in the load to Costco.
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Case patients – Product (Rotisserie Chicken) available on the purchase day consisted of seven Foster Farms invoices to Costco with several different slaughter and pack dates from Est. 7632, 6137, 6137A, and 33900. Positive test results, PFGE pattern 258, from FSIS sampling with slaughter dates of; 9/7, 9/9, 9/10, 9/11, and 9/17, taken at Est. 6137 and 6137A made up part of the product included on the invoices.
Case patient – OIEA is still waiting on California for membership card information.
Case patient - OIEA is still waiting on California for additional purchase dates.
Case patients – Product (Rotisserie Chicken) available on the day of purchase consisted of a single invoice from Foster Farms to Costco. Product represented on the invoice originated from Est. P-7632 and P-33900. Positive test results, PFGE pattern 258, from FSIS sampling with a slaughter date of 9/9 from Est. 7632 comprised part of the load.
The CCMS patient in NV:
OPHS spoke with complainant as did OIEA’s investigator. Review labs – CBC- WNL, Chemistry Profile – Elevated liver enzymes, Stool Sample negative for Salmonella, Shigella and Campy. He might give us some of the sample but not all of it. We are concerned about how we would do that.
Alice and SDC pl:
Isolate numbers
Types of parts, production/analysis dates and PFGEs
PFGE Types
P1
P2
P3
P4
P5
whole
Patient info
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1?
NA
NA
NA
NA
NA
NA
Product info
5 each (!)
OB/PFGE types
Note: Same or different PFGE types can be found in a given sample. And the prevalence of a PFGE type in the enriched medium, does not in any fashion or manner indicates absence of other PFGE types in the product.
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From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 3:35 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSISSubject: Re: Positive chicken sample for S. Heidelberg patient
Good idea(s). We do need to figure this one out--I think I heard that FDA will sequence these strains. I would appreciate a separate discussion so that I understand how much we can learn about the genetic profile and phenotypic expression from this sequencing.
David P. Goldman, M.D., M.P.H.
Captain, USPHS
Assistant Administrator
Office of Public Health Science
Food Safety and Inspection Service
USDA
Room 341-E, Whitten Bldg.
1400 Independence Ave, SW
Washington, DC 20250
202-720-2644 (o)
202-690-2980 (f)
On Oct 25, 2013, at 1:34 PM, "Dessai, Uday - FSIS" <[email protected]> wrote:
Good point SDC Just a thought: Looks like there is a lot happening I Heidelberg genome.. For instance in the heidelbergs associated with this O/B, the virulence factors may be (just may be) up regulated for some reason... Alice and team: is it possible to tabulate rate of hospitalization for different PFGE types (if numbers are available!) Thx
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From: Defibaugh-Chavez, Stephanie - FSIS Sent: Friday, October 25, 2013 01:18 PM To: Green, Alice - FSIS; Goldman, David - Commissioned Corps - FSIS; Dessai, Uday - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Can we also follow-up with CDC to see if they included pattern 0041 in the cluster because of similarity to 0122? An alternative way of asking that is David’s original question of whether they would consider those two patterns the same strain. As Uday pointed out, sometimes lack of or additional bands in the lower molecular weight region (i.e. <100k bp) can be due to plasmid or just poor band resolution in that region. It would be nice to know how they would interpret this situation of finding these two specific patterns in connection with a leftover product and a case-patient clinical isolate.
Stephanie Defibaugh-Chávez, Ph.D.
Microbiologist
Science Staff, Office of Public Health Science
Food Safety and Inspection Service
United States Department of Agriculture
202-690-6042 (office)
202-641-5540 (Blackberry)
202-690-6364 (fax)
email: [email protected]
Stay Connected with USDA:
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From: Green, Alice - FSIS Sent: Friday, October 25, 2013 1:13 PM To: Goldman, David - Commissioned Corps - FSIS; Dessai, Uday - FSIS Cc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
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The health department picked up 3 packages of FF product. There were no other suspect products noted. I’ll seek guidance from OSEL on pattern similarity between patterns 41 and 122.
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 11:46 AM To: Dessai, Uday - FSIS Cc: Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: Re: Positive chicken sample for S. Heidelberg patient
Thanks for the latest on the PFGE similarity. I am confused about the leftover products--I just assumed that the health dept picked any "suspect" product (meaning something eaten by the case and so a possible exposure). Given that 2 of the samples were negative, what other possibility is there except that the positive product led to the illness? Is CA aware of other chicken exposures that might complicate the picture?
If need be, would CDC say that these 2 patterns are so close that they may represent the same pathogen in this instance?
David P. Goldman, M.D., M.P.H.
Captain, USPHS
Assistant Administrator
Office of Public Health Science
Food Safety and Inspection Service
USDA
Room 341-E, Whitten Bldg.
1400 Independence Ave, SW
Washington, DC 20250
202-720-2644 (o)
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
202-690-2980 (f)
On Oct 25, 2013, at 12:33 PM, "Dessai, Uday - FSIS" <[email protected]> wrote:
Thx Alice!
The Two bands (I would imagine in low molecular weight region!) may need to be considered a method artifact in this instance – given both are very close and part of the OB.
Cheers!
Uday
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 12:26 PM To: Dessai, Uday - FSIS; Goldman, David - Commissioned Corps - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Hi Uday—
You are correct! I do want to emphasize that both are outbreak strains, and pattern 122 and pattern 41 are 94.4% similar, differing in only two bands.
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
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Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Dessai, Uday - FSIS Sent: Friday, October 25, 2013 11:20 AM To: Goldman, David - Commissioned Corps - FSIS; Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Hi Alice
It is interesting that although we have pattern O122 in the product, we are not sure of the three products, which one was consumed by the patient!
So we have diffferent patterns between patient and product and we are not sure which product (1/3 positive) was consumed – right!
Thx!
From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 12:11 PM To: Green, Alice - FSIS; Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: Re: Positive chicken sample for S. Heidelberg patient
Thanks Alice--just want to clarify; were all 5 subs pattern 122? If so, then are there more isolates to test? David Goldman, MD, MPH CAPT, USPHS Chief Medical Officer Assistant Administrator USDA-FSIS-OPHS 202-720-2644 -------------------------- Sent from my BlackBerry Wireless Handheld
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From: Green, Alice - FSIS Sent: Friday, October 25, 2013 12:08 PM To: Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS; Goldman, David - Commissioned Corps - FSIS Subject: FW: Positive chicken sample for S. Heidelberg patient
FYI—
PFGE table for tested products is below.
is the appropriate lab contact ( Pictures have use-by date of 03-29-2014. Product is frozen Kirkland Signature boneless skinless chicken tenders (mis-stated as chicken breast in my previous email).
Thanks much,
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Higa, Jeffrey (CDPH-CID-DCDC-IDB) [mailto:[email protected]] Sent: Friday, October 25, 2013 10:57 AM To: Green, Alice - FSIS; Kissler, Bonnie - FSIS; Robertson, Kis - FSIS; Allen, Latasha - Commissioned Corps - FSIS; [email protected]; [email protected]; [email protected]; [email protected]; [email protected] Cc: Needham, Michael (CDPH-DFDRS FDB); Hernandez, Michael (CDPH-DFDRS); Kennelly, Pat (CDPH-FDB); Peralta, Vi (CDPH-CID-DCDC-IDB); Kimura, Akiko (CDPH-CID-DCDC); Gilliss, Debra (CDPH-CID-DCDC-IDB) Subject: Positive chicken sample for S. Heidelberg patient
Hello USDA and CDC colleagues,
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On 10/9/2013, 3 open packages of Kirkland Signature Boneless, Skinless Chicken Tenderloins were collected from the home of S. Heidelberg pattern 0041 patient ). Our Food and Drug Lab tested chicken from all 3 packages. Chicken from one of packages was positive for Salmonella:
FDLB Sample ID
Product
Establishment #
Result
PulseNet Isolate #
184100913-P001
Kirkland Signature boneless, skinless Chicken tenderloins
P33901
negative for Salmonella
n/a
184100913-P002
Kirkland Signature boneless, skinless Chicken tenderloins
P6137A
(best by 3/29/2014)
· positive for Salmonella group B
· 5 of 10 subs positive
· PFGE pattern JF6X01.0122
CA2__CA2F13M00985PP2A1
184100913-P003
Kirkland Signature boneless, skinless Chicken tenderloins
P33901
negative for Salmonella
n/a
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Attached are pictures of the package for the positive chicken sample. The chicken isolate was pattern 0122 and the patient had pattern 0041. Unfortunately, all 3 packages were open and the specific package the patient had chicken from prior to illness onset could not be determined.
FDB, please correct me if any of the information above is inaccurate.
-Jeff
Jeffrey Higa, MPH
California Department of Public Health
Infectious Diseases Branch
Disease Investigations Section
19300 S. Hamilton Ave., Suite 140
Gardena, CA 90248
310-217-6906
310-217-6911 (fax)
[email protected] <mailto:[email protected]>
NOTICE of CONFIDENTIALITY: This E-mail is the property of the California Department of Public Health and contains information that may be PRIVILEGED, CONFIDENTIAL or otherwise exempt from disclosure by applicable law. It is intended only for the person(s) to whom it is addressed. If you receive this communication in error, please do not retain or distribute it. Please notify the sender immediately by E-mail at the address shown above and delete the original message.
From: Gieraltowski, Laura (CDC/OID/NCEZID) [[email protected]]Sent: Monday, October 28, 2013 2:23 PMTo: Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Kissler, Bonnie - FSIS; Robertson, Kis - FSISCc: Nakao, Jolene H. (CDC/OID/NCEZID); Schwensohn, Colin A. (CDC/OID/NCEZID)Subject: Re: NARMS chicken sample postive for S. Heidelberg
Thanks, Alice. This isolate was uploaded to PulseNet today.
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
From: Green, Alice - FSIS [mailto:[email protected]] Sent: Monday, October 28, 2013 03:20 PM Eastern Standard TimeTo: Defibaugh-Chavez, Stephanie - FSIS <[email protected]>; Kissler, Bonnie - FSIS <[email protected]>; Robertson, Kis - FSIS <[email protected]> Cc: Gieraltowski, Laura (CDC/OID/NCEZID); Nakao, Jolene H. (CDC/OID/NCEZID); Schwensohn, Colin A. (CDC/OID/NCEZID) Subject: FW: NARMS chicken sample postive for S. Heidelberg
FYI.
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Lofy, Kathy H (DOH) [mailto:[email protected]] Sent: Monday, October 28, 2013 1:22 PMTo: Green, Alice - FSISCc: Melius, Beth J (DOH); Stewart, Laurie K (DOH)Subject: NARMS chicken sample postive for S. Heidelberg
Hi Alice,
I want to let you know that routine meat testing in Washington for the NARMS program detected S. Heidelberg in a chicken sample. The label of this chicken sample is attached. It appears this chicken sample was processed at plant P-6137A (CA FF plant). The PulseNet PFGE pattern is not yet in our Washington database but I believe the pattern is XbaI JF6X01.0122. The isolate number is WA_19012.
Let us know if you need additional information.
Thanks
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Kathy
Kathy Lofy, M.D.
Medical Epidemiologist
Washington State Department of Health
Office of Communicable Disease Epidemiology
Phone: 206-418-5500
Public Health--Always Working for a Safer and Healthier Washington
This electronic message contains information generated by the USDA solely for the intended recipients. Any unauthorized interception of this message or the use or disclosure of the information it contains may violate the law and subject the violator to civil or criminal penalties. If you believe you have received this message in error, please notify the sender and delete the email immediately. From: Dessai, Uday - FSISSent: Monday, October 28, 2013 2:17 PMTo: Dessai, Uday - FSIS; Goldman, David - Commissioned Corps - FSIS; Kause, Janell - FSISCc: Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Douris, Aphrodite - FSIS; Defibaugh-Chavez, Stephanie - FSISSubject: RE: Positive chicken sample for S. Heidelberg patient
Also here are summary points from SDC email from Friday:
About case-patient ( traceback and FSIS intensified sampling:
The specific product identified is a boneless skinless chicken thigh product. It was collected at P6137A but was produced from source materials that originated from P7632 (slaughtered on 9/9/2013). StephanieDC had suggested in her Friday’s email to consider recalling all chicken products (including parts and whole chicken!) produced from birds slaughtered on 9/9/2013 at P7632 . This was based on the fact that 11 total product –positives were produced from source materials that originated from P7632 (slaughtered on 9/9/2013 and includes a variety of parts and whole/rotisserie chicken.
Thanks much!
Uday
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From: Dessai, Uday - FSIS Sent: Monday, October 28, 2013 8:57 AMTo: Goldman, David - Commissioned Corps - FSIS; Kause, Janell - FSISCc: Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Douris, Aphrodite - FSIS; Defibaugh-Chavez, Stephanie - FSISSubject: RE: Positive chicken sample for S. Heidelberg patient
HI David
Stephanie, Alice and Aphrodite are looking at the following two issues and here are our initial thoughts:
1) OIEA has established a compelling link in the Foster Farms illness outbreak investigation. Here are the details from
This revolves around The case patient shopper data and intensified sampling conducted at the three Foster farms facilities in California was utilized. The linkages are detailed below:
· tested for positive for PFGE 045, and the like sample collected on the same date, sample form ID number 100583269, as one of the pack dates is PFGE 045, which is the same PFGE pattern.
· The product purchased by the case patient and the like sample, Foster Farms boneless, skinless thighs, were slaughtered at P-7632 on 9/9/2013 and were processed/packed at P-6137A on 9/9/2013.
· There are other multiple sample positives for PFGE 45 at p-7632 and P-6137A on 9/9/2013, both parts and whole birds.
· SDC will look into this further….
2) P6137A PFGE pattern JF6X01.0122 (5/10 subs positive), additional 2 being tested for PFGEs; case patient has PFGE type 45
· Although:
o during the specpgm_02 Sept sampling there was a single positive with pattern .0122 from the same establishment
o the fact that mixed PFGE patterns can be found in the same sample
o There may be overwhelming indirect evidences..
o We cannot make a conclusive claim that there is a link between the patient and chicken samples recovered from the patients home
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o A close examination of the two band difference between 0122 and 45 shows that - these are distinctly different PFGE types (on the gel)
o We are awaiting the final results from the additional 2 PFGEs
o We are analyzing the hospitalization rate for the two PFGE types
o Etc.
Thanks much!
Uday
Yes, I would say that these two patterns are significantly different.
Aphrodite DourisMicrobiologistOutbreaks Section, Eastern LaboratoryFood Safety and Inspection ServiceThe United States Department of AgricultureRussell Research Center950 College Station RoadAthens, GA [email protected]: (706) 546-2330 FAX:(706)546-3144
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_____________________________________________
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From: Dessai, Uday - FSIS Sent: Friday, October 25, 2013 2:22 PMTo: Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg similarity matrix
Thx much Alice and Douris.
2 bands different (~ 200 and ~ 80 region) as I see it on the picture.
Douris – does the ~ 200 region band constitute a real diffence ! ( I would imagin yes!)
Thanks
What remains to be done
<<6002696219 FF Invoice.pdf>> <<Originating Spreadsheet Special 102413.xlsx>> <<2013-10-22_Phase1-Heidelbergs.xlsx>>
Hello,
We have a compelling link in the Foster Farms illness outbreak investigation. This revolves around The case patient shopper data and intensified sampling conducted at the three Foster farms facilities in California was utilized. The linkages are detailed below:
· tested for positive for PFGE 045, and the like sample collected on the same date, sample form ID number 100583269, as one of the pack dates is PFGE 045, which is the same PFGE pattern.
· The product purchased by the case patient and the like sample, Foster Farms boneless, skinless thighs, were slaughtered at P-7632 on 9/9/2013 and were processed/packed at P-6137A on 9/9/2013.
· There are other multiple sample positives for PFGE 45 at p-7632 and P-6137A on 9/9/2013, both parts and whole birds.
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I have attached invoice 6002696219 that shows the link in commerce between Foster Farms and the COSTCO store where the case patient purchased the product. I have also attached a spreadsheet titled “original Spreadsheet Special” that demonstrates the linkages between and the samples collected at Foster farms, and finally, I have attached the sample data spreadsheet that represents all samples collected at the three Foster farms facilities.
About the other CPs, are not as compelling:
Case patients – We could not make a connection between FSIS sampling dates for Est. 7632 & Est. 6137 for product comprising the load distributed to Costco, part of which may have been consumed by both case patients. Product from Est. 33900 was also included in the load to Costco.
Case patients – Product (Rotisserie Chicken) available on the purchase day consisted of seven Foster Farms invoices to Costco with several different slaughter and pack dates from Est. 7632, 6137, 6137A, and 33900. Positive test results, PFGE pattern 258, from FSIS sampling with slaughter dates of; 9/7, 9/9, 9/10, 9/11, and 9/17, taken at Est. 6137 and 6137A made up part of the product included on the invoices.
Case patient – OIEA is still waiting on California for membership card information.
Case patient - OIEA is still waiting on California for additional purchase dates.
Case patients – Product (Rotisserie Chicken) available on the day of purchase consisted of a single invoice from Foster Farms to Costco. Product represented on the invoice originated from Est. P-7632 and P-33900. Positive test results, PFGE pattern 258, from FSIS sampling with a slaughter date of 9/9 from Est. 7632 comprised part of the load.
The CCMS patient in NV:
OPHS spoke with complainant as did OIEA’s investigator. Review labs – CBC- WNL, Chemistry Profile – Elevated liver enzymes, Stool Sample negative for Salmonella, Shigella and Campy. He might give us some of the sample but not all of it. We are concerned about how we would do that.
Alice and SDC pl:
Isolate numbers
Types of parts, production/analysis dates and PFGEs
PFGE Types
P1
P2
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P3
P4
P5
whole
Patient info
1?
NA
NA
NA
NA
NA
NA
Product info
5 each (!)
OB/PFGE types
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Note: Same or different PFGE types can be found in a given sample. And the prevalence of a PFGE type in the enriched medium, does not in any fashion or manner indicates absence of other PFGE types in the product.
From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 3:35 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSISSubject: Re: Positive chicken sample for S. Heidelberg patient
Good idea(s). We do need to figure this one out--I think I heard that FDA will sequence these strains. I would appreciate a separate discussion so that I understand how much we can learn about the genetic profile and phenotypic expression from this sequencing.
