VirginiaKatherine G. McCombs, MPH

Foodborne Disease Epidemiology Program Coordinator

Virginia Department of Health

And

Lauren Turner, Ph.D.

Foodborne and Advanced Pathogen Characterization Lead Scientist

Division of Consolidated Laboratory Services

Department of General Services

Country Ham vs. Deli Ham vs. Country Ham Sliced

Reported Listeriosis Cases by Year

Virginia, 2008-2018

0

5

10

15

20

25

30

35

40

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Num

ber

of

Lis

teri

osi

sCase

s

Year

Patient Information

Patient 1 (2017)

• Onset 7/8/2017

• 70 years of age

• underlying illnesses

• hospitalized for illness

• survived illness

• died in July 2018

Patient 3 (2018)

• Onset 6/19/2018

• 70 years of age

• underlying illness and dementia

• survived

• died in August 2018

Patient 2 (2018)

• Onset 6/14/2018

• 81 years of age

• underlying illnesses

• living in an ALF

• Died in June 2018 from

the illness

Timeline of Listeriosis Investigation, Virginia

7/7/17:

P1 Onset

Timeline of Listeriosis Investigation, Virginia

7/7/17:

P1 Onset

4/28/18:

P2 to ALF

Timeline of Listeriosis Investigation, Virginia

7/7/17:

P1 Onset

4/28/18:

P2 to ALF

6/14:

P2 Illness Onset

Timeline of Listeriosis Investigation, Virginia

7/7/17:

P1 Onset

4/28/18:

P2 to ALF

6/14:

P2 Illness Onset

6/18:

P2 Dies

Timeline of Listeriosis Investigation, Virginia

7/7/17:

P1 Onset

4/28/18:

P2 to ALF

6/14:

P2 Illness Onset

6/18:

P2 Dies

6/19:

P3 Illness Onset

Timeline of Listeriosis Investigation, Virginia

7/7/17:

P1 Onset

4/28/18:

P2 to ALF

6/14:

P2 Illness Onset

6/18:

P2 Dies

6/19:

P3 Illness Onset

6/22:

Interview at ALF for P2

Timeline of Listeriosis Investigation, Virginia

7/7/17:

P1 Onset

4/28/18:

P2 to ALF

6/14:

P2 Illness Onset

6/18:

P2 Dies

6/19:

P3 Illness Onset

6/22:

Interview at ALF for P2

6/29-7/3:

Interviews with family of

P2

Timeline of Listeriosis Investigation, Virginia

7/7/17:

P1 Onset

4/28/18: P2 to ALF

6/14:

P2 Illness Onset

6/18:

P2 Dies

6/19:

P3 Illness Onset

6/22:

Interview at ALF for P2

6/29-7/3:

Interviews with family

of P2

7/2:

DCLS informs of

cluster

Requirement for

submission of Listeria

monocytogenes to DCLS

DCLS’ Laboratory Testing Algorithm for Listeria monocytogenes

Day 1: Purity checkPass for Molecular

Day 2 - 4 Pathogen Confirmatory Identification

Day 2 - 4 Molecular Subtyping by PFGE

Lab Team Day 0 Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7/8

Micro Test Isolate Receipt and subculture

Purity check Confirmatory Identification

PFGE Test Plug Preparation Restriction Digestion

Gel Analysis

WGS Test DNA extraction Library Preparation/MiSeq Run Data Review and Analysis:• Run Metrics• Worksheets• BioNumericsReporting to VDH/CDC

1807VAGX6-1: Virginia Testing Timeline

2017

July

July

July

2018

VDH Epidemiologist Notification Format

1807VAGX6-1: August 13, 2018

Updated: 2018-08-13

wgMLST (<All Characters>)

100 Key

USDA_853313749

VA___R180620742

VA___R180617588

USDA_590324576

VA___R170709909

USDA_210373329

Modified date

.

.

.

.

.

.

cdc_id

2018L-6276

2018L-6221

2017L-6294

WGS_id

FSIS31800263

PNUSAL004057

PNUSAL004045

FSIS1606762

PNUSAL003187

FSIS11809104

NCBI_ACCESSION

.

.

.

.

.

.

SRR_ID

.

.

.

.

.

.

WGST

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

Outbreak

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

SourceType

.

.

.

.

.

.

SourceSite

Pork

Blood

Blood

Pork

Blood

Pork

TypeDetails

.

PulseNet_UploadDate

.

.

.

.

.

.

IsolatDate

2018-03-08

2018-06-19

2018-06-15

2016-05-12

2017-07-08

2018-03-28

ReceivedDate

.

.

.

.

.

.

UploadDate

.

.

.

.

.

.

PFGE-AscI-pattern

GX6A16.0048

GX6A16.0048

PFGE-AscI-status

.

.

PFGE-ApaI-pattern

GX6A12.0804

GX6A12.0804

PFGE-ApaI-status

.

.

Genus

.

.

.

