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Morbidity and Mortality Weekly Report - page 5 / 24





5 / 24

Vol. 57 / No. 44



the May 16, 2008 report) announced voluntary recalls of selected sized bags of two brands of dry dog food, both manufactured by the company at its plant in Everson, Pennsylvania. e recall was based on microbiologic testing by FDA, which found unopened bags of the two brands contaminated with the outbreak strain. Other brands of dry dog and cat food produced at the same facility were not included in that recall. e Everson, Pennsylvania, facility ceased operations during July–November 2007 to enable cleaning, disinfection, and renovation, and resumed nor- mal operations in mid-November 2007.

FIGURE 1. Number of cases* of Salmonella Schwarzengrund human infection associated with contaminated dry dog food, by month outbreak strain was isolated — United States, January 2006–September 2008



Everson, Pennsylvania, plant suspends operation


First recall announced

No. of cases




Plant resumes operation

Plant closed again

Second recall announced


Despite the 2007 recall, the outbreak strain of S.Schwarzengrund was isolated from eight more ill persons during January–October 2008 (Figure 1), bringing the total number of cases to 79 in 21 states (Figure 2). e ill persons were residents of Pennsylvania (three), Georgia (two), New York (two), and Texas (one). e last reported specimen collection date was September 18, 2008. e only connection between the ill persons was infection with the outbreak strain; they shared no household or family contacts. 1 0 Jan Mar May Jul Sep Nov Jan Mar May Jul Sep Nov Jan Mar May Jul Sep Nov 2007 Month and year 2006 2008 * Cases (n = 68) for which date of S. Schwarzengrund isolation was conrmed. 12, the company announced a nationwide voluntary recall of all dry dog and cat food products produced at the Everson plant from February 18 to July 29, 2008, when production again was suspended at the plant. In addition, Mars Petcare US has taken steps to ensure that recalled products are no longer on store shelves. On October 1, the company announced that the Everson plant would be closed permanently. e FDA investigation is continuing. Among the eight ill persons, five were female. Among the seven whose age was available, the median age was 8 months (range: 4 months–39 years); six persons were aged <2 years. Of five ill persons for whom clinical information was available, all five had visited a health-care professional, two had bloody diarrhea (no information on symptoms was available for the other three), and one had been hospitalized. No deaths were reported. Of six households with pet ownership known, all six had pets (i.e., dogs, cats, or both), but no illness was reported in any pet. Pets in three households were being fed a brand of dry pet food known to be produced at the Everson plant. Investigators collected seven dog stool specimens and two samples of dry dog food from the homes of two Pennsylvania patients. None of the stool specimens or dog food samples tested positive for Salmonella. Bag lot numbers and “best by” dates could not be examined in these households because the dog food had been poured into plastic containers and the bags discarded. Consequentl , investigators could not be certain that the dog food from the two households had been produced at the Everson plant, and, if so, whether the dog food had been produced after the plant was reopened in November 2007 or earlier. Reported by: M Deas , M Moll, MD, V rdaneta, MD, S Ostroff, MD, Pennsylvania Dept of ealth. E illamil, MPH, P Smith, MD, ew ork tate Dept of PhD, Div of for Zoonotic, ealth. Pulse et; C Barton Behravesh, DVM, IT illiams, oodborne, Bacterial, and ational Center ycotic Diseases, ector-Borne, and Enteric Diseases, CDC. Editorial Note: This outbreak of human Salmonella Schwarzengrund infections has continued over a 3-year period, likely because of continued contamination in the Everson, Pennsylvania, pet food production facility. S. Schwarzengrund is a rare serotype of Salmonella. Although the outbreak PFGE pattern is the most common S. Schwarzengrund PFGE pat- tern in the PulseNet database, isolates with that pattern made up only 20 (4%) of the 498 S. Schwarzengrund isolates from humans submitted to PulseNet during 1999–2005, suggest- ing that the illnesses described in this report resulted from a common source. Considering the wide distribution of these products and the relatively small number of cases, the attack rate for this outbreak appears to be low. However, only an estimated 3% of all Salmonella infections in the United States are laboratory confirmed and reported to surveillance systems (2). A low After additional outbreak-linked illnesses were identified in 2008, FDA conducted another investigation. In August 2008, FDA found the outbreak strain of S. Schwarzengrund in multiple brands of finished product at the plant, prompting another recall of products by Mars Petcare US. On September

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