David P. Goldman, M.D., M.P.H.
Captain, USPHS
Assistant Administrator
Office of Public Health Science
Food Safety and Inspection Service
USDA
Room 341-E, Whitten Bldg.
1400 Independence Ave, SW
Washington, DC 20250
202-720-2644 (o)
202-690-2980 (f)
On Oct 25, 2013, at 1:34 PM, "Dessai, Uday - FSIS" <[email protected]> wrote:
Good point SDC
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Just a thought: Looks like there is a lot happening I Heidelberg genome.. For instance in the heidelbergs associated with this O/B, the virulence factors may be (just may be) up regulated for some reason... Alice and team: is it possible to tabulate rate of hospitalization for different PFGE types (if numbers are available!) Thx
From: Defibaugh-Chavez, Stephanie - FSIS Sent: Friday, October 25, 2013 01:18 PM To: Green, Alice - FSIS; Goldman, David - Commissioned Corps - FSIS; Dessai, Uday - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Can we also follow-up with CDC to see if they included pattern 0041 in the cluster because of similarity to 0122? An alternative way of asking that is David’s original question of whether they would consider those two patterns the same strain. As Uday pointed out, sometimes lack of or additional bands in the lower molecular weight region (i.e. <100k bp) can be due to plasmid or just poor band resolution in that region. It would be nice to know how they would interpret this situation of finding these two specific patterns in connection with a leftover product and a case-patient clinical isolate.
Stephanie Defibaugh-Chávez, Ph.D.
Microbiologist
Science Staff, Office of Public Health Science
Food Safety and Inspection Service
United States Department of Agriculture
202-690-6042 (office)
202-641-5540 (Blackberry)
202-690-6364 (fax)
email: [email protected]
Stay Connected with USDA:
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From: Green, Alice - FSIS Sent: Friday, October 25, 2013 1:13 PM To: Goldman, David - Commissioned Corps - FSIS; Dessai, Uday - FSIS Cc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
The health department picked up 3 packages of FF product. There were no other suspect products noted. I’ll seek guidance from OSEL on pattern similarity between patterns 41 and 122.
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 11:46 AM To: Dessai, Uday - FSIS Cc: Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: Re: Positive chicken sample for S. Heidelberg patient
Thanks for the latest on the PFGE similarity. I am confused about the leftover products--I just assumed that the health dept picked any "suspect" product (meaning something eaten by the case and so a possible exposure). Given that 2 of the samples were negative, what other possibility is there except that the positive product led to the illness? Is CA aware of other chicken exposures that might complicate the picture?
If need be, would CDC say that these 2 patterns are so close that they may represent the same pathogen in this instance?
David P. Goldman, M.D., M.P.H.
Captain, USPHS
Assistant Administrator
Office of Public Health Science
Food Safety and Inspection Service
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USDA
Room 341-E, Whitten Bldg.
1400 Independence Ave, SW
Washington, DC 20250
202-720-2644 (o)
202-690-2980 (f)
On Oct 25, 2013, at 12:33 PM, "Dessai, Uday - FSIS" <[email protected]> wrote:
Thx Alice!
The Two bands (I would imagine in low molecular weight region!) may need to be considered a method artifact in this instance – given both are very close and part of the OB.
Cheers!
Uday
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 12:26 PM To: Dessai, Uday - FSIS; Goldman, David - Commissioned Corps - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Hi Uday—
You are correct! I do want to emphasize that both are outbreak strains, and pattern 122 and pattern 41 are 94.4% similar, differing in only two bands.
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Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Dessai, Uday - FSIS Sent: Friday, October 25, 2013 11:20 AM To: Goldman, David - Commissioned Corps - FSIS; Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Hi Alice
It is interesting that although we have pattern O122 in the product, we are not sure of the three products, which one was consumed by the patient!
So we have diffferent patterns between patient and product and we are not sure which product (1/3 positive) was consumed – right!
Thx!
From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 12:11 PM To: Green, Alice - FSIS; Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: Re: Positive chicken sample for S. Heidelberg patient
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Thanks Alice--just want to clarify; were all 5 subs pattern 122? If so, then are there more isolates to test? David Goldman, MD, MPH CAPT, USPHS Chief Medical Officer Assistant Administrator USDA-FSIS-OPHS 202-720-2644 -------------------------- Sent from my BlackBerry Wireless Handheld
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 12:08 PM To: Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS; Goldman, David - Commissioned Corps - FSIS Subject: FW: Positive chicken sample for S. Heidelberg patient
FYI—
PFGE table for tested products is below.
is the appropriate lab contact ( Pictures have use-by date of 03-29-2014. Product is frozen Kirkland Signature boneless skinless chicken tenders (mis-stated as chicken breast in my previous email).
Thanks much,
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
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From: Higa, Jeffrey (CDPH-CID-DCDC-IDB) [mailto:[email protected]] Sent: Friday, October 25, 2013 10:57 AM To: Green, Alice - FSIS; Kissler, Bonnie - FSIS; Robertson, Kis - FSIS; Allen, Latasha - Commissioned Corps - FSIS; [email protected]; [email protected]; [email protected]; [email protected]; [email protected] Cc: Needham, Michael (CDPH-DFDRS FDB); Hernandez, Michael (CDPH-DFDRS); Kennelly, Pat (CDPH-FDB); Peralta, Vi (CDPH-CID-DCDC-IDB); Kimura, Akiko (CDPH-CID-DCDC); Gilliss, Debra (CDPH-CID-DCDC-IDB) Subject: Positive chicken sample for S. Heidelberg patient
Hello USDA and CDC colleagues,
On 10/9/2013, 3 open packages of Kirkland Signature Boneless, Skinless Chicken Tenderloins were collected from the home of S. Heidelberg pattern 0041 patient Our Food and Drug Lab tested chicken from all 3 packages. Chicken from one of packages was positive for Salmonella:
FDLB Sample ID
Product
Establishment #
Result
PulseNet Isolate #
184100913-P001
Kirkland Signature boneless, skinless Chicken tenderloins
P33901
negative for Salmonella
n/a
184100913-P002
Kirkland Signature boneless, skinless Chicken tenderloins
P6137A
(best by 3/29/2014)
· positive for Salmonella group B
· 5 of 10 subs positive
· PFGE pattern JF6X01.0122
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CA2__CA2F13M00985PP2A1
184100913-P003
Kirkland Signature boneless, skinless Chicken tenderloins
P33901
negative for Salmonella
n/a
Attached are pictures of the package for the positive chicken sample. The chicken isolate was pattern 0122 and the patient had pattern 0041. Unfortunately, all 3 packages were open and the specific package the patient had chicken from prior to illness onset could not be determined.
FDB, please correct me if any of the information above is inaccurate.
-Jeff
Jeffrey Higa, MPH
California Department of Public Health
Infectious Diseases Branch
Disease Investigations Section
19300 S. Hamilton Ave., Suite 140
Gardena, CA 90248
310-217-6906
310-217-6911 (fax)
[email protected] <mailto:[email protected]>
NOTICE of CONFIDENTIALITY: This E-mail is the property of the California Department of Public Health and contains information that may be PRIVILEGED, CONFIDENTIAL or otherwise exempt from disclosure by applicable law. It is intended only for the person(s) to whom it is addressed. If you receive this communication in
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error, please do not retain or distribute it. Please notify the sender immediately by E-mail at the address shown above and delete the original message.
From: Peralta, Vi (CDPH-CID-DCDC-IDB) [[email protected]]Sent: Monday, October 28, 2013 1:33 PMTo: Green, Alice - FSISCc: Higa, Jeffrey (CDPH-CID-DCDC-IDB); Kimura, Akiko (CDPH-CID-DCDC)Subject: RE: One Costco shopper history, etc.
Hi Alice,
Yes, I finally have hot water again and it’s been glorious!
Thank you for the record. As for an update call, unfortunately Tuesday will not work for us as there is a conference that all 3 of us will be attending/participating in at various times of the day. We’ve got a few meetings on Wednesday as well. Thursday morning may work. Do you want to send us specific times on Wednesday and Thursday that you can do and maybe we can choose among those options?
Also, FYI, I spoke to my contact at Ralphs (part of the Kroger family) on Friday because one of our cases granted us written consent to obtain their records (however it was on our form and asked Ralphs to release the records to me) and the Ralphs representative said that Krogers is now very strict about releasing records. They indicated that since the chicken recall, Krogers is requiring that consent forms must be notarized and that they will not release records except under a court order or subpoena.
Vi
From: Green, Alice - FSIS [mailto:[email protected]] Sent: Monday, October 28, 2013 11:04 AMTo: Peralta, Vi (CDPH-CID-DCDC-IDB)Cc: Higa, Jeffrey (CDPH-CID-DCDC-IDB); Kimura, Akiko (CDPH-CID-DCDC)Subject: One Costco shopper history, etc.
Hi Vi—
Good morning! I hope you have hot water at home.
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I checked in with our investigators regarding the most recent outstanding shopper history list. Apparently this is the only one we’ve received and the others are still pending or need to be requested.
Would you guys like to try and schedule an update call for tomorrow or Wednesday? Also I am not sure the forms I sent last week really addressed your questions regarding Sam’s and Raley’s. Maybe we can chat a bit about that tomorrow too. When I responded to you last Wednesday, I was kind of muddled after the long Tuesday revolving around the MN Costco ground beef recall.
Thanks much,
Alice
This electronic message contains information generated by the USDA solely for the intended recipients. Any unauthorized interception of this message or the use or disclosure of the information it contains may violate the law and subject the violator to civil or criminal penalties. If you believe you have received this message in error, please notify the sender and delete the email immediately.
From: Lofy, Kathy H (DOH) [[email protected]]Sent: Monday, October 28, 2013 1:22 PMTo: Green, Alice - FSISCc: Melius, Beth J (DOH); Stewart, Laurie K (DOH)Subject: NARMS chicken sample postive for S. HeidelbergAttachments: F13-486.JPG
Hi Alice,
I want to let you know that routine meat testing in Washington for the NARMS program detected S. Heidelberg in a chicken sample. The label of this chicken sample is attached. It appears this chicken sample was processed at plant P-6137A (CA FF plant). The PulseNet PFGE pattern is not yet in our Washington database but I believe the pattern is XbaI JF6X01.0122. The isolate number is WA_19012.
Let us know if you need additional information.
Thanks
Kathy
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Kathy Lofy, M.D.
Medical Epidemiologist
Washington State Department of Health
Office of Communicable Disease Epidemiology
Phone: 206-418-5500
Public Health--Always Working for a Safer and Healthier Washington
From: - FSISSent: Monday, October 28, 2013 1:03 PMTo: Green, Alice - FSIS; Leskowsky, Robert - FSIS; Atkinson, Richard - FSISCc: Kissler, Bonnie - FSISSubject: RE:
Okay, will do
Compliance InvestigatorUSDA/FSIS/OIEA/CID19110 Bothell Way NE, Suite #201Bothell, WA 98011Office: Cell: Fax: (425) 483-3492
fsis.usda.gov
PREDECISIONAL - NOT FOR COPY OR FURTHER DISTRIBUTION"This electronic message contains information generated by the USDA solely for the intended recipients. Any unauthorized interception of this message or the use or disclosure of the information it contains may violate the law and subject the violator to civil or criminal penalties. If you believe you have received this message in error, please notify the sender and delete the email immediately."
_____________________________________________From: Green, Alice - FSIS Sent: Monday, October 28, 2013 10:45 AMTo: Leskowsky, Robert - FSIS; - FSIS; Atkinson, Richard - FSISCc: Kissler, Bonnie - FSISSubject: CDC_067
Hi
Let me modify that last email. I've renamed the shopper history for . Can you please redact and
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upload it to the IR? I want to be sure you guys have the numbers you need.
Thank you,Alice
<< File: Safeway .xls >>
Alice L. Green, MS, DVM Public Health and Epidemiology LiaisonOffice of Public Health Science | Food Safety and Inspection Service | U.S. Department of AgricultureButler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected]
From: Kissler, Bonnie - FSISSent: Monday, October 28, 2013 12:08 PMTo: Robertson, Kis - FSIS; Allen, Latasha - Commissioned Corps - FSIS; Green, Alice - FSISSubject: FW: Foster Farms system wide strategy
FYI -- sorry if this is duplication.
Bonnie KisslerSenior EpidemiologistUSDA, FSIS, OPHS, AESc/o Centers for Disease Control and Prevention1600 Clifton Road, NE, MS A-38Building 24, Room 10203Atlanta, GA 30329Office: 404.639.5012Blackberry: 404.661.6640Fax: 404.718.2126Email: [email protected] <mailto:[email protected]>
From: Gomez, Thomas M. (CDC/OID/NCEZID) [mailto:[email protected]] Sent: Monday, October 28, 2013 12:49 PMTo: Gieraltowski, Laura (CDC/OID/NCEZID); Wise, Matthew E. (CDC/OID/NCEZID); Barton Behravesh, Casey (CDC/OID/NCEZID); Williams, Ian (CDC/OID/NCEZID); Tauxe, Robert V. (CDC/OID/NCEZID); Braden, Chris (CDC/OID/NCEZID); Liang, Arthur P. (CDC/OID/NCEZID); Kissler, Bonnie - FSIS; Basu, Pat - FSIS; [email protected]; Goldman, David - Commissioned Corps - FSIS; Annelli, Joseph F - APHIS; Rooney, Jane A - APHIS; McCluskey, Brian J - APHISCc: [email protected]: Foster Farms system wide strategy
All - FYI, the following was provided today by Dr. Richard Breitmeyer, Director, California Animal Health and Food Safety Laboratory System --
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Tom, this was in Friday's Meatingplace, an industry newsletter:
In an interview with Meatingplace, Dr. Robert O'Connor, Foster Farms senior vice president of technical services, detailed the changes the company is making at every level, from the breeder flocks through growout and processing.
* The company has vaccinated its breeder flocks at the pullet level since 2006, he said, but has switched to a vaccine that is more specific for Salmonella heidelberg, the strain that is responsible for the recent outbreak. He said that Dr. Charles Hofacre of the University of Georgia, who has published research on vaccination to control Salmonella in chickens, is serving as a consultant to the company.
* "Competitive exclusion" products are being used in both water and feed for both breeders and broilers to help fill their systems with benign microorganisms and crowd out potentially pathogenic bacteria.
* The company is requiring its supplier of replacement breeder pullets to certify that they are Salmonella-free. Foster has had this as a general rule for some years but is now putting the specification into contracts with the supplier, O'Connor said.
* Treatments are being used to try to reduce the prevalence of Salmonella and other microorganisms in the barns on the company-owned ranch on which broilers are raised to market weight, focusing on the litter that covers the floors of the structures.
"We are acidifying the bedding to make it less hospitable to the Salmonella organism," O'Connor said. The bedding is replaced after every third flock, he said. The birds' drinking water is also being treated with an acidifier to discourage bacterial growth, he added.
* In the processing plants, equipment, food contact surfaces, knives, workers' gear, and other places where contamination might occur are being subjected to "enhanced sanitization" and cleaned more frequently.
"We're putting a very heavy emphasis on operational sanitation," O'Connor said. He said the company aims to make the slaughter processing area of the plants "more like a ready-to-eat (product) environment" in terms of microbial status.
* The company is also implementing interventions to reduce microbial contamination of the carcasses as they move through processing.
"We are enhancing the sanitization of bird throughout the process," O'Connor said. "Where we have the opportunity to erect a hurdle, we are erecting a hurdle. We are enhancing sanitation across the board."
O'Connor said changes are being made in all five of the company's processing plants: three in California, one in Louisiana, and one in Washington.
"We are not going to stop at one plant," he said.
USDA's Food Safety & Inspection Service had threatened to withdraw its inspectors from the three California plants, effectively suspending their operations, unless changes were made.
##
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Thomas M. Gomez DVM, MS
USDA, APHIS, Veterinary Services Liaison to CDC
One Health Coordination Office, USDA:APHIS:VS
1600 Clifton Road, NE Mailstop A-38
Building 24, room 10105
Atlanta, GA 30329
office: 404-639-3233
cell:
e-mail: [email protected]
From: Defibaugh-Chavez, Stephanie - FSISSent: Monday, October 28, 2013 10:56 AMTo: Atkinson, Richard - FSIS; Green, Alice - FSISCc: - FSIS; Leskowsky, Robert - FSISSubject: RE: Week of October 28, 2013
I’ll try to get an update to you on Phase 2 positives today so you guys know what we’ve got so far…-Stephanie
Stephanie Defibaugh-Chávez, Ph.D.MicrobiologistScience Staff, Office of Public Health ScienceFood Safety and Inspection ServiceUnited States Department of Agriculture202-690-6042 (office)202-641-5540 (Blackberry)202-690-6364 (fax)email: [email protected]
Stay Connected with USDA: <http://www.facebook.com/usda> <http://www.twitter.com/usda> <http://www.youtube.com/usda>
_____________________________________________From: Atkinson, Richard - FSIS Sent: Monday, October 28, 2013 11:19 AMTo: Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSISCc: - FSIS; Leskowsky, Robert - FSISSubject: Week of October 28, 2013
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Hello,I will be out of the office this week. Robert Leskowsky will cover for me, and is still the lead for the FF illness outbreak. Any results from Phase Two FF sampling?Thank you.
Richard AtkinsonSupervisory InvestigatorCO, NM, WY, MT, ID, UT, NV, WA, AKUSDA, FSIS, OIEA, CIDDenver Sub-Region1 Denver Federal CenterBuilding 45, S-3Mail:P.O. Box 25387Denver, Colorado 80225-0387Office 303-236-9860Fax 303-236-9858Cell 303-618-5006
PREDECISIONAL NOT FOR COPY OR FURTHER DISTRIBUTIONThis electronic message contains information generated by theUSDA solely for the intended recipients. Any unauthorizedinterception of this message or the use or disclosure of theinformation it contains may violate the law and subject the violator tocivil or criminal penalties. If you believe you have received thismessage in error, please notify the sender and delete the emailimmediately.