.

.

.

Species

.

.

.

.

.

.

Lineage

.

.

.

.

.

.

Serotype

not typed

not typed

not typed

not typed

not typed

not typed

ANI

.

.

.

.

.

.

ANICoverage

.

.

.

.

.

.

MLST loci ST

.

.

.

.

.

.

SequencerRun_id

.

.

commentsExposureLabID

.

.

.

.

.

.

ListMemberNARMS-EBNCBISubmissionDateOtherStateIsolatePatientAgeDaysPatientAgeMonthsPatientAgeYears

.

.

.

PatientSex

.

.

.

PFGE-ApaI-file

.

.

PFGE-ApaI-rundatePFGE-AscI-file

.

.

PFGE-AscI-rundatePFGE-SmaI-filePFGE-SmaI-patternPFGE-SmaI-rundatePFGE-SmaI-statusSourceCity

.

.

.

SourceCountry

.

.

.

.

.

.

SourceCounty

.

.

.

SourceState

NC

VA

VA

NC

VA

NC

4[1,7]

wgMLST (<All Characters>)

100 Key

USDA_853313749

VA___R180620742

VA___R180617588

USDA_590324576

VA___R170709909

USDA_210373329

Modified date

.

.

.

.

.

.

cdc_id

2018L-6276

2018L-6221

2017L-6294

WGS_id

FSIS31800263

PNUSAL004057

PNUSAL004045

FSIS1606762

PNUSAL003187

FSIS11809104

NCBI_ACCESSION

.

.

.

.

.

.

SRR_ID

.

.

.

.

.

.

WGST

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

Outbreak

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

SourceType

.

.

.

.

.

.

SourceSite

Pork

Blood

Blood

Pork

Blood

Pork

TypeDetails

.

PulseNet_UploadDate

.

.

.

.

.

.

IsolatDate

2018-03-08

2018-06-19

2018-06-15

2016-05-12

2017-07-08

2018-03-28

ReceivedDate

.

.

.

.

.

.

UploadDate

.

.

.

.

.

.

PFGE-AscI-pattern

GX6A16.0048

GX6A16.0048

PFGE-AscI-status

.

.

PFGE-ApaI-pattern

GX6A12.0804

GX6A12.0804

PFGE-ApaI-status

.

.

Genus

.

.

.

.

.

.

Species

.

.

.

.

.

.

Lineage

.

.

.

.

.

.

Serotype

not typed

not typed

not typed

not typed

not typed

not typed

ANI

.

.

.

.

.

.

ANICoverage

.

.

.

.

.

.

MLST loci ST

.

.

.

.

.

.

SequencerRun_id

.

.

commentsExposureLabID

.

.

.

.

.

.

ListMemberNARMS-EBNCBISubmissionDateOtherStateIsolatePatientAgeDaysPatientAgeMonthsPatientAgeYears

.

.

.

PatientSex

.

.

.

PFGE-ApaI-file

.

.

PFGE-ApaI-rundatePFGE-AscI-file

.

.

PFGE-AscI-rundatePFGE-SmaI-filePFGE-SmaI-patternPFGE-SmaI-rundatePFGE-SmaI-statusSourceCity

.

.

.

SourceCountry

.

.

.

.

.

.

SourceCounty

.

.

.

SourceState

NC

VA

VA

NC

VA

NC

wgMLST (<All Characters>)

100 Key

USDA_853313749

VA___R180620742

VA___R180617588

USDA_590324576

VA___R170709909

USDA_210373329

Modified date

.

.

.

.

.

.

cdc_id

2018L-6276

2018L-6221

2017L-6294

WGS_id

FSIS31800263

PNUSAL004057

PNUSAL004045

FSIS1606762

PNUSAL003187

FSIS11809104

NCBI_ACCESSION

.

.

.

.

.

.

SRR_ID

.

.

.

.

.

.

WGST

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

Outbreak

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

SourceType

.

.

.

.

.

.

SourceSite

Pork

Blood

Blood

Pork

Blood

Pork

TypeDetails

.

PulseNet_UploadDate

.

.

.

.

.

.

IsolatDate

2018-03-08

2018-06-19

2018-06-15

2016-05-12

2017-07-08

2018-03-28

ReceivedDate

.

.

.

.

.

.

UploadDate

.

.

.

.

.

.

PFGE-AscI-pattern

GX6A16.0048

GX6A16.0048

PFGE-AscI-status

.

.

PFGE-ApaI-pattern

GX6A12.0804

GX6A12.0804

PFGE-ApaI-status

.

.

Genus

.

.

.

.

.

.

Species

.

.

.

.

.

.

Lineage

.

.

.

.

.

.

Serotype

not typed

not typed

not typed

not typed

not typed

not typed

ANI

.

.

.

.

.

.

ANICoverage

.

.

.

.

.

.

MLST loci ST

.

.

.

.

.

.

SequencerRun_id

.