From: Kissler, Bonnie - FSISSent: Monday, October 28, 2013 10:15 AMTo: FSIS - OPHS/HHSD; Fore, Sandra - FSISSubject: Investigations Team Daily 10/28/2013
In the Office (at meeting): LA, AG, TI, BK, KR, KS, PW
Out of Office Plans:
BK: 11/20/13-11/22/13
Investigations (active investigation; possible involvement of FSIS-regulated product):
* Multistate Salmonella Heidelberg cluster associated with chicken, FDIB# 2013-14 - Alice Green
* 349 case-patients from 20 states and PR (1-AK, 1-AR, 14-AZ, 257-CA, 6-CO, 1-CT, 4-FL, 3-ID, 1-KY, 3-MI,
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5-MO, 1-NC, 2-NM, 9-NV, 9-OR, 1-PR, 11-TX, 2-UT, 2-VA, 15-WA, 1-WI)
* Case definition: Person with Salmonella Heidelberg infection, with illness onset (or isolation, if onset date unknown) on 3/1/13 - present, and with isolate matching PFGE XbaI pattern JF6X01.0258, JF6X01.0045, JF6X01.0041, JF6X01.0672, JF6X01.0122, or JFX601.0326, or CA case-patient with PFGE pattern JF6X01.0022
* Onset dates: 3/2/13 - 10/7/13*
* Hospitalizations: 97/257 (38%)
* Deaths: 0
* Exposure: 134/190 (71%) consumed chicken prepared at home
* NARMS (clinical): Results available on 5 JF6X01.0258 clinical isolates (3-MDR; 2-pansusceptible); results available on 3 pattern JF6X01.0045 clinical isolates (2-MDR, 1-pansusceptible)
* NARMS (retail): 3 CA company A (establishment A1) retail chicken isolates from 2013 with PFGE patterns JF6X01.0258, JF6X01.0041, and JF6X01.0022 are MDR
* Leftover product: WA collected leftover chicken from 2 case-patients' homes for testing; results are negative for 1; 2nd WA leftover chicken product for which shopper card has been shared with OIEA is confirmed positive for Salmonella Heidelberg, PFGE is indistinguishable from case-patient's (JF6X01.0672). CA collected leftover chicken from 3 case-patients' homes for testing; results are negative. One product (from establishment A4 in Louisiana) was most likely consumed several weeks prior to illness onset. Leftover rotisserie chicken collected from CA case-patient tested positive for Salmonella Heidelberg with PFGE pattern JF6X01.0258.
* FSIS AMR results: 2 CA company A (establishments A2 and A3) ground chicken isolates from 2013 with PFGE pattern JF6X01.0258 are MDR; 2 CA company A (establishment A2) chicken parts isolates from 2012 with PFGE pattern JF6X01.0326 are pan-susceptible
* FSIS intensified testing: Ongoing data collection and summarization in progress
* CDC cluster code: 1306MLJF6-1
* PFGE patterns (ranking as of 6/30/13): JF6X01.0258 (not in top 10), JF6X01.0045 (ranked 9th), JF6X01.0041 (ranked 7th), JF6X01.0672 (new), JF6X01.0022 (ranked 1st), JF6X01.0122 (ranked 3rd), JFX601.0326 (ranked 6th)
* FIMS number: 20130703-01
* Recall: FSIS-RC-058-2013; recall expansion 10/17/13
Summary: Currently, there are 349 case-patients from 20 states and PR. PFGE patterns JF6X01.0258, JF6X01.0045, JF6X01.0041, JF6X01.0672, JF6X01.0022, JF6X01.0122, and JFX601.0326 have been combined by CDC as 1 cluster; 97 case-patients have been hospitalized; 134/190 (71%) consumed chicken prepared at home prior to illness onset. On 9/30/13, CA identified sub-clusters of 50 illnesses (36 lab confirmed) possibly linked to rotisserie chicken in San Mateo. Sampling at 4 Company A establishments completed on 9/23/13; 3 establishments were issued NOIEs on 10/7/13. FSIS issued a public health alert on 10/7/13. Leftover rotisserie chicken collected from CA case-patients tested positive for Salmonella Heidelberg with PFGE pattern JF6X01.0258. Costco's El Camino Real store in South San Francisco, CA recalled 9,043 units (approximately 39,755 lbs.)of rotisserie chicken products on 10/12/13. Retail product collected by CA tested positive for Salmonella Heidelberg with PFGE pattern JF6X01.0258, a recall expansion (14,093 units) based on these results was issued 10/17/13.
FSIS: Continue sampling at 5 Company A establishments; analyze sampling results; work with CDC and states to
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gather epidemiologic and product information; traceback ongoing
* Tennessee University Chattanooga Salmonella Enteritidis and Campylobacter jejuni outbreak possibly associated with ground chicken product, FDIB# 2013-18 - Latasha Allen
* 25 (9 lab confirmed) case-patients
* Case definition: Pending
* Onset dates: 8/20/13 - 8/29/13
* Hospitalizations: 0
* Deaths: 0
* Exposure: 23 students and 2 staff members reported being ill after eating at the food service facilities on campus; 7 cases reported consumption of a stuffed pepper meal
* Product: Chicken dish was prepared with ground chicken; positive for SE and Campy with PFGE patterns matching outbreak strain
* CDC cluster code: N/A
* PFGE: JEGX01.0021 and JEGX01.0023 (Salmonella Enteritidis), both are common patterns; pattern for Campylobacter jejuni is DBRS16.0218
* MLVA: N/A
* FIMS number: 20130920-01
* Recall: N/A
Summary: There are 25 reported ill persons who were patrons of the food service facilities on the Tennessee University (UTC) campus in Chattanooga, TN. Epidemiologic information indicates that stuffed peppers containing ground chicken was served and consumed by 7 patrons to the cafeteria. 4/9 case-patients have been confirmed to be co-infected with Salmonella Enteritidis and Campylobacter jejuni; 3/9 case-patients are only infected with Salmonella Enteritidis; 2/9 case-patients are only infected with Campylobacter jejuni. Two PFGE patterns, JEGX01.0021 and JEGX01.0023, are from Salmonella Enteritidis isolates. The PFGE pattern for Campylobacter jejuni is DBRS16.0218. TN Health Department collected an intact chub chicken (ground chicken) sample from the cafeteria for testing and results are positive for Salmonella Enteritidis PFGE pattern JEGX01.0021 and Campylobacter jejuni PFGE pattern DBRS16.0218 and DBRS16.0008. Traceback information shows that the ground chicken chub tested was produced by Establishment B in Sedalia, MO. OIEA investigation determined that this product was distributed to UTC on 8/9/13 and 8/16/13 and used to prepare the stuffed peppers on 8/20/13. USDA (Buffalo Style Chicken Sausage) sample collected on 8/13/13 from Establishment C, in Woburn, MA tested positive for Salmonella Enteritidis with PFGE pattern JEGX01.0021, matching one of the outbreak patterns. USDA (ground chicken) sample collected on 8/7/13 from Establishment D, in Waco, TX tested positive for Campylobacter jejuni with PFGE pattern DBRS16.0008, matching one of the patterns seen in the positive intact product. Environmental assessment conducted by TN showed potential for cross-contamination.
OPHS: Work with state and CDC to gather additional detail epidemiologic information
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* Minnesota E. coli O157:H7 illness associated with ground beef consumption, FDI# 2014-03 - Alice Green
* 1 case-patient
* Onset date: 9/29/13
* Hospitalization: 0
* Death: 0
* Exposure: Ground beef purchased from a wholesale chain on 9/6/13; product was 88/12 ground beef, as documented by the purchase receipt
* CDC cluster code: N/A
* PFGE: EXHX01.0074/EXHA26.0569, common
* MLVA: Pending
* FIMS number: N/A
* Recall: FSIS-RC-060-2013
Summary: There is one case-patient with illness onset 9/29/13. Tested leftover ground beef is positive for E. coli O157:H7 matching the outbreak strain. A Costco in Coon Rapids, MN issued a retail recall of 838 units 88% lean fresh ground beef products on 10/22/13. This illness has the same PFGE pattern combination as a multistate cluster for which CDC is currently gathering epi information.
OPHS: Work with CDC and state to gather additional epidemiologic information
Watches (following public health partner investigation; not sure if FSIS-regulated product is involved):
* Multistate Salmonella Typhimurium cluster possibly associated with beef, FDI# 2014-01 - Latasha Allen
* 28 case-patients in 8 states (8-CA, 3-ID, 1- IA, 1- MN, 2-NE, 1- NC, 7-OR, 5-UT)
* Case definition: Person with Salmonella Typhimurium infection with an onset date after 7/13/13 (or isolate date after 7/20/13 if onset date information is not available), and Isolate matching PFGE Xbal pattern JPXX01.2350
* Onset dates: 7/19/13- 10/7/13*
* Isolation dates: 7/22/13 - 10/10/13
* Hospitalizations: 0
* Deaths: 0
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* Exposure: 2/8 (25%) report carne asada; 5/8 (63%) report beef, 2/5 (40%) report fresh killed whole cow from farm, 3/8 (38%) report exposure to farm animals
* Product/animal: 2 ground beef isolates from OH (8/13/13 and 8/20/13); 1 isolate from OR was stool from a dairy cow (9/6/13)
* CDC cluster code: 1310MLJPX-1
* PFGE: JPXX01.2350 (comprises 0.38%, 9348/91616)
* MLVA: N/A
* FIMS number: N/A
* Recall: N/A
Summary: There are 28 ill persons reported in 8 states possibly associated with the consumption of beef carne asada. 2/8 report carne asada, 5/8 case-patients report consumption of beef, 2/5 report fresh killed whole cow from farm, 3/8 farm animal exposure, 3/8 watermelon, and 3/8 banana. There are two ground beef isolates that tested positive for Salmonella. Preliminary epidemiologic information indicated that food items containing beef are possibly associated with the outbreak. OPHS has been in contact with CDC, who is following this cluster of illnesses, and additional epidemiologic information is pending.
OPHS: Work with CDC to gather additional epidemiologic information
* Ohio Salmonella I 4, [5],12:i-: cluster possibly associated with an Ohio restaurant, FDI# 2014-02 - Latasha Allen
* 27 case-patients (18 lab confirmed)
* Case definition: Pending
* Onset dates: 9/10/13 - 9/18/13
* Hospitalizations: 0
* Deaths: 0
* Exposure: Prime rib with au jus served at the restaurant (au jus is similar to gravy)
* Product: Prime rib sample tested positive for Salmonella, 2 samples taken from restaurant tested positive
* CDC cluster code: 1210OHJPX-1
* PFGE: JPXX01.0026
* MLVA: N/A
* FIMS number: N/A
* Recall: N/A
Summary: There are 18 lab confirmed case-patients who became ill after dining and consuming prime ribs at a Fulton
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County, OH restaurant. The age range for case-patients is between 24 and 79 years. A leftover food sample (prime rib w/ au jus) collected from a case-patient's refrigerator tested positive for Salmonella matching the outbreak strain. Neither prime rib without au jus nor au jus without prime rib were available for testing alone and the two could not be separated in the data analysis as all prime rib is served with au jus poured on top. A case-control study conducted by the state using well meal companions as controls revealed the prime rib and the au jus were statistically significant for illness association.
OPHS: Work with state to gather additional epidemiologic information
*CDC last estimated onset date = 3 days before the isolation date
Bonnie KisslerSenior EpidemiologistUSDA, FSIS, OPHS, AESc/o Centers for Disease Control and Prevention1600 Clifton Road, NE, MS A-38Building 24, Room 10203Atlanta, GA 30329Office: 404.639.5012Blackberry: 404.661.6640Fax: 404.718.2126Email: [email protected] <mailto:[email protected]>
From: Elliott, Jerry - FSISSent: Monday, October 28, 2013 9:20 AMTo: Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Atkinson, Richard - FSIS; Hori, David - FSIS; Leskowsky, Robert - FSISCc: Khroustalev, Allison - FSISSubject: RE: chicken salad - RE: new MI match: Salmonella Heidelberg 1306MLJF6-1 outbreak
I am looping in the team from the Western Region to see if they are still looking at this info for non-FF related Sal.
Jerry L. Elliott DVMDirector - Compliance and Investigations DivisionUSDA, FSIS, OIEA, CID
Acting Director Import Inspection Management Division
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USDA, FSIS, OFO, IIMD
1400 Independence Ave SW Rm 2149Washington DC 20250 Office [email protected] <mailto:[email protected]>
From: Green, Alice - FSIS Sent: Thursday, October 24, 2013 4:15 PMTo: Elliott, Jerry - FSIS; Defibaugh-Chavez, Stephanie - FSISSubject: FW: chicken salad - RE: new MI match: Salmonella Heidelberg 1306MLJF6-1 outbreak
Jerry and Stephanie-
I know there's been some interest in non-Foster Farms follow-up. Please let me know how you'd like to proceed.
Thanks,
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Bidol, Sally (DCH) [mailto:[email protected]] Sent: Thursday, October 24, 2013 2:14 PMTo: 'Gieraltowski, Laura (CDC/OID/NCEZID)'; Green, Alice - FSISCc: Barton Behravesh, Casey (CDC/OID/NCEZID); Wise, Matthew E. (CDC/OID/NCEZID); Nakao, Jolene H. (CDC/OID/NCEZID); Schwensohn, Colin A. (CDC/OID/NCEZID); Arends, Katherine (DCH); Bohm, Susan (DCH)Subject: chicken salad - RE: new MI match: Salmonella Heidelberg 1306MLJF6-1 outbreak
Hi Laura and Alice,
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The case household did not have any purchase receipts for the chicken salad but we have obtained the shopper card information from the household. This has been shared with our State Ag partners (MDARD). Is there anyone else within FSIS that should be looped in on this?
Regarding leftover product testing, the household did have some leftover chicken salad in the original deli container which is being collected for testing at our state lab. We'll share photos of the container once we get them. Our lab plans to set the sample up for testing on Monday, unless you feel that it needs to be tested over the weekend; please let us know your thoughts about the urgency of the testing.
Based on some preliminary followup by MDARD at the Kroger store, this outlet uses either of the following for its rotisserie chicken salad:
1) rotisserie chicken breast meat-savory fully cooked from Kroger distribution but originating from Good Heart Specialty Foods 11122 Nacogdoches Rd San Antonio Tx, 78217 USDA Plant P20481A
2) raw chicken from Kroger distribution that originates from Pilgrim's Pride, Greenly, Co 80634
--Sally
From: Gieraltowski, Laura (CDC/OID/NCEZID) [mailto:[email protected]] Sent: Wednesday, October 23, 2013 10:37 AMTo: Bidol, Sally (DCH); Nakao, Jolene H. (CDC/OID/NCEZID)Cc: Barton Behravesh, Casey (CDC/OID/NCEZID); Wise, Matthew E. (CDC/OID/NCEZID); Schwensohn, Colin A. (CDC/OID/NCEZID); Arends, Katherine (DCH); Bohm, Susan (DCH)Subject: RE: new MI match: Salmonella Heidelberg 1306MLJF6-1 outbreak
Thanks, Sally.
I think you should go ahead and get the shopper card information and receipt now. We know that Kroger stores receive FF chicken. It might be useful for FSIS to have the shopper card in order to verify whether or not the MI Kroger stores use FF for their rotisserie.
Thanks!
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Laura
Laura B. Gieraltowski, PhD, MPHLCDR, US Public Health ServiceDoctoral EpidemiologistOutbreak Response and Prevention Branch Division of Foodborne, Waterborne and Environmental Diseases
National Center for Emerging and Zoonotic Infectious Diseases
Centers for Disease Control and Prevention1600 Clifton Road, MS A-38Atlanta, GA 30329 Phone: (404)639-3868 Fax: (404)718-2126
From: Bidol, Sally (DCH) [mailto:[email protected]] Sent: Wednesday, October 23, 2013 10:33 AMTo: Nakao, Jolene H. (CDC/OID/NCEZID)Cc: Barton Behravesh, Casey (CDC/OID/NCEZID); Gieraltowski, Laura (CDC/OID/NCEZID); Wise, Matthew E. (CDC/OID/NCEZID); Schwensohn, Colin A. (CDC/OID/NCEZID); Arends, Katherine (DCH); Bohm, Susan (DCH)Subject: new MI match: Salmonella Heidelberg 1306MLJF6-1 outbreak
Hi Jolene,
Wanted to give you a heads up that we have a new match to pattern JF6X01.0045:
MI_CL13-174980 (stool coll 10/8); 81 yo F with symptom onset 10/2/2013, hosp x 7D. She reported eating rotisserie chicken salad on 10/1 from a local Kroger store in the Detroit metro area. We've advised our State Ag partners.
If it should be determined that the store uses FF chicken for their rotisserie chicken, we can see whether the household has any purchase receipts or uses a Kroger shopper card. We're also checking to see if the patient may have any leftover chicken salad for possible testing at our lab.
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Other thoughts or suggestions?
Thanks, --Sally
From: Nakao, Jolene H. (CDC/OID/NCEZID) [mailto:[email protected]] Sent: Thursday, October 17, 2013 10:54 AMTo: [email protected]; [email protected]; [email protected]; Rosen, Hilary (CDPH-CID-DCDC-IDB; Linda Gladden - AR; Stewart Matthews; [email protected]; Carmon Greene; Rashida Hassan; Selam Tecle; [email protected]; [email protected]; Cronquist, Alicia (CDC state.co.us); [email protected]; [email protected]; [email protected]; [email protected]; Hahn, Christine G. <ID> (CDC dhw.idaho.gov); [email protected]; Bohm, Susan (DCH); Bidol, Sally (DCH); Arends, Katherine (DCH); [email protected]; [email protected]; Rick Sowadsky; 'Chen, Lei'; Keene, Bill (CDC epilinks.com); Julie Hatch - OR; Borders,Julie (DSHS; Leos,Greg (DSHS; [email protected]; [email protected]; [email protected]; [email protected]; [email protected]; Traci DeSalvo - WI; 'Justin R - DHS Kohl'; [email protected]; Martinek, Karen (CDC alaska.gov); [email protected]; [email protected]; [email protected]; [email protected]; [email protected]; [email protected]; [email protected]; [email protected]; [email protected]; [email protected]; [email protected]; [email protected]; [email protected]; [email protected]; [email protected]: Barton Behravesh, Casey (CDC/OID/NCEZID); Gieraltowski, Laura (CDC/OID/NCEZID); Wise, Matthew E. (CDC/OID/NCEZID); Schwensohn, Colin A. (CDC/OID/NCEZID); Robertson, Kis - FSIS ([email protected]); Allen, Latasha - Commissioned Corps - FSIS ([email protected])Subject: RE: conference call tomorrow, Thursday, October 17, 2013 at 1pm EST - Salmonella Heidelberg 1306MLJF6-1 outbreak
Colleagues,
The updated line list as of today is attached.
New cases: CA (9), AZ (1).
Jolene
From: Nakao, Jolene H. (CDC/OID/NCEZID) Sent: 16 October 2013 16:46To: '[email protected]'; '[email protected]'; '[email protected]'; 'Rosen, Hilary (CDPH-CID-DCDC-IDB'; 'Linda Gladden - AR'; 'Stewart Matthews'; '[email protected]'; 'Carmon Greene'; 'Rashida Hassan'; 'Selam Tecle'; '[email protected]'; '[email protected]'; Cronquist, Alicia (CDC state.co.us); '[email protected]'; '[email protected]'; '[email protected]'; '[email protected]'; Hahn, Christine G. <ID> (CDC dhw.idaho.gov); '[email protected]'; 'Susan Bohm - MI'; 'Sally Bidol - MI'; 'Katie Arends - MI'; '[email protected]'; '[email protected]';
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'Rick Sowadsky'; 'Chen, Lei'; Keene, Bill (CDC epilinks.com); 'Julie Hatch - OR'; 'Borders,Julie (DSHS'; 'Leos,Greg (DSHS'; '[email protected]'; '[email protected]'; '[email protected]'; '[email protected]'; '[email protected]'; 'Traci DeSalvo - WI'; 'Justin R - DHS Kohl'; '[email protected]'; Martinek, Karen (CDC alaska.gov); '[email protected]'; '[email protected]'; '[email protected]'; '[email protected]'; '[email protected]'; '[email protected]'; '[email protected]'; '[email protected]'; '[email protected]'; '[email protected]'; '[email protected]'; '[email protected]'; '[email protected]'; '[email protected]'; '[email protected]'Cc: Barton Behravesh, Casey (CDC/OID/NCEZID); Gieraltowski, Laura (CDC/OID/NCEZID); Wise, Matthew E. (CDC/OID/NCEZID); Schwensohn, Colin A. (CDC/OID/NCEZID); Robertson, Kis - FSIS ([email protected]); Allen, Latasha - Commissioned Corps - FSIS ([email protected])Subject: conference call tomorrow, Thursday, October 17, 2013 at 1pm EST - Salmonella Heidelberg 1306MLJF6-1 outbreak
Dear colleagues,
We would like to invite you to a conference call tomorrow, Thursday, October 17, 2013 at 1pm EST to discuss updates in the Salmonella Heidelberg 1306MLJF6-1 outbreak investigation and to confirm case counts in each state. The conference call information is below.
Attached is the master line list updated as of yesterday. A total of 329 cases have been reported from 20 states and Puerto Rico, with the great majority (74%) in CA: AK (2), AR (1), AZ (13), CA (243), CO (4), CT (1), FL (4), ID (2), KY(1), MI (2), MO (5), NC (1), NM (2), NV (9), OR (9), PR (1), TX (9), UT (2), VA (2), WA (15), WI (1). Case-patients range in age from <1 - 93 (median: 18) and 48% are female. 40% have been hospitalized and no deaths have been reported.
Seven PFGE XbaI patterns are included in this cluster: JF6X01.0258, JF6X01.0045, JF6X01.0041, JF6X01.0122, JF6X01.0326, JF6X01.0672, JF6X01.0022.
The CDC web posting is available at:
http://www.cdc.gov/salmonella/heidelberg-10-13/index.html
Thank you very much for continuing to update us with epi information on your cases! This investigation is ongoing. As you know, FSIS sampled extensively in three of the Foster Farms plants of concern during the period Sept 9-Sept 27. FSIS is highly interested in any of the new cases that may have exposure information that overlaps with this period of intensified sampling. Please continue to collect shopper card numbers, receipts or left over products. This information is still very important to potentially link illnesses to specific lots and production times, and to support the investigation and future regulatory action as evidence allows.
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Thank you and best regards,
Jolene
Conference line:
Passcode:
________________________________
Jolene Nakao, M.D., M.P.H. LCDR, US Public Health Service Epidemic Intelligence Service Officer Enteric Diseases Epidemiology Branch
Division of Foodborne, Waterborne and Environmental Diseases
National Center for Emerging and Zoonotic Infectious Diseases
U.S. Centers for Disease Control and Prevention
1600 Clifton Road, MS-A38
Atlanta, Georgia 30333 / USA
404-718-1151 (w)
(c)
404-718-2126 (f)
From: Dessai, Uday - FSISSent: Monday, October 28, 2013 7:57 AMTo: Goldman, David - Commissioned Corps - FSIS; Kause, Janell - FSISCc: Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Douris, Aphrodite - FSIS; Defibaugh-Chavez, Stephanie - FSIS
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Subject: RE: Positive chicken sample for S. Heidelberg patient
HI David
Stephanie, Alice and Aphrodite are looking at the following two issues and here are our initial thoughts:
1) OIEA has established a compelling link in the Foster Farms illness outbreak investigation. Here are the details from
This revolves around The case patient shopper data and intensified sampling conducted at the three Foster farms facilities in California was utilized. The linkages are detailed below:
· tested for positive for PFGE 045, and the like sample collected on the same date, sample form ID number 100583269, as one of the pack dates is PFGE 045, which is the same PFGE pattern.
· The product purchased by the case patient and the like sample, Foster Farms boneless, skinless thighs, were slaughtered at P-7632 on 9/9/2013 and were processed/packed at P-6137A on 9/9/2013.
· There are other multiple sample positives for PFGE 45 at p-7632 and P-6137A on 9/9/2013, both parts and whole birds.
· SDC will look into this further….
2) P6137A PFGE pattern JF6X01.0122 (5/10 subs positive), additional 2 being tested for PFGEs; case patient has PFGE type 45
· Although:
o during the specpgm_02 Sept sampling there was a single positive with pattern .0122 from the same establishment
o the fact that mixed PFGE patterns can be found in the same sample
o There may be overwhelming indirect evidences..
o We cannot make a conclusive claim that there is a link between the patient and chicken samples recovered from the patients home
----------
o A close examination of the two band difference between 0122 and 45 shows that - these are distinctly different PFGE types (on the gel)
o We are awaiting the final results from the additional 2 PFGEs
o We are analyzing the hospitalization rate for the two PFGE types
o Etc.
Thanks much!
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Uday
Yes, I would say that these two patterns are significantly different.
Aphrodite DourisMicrobiologistOutbreaks Section, Eastern LaboratoryFood Safety and Inspection ServiceThe United States Department of AgricultureRussell Research Center950 College Station RoadAthens, GA [email protected]: (706) 546-2330 FAX:(706)546-3144
Privileged Communications: This transmission (and/or the documents accompanying it) may contain confidential information belonging to the sender. The information is intended only for the use of the individual or entity named in the distribution. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error, please notify us by telephone to arrange for the return of the documents.
_____________________________________________From: Dessai, Uday - FSIS Sent: Friday, October 25, 2013 2:22 PMTo: Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg similarity matrix
Thx much Alice and Douris.
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2 bands different (~ 200 and ~ 80 region) as I see it on the picture.
Douris – does the ~ 200 region band constitute a real diffence ! ( I would imagin yes!)
Thanks
What remains to be done
<<6002696219 FF Invoice.pdf>> <<Originating Spreadsheet Special 102413.xlsx>> <<2013-10-22_Phase1-Heidelbergs.xlsx>>
Hello,
We have a compelling link in the Foster Farms illness outbreak investigation. This revolves around The case patient shopper data and intensified sampling conducted at the three Foster farms facilities in California was utilized. The linkages are detailed below:
· tested for positive for PFGE 045, and the like sample collected on the same date, sample form ID number 100583269, as one of the pack dates is PFGE 045, which is the same PFGE pattern.
· The product purchased by the case patient and the like sample, Foster Farms boneless, skinless thighs, were slaughtered at P-7632 on 9/9/2013 and were processed/packed at P-6137A on 9/9/2013.
· There are other multiple sample positives for PFGE 45 at p-7632 and P-6137A on 9/9/2013, both parts and whole birds.
I have attached invoice 6002696219 that shows the link in commerce between Foster Farms and the COSTCO store where the case patient purchased the product. I have also attached a spreadsheet titled “original Spreadsheet Special” that demonstrates the linkages between and the samples collected at Foster farms, and finally, I have attached the sample data spreadsheet that represents all samples collected at the three Foster farms facilities.
About the other CPs, are not as compelling:
Case patients – We could not make a connection between FSIS sampling dates for Est. 7632 & Est. 6137 for product comprising the load distributed to Costco, part of which may have been consumed by both case patients. Product from Est. 33900 was also included in the load to Costco.
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Case patients – Product (Rotisserie Chicken) available on the purchase day consisted of seven Foster Farms invoices to Costco with several different slaughter and pack dates from Est. 7632, 6137, 6137A, and 33900. Positive test results, PFGE pattern 258, from FSIS sampling with slaughter dates of; 9/7, 9/9, 9/10, 9/11, and 9/17, taken at Est. 6137 and 6137A made up part of the product included on the invoices.
Case patient – OIEA is still waiting on California for membership card information.
Case patient - OIEA is still waiting on California for additional purchase dates.
Case patients – Product (Rotisserie Chicken) available on the day of purchase consisted of a single invoice from Foster Farms to Costco. Product represented on the invoice originated from Est. P-7632 and P-33900. Positive test results, PFGE pattern 258, from FSIS sampling with a slaughter date of 9/9 from Est. 7632 comprised part of the load.
The CCMS patient in NV:
OPHS spoke with complainant as did OIEA’s investigator. Review labs – CBC- WNL, Chemistry Profile – Elevated liver enzymes, Stool Sample negative for Salmonella, Shigella and Campy. He might give us some of the sample but not all of it. We are concerned about how we would do that.
Alice and SDC pl:
Isolate numbers
Types of parts, production/analysis dates and PFGEs
PFGE Types
P1
P2
P3
P4
P5
whole
Patient info
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1?
NA
NA
NA
NA
NA
NA
Product info
5 each (!)
OB/PFGE types
Note: Same or different PFGE types can be found in a given sample. And the prevalence of a PFGE type in the enriched medium, does not in any fashion or manner indicates absence of other PFGE types in the product.
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From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 3:35 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSISSubject: Re: Positive chicken sample for S. Heidelberg patient
Good idea(s). We do need to figure this one out--I think I heard that FDA will sequence these strains. I would appreciate a separate discussion so that I understand how much we can learn about the genetic profile and phenotypic expression from this sequencing.
David P. Goldman, M.D., M.P.H.
Captain, USPHS
Assistant Administrator
Office of Public Health Science
Food Safety and Inspection Service
USDA
Room 341-E, Whitten Bldg.
1400 Independence Ave, SW
Washington, DC 20250
202-720-2644 (o)
202-690-2980 (f)
On Oct 25, 2013, at 1:34 PM, "Dessai, Uday - FSIS" <[email protected]> wrote:
Good point SDC Just a thought: Looks like there is a lot happening I Heidelberg genome.. For instance in the heidelbergs associated with this O/B, the virulence factors may be (just may be) up regulated for some reason... Alice and team: is it possible to tabulate rate of hospitalization for different PFGE types (if numbers are available!) Thx
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From: Defibaugh-Chavez, Stephanie - FSIS Sent: Friday, October 25, 2013 01:18 PM To: Green, Alice - FSIS; Goldman, David - Commissioned Corps - FSIS; Dessai, Uday - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Can we also follow-up with CDC to see if they included pattern 0041 in the cluster because of similarity to 0122? An alternative way of asking that is David’s original question of whether they would consider those two patterns the same strain. As Uday pointed out, sometimes lack of or additional bands in the lower molecular weight region (i.e. <100k bp) can be due to plasmid or just poor band resolution in that region. It would be nice to know how they would interpret this situation of finding these two specific patterns in connection with a leftover product and a case-patient clinical isolate.
Stephanie Defibaugh-Chávez, Ph.D.
Microbiologist
Science Staff, Office of Public Health Science
Food Safety and Inspection Service
United States Department of Agriculture
202-690-6042 (office)
202-641-5540 (Blackberry)
202-690-6364 (fax)
email: [email protected]
Stay Connected with USDA:
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From: Green, Alice - FSIS Sent: Friday, October 25, 2013 1:13 PM To: Goldman, David - Commissioned Corps - FSIS; Dessai, Uday - FSIS Cc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
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The health department picked up 3 packages of FF product. There were no other suspect products noted. I’ll seek guidance from OSEL on pattern similarity between patterns 41 and 122.
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 11:46 AM To: Dessai, Uday - FSIS Cc: Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: Re: Positive chicken sample for S. Heidelberg patient
Thanks for the latest on the PFGE similarity. I am confused about the leftover products--I just assumed that the health dept picked any "suspect" product (meaning something eaten by the case and so a possible exposure). Given that 2 of the samples were negative, what other possibility is there except that the positive product led to the illness? Is CA aware of other chicken exposures that might complicate the picture?
If need be, would CDC say that these 2 patterns are so close that they may represent the same pathogen in this instance?
David P. Goldman, M.D., M.P.H.
Captain, USPHS
Assistant Administrator
Office of Public Health Science
Food Safety and Inspection Service
USDA
Room 341-E, Whitten Bldg.
1400 Independence Ave, SW
Washington, DC 20250
202-720-2644 (o)
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202-690-2980 (f)
On Oct 25, 2013, at 12:33 PM, "Dessai, Uday - FSIS" <[email protected]> wrote:
Thx Alice!
The Two bands (I would imagine in low molecular weight region!) may need to be considered a method artifact in this instance – given both are very close and part of the OB.
Cheers!
Uday
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 12:26 PM To: Dessai, Uday - FSIS; Goldman, David - Commissioned Corps - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Hi Uday—
You are correct! I do want to emphasize that both are outbreak strains, and pattern 122 and pattern 41 are 94.4% similar, differing in only two bands.
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
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Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Dessai, Uday - FSIS Sent: Friday, October 25, 2013 11:20 AM To: Goldman, David - Commissioned Corps - FSIS; Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Hi Alice
It is interesting that although we have pattern O122 in the product, we are not sure of the three products, which one was consumed by the patient!
So we have diffferent patterns between patient and product and we are not sure which product (1/3 positive) was consumed – right!
Thx!
From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 12:11 PM To: Green, Alice - FSIS; Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: Re: Positive chicken sample for S. Heidelberg patient
Thanks Alice--just want to clarify; were all 5 subs pattern 122? If so, then are there more isolates to test? David Goldman, MD, MPH CAPT, USPHS Chief Medical Officer Assistant Administrator USDA-FSIS-OPHS 202-720-2644 --------------------------
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Sent from my BlackBerry Wireless Handheld
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 12:08 PM To: Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS; Goldman, David - Commissioned Corps - FSIS Subject: FW: Positive chicken sample for S. Heidelberg patient
FYI—
PFGE table for tested products is below.
is the appropriate lab contact ( Pictures have use-by date of 03-29-2014. Product is frozen Kirkland Signature boneless skinless chicken tenders (mis-stated as chicken breast in my previous email).
Thanks much,
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Higa, Jeffrey (CDPH-CID-DCDC-IDB) [mailto:[email protected]] Sent: Friday, October 25, 2013 10:57 AM To: Green, Alice - FSIS; Kissler, Bonnie - FSIS; Robertson, Kis - FSIS; Allen, Latasha - Commissioned Corps - FSIS; [email protected]; [email protected]; [email protected]; [email protected]; [email protected] Cc: Needham, Michael (CDPH-DFDRS FDB); Hernandez, Michael (CDPH-DFDRS); Kennelly, Pat (CDPH-FDB); Peralta, Vi (CDPH-CID-DCDC-IDB); Kimura, Akiko (CDPH-CID-DCDC); Gilliss, Debra (CDPH-CID-DCDC-IDB) Subject: Positive chicken sample for S. Heidelberg patient
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Hello USDA and CDC colleagues,
On 10/9/2013, 3 open packages of Kirkland Signature Boneless, Skinless Chicken Tenderloins were collected from the home of S. Heidelberg pattern 0041 patient Our Food and Drug Lab tested chicken from all 3 packages. Chicken from one of packages was positive for Salmonella:
FDLB Sample ID
Product
Establishment #
Result
PulseNet Isolate #
184100913-P001
Kirkland Signature boneless, skinless Chicken tenderloins
P33901
negative for Salmonella
n/a
184100913-P002
Kirkland Signature boneless, skinless Chicken tenderloins
P6137A
(best by 3/29/2014)
· positive for Salmonella group B
· 5 of 10 subs positive
· PFGE pattern JF6X01.0122
CA2__CA2F13M00985PP2A1
184100913-P003
Kirkland Signature boneless, skinless Chicken tenderloins
P33901
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negative for Salmonella
n/a
Attached are pictures of the package for the positive chicken sample. The chicken isolate was pattern 0122 and the patient had pattern 0041. Unfortunately, all 3 packages were open and the specific package the patient had chicken from prior to illness onset could not be determined.
FDB, please correct me if any of the information above is inaccurate.
-Jeff
Jeffrey Higa, MPH
California Department of Public Health
Infectious Diseases Branch
Disease Investigations Section
19300 S. Hamilton Ave., Suite 140
Gardena, CA 90248
310-217-6906
310-217-6911 (fax)
[email protected] <mailto:[email protected]>
NOTICE of CONFIDENTIALITY: This E-mail is the property of the California Department of Public Health and contains information that may be PRIVILEGED, CONFIDENTIAL or otherwise exempt from disclosure by applicable law. It is intended only for the person(s) to whom it is addressed. If you receive this communication in error, please do not retain or distribute it. Please notify the sender immediately by E-mail at the address shown above and delete the original message.