.

commentsExposureLabID

.

.

.

.

.

.

ListMemberNARMS-EBNCBISubmissionDateOtherStateIsolatePatientAgeDaysPatientAgeMonthsPatientAgeYears

.

.

.

PatientSex

.

.

.

PFGE-ApaI-file

.

.

PFGE-ApaI-rundatePFGE-AscI-file

.

.

PFGE-AscI-rundatePFGE-SmaI-filePFGE-SmaI-patternPFGE-SmaI-rundatePFGE-SmaI-statusSourceCity

.

.

.

SourceCountry

.

.

.

.

.

.

SourceCounty

.

.

.

SourceState

NC

VA

VA

NC

VA

NC

wgMLST (<All Characters>)

100 Key

USDA_853313749

VA___R180620742

VA___R180617588

USDA_590324576

VA___R170709909

USDA_210373329

Modified date

.

.

.

.

.

.

cdc_id

2018L-6276

2018L-6221

2017L-6294

WGS_id

FSIS31800263

PNUSAL004057

PNUSAL004045

FSIS1606762

PNUSAL003187

FSIS11809104

NCBI_ACCESSION

.

.

.

.

.

.

SRR_ID

.

.

.

.

.

.

WGST

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

Outbreak

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

SourceType

.

.

.

.

.

.

SourceSite

Pork

Blood

Blood

Pork

Blood

Pork

TypeDetails

.

PulseNet_UploadDate

.

.

.

.

.

.

IsolatDate

2018-03-08

2018-06-19

2018-06-15

2016-05-12

2017-07-08

2018-03-28

ReceivedDate

.

.

.

.

.

.

UploadDate

.

.

.

.

.

.

PFGE-AscI-pattern

GX6A16.0048

GX6A16.0048

PFGE-AscI-status

.

.

PFGE-ApaI-pattern

GX6A12.0804

GX6A12.0804

PFGE-ApaI-status

.

.

Genus

.

.

.

.

.

.

Species

.

.

.

.

.

.

Lineage

.

.

.

.

.

.

Serotype

not typed

not typed

not typed

not typed

not typed

not typed

ANI

.

.

.

.

.

.

ANICoverage

.

.

.

.

.

.

MLST loci ST

.

.

.

.

.

.

SequencerRun_id

.

.

commentsExposureLabID

.

.

.

.

.

.

ListMemberNARMS-EBNCBISubmissionDateOtherStateIsolatePatientAgeDaysPatientAgeMonthsPatientAgeYears

.

.

.

PatientSex

.

.

.

PFGE-ApaI-file

.

.

PFGE-ApaI-rundatePFGE-AscI-file

.

.

PFGE-AscI-rundatePFGE-SmaI-filePFGE-SmaI-patternPFGE-SmaI-rundatePFGE-SmaI-statusSourceCity

.

.

.

SourceCountry

.

.

.

.

.

.

SourceCounty

.

.

.

SourceState

NC

VA

VA

NC

VA

NC

wgMLST (<All Characters>)

100 Key

USDA_853313749

VA___R180620742

VA___R180617588

USDA_590324576

VA___R170709909

USDA_210373329

Modified date

.

.

.

.

.

.

cdc_id

2018L-6276

2018L-6221

2017L-6294

WGS_id

FSIS31800263

PNUSAL004057

PNUSAL004045

FSIS1606762

PNUSAL003187

FSIS11809104

NCBI_ACCESSION

.

.

.

.

.

.

SRR_ID

.

.

.

.

.

.

WGST

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

Outbreak

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

SourceType

.

.

.

.

.

.

SourceSite

Pork

Blood

Blood

Pork

Blood

Pork

TypeDetails

.

PulseNet_UploadDate

.

.

.

.

.

.

IsolatDate

2018-03-08

2018-06-19

2018-06-15

2016-05-12

2017-07-08

2018-03-28

ReceivedDate

.

.

.

.

.

.

UploadDate

.

.

.

.

.

.

PFGE-AscI-pattern

GX6A16.0048

GX6A16.0048

PFGE-AscI-status

.

.

PFGE-ApaI-pattern

GX6A12.0804

GX6A12.0804

PFGE-ApaI-status

.

.

Genus

.

.

.

.

.

.

Species

.

.

.

.

.

.

Lineage

.

.

.

.

.

.

Serotype

not typed

not typed

not typed

not typed

not typed

not typed

ANI

.

.

.

.

.

.

ANICoverage

.

.

.

.

.

.

MLST loci ST

.

.

.

.

.

.

SequencerRun_id

.

.

commentsExposureLabID

.

.

.

.

.

.

ListMemberNARMS-EBNCBISubmissionDateOtherStateIsolatePatientAgeDaysPatientAgeMonthsPatientAgeYears

.

.

.

PatientSex

.

.

.

PFGE-ApaI-file

.

.

PFGE-ApaI-rundatePFGE-AscI-file

.

.