From: Dessai, Uday - FSISSent: Monday, October 28, 2013 6:40 AMTo: Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Subject: RE: Heidelberg Pct Hospitalized by PFGE
This is very neat Alice :-)!Although the lower numbers will be heavily influenced by the denominator, we may be able to divide these into atleast two categories based on % hospitalizations. (note: qualifying criteria could be something like we should have atleast 10 total illnesses to be counted in the categories)1) 35% and below - 122, 258, 3262) 35% and above - 22, 41, 45, 122, 672 (just 2 cases - does not qualify))
The next part will be to see if PFGEs in these categories have any commonality/similarity etc. If not all, atleast hose at the extreme ends of hospitalization..Also, in your table, do if we add the columns for demographics (age, sensitive population etc.. if available, would that be useful to see..!)
Again, nice work Alice :-)!
_____________________________________________From: Green, Alice - FSIS Sent: Friday, October 25, 2013 2:41 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: Heidelberg Pct Hospitalized by PFGE
Pattern % hospitalized (n) 22 42% (21/50) 41 44% (14/32) 45 52% (28/54) 122 33% (8/24) 258 29% (22/75) 326 25% (4/16) 672 50% (1/2)
Alice L. Green, MS, DVM Public Health and Epidemiology LiaisonOffice of Public Health Science | Food Safety and Inspection Service | U.S. Department of AgricultureButler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected]
From: Higa, Jeffrey (CDPH-CID-DCDC-IDB) [[email protected]]Sent: Friday, October 25, 2013 4:47 PMTo: Green, Alice - FSISCc: Peralta, Vi (CDPH-CID-DCDC-IDB); Kimura, Akiko (CDPH-CID-DCDC)Subject: Any possibility of recall this weekend?
Hi Alice,
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I hope you made it home and did not get stuck at the office.
Just one quick question…..after the flurry of activity this morning regarding the positive chicken sample from the San Jose patient’s home, is there any possibility of a recall this weekend?
Okay, two quick questions…..did Stephanie get a chance to talk with with Food and Drug Lab?
Thanks,
Jeff
Jeffrey Higa, MPH
California Department of Public Health
Infectious Diseases Branch
Disease Investigations Section
19300 S. Hamilton Ave., Suite 140
Gardena, CA 90248
310-217-6906
310-217-6911 (fax)
[email protected] <mailto:[email protected]>
NOTICE of CONFIDENTIALITY: This E-mail is the property of the California Department of Public Health and contains information that may be PRIVILEGED, CONFIDENTIAL or otherwise exempt from disclosure by applicable law. It is intended only for the person(s) to whom it is addressed. If you receive this communication in error, please do not retain or distribute it. Please notify the sender immediately by E-mail at the address shown above and delete the original message.
From: Dessai, Uday - FSISSent: Friday, October 25, 2013 4:07 PM
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
To: Goldman, David - Commissioned Corps - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS; Cook, Victor - FSISSubject: Re: Positive chicken sample for S. Heidelberg patient
Hi DavidDouris, SDC, Alice and I have gone back and forth on this issue and I will send a summary of our discussion/situation. About geeting the PFGE types in question and sequencing - SDC will follow-up and provide you an update.
Cheers!
From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 03:34 PMTo: Dessai, Uday - FSIS Cc: Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: Re: Positive chicken sample for S. Heidelberg patient
Good idea(s). We do need to figure this one out--I think I heard that FDA will sequence these strains. I would appreciate a separate discussion so that I understand how much we can learn about the genetic profile and phenotypic expression from this sequencing.
David P. Goldman, M.D., M.P.H. Captain, USPHS Assistant AdministratorOffice of Public Health ScienceFood Safety and Inspection ServiceUSDA Room 341-E, Whitten Bldg. 1400 Independence Ave, SW Washington, DC 20250 202-720-2644 (o) 202-690-2980 (f) [email protected]
On Oct 25, 2013, at 1:34 PM, "Dessai, Uday - FSIS" <[email protected]> wrote:
Good point SDC Just a thought: Looks like there is a lot happening I Heidelberg genome.. For instance in the heidelbergs associated with this O/B, the virulence factors may be (just may be) up regulated for some reason... Alice and team: is it possible to tabulate rate of hospitalization for different PFGE types (if numbers are available!) Thx
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From: Defibaugh-Chavez, Stephanie - FSIS Sent: Friday, October 25, 2013 01:18 PM To: Green, Alice - FSIS; Goldman, David - Commissioned Corps - FSIS; Dessai, Uday - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Can we also follow-up with CDC to see if they included pattern 0041 in the cluster because of similarity to 0122? An alternative way of asking that is David's original question of whether they would consider those two patterns the same strain. As Uday pointed out, sometimes lack of or additional bands in the lower molecular weight region (i.e. <100k bp) can be due to plasmid or just poor band resolution in that region. It would be nice to know how they would interpret this situation of finding these two specific patterns in connection with a leftover product and a case-patient clinical isolate.
Stephanie Defibaugh-Chávez, Ph.D.
Microbiologist
Science Staff, Office of Public Health Science
Food Safety and Inspection Service
United States Department of Agriculture
202-690-6042 (office)
202-641-5540 (Blackberry)
202-690-6364 (fax)
email: [email protected]
Stay Connected with USDA:
<image001.png> <http://www.facebook.com/usda/> <image002.gif> <http://www.twitter.com/usda/> <image003.png> <http://www.youtube.com/usda/>
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 1:13 PM To: Goldman, David - Commissioned Corps - FSIS; Dessai, Uday - FSIS Cc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
The health department picked up 3 packages of FF product. There were no other suspect products noted. I'll seek guidance from OSEL on pattern similarity between patterns 41 and 122.
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 11:46 AM To: Dessai, Uday - FSIS Cc: Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: Re: Positive chicken sample for S. Heidelberg patient
Thanks for the latest on the PFGE similarity. I am confused about the leftover products--I just assumed that the health dept picked any "suspect" product (meaning something eaten by the case and so a possible exposure). Given that 2 of the samples were negative, what other possibility is there except that the positive product led to the illness? Is CA aware of other chicken exposures that might complicate the picture?
If need be, would CDC say that these 2 patterns are so close that they may represent the same pathogen in this instance?
David P. Goldman, M.D., M.P.H.
Captain, USPHS
Assistant Administrator
Office of Public Health Science
Food Safety and Inspection Service
USDA
Room 341-E, Whitten Bldg.
1400 Independence Ave, SW
Washington, DC 20250
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202-720-2644 (o)
202-690-2980 (f)
On Oct 25, 2013, at 12:33 PM, "Dessai, Uday - FSIS" <[email protected]> wrote:
Thx Alice!
The Two bands (I would imagine in low molecular weight region!) may need to be considered a method artifact in this instance - given both are very close and part of the OB.
Cheers!
Uday
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 12:26 PM To: Dessai, Uday - FSIS; Goldman, David - Commissioned Corps - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Hi Uday-
You are correct! I do want to emphasize that both are outbreak strains, and pattern 122 and pattern 41 are 94.4% similar, differing in only two bands.
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
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Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Dessai, Uday - FSIS Sent: Friday, October 25, 2013 11:20 AM To: Goldman, David - Commissioned Corps - FSIS; Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Hi Alice
It is interesting that although we have pattern O122 in the product, we are not sure of the three products, which one was consumed by the patient!
So we have diffferent patterns between patient and product and we are not sure which product (1/3 positive) was consumed - right!
Thx!
From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 12:11 PM To: Green, Alice - FSIS; Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: Re: Positive chicken sample for S. Heidelberg patient
Thanks Alice--just want to clarify; were all 5 subs pattern 122? If so, then are there more isolates to test? David Goldman, MD, MPH CAPT, USPHS Chief Medical Officer Assistant Administrator USDA-FSIS-OPHS 202-720-2644 --------------------------
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Sent from my BlackBerry Wireless Handheld
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 12:08 PM To: Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS; Goldman, David - Commissioned Corps - FSIS Subject: FW: Positive chicken sample for S. Heidelberg patient
FYI-
PFGE table for tested products is below.
is the appropriate lab contact ( Pictures have use-by date of 03-29-2014. Product is frozen Kirkland Signature boneless skinless chicken tenders (mis-stated as chicken breast in my previous email).
Thanks much,
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Higa, Jeffrey (CDPH-CID-DCDC-IDB) [mailto:[email protected]] Sent: Friday, October 25, 2013 10:57 AM To: Green, Alice - FSIS; Kissler, Bonnie - FSIS; Robertson, Kis - FSIS; Allen, Latasha - Commissioned Corps - FSIS; [email protected]; [email protected]; [email protected]; [email protected]; [email protected] Cc: Needham, Michael (CDPH-DFDRS FDB); Hernandez, Michael (CDPH-DFDRS); Kennelly, Pat (CDPH-FDB); Peralta, Vi (CDPH-CID-DCDC-IDB); Kimura, Akiko (CDPH-CID-DCDC); Gilliss, Debra (CDPH-CID-DCDC-IDB) Subject: Positive chicken sample for S. Heidelberg patient
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Hello USDA and CDC colleagues,
On 10/9/2013, 3 open packages of Kirkland Signature Boneless, Skinless Chicken Tenderloins were collected from the home of S. Heidelberg pattern 0041 patient Our Food and Drug Lab tested chicken from all 3 packages. Chicken from one of packages was positive for Salmonella:
FDLB Sample ID
Product
Establishment #
Result
PulseNet Isolate #
184100913-P001
Kirkland Signature boneless, skinless Chicken tenderloins
P33901
negative for Salmonella
n/a
184100913-P002
Kirkland Signature boneless, skinless Chicken tenderloins
P6137A
(best by 3/29/2014)
· positive for Salmonella group B
· 5 of 10 subs positive
· PFGE pattern JF6X01.0122
CA2__CA2F13M00985PP2A1
184100913-P003
Kirkland Signature boneless, skinless Chicken tenderloins
P33901
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
negative for Salmonella
n/a
Attached are pictures of the package for the positive chicken sample. The chicken isolate was pattern 0122 and the patient had pattern 0041. Unfortunately, all 3 packages were open and the specific package the patient had chicken from prior to illness onset could not be determined.
FDB, please correct me if any of the information above is inaccurate.
-Jeff
Jeffrey Higa, MPH
California Department of Public Health
Infectious Diseases Branch
Disease Investigations Section
19300 S. Hamilton Ave., Suite 140
Gardena, CA 90248
310-217-6906
310-217-6911 (fax)
[email protected] <mailto:[email protected]>
NOTICE of CONFIDENTIALITY: This E-mail is the property of the California Department of Public Health and contains information that may be PRIVILEGED, CONFIDENTIAL or otherwise exempt from disclosure by applicable law. It is intended only for the person(s) to whom it is addressed. If you receive this communication in error, please do not retain or distribute it. Please notify the sender immediately by E-mail at the address shown above and delete the original message.
From: - FSISSent: Friday, October 25, 2013 3:36 PMTo: Green, Alice - FSIS; Atkinson, Richard - FSISCc: Khroustalev, Allison - FSIS
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Subject: RE: More Costco shopper records to request
Alice, we have Costco shopping history already. The rest are new and we will need them.
Compliance Investigator
USDA/FSIS/OIEA/CID
19110 Bothell Way NE, Suite #201
Bothell, WA 98011
Office:
Cell:
Fax: (425) 483-3492
fsis.usda.gov
PREDECISIONAL - NOT FOR COPY OR FURTHER DISTRIBUTION"This electronic message contains information generated by the USDA solely for the intended recipients. Any unauthorized interception of this message or the use or disclosure of the information it contains may violate the law and subject the violator to civil or criminal penalties. If you believe you have received this message in error, please notify the sender and delete the email immediately."
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 1:28 PMTo: Atkinson, Richard - FSIS; - FSISCc: Khroustalev, Allison - FSISSubject: FW: More Costco shopper records to request
Please forgive me if I've missed any of these, but I didn't see them in the IR. Do these need to be requested from Costco?
Thank you!
Alice L. Green, MS, DVM
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Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Peralta, Vi (CDPH-CID-DCDC-IDB) [mailto:[email protected]] Sent: Thursday, October 24, 2013 8:19 PMTo: Green, Alice - FSIS; Kimura, Akiko (CDPH-CID-DCDC); Higa, Jeffrey (CDPH-CID-DCDC-IDB)Subject: More Costco shopper records to request
Hi Alice,
I've had a chance to go through all the records....whew! Thank you!
These are all the ones for which we don't have any records yet (the last two are new).
Talk to you tomorrow morning!
PulseNet ID
CDC ID
Onset Date
Cluster pattern
SourceCounty
Reported Chicken Exposures from Interview
Store1
Costco Shopper Card #
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
7/28/2013
JF6X01.0041
San Diego
Foster Farms chicken livers (used as bait for fishing several time during week prior to illness onset) purchased from Stater Bros; Stater Bros brand chicken thighs; Sprouts natural chicken brand thighs
Costco
9/1/2013
JF6X01.0045
San Mateo
Foster Farm chicken tenderloins, frozen raw (Costco) consumed 8/26-8/28
Costco
8/29/2013
JF6X01.0022
San Diego
Costco/Kirkland thighs and maybe rotisserie chicken. Legs (Vons/Ralphs)
Costco
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9/23/2013
JF6X01.0045
Santa Clara
chicken bake 9/21/13 from Costco food court
Costco
and
9/14/2013
JF6X01.0258
Riverside
Maybe had Foster Farms breaded boneless skinless chicken, looks like strips (Costco). Maybe had pre-cooked rotisserie (Stater Bros)
Costco
9/11/2013
JF6X01.0258
San Francisco
Costco rotisserie chicken purchased and consumed 9/11/13
Costco
9/14/2013
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JF6X01.0258
San Mateo
Buys Foster Farms chicken every week from Costco. Reports Foster Farms whole chicken, fresh raw, consumed 9/11/13. Foster Farms thighs, fresh raw, consumed within week before onset
Costco
and
From: Green, Alice - FSIS [mailto:[email protected]] Sent: Thursday, October 24, 2013 1:06 PMTo: Peralta, Vi (CDPH-CID-DCDC-IDB); Kimura, Akiko (CDPH-CID-DCDC); Higa, Jeffrey (CDPH-CID-DCDC-IDB)Cc: Gieraltowski, Laura (CDC/OID/NCEZID); Schwensohn, Colin A. (CDC/OID/NCEZID); Nakao, Jolene H. (CDC/OID/NCEZID); Allen, Latasha - Commissioned Corps - FSIS; Robertson, Kis - FSISSubject: shopper records
Hi Vi-
I believe I've covered all the records in your request. There might be some duplicates-I wanted to include all versions of shopper histories in case some are more complete than others.
Please let me know if I've omitted any of the ones you gently reminded us about. J
Thanks much,
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: (b) (6)
(b) (6) (b) (6)
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
[email protected] <mailto:[email protected]>
This electronic message contains information generated by the USDA solely for the intended recipients. Any unauthorized interception of this message or the use or disclosure of the information it contains may violate the law and subject the violator to civil or criminal penalties. If you believe you have received this message in error, please notify the sender and delete the email immediately.
From: Dessai, Uday - FSISSent: Friday, October 25, 2013 3:17 PMTo: Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Douris, Aphrodite - FSISSubject: Re: Heidelberg similarity matrix
Excellent point and adds to our rationale..I do understand where SDC is coming from given our experience with this... Case.
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 03:17 PMTo: Defibaugh-Chavez, Stephanie - FSIS; Douris, Aphrodite - FSIS; Dessai, Uday - FSIS Subject: RE: Heidelberg similarity matrix
Good catch. I goofed. Thanks!
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Defibaugh-Chavez, Stephanie - FSIS Sent: Friday, October 25, 2013 2:15 PMTo: Green, Alice - FSIS; Douris, Aphrodite - FSIS; Dessai, Uday - FSISSubject: RE: Heidelberg similarity matrix
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Wait… I have that the pattern 0122 isolate has a slaughter date of 9/27 at P6137, but that the sample was collected at P6137A…
Stephanie Defibaugh-Chávez, Ph.D.
Microbiologist
Science Staff, Office of Public Health Science
Food Safety and Inspection Service
United States Department of Agriculture
202-690-6042 (office)
202-641-5540 (Blackberry)
202-690-6364 (fax)
email: [email protected]
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From: Green, Alice - FSIS Sent: Friday, October 25, 2013 3:11 PMTo: Douris, Aphrodite - FSIS; Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: RE: Heidelberg similarity matrix
Thanks Aphrodite. It looks like the product is Simple Truth Organic, boneless skinless chicken breast, slaughter date 9/9/13. The case-patient’s illness onset date is 9/12/13.
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Douris, Aphrodite - FSIS Sent: Friday, October 25, 2013 2:02 PMTo: Dessai, Uday - FSIS; Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: RE: Heidelberg similarity matrix
Also, during the specpgm_02 Sept sampling we had a single positive with pattern .0122 and it is my understanding that this product tested is from the same establishment. Alice, is this correct?
Aphrodite DourisMicrobiologistOutbreaks Section, Eastern LaboratoryFood Safety and Inspection ServiceThe United States Department of AgricultureRussell Research Center950 College Station RoadAthens, GA [email protected]: (706) 546-2330 FAX:(706)546-3144
Privileged Communications: This transmission (and/or the documents accompanying it) may contain confidential information belonging to the sender. The information is intended only for the use of the individual or entity named in the distribution. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error, please notify us by telephone to arrange for the return of the documents.
From: Dessai, Uday - FSIS Sent: Friday, October 25, 2013 2:39 PMTo: Douris, Aphrodite - FSIS; Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: Re: Heidelberg similarity matrix
Yep, I agree..so, no point asking CDC to relook at this, right!In that case:I think our focus should be that:1) Finding Salmonella in the product is relatively a rare event2) Finding Heidelberg in the product is even more rare3) Hence it is sufficint that we have case and product positive for Heidelberg
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
4) The fact that although the PFGE patterns are different, are part of the O/B and very closely related (about 95% similar) - strengthens our conclusion about the link. Note: in this case PFGe should be used as added informance in establishing the link
Team - is this a fair argument given the circumstances around this O/B!