PFGE-AscI-rundatePFGE-SmaI-filePFGE-SmaI-patternPFGE-SmaI-rundatePFGE-SmaI-statusSourceCity

.

.

.

SourceCountry

.

.

.

.

.

.

SourceCounty

.

.

.

SourceState

NC

VA

VA

NC

VA

NC

wgMLST (<All Characters>)

100 Key

USDA_853313749

VA___R180620742

VA___R180617588

USDA_590324576

VA___R170709909

USDA_210373329

Modified date

.

.

.

.

.

.

cdc_id

2018L-6276

2018L-6221

2017L-6294

WGS_id

FSIS31800263

PNUSAL004057

PNUSAL004045

FSIS1606762

PNUSAL003187

FSIS11809104

NCBI_ACCESSION

.

.

.

.

.

.

SRR_ID

.

.

.

.

.

.

WGST

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

Outbreak

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

SourceType

.

.

.

.

.

.

SourceSite

Pork

Blood

Blood

Pork

Blood

Pork

TypeDetails

.

PulseNet_UploadDate

.

.

.

.

.

.

IsolatDate

2018-03-08

2018-06-19

2018-06-15

2016-05-12

2017-07-08

2018-03-28

ReceivedDate

.

.

.

.

.

.

UploadDate

.

.

.

.

.

.

PFGE-AscI-pattern

GX6A16.0048

GX6A16.0048

PFGE-AscI-status

.

.

PFGE-ApaI-pattern

GX6A12.0804

GX6A12.0804

PFGE-ApaI-status

.

.

Genus

.

.

.

.

.

.

Species

.

.

.

.

.

.

Lineage

.

.

.

.

.

.

Serotype

not typed

not typed

not typed

not typed

not typed

not typed

ANI

.

.

.

.

.

.

ANICoverage

.

.

.

.

.

.

MLST loci ST

.

.

.

.

.

.

SequencerRun_id

.

.

commentsExposureLabID

.

.

.

.

.

.

ListMemberNARMS-EBNCBISubmissionDateOtherStateIsolatePatientAgeDaysPatientAgeMonthsPatientAgeYears

.

.

.

PatientSex

.

.

.

PFGE-ApaI-file

.

.

PFGE-ApaI-rundatePFGE-AscI-file

.

.

PFGE-AscI-rundatePFGE-SmaI-filePFGE-SmaI-patternPFGE-SmaI-rundatePFGE-SmaI-statusSourceCity

.

.

.

SourceCountry

.

.

.

.

.

.

SourceCounty

.

.

.

SourceState

NC

VA

VA

NC

VA

NC

wgMLST (<All Characters>)

100 Key

USDA_853313749

VA___R180620742

VA___R180617588

USDA_590324576

VA___R170709909

USDA_210373329

Modified date

.

.

.

.

.

.

cdc_id

2018L-6276

2018L-6221

2017L-6294

WGS_id

FSIS31800263

PNUSAL004057

PNUSAL004045

FSIS1606762

PNUSAL003187

FSIS11809104

NCBI_ACCESSION

.

.

.

.

.

.

SRR_ID

.

.

.

.

.

.

WGST

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

Outbreak

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

SourceType

.

.

.

.

.

.

SourceSite

Pork

Blood

Blood

Pork

Blood

Pork

TypeDetails

.

PulseNet_UploadDate

.

.

.

.

.

.

IsolatDate

2018-03-08

2018-06-19

2018-06-15

2016-05-12

2017-07-08

2018-03-28

ReceivedDate

.

.

.

.

.

.

UploadDate

.

.

.

.

.

.

PFGE-AscI-pattern

GX6A16.0048

GX6A16.0048

PFGE-AscI-status

.

.

PFGE-ApaI-pattern

GX6A12.0804

GX6A12.0804

PFGE-ApaI-status

.

.

Genus

.

.

.

.

.

.

Species

.

.

.

.

.

.

Lineage

.

.

.

.

.

.

Serotype

not typed

not typed

not typed

not typed

not typed

not typed

ANI

.

.

.

.

.

.

ANICoverage

.

.

.

.

.

.

MLST loci ST

.

.

.

.

.

.

SequencerRun_id

.

.

commentsExposureLabID

.

.

.

.

.

.

ListMemberNARMS-EBNCBISubmissionDateOtherStateIsolatePatientAgeDaysPatientAgeMonthsPatientAgeYears

.

.

.

PatientSex

.

.

.

PFGE-ApaI-file

.

.

PFGE-ApaI-rundatePFGE-AscI-file

.

.

PFGE-AscI-rundatePFGE-SmaI-filePFGE-SmaI-patternPFGE-SmaI-rundatePFGE-SmaI-statusSourceCity

.

.

.

SourceCountry

.

.

.

.

.

.

SourceCounty

.

.

.

SourceState

NC

VA

VA

NC

VA

NC

1807VAGX6-1: August 30, 2018wgMLST Analysis

Updated: 2018-08-30

3.0 [1, 7]

wgMLST (<All Characters>)

100 Key

NC___MB081518-0059

VA___R180620742

USDA_853313749

VA___R180617588

USDA_590324576

VA___R170709909

USDA_210373329

Modified date

.

.

.

.

.

.

.

cdc_id

2018L-6276

2018L-6221

2017L-6294

WGS_id

PNUSAL004247

PNUSAL004057

FSIS31800263

PNUSAL004045

FSIS1606762

PNUSAL003187

FSIS11809104

NCBI_ACCESSION

.

.

.

.

.

.

.

SRR_ID

.

.

.

.

.

.

.

WGST

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

Outbreak

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

SourceType

.

.

.

.

.

.

.

SourceSite

Blood

Blood

Pork

Blood

Pork

Blood

Pork

TypeDetails

.

PulseNet_UploadDate

.

.

.

.

.

.

.

IsolatDate

2018-08-11

2018-06-19

2018-03-08

2018-06-15

2016-05-12

2017-07-08

2018-03-28

ReceivedDate

.

.

.

.

.

.

.

UploadDate

.

.

.

.

.

.

.

PFGE-AscI-pattern

GX6A16.0048

GX6A16.0048

PFGE-AscI-status

.

.

PFGE-ApaI-pattern

GX6A12.0804

GX6A12.0804

PFGE-ApaI-status

.

.

Genus

.

.

.

.

.

.

.

Species

.

.

.

.

.

.

.

Lineage

.

.

.

.

.

.

.

Serotype

not typed

not typed

not typed

not typed

not typed

not typed

not typed

ANI

.

.

.

.

.

.

.

ANICoverage

.

.

.

.

.

.

.

MLST loci ST

.

.

.

.

.

.

.

SequencerRun_id

.

.

.

commentsExposureLabID

.

.

.

.

.

.

.

ListMemberNARMS-EBNCBISubmissionDateOtherStateIsolatePatientAgeDaysPatientAgeMonthsPatientAgeYears

.

.

.

.

PatientSex

.

.

.

.

PFGE-ApaI-file

.

.

PFGE-ApaI-rundatePFGE-AscI-file

.

.

PFGE-AscI-rundatePFGE-SmaI-filePFGE-SmaI-patternPFGE-SmaI-rundatePFGE-SmaI-statusSourceCity

.

.

.

.

SourceCountry

.

.

.

.

.

.

.

SourceCounty

.

.

.

.

SourceState

NC

VA

NC

VA

NC

VA

NC

3.0 [1, 7]

wgMLST (<All Characters>)

100 Key

NC___MB081518-0059

VA___R180620742

USDA_853313749

VA___R180617588

USDA_590324576

VA___R170709909

USDA_210373329

Modified date

.

.

.

.

.

.

.

cdc_id

2018L-6276

2018L-6221

2017L-6294

WGS_id

PNUSAL004247

PNUSAL004057

FSIS31800263

PNUSAL004045

FSIS1606762

PNUSAL003187

FSIS11809104

NCBI_ACCESSION

.

.

.

.

.

.

.

SRR_ID

.

.

.

.

.

.

.

WGST

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

Outbreak

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

SourceType

.

.

.

.

.

.

.

SourceSite

Blood

Blood

Pork

Blood

Pork

Blood

Pork

TypeDetails

.

PulseNet_UploadDate

.

.

.

.

.

.

.

IsolatDate

2018-08-11

2018-06-19

2018-03-08

2018-06-15

2016-05-12

2017-07-08

2018-03-28

ReceivedDate

.

.

.

.

.

.

.

UploadDate

.

.

.

.

.

.

.

PFGE-AscI-pattern

GX6A16.0048

GX6A16.0048

PFGE-AscI-status

.

.

PFGE-ApaI-pattern

GX6A12.0804

GX6A12.0804

PFGE-ApaI-status

.

.

Genus

.

.

.

.

.

.

.

Species

.

.

.

.

.

.

.

Lineage

.

.

.

.

.

.

.

Serotype

not typed

not typed

not typed

not typed

not typed

not typed

not typed

ANI

.

.

.

.

.

.

.

ANICoverage

.

.

.

.

.

.

.

MLST loci ST

.

.

.

.

.

.

.

SequencerRun_id

.

.

.

commentsExposureLabID

.

.

.

.

.

.

.

ListMemberNARMS-EBNCBISubmissionDateOtherStateIsolatePatientAgeDaysPatientAgeMonthsPatientAgeYears

.

.

.

.

PatientSex

.

.

.

.

PFGE-ApaI-file

.

.

PFGE-ApaI-rundatePFGE-AscI-file

.

.

PFGE-AscI-rundatePFGE-SmaI-filePFGE-SmaI-patternPFGE-SmaI-rundatePFGE-SmaI-statusSourceCity

.

.

.

.

SourceCountry

.

.

.

.

.