Thx
From: Douris, Aphrodite - FSIS Sent: Friday, October 25, 2013 02:23 PMTo: Dessai, Uday - FSIS; Green, Alice - FSIS Cc: Defibaugh-Chavez, Stephanie - FSIS Subject: RE: Heidelberg similarity matrix
Yes, I would say that these two patterns are significantly different.
Aphrodite DourisMicrobiologistOutbreaks Section, Eastern LaboratoryFood Safety and Inspection ServiceThe United States Department of AgricultureRussell Research Center950 College Station RoadAthens, GA [email protected] <mailto:[email protected]> PHONE: (706) 546-2330 FAX:(706)546-3144
Privileged Communications: This transmission (and/or the documents accompanying it) may contain confidential information belonging to the sender. The information is intended only for the use of the individual or entity named in the distribution. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error, please notify us by telephone to arrange for the return of the documents.
_____________________________________________From: Dessai, Uday - FSISSent: Friday, October 25, 2013 2:22 PMTo: Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg similarity matrix
Thx much Alice and Douris.
Yep 2 bands different (~ 200 and ~ 80 region) as I see it on the picture.
Douris – does the ~ 200 region band constitute a real diffence ! ( I would imagin yes!)
Thanks
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
_____________________________________________From: Green, Alice - FSISSent: Friday, October 25, 2013 1:45 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Douris, Aphrodite - FSISSubject: Heidelberg similarity matrixImportance: High
This is the series of tables Aphrodite created in regards to this investigation back in July. Band comparisons for patterns 122 and 45 are on pages 4 and 5. The small bands appear to be low molecular weight.
<< File: Heidelberg matrix 072513.doc >>
Thanks,
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Goldman, David - Commissioned Corps - FSISSent: Friday, October 25, 2013 2:35 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Green, Alice - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSISSubject: Re: Positive chicken sample for S. Heidelberg patient
Good idea(s). We do need to figure this one out--I think I heard that FDA will sequence these strains. I would appreciate a separate discussion so that I understand how much we can learn about the genetic profile and phenotypic expression from this sequencing.
David P. Goldman, M.D., M.P.H. Captain, USPHS Assistant AdministratorOffice of Public Health ScienceFood Safety and Inspection ServiceUSDA Room 341-E, Whitten Bldg. 1400 Independence Ave, SW Washington, DC 20250 202-720-2644 (o)
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202-690-2980 (f) [email protected]
On Oct 25, 2013, at 1:34 PM, "Dessai, Uday - FSIS" <[email protected]> wrote:
Good point SDC Just a thought: Looks like there is a lot happening I Heidelberg genome.. For instance in the heidelbergs associated with this O/B, the virulence factors may be (just may be) up regulated for some reason... Alice and team: is it possible to tabulate rate of hospitalization for different PFGE types (if numbers are available!) Thx From: Defibaugh-Chavez, Stephanie - FSIS Sent: Friday, October 25, 2013 01:18 PM To: Green, Alice - FSIS; Goldman, David - Commissioned Corps - FSIS; Dessai, Uday - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Can we also follow-up with CDC to see if they included pattern 0041 in the cluster because of similarity to 0122? An alternative way of asking that is David’s original question of whether they would consider those two patterns the same strain. As Uday pointed out, sometimes lack of or additional bands in the lower molecular weight region (i.e. <100k bp) can be due to plasmid or just poor band resolution in that region. It would be nice to know how they would interpret this situation of finding these two specific patterns in connection with a leftover product and a case-patient clinical isolate.
Stephanie Defibaugh-Chávez, Ph.D.
Microbiologist
Science Staff, Office of Public Health Science
Food Safety and Inspection Service
United States Department of Agriculture
202-690-6042 (office)
202-641-5540 (Blackberry)
202-690-6364 (fax)
email: [email protected]
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
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From: Green, Alice - FSIS Sent: Friday, October 25, 2013 1:13 PM To: Goldman, David - Commissioned Corps - FSIS; Dessai, Uday - FSIS Cc: Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
The health department picked up 3 packages of FF product. There were no other suspect products noted. I’ll seek guidance from OSEL on pattern similarity between patterns 41 and 122.
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 11:46 AM To: Dessai, Uday - FSIS Cc: Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS; Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: Re: Positive chicken sample for S. Heidelberg patient
Thanks for the latest on the PFGE similarity. I am confused about the leftover products--I just assumed that the health dept picked any "suspect" product (meaning something eaten by the case and so a possible exposure). Given that 2 of the samples were negative, what other possibility is there except that the positive product led to the illness? Is CA aware of other chicken exposures that might complicate the picture?
If need be, would CDC say that these 2 patterns are so close that they may represent the same pathogen in this instance?
(b) (6)
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
David P. Goldman, M.D., M.P.H.
Captain, USPHS
Assistant Administrator
Office of Public Health Science
Food Safety and Inspection Service
USDA
Room 341-E, Whitten Bldg.
1400 Independence Ave, SW
Washington, DC 20250
202-720-2644 (o)
202-690-2980 (f)
On Oct 25, 2013, at 12:33 PM, "Dessai, Uday - FSIS" <[email protected]> wrote:
Thx Alice!
The Two bands (I would imagine in low molecular weight region!) may need to be considered a method artifact in this instance – given both are very close and part of the OB.
Cheers!
Uday
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 12:26 PM To: Dessai, Uday - FSIS; Goldman, David - Commissioned Corps - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
(b) (6)
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Hi Uday—
You are correct! I do want to emphasize that both are outbreak strains, and pattern 122 and pattern 41 are 94.4% similar, differing in only two bands.
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Dessai, Uday - FSIS Sent: Friday, October 25, 2013 11:20 AM To: Goldman, David - Commissioned Corps - FSIS; Green, Alice - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: RE: Positive chicken sample for S. Heidelberg patient
Hi Alice
It is interesting that although we have pattern O122 in the product, we are not sure of the three products, which one was consumed by the patient!
So we have diffferent patterns between patient and product and we are not sure which product (1/3 positive) was consumed – right!
Thx!
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
From: Goldman, David - Commissioned Corps - FSIS Sent: Friday, October 25, 2013 12:11 PM To: Green, Alice - FSIS; Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS Subject: Re: Positive chicken sample for S. Heidelberg patient
Thanks Alice--just want to clarify; were all 5 subs pattern 122? If so, then are there more isolates to test? David Goldman, MD, MPH CAPT, USPHS Chief Medical Officer Assistant Administrator USDA-FSIS-OPHS 202-720-2644 -------------------------- Sent from my BlackBerry Wireless Handheld
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 12:08 PM To: Dessai, Uday - FSIS; Defibaugh-Chavez, Stephanie - FSIS Cc: Robertson, Kis - FSIS; Kissler, Bonnie - FSIS; Bennett, Patty - FSIS; Kause, Janell - FSIS; Goldman, David - Commissioned Corps - FSIS Subject: FW: Positive chicken sample for S. Heidelberg patient
FYI—
PFGE table for tested products is below.
is the appropriate lab contact ( Pictures have use-by date of 03-29-2014. Product is frozen Kirkland Signature boneless skinless chicken tenders (mis-stated as chicken breast in my previous email).
Thanks much,
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Higa, Jeffrey (CDPH-CID-DCDC-IDB) [mailto:[email protected]] Sent: Friday, October 25, 2013 10:57 AM To: Green, Alice - FSIS; Kissler, Bonnie - FSIS; Robertson, Kis - FSIS; Allen, Latasha - Commissioned Corps - FSIS; [email protected]; [email protected]; [email protected]; [email protected]; [email protected] Cc: Needham, Michael (CDPH-DFDRS FDB); Hernandez, Michael (CDPH-DFDRS); Kennelly, Pat (CDPH-FDB); Peralta, Vi (CDPH-CID-DCDC-IDB); Kimura, Akiko (CDPH-CID-DCDC); Gilliss, Debra (CDPH-CID-DCDC-IDB) Subject: Positive chicken sample for S. Heidelberg patient
Hello USDA and CDC colleagues,
On 10/9/2013, 3 open packages of Kirkland Signature Boneless, Skinless Chicken Tenderloins were collected from the home of S. Heidelberg pattern 0041 patient Our Food and Drug Lab tested chicken from all 3 packages. Chicken from one of packages was positive for Salmonella:
FDLB Sample ID
Product
Establishment #
Result
PulseNet Isolate #
184100913-P001
Kirkland Signature boneless, skinless Chicken tenderloins
P33901
negative for Salmonella
n/a
184100913-P002
Kirkland Signature boneless, skinless Chicken tenderloins
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P6137A
(best by 3/29/2014)
· positive for Salmonella group B
· 5 of 10 subs positive
· PFGE pattern JF6X01.0122
CA2__CA2F13M00985PP2A1
184100913-P003
Kirkland Signature boneless, skinless Chicken tenderloins
P33901
negative for Salmonella
n/a
Attached are pictures of the package for the positive chicken sample. The chicken isolate was pattern 0122 and the patient had pattern 0041. Unfortunately, all 3 packages were open and the specific package the patient had chicken from prior to illness onset could not be determined.
FDB, please correct me if any of the information above is inaccurate.
-Jeff
Jeffrey Higa, MPH
California Department of Public Health
Infectious Diseases Branch
Disease Investigations Section
19300 S. Hamilton Ave., Suite 140
Gardena, CA 90248
310-217-6906
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
310-217-6911 (fax)
[email protected] <mailto:[email protected]>
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From: Defibaugh-Chavez, Stephanie - FSISSent: Friday, October 25, 2013 2:15 PMTo: Green, Alice - FSIS; Douris, Aphrodite - FSIS; Dessai, Uday - FSISSubject: RE: Heidelberg similarity matrix
Wait… I have that the pattern 0122 isolate has a slaughter date of 9/27 at P6137, but that the sample was collected at P6137A…
Stephanie Defibaugh-Chávez, Ph.D.
Microbiologist
Science Staff, Office of Public Health Science
Food Safety and Inspection Service
United States Department of Agriculture
202-690-6042 (office)
202-641-5540 (Blackberry)
202-690-6364 (fax)
email: [email protected]
Stay Connected with USDA:
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From: Green, Alice - FSIS Sent: Friday, October 25, 2013 3:11 PMTo: Douris, Aphrodite - FSIS; Dessai, Uday - FSIS
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Cc: Defibaugh-Chavez, Stephanie - FSISSubject: RE: Heidelberg similarity matrix
Thanks Aphrodite. It looks like the product is Simple Truth Organic, boneless skinless chicken breast, slaughter date 9/9/13. The case-patient’s illness onset date is 9/12/13.
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Douris, Aphrodite - FSIS Sent: Friday, October 25, 2013 2:02 PMTo: Dessai, Uday - FSIS; Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: RE: Heidelberg similarity matrix
Also, during the specpgm_02 Sept sampling we had a single positive with pattern .0122 and it is my understanding that this product tested is from the same establishment. Alice, is this correct?
Aphrodite DourisMicrobiologistOutbreaks Section, Eastern LaboratoryFood Safety and Inspection ServiceThe United States Department of AgricultureRussell Research Center950 College Station RoadAthens, GA [email protected]: (706) 546-2330 FAX:(706)546-3144
Privileged Communications: This transmission (and/or the documents accompanying it) may contain confidential information belonging to the sender. The information is intended only for the use of the individual or entity named in the distribution. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error, please notify us by telephone to arrange for the return of the documents.
(b) (6)
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
From: Dessai, Uday - FSIS Sent: Friday, October 25, 2013 2:39 PMTo: Douris, Aphrodite - FSIS; Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: Re: Heidelberg similarity matrix
Yep, I agree..so, no point asking CDC to relook at this, right!In that case:I think our focus should be that:1) Finding Salmonella in the product is relatively a rare event2) Finding Heidelberg in the product is even more rare3) Hence it is sufficint that we have case and product positive for Heidelberg4) The fact that although the PFGE patterns are different, are part of the O/B and very closely related (about 95% similar) - strengthens our conclusion about the link. Note: in this case PFGe should be used as added informance in establishing the link
Team - is this a fair argument given the circumstances around this O/B!
Thx
From: Douris, Aphrodite - FSIS Sent: Friday, October 25, 2013 02:23 PMTo: Dessai, Uday - FSIS; Green, Alice - FSIS Cc: Defibaugh-Chavez, Stephanie - FSIS Subject: RE: Heidelberg similarity matrix
Yes, I would say that these two patterns are significantly different.
Aphrodite DourisMicrobiologistOutbreaks Section, Eastern LaboratoryFood Safety and Inspection ServiceThe United States Department of AgricultureRussell Research Center950 College Station RoadAthens, GA [email protected] <mailto:[email protected]> PHONE: (706) 546-2330 FAX:(706)546-3144
Privileged Communications: This transmission (and/or the documents accompanying it) may contain confidential information belonging to the sender. The information is intended only for the use of the individual or entity named in the distribution. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
this transmission in error, please notify us by telephone to arrange for the return of the documents.
_____________________________________________From: Dessai, Uday - FSISSent: Friday, October 25, 2013 2:22 PMTo: Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg similarity matrix
Thx much Alice and Douris.
Yep 2 bands different (~ 200 and ~ 80 region) as I see it on the picture.
Douris – does the ~ 200 region band constitute a real diffence ! ( I would imagin yes!)
Thanks
_____________________________________________From: Green, Alice - FSISSent: Friday, October 25, 2013 1:45 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Douris, Aphrodite - FSISSubject: Heidelberg similarity matrixImportance: High
This is the series of tables Aphrodite created in regards to this investigation back in July. Band comparisons for patterns 122 and 45 are on pages 4 and 5. The small bands appear to be low molecular weight.
<< File: Heidelberg matrix 072513.doc >>
Thanks,
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Defibaugh-Chavez, Stephanie - FSISSent: Friday, October 25, 2013 2:13 PMTo: Green, Alice - FSISSubject: RE: Heidelberg similarity matrix
(b) (6)
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Remind me… product was 0122 and patient was 41?
Stephanie Defibaugh-Chávez, Ph.D.
Microbiologist
Science Staff, Office of Public Health Science
Food Safety and Inspection Service
United States Department of Agriculture
202-690-6042 (office)
202-641-5540 (Blackberry)
202-690-6364 (fax)
email: [email protected]
Stay Connected with USDA:
USDA In Facebook <http://www.facebook.com/usda/> USDA In Twitter <http://www.twitter.com/usda/> USDA In Youtube <http://www.youtube.com/usda/>
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 3:11 PMTo: Douris, Aphrodite - FSIS; Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: RE: Heidelberg similarity matrix
Thanks Aphrodite. It looks like the product is Simple Truth Organic, boneless skinless chicken breast, slaughter date 9/9/13. The case-patient’s illness onset date is 9/12/13.
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: (b) (6)
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
[email protected] <mailto:[email protected]>
From: Douris, Aphrodite - FSIS Sent: Friday, October 25, 2013 2:02 PMTo: Dessai, Uday - FSIS; Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: RE: Heidelberg similarity matrix
Also, during the specpgm_02 Sept sampling we had a single positive with pattern .0122 and it is my understanding that this product tested is from the same establishment. Alice, is this correct?
Aphrodite DourisMicrobiologistOutbreaks Section, Eastern LaboratoryFood Safety and Inspection ServiceThe United States Department of AgricultureRussell Research Center950 College Station RoadAthens, GA [email protected]: (706) 546-2330 FAX:(706)546-3144
Privileged Communications: This transmission (and/or the documents accompanying it) may contain confidential information belonging to the sender. The information is intended only for the use of the individual or entity named in the distribution. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error, please notify us by telephone to arrange for the return of the documents.
From: Dessai, Uday - FSIS Sent: Friday, October 25, 2013 2:39 PMTo: Douris, Aphrodite - FSIS; Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: Re: Heidelberg similarity matrix
Yep, I agree..so, no point asking CDC to relook at this, right!In that case:I think our focus should be that:1) Finding Salmonella in the product is relatively a rare event2) Finding Heidelberg in the product is even more rare3) Hence it is sufficint that we have case and product positive for Heidelberg4) The fact that although the PFGE patterns are different, are part of the O/B and very closely related (about 95%
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
similar) - strengthens our conclusion about the link. Note: in this case PFGe should be used as added informance in establishing the link
Team - is this a fair argument given the circumstances around this O/B!
Thx
From: Douris, Aphrodite - FSIS Sent: Friday, October 25, 2013 02:23 PMTo: Dessai, Uday - FSIS; Green, Alice - FSIS Cc: Defibaugh-Chavez, Stephanie - FSIS Subject: RE: Heidelberg similarity matrix
Yes, I would say that these two patterns are significantly different.
Aphrodite DourisMicrobiologistOutbreaks Section, Eastern LaboratoryFood Safety and Inspection ServiceThe United States Department of AgricultureRussell Research Center950 College Station RoadAthens, GA [email protected] <mailto:[email protected]> PHONE: (706) 546-2330 FAX:(706)546-3144
Privileged Communications: This transmission (and/or the documents accompanying it) may contain confidential information belonging to the sender. The information is intended only for the use of the individual or entity named in the distribution. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error, please notify us by telephone to arrange for the return of the documents.
_____________________________________________From: Dessai, Uday - FSISSent: Friday, October 25, 2013 2:22 PMTo: Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg similarity matrix
Thx much Alice and Douris.
Yep 2 bands different (~ 200 and ~ 80 region) as I see it on the picture.
Douris – does the ~ 200 region band constitute a real diffence ! ( I would imagin yes!)
Thanks
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
_____________________________________________From: Green, Alice - FSISSent: Friday, October 25, 2013 1:45 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Douris, Aphrodite - FSISSubject: Heidelberg similarity matrixImportance: High
This is the series of tables Aphrodite created in regards to this investigation back in July. Band comparisons for patterns 122 and 45 are on pages 4 and 5. The small bands appear to be low molecular weight.