.

.

SourceCounty

.

.

.

.

SourceState

NC

VA

NC

VA

NC

VA

NC

3.0 [1, 7]

wgMLST (<All Characters>)

100 Key

NC___MB081518-0059

VA___R180620742

USDA_853313749

VA___R180617588

USDA_590324576

VA___R170709909

USDA_210373329

Modified date

.

.

.

.

.

.

.

cdc_id

2018L-6276

2018L-6221

2017L-6294

WGS_id

PNUSAL004247

PNUSAL004057

FSIS31800263

PNUSAL004045

FSIS1606762

PNUSAL003187

FSIS11809104

NCBI_ACCESSION

.

.

.

.

.

.

.

SRR_ID

.

.

.

.

.

.

.

WGST

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

Outbreak

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

SourceType

.

.

.

.

.

.

.

SourceSite

Blood

Blood

Pork

Blood

Pork

Blood

Pork

TypeDetails

.

PulseNet_UploadDate

.

.

.

.

.

.

.

IsolatDate

2018-08-11

2018-06-19

2018-03-08

2018-06-15

2016-05-12

2017-07-08

2018-03-28

ReceivedDate

.

.

.

.

.

.

.

UploadDate

.

.

.

.

.

.

.

PFGE-AscI-pattern

GX6A16.0048

GX6A16.0048

PFGE-AscI-status

.

.

PFGE-ApaI-pattern

GX6A12.0804

GX6A12.0804

PFGE-ApaI-status

.

.

Genus

.

.

.

.

.

.

.

Species

.

.

.

.

.

.

.

Lineage

.

.

.

.

.

.

.

Serotype

not typed

not typed

not typed

not typed

not typed

not typed

not typed

ANI

.

.

.

.

.

.

.

ANICoverage

.

.

.

.

.

.

.

MLST loci ST

.

.

.

.

.

.

.

SequencerRun_id

.

.

.

commentsExposureLabID

.

.

.

.

.

.

.

ListMemberNARMS-EBNCBISubmissionDateOtherStateIsolatePatientAgeDaysPatientAgeMonthsPatientAgeYears

.

.

.

.

PatientSex

.

.

.

.

PFGE-ApaI-file

.

.

PFGE-ApaI-rundatePFGE-AscI-file

.

.

PFGE-AscI-rundatePFGE-SmaI-filePFGE-SmaI-patternPFGE-SmaI-rundatePFGE-SmaI-statusSourceCity

.

.

.

.

SourceCountry

.

.

.

.

.

.

.

SourceCounty

.

.

.

.

SourceState

NC

VA

NC

VA

NC

VA

NC

3.0 [1, 7]

wgMLST (<All Characters>)

100 Key

NC___MB081518-0059

VA___R180620742

USDA_853313749

VA___R180617588

USDA_590324576

VA___R170709909

USDA_210373329

Modified date

.

.

.

.

.

.

.

cdc_id

2018L-6276

2018L-6221

2017L-6294

WGS_id

PNUSAL004247

PNUSAL004057

FSIS31800263

PNUSAL004045

FSIS1606762

PNUSAL003187

FSIS11809104

NCBI_ACCESSION

.

.

.

.

.

.

.

SRR_ID

.

.

.

.

.

.

.

WGST

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

Outbreak

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

SourceType

.

.

.

.

.

.

.

SourceSite

Blood

Blood

Pork

Blood

Pork

Blood

Pork

TypeDetails

.

PulseNet_UploadDate

.

.

.

.

.

.

.

IsolatDate

2018-08-11

2018-06-19

2018-03-08

2018-06-15

2016-05-12

2017-07-08

2018-03-28

ReceivedDate

.

.

.

.

.

.

.

UploadDate

.

.

.

.

.

.

.

PFGE-AscI-pattern

GX6A16.0048

GX6A16.0048

PFGE-AscI-status

.

.

PFGE-ApaI-pattern

GX6A12.0804

GX6A12.0804

PFGE-ApaI-status

.

.

Genus

.

.

.

.

.

.

.

Species

.

.

.

.

.

.

.

Lineage

.

.

.

.

.

.

.

Serotype

not typed

not typed

not typed

not typed

not typed

not typed

not typed

ANI

.

.

.

.

.

.

.

ANICoverage

.

.

.

.

.

.

.

MLST loci ST

.

.

.

.

.

.

.

SequencerRun_id

.

.

.

commentsExposureLabID

.

.

.

.

.

.

.

ListMemberNARMS-EBNCBISubmissionDateOtherStateIsolatePatientAgeDaysPatientAgeMonthsPatientAgeYears

.

.

.

.

PatientSex

.

.

.

.

PFGE-ApaI-file

.

.

PFGE-ApaI-rundatePFGE-AscI-file

.

.

PFGE-AscI-rundatePFGE-SmaI-filePFGE-SmaI-patternPFGE-SmaI-rundatePFGE-SmaI-statusSourceCity

.