<< File: Heidelberg matrix 072513.doc >>
Thanks,
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: [email protected] on behalf of Meatingplace Editorial [[email protected]]Sent: Friday, October 25, 2013 2:04 PMTo: Green, Alice - FSISSubject: NewsMakers PM: Mexico bans Foster Farms poultry plants amid salmonella outbreak
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Mexico bans Foster Farms poultry plants amid salmonella outbreak <http://www.meatingplace.com/ArticleRedirector/?code=2s45610&rType=3> Massachusetts company recalls RTE products over Listeria concerns <http://www.meatingplace.com/ArticleRedirector/?code=2s45608&rType=3> Scientists explore link between genetics, meat and colorectal cancer <http://www.meatingplace.com/ArticleRedirector/?code=2s45616&rType=3> U.S. gamers go down on the farm starting next month <http://www.meatingplace.com/ArticleRedirector/?code=2s45611&rType=3>
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NEED TECHNICAL SUPPORT?Email [email protected] <http://www.marketingandtechnology.com/repository/corpGraphics/spacer.gif> <http://www.marketingandtechnology.com/repository/corpGraphics/spacer.gif> <http://www.marketingandtechnology.com/repository/corpGraphics/spacer.gif> <http://www.marketingandtechnology.com/repository/corpGraphics/spacer.gif> Copyright © 2013 Marketing & Technology Group, Inc. <http://www.marketingandtechnology.com/repository/corpGraphics/tagline_site13.gif> <http://www.marketingandtechnology.com/repository/corpGraphics/spacer.gif> <http://www.meatingplace.com/OpenRate.ashx?sentId=98599448> From: - FSISSent: Friday, October 25, 2013 2:09 PMTo: Green, Alice - FSISCc: Atkinson, Richard - FSISSubject: RE: Safeway shopper card records
Alice,
The only one that is new to me is . This is the first time I have seen that number. Can you convert this to a CDC number? I already have Safeway shopping histories for and they should be in the IR. I have Costco histories but not Safeway shopping histories for and have not seen them in the IR.
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Compliance Investigator
USDA/FSIS/OIEA/CID
19110 Bothell Way NE, Suite #201
Bothell, WA 98011
Office:
Cell:
Fax: (425) 483-3492
fsis.usda.gov
PREDECISIONAL - NOT FOR COPY OR FURTHER DISTRIBUTION"This electronic message contains information generated by the USDA solely for the intended recipients. Any unauthorized interception of this message or the use or disclosure of the information it contains may violate the law and subject the violator to civil or criminal penalties. If you believe you have received this message in error, please notify the sender and delete the email immediately."
From: Green, Alice - FSIS Sent: Friday, October 25, 2013 11:47 AMTo: Atkinson, Richard - FSIS; - FSIS; Elliott, Jerry - FSIS; Khroustalev, Allison - FSISSubject: FW: Safeway shopper card records
If you like I can change these to CDC pattern names and upload them to the IR (at least the ones that aren't already there).
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
From: Peralta, Vi (CDPH-CID-DCDC-IDB) [mailto:[email protected]] Sent: Friday, October 25, 2013 1:44 PMTo: Green, Alice - FSISSubject: Safeway shopper card records
Hi Alice,
Since I've lost track of which Safeway records I have already sent, I am sending them all to you in this one email!
Vi
**********************************
Vi Peralta
Foodborne Epidemiologist
Disease Investigations Section
Infectious Diseases Branch
California Department of Public Health
850 Marina Bay Parkway | Building P, 2nd Floor | Richmond, CA 94804
Phone: 510-620-3633 | Fax: 510-620-3425 | Email: [email protected]
CONFIDENTIALITY NOTICE WARNING: This transmission may contain confidential and proprietary information intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you have received this transmission in error, any disclosure, copying, distribution, downloading, uploading or the taking of any action in reliance on the contents of this information is strictly prohibited, and you are requested to immediately notify the above sender.
From: Defibaugh-Chavez, Stephanie - FSISSent: Friday, October 25, 2013 2:07 PMTo: Dessai, Uday - FSIS; Douris, Aphrodite - FSIS; Green, Alice - FSISSubject: RE: Heidelberg similarity matrix
Uday,
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
I think the problem will be saying that the product is linked to illness. If the case-patient has one pattern, and the product has another, I think it will be an uphill battle trying to leverage some sort of regulatory action. The firm will claim that since the patterns are different (and considered significantly different) that it must have been something else that caused the illness. I don’t know that we would be able to dispute that legally speaking.
If the same pattern had been found, I think it would be a different story, but unless we can say these patterns are essentially the same (and justify it legally) then I don’t think we have anything here… Just my take on the situation.
-Stephanie
Stephanie Defibaugh-Chávez, Ph.D.
Microbiologist
Science Staff, Office of Public Health Science
Food Safety and Inspection Service
United States Department of Agriculture
202-690-6042 (office)
202-641-5540 (Blackberry)
202-690-6364 (fax)
email: [email protected]
Stay Connected with USDA:
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From: Dessai, Uday - FSIS Sent: Friday, October 25, 2013 2:39 PMTo: Douris, Aphrodite - FSIS; Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: Re: Heidelberg similarity matrix
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Yep, I agree..so, no point asking CDC to relook at this, right!In that case:I think our focus should be that:1) Finding Salmonella in the product is relatively a rare event2) Finding Heidelberg in the product is even more rare3) Hence it is sufficint that we have case and product positive for Heidelberg4) The fact that although the PFGE patterns are different, are part of the O/B and very closely related (about 95% similar) - strengthens our conclusion about the link. Note: in this case PFGe should be used as added informance in establishing the link
Team - is this a fair argument given the circumstances around this O/B!
Thx
From: Douris, Aphrodite - FSIS Sent: Friday, October 25, 2013 02:23 PMTo: Dessai, Uday - FSIS; Green, Alice - FSIS Cc: Defibaugh-Chavez, Stephanie - FSIS Subject: RE: Heidelberg similarity matrix
Yes, I would say that these two patterns are significantly different.
Aphrodite DourisMicrobiologistOutbreaks Section, Eastern LaboratoryFood Safety and Inspection ServiceThe United States Department of AgricultureRussell Research Center950 College Station RoadAthens, GA [email protected] <mailto:[email protected]> PHONE: (706) 546-2330 FAX:(706)546-3144
Privileged Communications: This transmission (and/or the documents accompanying it) may contain confidential information belonging to the sender. The information is intended only for the use of the individual or entity named in the distribution. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error, please notify us by telephone to arrange for the return of the documents.
_____________________________________________From: Dessai, Uday - FSISSent: Friday, October 25, 2013 2:22 PMTo: Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg similarity matrix
Thx much Alice and Douris.
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Yep 2 bands different (~ 200 and ~ 80 region) as I see it on the picture.
Douris – does the ~ 200 region band constitute a real diffence ! ( I would imagin yes!)
Thanks
_____________________________________________From: Green, Alice - FSISSent: Friday, October 25, 2013 1:45 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Douris, Aphrodite - FSISSubject: Heidelberg similarity matrixImportance: High
This is the series of tables Aphrodite created in regards to this investigation back in July. Band comparisons for patterns 122 and 45 are on pages 4 and 5. The small bands appear to be low molecular weight.
<< File: Heidelberg matrix 072513.doc >>
Thanks,
Alice
Alice L. Green, MS, DVM
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Douris, Aphrodite - FSISSent: Friday, October 25, 2013 2:02 PMTo: Dessai, Uday - FSIS; Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: RE: Heidelberg similarity matrix
Also, during the specpgm_02 Sept sampling we had a single positive with pattern .0122 and it is my understanding that this product tested is from the same establishment. Alice, is this correct?
Aphrodite DourisMicrobiologistOutbreaks Section, Eastern LaboratoryFood Safety and Inspection Service
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file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
The United States Department of AgricultureRussell Research Center950 College Station RoadAthens, GA [email protected]: (706) 546-2330 FAX:(706)546-3144
Privileged Communications: This transmission (and/or the documents accompanying it) may contain confidential information belonging to the sender. The information is intended only for the use of the individual or entity named in the distribution. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error, please notify us by telephone to arrange for the return of the documents.
From: Dessai, Uday - FSIS Sent: Friday, October 25, 2013 2:39 PMTo: Douris, Aphrodite - FSIS; Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSISSubject: Re: Heidelberg similarity matrix
Yep, I agree..so, no point asking CDC to relook at this, right!In that case:I think our focus should be that:1) Finding Salmonella in the product is relatively a rare event2) Finding Heidelberg in the product is even more rare3) Hence it is sufficint that we have case and product positive for Heidelberg4) The fact that although the PFGE patterns are different, are part of the O/B and very closely related (about 95% similar) - strengthens our conclusion about the link. Note: in this case PFGe should be used as added informance in establishing the link
Team - is this a fair argument given the circumstances around this O/B!
Thx
From: Douris, Aphrodite - FSIS Sent: Friday, October 25, 2013 02:23 PMTo: Dessai, Uday - FSIS; Green, Alice - FSIS Cc: Defibaugh-Chavez, Stephanie - FSIS Subject: RE: Heidelberg similarity matrix
Yes, I would say that these two patterns are significantly different.
Aphrodite DourisMicrobiologistOutbreaks Section, Eastern Laboratory
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Food Safety and Inspection ServiceThe United States Department of AgricultureRussell Research Center950 College Station RoadAthens, GA [email protected] <mailto:[email protected]> PHONE: (706) 546-2330 FAX:(706)546-3144
Privileged Communications: This transmission (and/or the documents accompanying it) may contain confidential information belonging to the sender. The information is intended only for the use of the individual or entity named in the distribution. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error, please notify us by telephone to arrange for the return of the documents.
_____________________________________________From: Dessai, Uday - FSISSent: Friday, October 25, 2013 2:22 PMTo: Green, Alice - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Douris, Aphrodite - FSISSubject: RE: Heidelberg similarity matrix
Thx much Alice and Douris.
Yep 2 bands different (~ 200 and ~ 80 region) as I see it on the picture.
Douris - does the ~ 200 region band constitute a real diffence ! ( I would imagin yes!)
Thanks
_____________________________________________From: Green, Alice - FSISSent: Friday, October 25, 2013 1:45 PMTo: Dessai, Uday - FSISCc: Defibaugh-Chavez, Stephanie - FSIS; Douris, Aphrodite - FSISSubject: Heidelberg similarity matrixImportance: High
This is the series of tables Aphrodite created in regards to this investigation back in July. Band comparisons for patterns 122 and 45 are on pages 4 and 5. The small bands appear to be low molecular weight.
<< File: Heidelberg matrix 072513.doc >>
Thanks,
Alice
Alice L. Green, MS, DVM
file:///Z|/All%202014%20FOIA's/01%20-%2050/14-07/from%20OPHS/14-07/AG/2013%20Foster%20Farms.txt[12/6/2013 3:31:24 PM]
Public Health and Epidemiology Liaison
Office of Public Health Science | Food Safety and Inspection Service | U.S. Department of Agriculture
Butler Square West | 100 North 6th Street, Suite 420-C | Minneapolis, MN, 55403
Tel: 612-659-8632 | Blackberry: 202-441-4752 | Cell: | Fax: 612-370-2070 | Email: [email protected] <mailto:[email protected]>
From: Peralta, Vi (CDPH-CID-DCDC-IDB) [[email protected]]Sent: Friday, October 25, 2013 1:44 PMTo: Green, Alice - FSISSubject: Safeway shopper card records Attachments: Safeway_pattern0022_CA005_M13X01887.xls; Safeway_pattern0022_CA08_M13X02218.xlsx; Safeway_pattern0022_CA012_M13X02445.xlsx; Safeway_pattern0022_CA025_M13X02989.xls; Safeway_pattern0045_CA012_M13X02584_daughter.xlsx; Safeway_pattern0045_CA017_M13X03242.xlsx; Safeway_pattern0045_CA020_M13X03447.xls; Safeway_pattern0258_CA017_M13X03485.xls; Safeway_pattern0258_CA019_M13X03917_card1.xls; Safeway_pattern0258_CA019_M13X03917_card2.xls
Hi Alice,
Since I’ve lost track of which Safeway records I have already sent, I am sending them all to you in this one email!
Vi
**********************************
Vi Peralta
Foodborne Epidemiologist
Disease Investigations Section
Infectious Diseases Branch
California Department of Public Health
850 Marina Bay Parkway | Building P, 2nd Floor | Richmond, CA 94804
Phone: 510-620-3633 | Fax: 510-620-3425 | Email: [email protected] <mailto:[email protected]>
CONFIDENTIALITY NOTICE WARNING: This transmission may contain confidential and proprietary information intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you have received this transmission in error, any disclosure, copying, distribution, downloading, uploading or the taking of any action in reliance on the contents of this information is strictly prohibited, and you are requested to immediately notify the above sender.
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Case Data (For Case No 2013-0702)
CONFIDENTIAL
1
CONFIDENTIAL
CCMS II Case Report For Case # 2013-0702 Page 1 of 12
10/30/2013 7:47:30AM
CONFIDENTIAL
1
Case OverviewCase In Charge Of OPHS
Case Status: Closed
Case Type: Illness
Alerts Were Sent To:
Reported Date: Monday, October 14, 2013
Entered By Agency: OFO - Alameda, CA (05)
Complainant State: NEVADA
Entered By:
Incident Date: 10/7/2013
Original Statement: The complainant bought 1 package (net weight 6.12 lbs.) of Foster Farms leg quarters on Monday,
Oct. 7, 2013, at approximately 0800 hours, from Food 4 Less on 8180 S. Las Vegas Blvd., Las
Vegas, Nevada. He said that, at approximately 1000 am on that same day, he cooked and
consumed some of the product. He said he went to sleep, and he woke up feeling muscle pains at
around 6pm or 7pm that day. He said he also experienced the following symptoms: headache, chills,
hot flashes, vomiting, and diarrhea. He said he also felt sluggish. He said he was experiencing these
symptoms until Friday, Oct. 11, when the diarrhea began to stop. He said he went to the hospital on
Sunday, October 13, for the pains he was still experiencing. He said the hospital wanted to take a
stool sample but that he already went to the bathroom before going to the hospital, so the hospital
took 2 blood samples (CBC,Chemistry) for diagnostics. He went to Valley Hospital Medical Center
on 620 Shadow Lane, Las Vegas, Nevada, 89106. The hospital gave him Cipro and Norco.
He indicated that the establishment number on the packaging is Est. P6137 with a use by/freeze by
date of October 9, 2013.
He said that he still has the product and packaging at his home. He is still currently experiencing
side pains on the right side of his body. He has not been able to eat. His headache comes and goes.
Complainant District: Alameda, CA (05)
Case Closing Reason: Wednesday, October 16, 2013 Not Investigated
Alleged incident appears isolated. Case will be archived and reevaluated should a similar
complaint be reported or additional information comes forward. Letter explaining disposition of
case will be sent to complainant. Plant will be informed of complaint by letter.
Tuesday, October 22, 2013 Not Investigated
Not Lab Confirmed, Not Isolated, Possibly Connected to a Recall or Investigation
Illness is not laboratory confirmed. This case may be associated with FSIS Recall # --- or a
current or recent outbreak investigation. Multiple complaints have been registered in CCMS as a
result of this recall or investigation, but the information provided in this case does not identify a
definitive relationship to other reported cases or investigations. The case will be archived and
reevaluated should additional information become available. No complainant address was
provided. Establishment (if identified) will be informed of complaint by letter.
Tuesday, October 29, 2013 Investigated, No Further Action Taken
Not Lab Confirmed, Not Isolated, Possibly Connected to a Recall or Investigation
Illness is not laboratory confirmed. This case may be associated with retail level recall 2013-058,
public health alert or a current or recent outbreak investigation. Multiple complaints have been
registered in CCMS as a result of this recall or investigation, but the information provided in this
case does not identify a definitive relationship to other reported cases or investigations. The case
will be archived and reevaluated should additional information become available. A letter
explaining the disposition of the case will be sent to complainant. Establishment will be informed
of complaint by letter.
Case Closing Remarks:
CONFIDENTIAL
CCMS II Case Report For Case # 2013-0702 Page 2 of 12
10/30/2013 7:47:30AM
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CONFIDENTIAL
1
Nature of Complaints
Is Primary Complaint Type Medical Visit Hospitalized Life Threatening Complaint Description
Illness Yes No NoYes
Case Symptoms
Symptom Onset Time Comment
24-72 HoursDiarrhea
24-72 HoursDiarrhea - Blood In
8-24 HoursPain - Muscle
3-8 HoursNausea
8-24 HoursVomiting
CONFIDENTIAL
CCMS II Case Report For Case # 2013-0702 Page 3 of 12
10/30/2013 7:47:30AM
CONFIDENTIAL
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ProductsCountry of Origin
Product Brand
Product Date
Product Name
Species
Est. District Name
Processing Type
Purchase Date
Package
Case Status
Lot:
US
Foster Farms
10/9/2013 12:00:00AM
Leg quarters
Chicken
Alameda, CA (05)
Raw - Not Ground
10/7/2013 12:00:00AM
6.12 lbs. net weight
New
Est. Number Est. District Role Establishment Name Primary Intl.
06137 P 05 Processing Foster Poultry Farms Yes
06137 P 05 Unknown Foster Poultry Farms
CONFIDENTIAL
CCMS II Case Report For Case # 2013-0702 Page 4 of 12
10/30/2013 7:47:30AM
CONFIDENTIAL
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Similar Cases
Case # Reported On Case Type Status Compl. Dist. qi qk qik v Reason
10/14/2013 4:59:18PM Illness Closed Alameda, CA (05)Manually identified
2013-0703
9/6/2012 9:10:05AM Illness Closed Boulder, CO (15) 0.00 0.00 0.00 0.112012-0464
10/11/2013 2:02:56PM Illness Closed Raleigh, NC (80) 0.00 0.00 0.00 0.112013-0698
10/17/2013 10:06:13AM Illness Closed Alameda, CA (05) 0.00 0.00 0.03 0.112013-0714
10/9/2013 2:11:08PM Illness Active Alameda, CA (05) 0.00 0.00 0.03 0.112013-0684
10/8/2013 1:46:03PM Illness Active Alameda, CA (05) 0.00 0.00 0.03 0.112013-0672
7/24/2012 4:13:49PM Illness Closed Boulder, CO (15) 0.00 0.00 0.00 0.112012-0407
10/9/2013 9:11:05AM Illness Closed Boulder, CO (15) 0.00 0.00 0.00 0.112013-0680
10/9/2013 2:11:28PM Illness Closed Alameda, CA (05) 0.00 0.00 0.00 0.112013-0687
CONFIDENTIAL
CCMS II Case Report For Case # 2013-0702 Page 5 of 12
10/30/2013 7:47:30AM
CONFIDENTIAL
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Case TasksBrand: Foster Farms
Product Name: Leg quarters
Upload Document 10/14/13 10/14/13 Complete Standard
PriorityCurrent StatusInitiated OnTask Type Last
Activity
Instructions:
Upload Document 10/16/13 10/16/13 Complete Standard
PriorityCurrent StatusInitiated OnTask Type Last
Activity
Instructions:
Upload Document 10/24/13 10/24/13 Complete Standard
PriorityCurrent StatusInitiated OnTask Type Last
Activity
Instructions:
Search CCMS and/or PBIS 10/16/13 10/16/13 Complete Standard
PriorityCurrent StatusInitiated OnTask Type Last
Activity
Search CCMS and/or PBISInstructions:
Action For Task:
Created On: 10/16/2013 9:03:05AM
Created By:
Task has been marked as 'Complete'. There was no follow-up Task generated.