.

.

.

SourceCountry

.

.

.

.

.

.

.

SourceCounty

.

.

.

.

SourceState

NC

VA

NC

VA

NC

VA

NC

3.0 [1, 7]

wgMLST (<All Characters>)

100 Key

NC___MB081518-0059

VA___R180620742

USDA_853313749

VA___R180617588

USDA_590324576

VA___R170709909

USDA_210373329

Modified date

.

.

.

.

.

.

.

cdc_id

2018L-6276

2018L-6221

2017L-6294

WGS_id

PNUSAL004247

PNUSAL004057

FSIS31800263

PNUSAL004045

FSIS1606762

PNUSAL003187

FSIS11809104

NCBI_ACCESSION

.

.

.

.

.

.

.

SRR_ID

.

.

.

.

.

.

.

WGST

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

Outbreak

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

SourceType

.

.

.

.

.

.

.

SourceSite

Blood

Blood

Pork

Blood

Pork

Blood

Pork

TypeDetails

.

PulseNet_UploadDate

.

.

.

.

.

.

.

IsolatDate

2018-08-11

2018-06-19

2018-03-08

2018-06-15

2016-05-12

2017-07-08

2018-03-28

ReceivedDate

.

.

.

.

.

.

.

UploadDate

.

.

.

.

.

.

.

PFGE-AscI-pattern

GX6A16.0048

GX6A16.0048

PFGE-AscI-status

.

.

PFGE-ApaI-pattern

GX6A12.0804

GX6A12.0804

PFGE-ApaI-status

.

.

Genus

.

.

.

.

.

.

.

Species

.

.

.

.

.

.

.

Lineage

.

.

.

.

.

.

.

Serotype

not typed

not typed

not typed

not typed

not typed

not typed

not typed

ANI

.

.

.

.

.

.

.

ANICoverage

.

.

.

.

.

.

.

MLST loci ST

.

.

.

.

.

.

.

SequencerRun_id

.

.

.

commentsExposureLabID

.

.

.

.

.

.

.

ListMemberNARMS-EBNCBISubmissionDateOtherStateIsolatePatientAgeDaysPatientAgeMonthsPatientAgeYears

.

.

.

.

PatientSex

.

.

.

.

PFGE-ApaI-file

.

.

PFGE-ApaI-rundatePFGE-AscI-file

.

.

PFGE-AscI-rundatePFGE-SmaI-filePFGE-SmaI-patternPFGE-SmaI-rundatePFGE-SmaI-statusSourceCity

.

.

.

.

SourceCountry

.

.

.

.

.

.

.

SourceCounty

.

.

.

.

SourceState

NC

VA

NC

VA

NC

VA

NC

3.0 [1, 7]

wgMLST (<All Characters>)

100 Key

NC___MB081518-0059

VA___R180620742

USDA_853313749

VA___R180617588

USDA_590324576

VA___R170709909

USDA_210373329

Modified date

.

.

.

.

.

.

.

cdc_id

2018L-6276

2018L-6221

2017L-6294

WGS_id

PNUSAL004247

PNUSAL004057

FSIS31800263

PNUSAL004045

FSIS1606762

PNUSAL003187

FSIS11809104

NCBI_ACCESSION

.

.

.

.

.

.

.

SRR_ID

.

.

.

.

.

.

.

WGST

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20.

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

LMO1.0 - 106.1.1.1.20

Outbreak

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

1807VAGX6-1

SourceType

.

.

.

.

.

.

.

SourceSite

Blood

Blood

Pork

Blood

Pork

Blood

Pork

TypeDetails

.

PulseNet_UploadDate

.

.

.

.

.

.

.

IsolatDate

2018-08-11

2018-06-19

2018-03-08

2018-06-15

2016-05-12

2017-07-08

2018-03-28

ReceivedDate

.

.

.

.

.

.

.

UploadDate

.

.

.

.

.

.

.

PFGE-AscI-pattern

GX6A16.0048

GX6A16.0048

PFGE-AscI-status

.

.

PFGE-ApaI-pattern

GX6A12.0804

GX6A12.0804

PFGE-ApaI-status

.

.

Genus

.

.

.

.

.

.

.

Species

.

.

.

.

.

.

.

Lineage

.

.

.

.

.

.

.

Serotype

not typed

not typed

not typed

not typed

not typed

not typed

not typed

ANI

.

.

.

.

.

.

.

ANICoverage

.

.

.

.

.

.

.

MLST loci ST

.

.

.

.

.

.

.

SequencerRun_id

.

.

.

commentsExposureLabID

.

.

.

.

.

.

.

ListMemberNARMS-EBNCBISubmissionDateOtherStateIsolatePatientAgeDaysPatientAgeMonthsPatientAgeYears

.

.

.

.

PatientSex

.

.

.

.

PFGE-ApaI-file

.

.

PFGE-ApaI-rundatePFGE-AscI-file

.