Action For Task:
Created On: 10/16/2013 9:03:05AM
Created By:
Task Completion Report: ''
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Note For Task:
Created On: 10/16/2013 9:02:58AM
Created By:
[10/16/2013 9:02:58 AM] Manual review of CCMS data by establishment number revealed similar complaint(s)
reported within the last year.
Manual review of PBIS/PHIS data within the last 6 months revealed noncompliance (s) that may suggest a
direct relationship between this complaint and practices in the identified plant.
ccmsTitle:
Submit Products to Lab 10/29/13 10/24/13 Cancelled Standard
PriorityCurrent StatusInitiated OnTask Type Last
Activity
Submit Products to Lab
1. You have access to CCMS to review the case information and input notes. Here’s the link in
case you do not have it: http://ccms.fsis.usda.gov/ccmsweb/MainPage.aspx . Please remember
when logging in that your username should be reflected as “fsisusda\blaw” and your password is
your network password (the one you would use to log into your computer). If you experience any
errors logging in, please take a screen shot and call or send me an email so that I may assist you.
2. To complete the task you will need to do the following: Make arrangements with the
complainant to visually verify the establishment and any lot numbers from the index package,
examine the index and like-coded product, if available, and obtain photographic evidence to include
establishment and package coding information. Pictures of the product and packaging have already
been uploaded to the case, but you will need to verify that this is the same product that you are
collecting for sampling. Collect (See FSIS Directive 7355.1 and MLG Chapter 10 for guidance on
sample seals and procedures.) the index sample and any like-coded product and send to:
ATTN: Laboratory Supervisor, FSIS OSEL
Russell Research Center, 950 College Station Rd, Athens, GA 30605.
3. The following forms will need to be completed for sample collection and submission.
a. FSIS Form 10,000-2: Domestic Laboratory Report (inspector generated). Please let me know if
you do not have this form and we can email a copy to you.
b. FSIS Form 8000-17: Evidence Receipt and Chain of Custody should be filled out and included
with samples.
c. AES CCMS Verification Report (attached) – this is form that we created to standardized the
information collected during these investigations. If OIEA uses a different form or method of
collecting this information, please just send us (or input the updates into CCMS tasks notes) and we
can transfer the information to the form and upload it to CCMS.
See the document section for the the verification report form.
Thanks
Instructions:
Action For Task:
Created On: 10/29/2013 2:15:31PM
Created By:
Task has been marked as 'Cancelled'
CONFIDENTIAL
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Action For Task:
Created On: 10/29/2013 2:15:31PM
Created By:
Reason for cancellation: 'It was determined not to pursue the collection of the product from the consumer.'
Upload Document 10/14/13 10/14/13 Complete Standard
PriorityCurrent StatusInitiated OnTask Type Last
Activity
Instructions:
Search CCMS and/or PBIS 10/16/13 10/16/13 Cancelled Standard
PriorityCurrent StatusInitiated OnTask Type Last
Activity
Search CCMS and/or PBISInstructions:
Action For Task:
Created On: 10/16/2013 8:57:37AM
Created By:
Task has been marked as 'Cancelled'
Action For Task:
Created On: 10/16/2013 8:57:37AM
Created By:
Reason for cancellation: 'task'
Investigate: Interview Complainant 10/24/13 10/23/13 Complete Standard
PriorityCurrent StatusInitiated OnTask Type Last
Activity
Investigate: Interview ComplainantInstructions:
Action For Task:
Created On: 10/24/2013 12:45:59PM
Created By:
Task has been marked as 'Complete'. There was no follow-up Task generated.
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Action For Task:
Created On: 10/24/2013 12:45:59PM
Created By:
Task Completion Report: ''
Note For Task:
Created On: 10/23/2013 2:23:12PM
Created By:
[10/23/2013 2:23:12 PM] Spoke with complainant -
Purchased chicken - no receipt information
Baked chicken - overcooked with potatoes
Felt nauseated about 6-8 hours later
Ate two more pieces with bread
Started vomiting and diarrhea 12-24 hours later
Went to the ER 5 days after symptoms started
Was given medication. No stool sample availble.
Blood, Chemistry and UA were taken
Went back to ER for recheck.
US of gallbladder, stool sample, UA and more blood work pending.
Complainant feels somewhat better but is not back to normal. Mostly has a loss of appetite.
Interview with complainantTitle:
Note For Task:
Created On: 10/24/2013 12:45:44PM
Created By:
[10/24/2013 12:45:44 PM] Spoke with this am.
Blookwork results:
Alk P 176 (40-115)
AST 48 (10-35)
ALT 51 (9-46)
U/A within normal limits
Stool sample negative for Salmonella, Shigella and Campylobacter
Will give us product but not the whole thing. Advised him to keep frozen, not handle the product and discuss
with the investigator how they can get some of the product.
He still feels naseated and just not right.
[10/29/2013 2:19:10 PM] Spoke to complainant again that evening. Is unwilling to give the product to the
investigator at this time as he may want to pursue litigation.
spoke with complainantTitle:
Upload Document 10/14/13 10/14/13 Complete Standard
PriorityCurrent StatusInitiated OnTask Type Last
Activity
Instructions:
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Case Notes
Created By:
Created On: Wednesday, October 23, 2013
Modified By:
Modified On: Wednesday, October 23, 2013
Title: conversation
[10/23/2013 11:24:22 AM] bloodwork results
hematology 10/13/13
Procedure
WBC 3.5 (l)(3.8-10.8)
Chemistry- OK
urinalysis done on 15th - no stool sample
CDC with differential
CMP
Lipase
MICR(s)
US gallbladder
Sick on yesterday, pain behind left eye -cloudy vision
ach left thumb
Stomach - ADR, low appetite
Fatique
Gall bladder-US
[10/23/2013 2:16:23 PM] Stool sample collected on 10/18
Will try to get US,blood, urine and stool sample results today.
[10/23/2013 3:46:12 PM] There is no shopper card information.
Someone contacted the complainant to pick up the product.
He has raw product available.
He is going to the hospital tonight to get the lab results and says he will follow-up tomorrow.
Created By:
Created On: Tuesday, October 29, 2013
Modified By:
Modified On: Tuesday, October 29, 2013
Title: public health alert for Foster Farms raw product -
[10/29/2013 2:05:09 PM]
http://www.fsis.usda.gov/wps/portal/fsis/topics/recalls-and-public-health-alerts/current-recalls-and-alerts/!ut/p/a1/jY_BCoJAGISfxQdY9j
dF9CgLlpa7iGS2l1hMTdhWWa1DT5_SyUhy_tPAN_MzmOMccyWeTS2GplVCTp47F0jAMT0CEQv8AEJqBZlLtyYwZwTOM8AzJyBL2J
4QcKm1Mr8gH_7loxUPNjomcY15J4YbalTV4rx4aF2qAemyEFL2SKgrErLUQ49PmM87wRxv7EztXUQtYPY38GP0B1he1d2P-etQpWFt
GG85uhP2/?1dmy¤t=true&urile=wcm%3apath%3a%2Ffsis-content%2Finternet%2Fmain%2Fnewsroom%2Fnews-releases-stat
ements-and-transcripts%2Fnews-release-archives-by-year%2Farchive%2F2013%2Fpha-100713
Created By:
Created On: Thursday, October 24, 2013
Modified By:
Modified On: Thursday, October 24, 2013
Title: notes from field investigator
CONFIDENTIAL
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[10/24/2013 9:10:35 AM] Good Afternoon xxxxxx
Below is a summary of information gathered for CCMS cases 2013-0702. I will be out of the office tomorrow and Friday, and will be
back in the office Monday otherwise. Please feel free to contact me via blackberry if you should have any questions in the meantime.
Thanks.
2013-0702—On 10/22/13 left a message with complainant. Will follow up on 10/23/13.
On 10/23/13 complainant indicated that he still has product and willing to share for sample collection. Not willing to provide all left over
product because he wants to have some left for evidence, etc. Confirmed onset date of 10/7/13 and was FF leg quarters from Food 4
Less. The complainant also indicated that he regulatory purchases, cooks and consumes poultry products daily. Prior to 10/7/13,
complainant indicated that the regularly purchases Pilgrims Pride “ready-to-cook” whole chicken and chicken breasts from Walmart.
These stores have no shoppercard numbers. Complainant could not provide specific dates which Walmart poultry products were
purchased on, however, indicated that the FF product was purchased on 10/7/13 at Food 4 Less located at 8180 Las Vegas Blvd., Las
Vegas, NV. The complainant had the following tests done: blood chemistry (no culture/sensitivity conducted) and stool sample. He will
be provided test results later today or tomorrow morning and will let me know results tomorrow for stool sample.
Created By:
Created On: Tuesday, October 29, 2013
Modified By:
Modified On: Tuesday, October 29, 2013
Title: OIEA summary 10/23/13
[10/29/2013 2:12:09 PM] Good Afternoon:
Below is a summary of information gathered for CCMS cases 2013-0702. I will be out of the office tomorrow and Friday, and will be
back in the office Monday otherwise. Please feel free to contact me via blackberry if you should have any questions in the meantime.
Thanks.
2013-0702—On 10/22/13 left a message with complainant. Will follow up on 10/23/13.
On 10/23/13 complainant indicated that he still has product and willing to share for sample collection. Not willing to provide all left over
product because he wants to have some left for evidence, etc. Confirmed onset date of 10/7/13 and was FF leg quarters from Food 4
Less. The complainant also indicated that he regulatory purchases, cooks and consumes poultry products daily. Prior to 10/7/13,
complainant indicated that the regularly purchases Pilgrims Pride “ready-to-cook” whole chicken and chicken breasts from Walmart.
These stores have no shoppercard numbers. Complainant could not provide specific dates which Walmart poultry products were
purchased on, however, indicated that the FF product was purchased on 10/7/13 at Food 4 Less located at 8180 Las Vegas Blvd., Las
Vegas, NV. The complainant had the following tests done: blood chemistry (no culture/sensitivity conducted) and stool sample. He will
be provided test results later today or tomorrow morning and will let me know results tomorrow for stool sample.
CONFIDENTIAL
CCMS II Case Report For Case # 2013-0702 Page 11 of 12
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Uploaded Documents
Added On Added By Document Name Document Title Size (KB)
10/14/2013 C:\Documents and
Settings\All Users\Application
Data\USDA\FSIS\CCMS2\\C
CMS2TMP_f9d55494_ffc1_42
0d_a99c_19232f9c068c.data
Leg quarters package, picture 3 594.75
10/16/2013 C:\Documents and
Settings\All Users\Application
Data\USDA\FSIS\CCMS2\\C
CMS2TMP_98c05bc2_5957_
48f4_83ca_155297db7e78.da
ta
est. letter 2,174.30
10/24/2013 C:\Documents and
Settings\All Users\Application
Data\USDA\FSIS\CCMS2\\C
CMS2TMP_c82809d7_7234_
406b_9349_56444c74002a.d
ata
verification form 516.98
10/14/2013 C:\Documents and
Settings\All Users\Application
Data\USDA\FSIS\CCMS2\\C
CMS2TMP_22123e8b_e77c_
44f1_8faa_dbf90c713900.dat
a
Leg quarters package, picture 2 547.21
10/14/2013 C:\Documents and
Settings\All Users\Application
Data\USDA\FSIS\CCMS2\\C
CMS2TMP_ab73b5dd_f57e_4
c23_b59d_e15364e8968b.dat
a
Leg quarters package, picture 1 653.50
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United States Department of Agriculture
Food Safety and Inspection Service
Office of Public Health Science
Washington, D.C. 20250
October 16, 2013 To: Foster Poultry Farms 1000 Davis St. Livingston, CA 95334 From: Consumer Complaint Monitoring System Food Safety and Inspection Service Please find enclosed a copy of a consumer complaint received by the U.S. Department of Agriculture, Food Safety and Inspection Service (FSIS). According to the consumer report, the complaint involves a product produced by your establishment. FSIS has entered the information into the Consumer Complaint Monitoring System - an electronic database designed to document and track all consumer complaints received by the agency. FSIS has determined that no further action is necessary at this time. However, your review of the enclosed report may indicate that unilateral actions on your part are needed. You do not need to reply to this communication. Sincerely, The CCMS Surveillance Team Applied Epidemiology Division Office of Public Health Science
Case Number: 2013-0702 Date Reported: 10/14/2013 Complainant Location: Las Vegas, NV Establishment: 06137 P Foster Poultry Farms Product Brand: Foster Farms Product Name: Leg quarters Package Size: 6.12 lbs. net weight Codes: Purchase Point: Food 4 Less Date: 10/7/2013 Primary Complaint: Illness Complainant Comment: The complainant bought 1 package (net weight 6.12 lbs.) of Foster Farms leg quarters on Monday, Oct. 7, 2013, at approximately 0800 hours, from Food 4 Less on 8180 S. Las Vegas Blvd., Las Vegas, Nevada. He said that, at approximately 1000 hours on that same day, he cooked and consumed some of the product. He said he went to sleep, and he woke up feeling muscle pains at around 6pm or 7pm that day. He said he also experienced the following symptoms: headache, chills, hot flashes, vomiting, and diarrhea. He said he also felt sluggish. He said he was experiencing these symptoms until Friday, Oct. 11, when the diarrhea began to stop. He said he went to the hospital on Sunday, October 13, for the pains he was still experiencing. He said the hospital wanted to take a stool sample but that he already went to the bathroom before going to the hospital, so the hospital took 2 blood samples for diagnostics. He went to Valley Hospital Medical Center on 620 Shadow Lane, Las Vegas, Nevada, 89106. The hospital gave him Cipro and Norco. He indicated that the establishment number on the packaging is Est. P6137 with a use by/freeze by date of October 9, 2013. He said that he still has the product and packaging at his home. He is still currently experiencing side pains on the right side of his body. He has not been able to eat. His headache comes and goes. Sampling Instructions: NOTICE: REPORT CONTAINS UNVERIFIED INFORMATION FURNISHED BY COMPLAINANT
0
1
2
3
4
5
Num
ber o
f Pat
ient
s
Illness Onset Date
Probable (n=14)Confirmed (n = 13)
San Mateo County (CA) Salmonella Infection Cluster Case-Patients by Illness Onset Date, September 2013 (N=27)
(as of 10/4/13)
Date of Illness Onset
Persons infected with the outbreak strains of Salmonella Heidelberg and by date of illness onset*
Number of persons
2013
*known and estimated onset date
0
1
2
3
4
5
6
2/22 3/1 3/8 3/15 3/22 3/29 4/5 4/12 4/19 4/26 5/3 5/10 5/17 5/24 5/31 6/7 6/14 6/21 6/28 7/5 7/12 7/19 7/26 8/2 8/9 8/16 8/23 8/30 9/6 9/13 9/20
JF6X01.0672JF6X01.0326JF6X01.0258JF6X01.0122JF6X01.0045JF6X01.0041JF6X01.0022
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Information reported may be incomplete and should be considered preliminary. It is subject to change as information is updated. More detailed information is available upon request. This information is to be considered confidential and is to be shared with colleagues on a strict need-to-know basis. Case-specific health information, proprietary information, and
establishment-specific information should be carefully reviewed before further dissemination.
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CCMS II EIAO Verification Report
CCMS Case Number Reporting Date Incident Date and Complaint Description
2013-0702
10/14/2013 Illness possibly associated with raw
10/07/2013 chicken product; Medical visit required. I
I
Please verify the following information when visiting with the consumer:
EST Number Establishment Name and Address
P6137 Foster Poultry Farms Livingston, CA 95334
Use/Sell By Date Product Name(s) and Description
10/09/2013 Foster Farms Leg Quarters
Lot Number Explanation of Product Date and Lotting
FSIS Processing Type (Select One)
l:l
1. What is the condition of the index product packaging? (e.g.,intact,non-intact,puncture holes, etc.)
2. What is the condition of the index product? (e.g., no abnormalities,off-color,off-odor,etc.)
3. Description of foreign object(s),if applicable.
Type
Shape
Color
Dimensions
4. Additional observations or notes:
5. Sampling submission instructions:
please collect and send to:
ATTN: Laboratory Supervisor, FSIS OSEL Russell Research Center, 950 College Station Rd, Athens, GA 30605.
NOTE: FSIS Forms 10,000-2: Domestic Laboratory Report (inspector generated) and 8000-17: Evidence Receipt and Chain of Custody should be filled out and included with samples. See FSIS Directive 7355.1 and MLG Chapter 10 for guidance on sample seals and procedures. 11
6. Insert pictures in the spaces provided. Pictures should contain at a minimum, packaging codes, the product and foreign objects against an object for size comparison (e.g. coin, ruler, etc.). Double click above the word "Image" to add files.
NOTE: The total file size for all pictures should be no greater than 2 MB or the system may time-out when attempting to upload the file. Please use a picture editing program such as Microsoft Office Picture Manager to compress the file sizes, if necessary. large files or extra pictures can be uploaded directly to the documents sections of the case.
Image 1 Image 2
I Reset Image 1
I I Reset Image 2 I
lmage3 lmage4
I Reset Image 3 I I Reset Image 4 I
NOTE: When completmg th1s form, please be as descnpt1ve as poss1ble m order to g1ve the reader a clear p1cture of what
you are relating in each response. Thank you.