.

PFGE-AscI-rundatePFGE-SmaI-filePFGE-SmaI-patternPFGE-SmaI-rundatePFGE-SmaI-statusSourceCity

.

.

.

.

SourceCountry

.

.

.

.

.

.

.

SourceCounty

.

.

.

.

SourceState

NC

VA

NC

VA

NC

VA

NC

3 [1,7]

Timeline of Listeriosis Investigation, Virginia

7/7/17: P1

Onset

4/28/18: P2 to ALF

6/14:

P2 Illness Onset

6/18: P2 Dies

6/19:

P3 Illness Onset

6/22:

Interview at ALF for

P2

6/29-7/3:

Interviews with

family of P2

7/2:

DCLS informs of

cluster

7/3:

Pork products match

Timeline of Listeriosis Investigation, Virginia

7/7/1: P1

Onset

4/28/18: P2 to ALF

6/14:

P2 Illness Onset

6/18: P2

Dies

6/19:

P3 Illness Onset

6/22: Interview at ALF for

P2

6/29-7/3: Interviews

with family of

P2

7/2:

DCLS informs

of cluster

7/3:

Pork products match

7/6:

Pork product

list received

List of Ham Products, USDA (July 6)

• Country Ham

• Whole Ham – Bone-In

• Whole Boneless Ham

• Honey Cured Spiral Sliced Ham

• Dry Cured Bacon, in slices or

slabs

• Mangalista Bacon

• Thick Cut Hickory Smoked Dry

Cured Bacon

• Fatback, cubed, sliced, or slab

• Ham Chips (Small pieces for mini

biscuits)

• Large or Split Ham Hocks

• Centers and Ends (Country Ham)

• Trimmings (Country Ham)

• End Slices (from butt of ham)

• Chunk Side Meat

• Country Ham Aitch Bones

• Iberico Ham

Timeline of Listeriosis Investigation, Virginia

7/7/17: P1 Onset

4/28/18:

P2 to ALF

6/14:

P2 Illness Onset

6/18: P2

Dies

6/19:

P3 Illness Onset

6/22: Interview at ALF for

P2

6/29-7/3: Interviews

with family of

P2

7/2:

DCLS informs

of cluster

7/3:

Pork products match

7/6:

Pork product

list received

7/23: ALF

Menus and

supplier list

7/26: P1

dies

Timeline of Listeriosis Investigation, Virginia

7/7/17: P1 Onset

4/28/18:

P2 to ALF

6/14:

P2 Illness Onset

6/18: P2

Dies

6/19:

P3 Illness Onset

6/22: Interview

at ALF for P2

6/29-7/3: Interviews with family

of P2

7/2:

DCLS informs

of cluster

7/3:

Pork products match

7/6:

Pork product

list received

7/23: ALF

Menus and

supplier list

7/26: P1

dies

8/24: P3 dies

List of Product Samples From FSIS

With Name Brands

Isolate KeyCollection

DateSample Product Establishment Name

Establishment

Number

Establishment

LocationBrands

USDA_853313749 3/8/2018

Product-RTE-

Other Fully

Cooked, Not

Sliced-Pork

Whole Deli

Ham

Goodnight

Brothers

Produce Co.,

Inc.

M7431 Boone, NC

Johnston County Hams Inc., Padow’s

Hams & Deli, Inc., Good Night

Brothers Country Ham, Valley

Country Hams, LLC, WayCo Ham

Company, Old Dominion Brand

Hams, Wholesome Foods, Inc.

USDA_590324576 5/12/2016

Product-RTE-

Other Fully

Cooked, Not

Sliced-Pork

Deli HamJohnston County

HamsM2646

Smithfield,

NC

Johnston County Hams Inc., Padow’s

Hams & Deli, Inc., Good Night

Brothers Country Ham, Valley

Country Hams, LLC, WayCo Ham

Company, Old Dominion Brand

Hams, Wholesome Foods, Inc.

USDA_210373329 3/28/2018

Product-RTE-

Other Fully

Cooked, Not

Sliced-Pork

Country Style

Fully Cooked

Boneless Deli

Ham

Johnston County

HamsM2646

Smithfield,

NC

Johnston County Hams Inc., Padow’s

Hams & Deli, Inc., Good Night

Brothers Country Ham, Valley

Country Hams, LLC, WayCo Ham

Company, Old Dominion Brand

Hams, Wholesome Foods, Inc.

Recalled Products

Acknowledgments

DCLS

• DCLS Microbial Reference Lab

• Epidemiologic Support and

Molecular Detection and

Characterization Group

• DCLS Molecular Subtyping Lab

VDACS

• Christy Brennan

VDH

• Kelsey Holloman, MPH

• Lisa Sollot, MPH

• Okey Utah, MPH

• Angie Myrick-West, MPH, CIC

• Lori Dixon, RN, BSN

• Seth Levine, MPH

• Christy Brennan, VDACS