Traceback methods by state regulatory agencies were used to complement traditional epidemiological cluster investigation methods and confirmed hazelnuts (also referred to as filberts) as the vehicle in a multistate outbreak of Escherichia coli O157:H7 infections. Bulk in-shell hazelnut and mixed-nut purchase locations were identified during the initial epidemiological interviews. Based on purchase dates and case onset dates, regulators in Minnesota, Michigan, and Wisconsin traced product back through the supply chain. Six (86%) retail locations received the suspect hazelnut or mixed-nut shipments from a Minnesota distributor, with one retailer (14%) receiving products from a Wisconsin distributor. Both distributors received 100% of their bulk in-shell hazelnuts and mixed nuts from a distributor in California. The California distributor received 99% of their hazelnuts from a packing company in Oregon. The California distributor received the hazelnuts in 50-lb (22.7-kg) bags and either resold them without opening the bags or used the in-shell hazelnuts in the manufacture of their in-shell mixed nuts. Records at the packing company in Oregon were incomplete or lacked sufficient detail needed to identify a suspect farm or group of suspect farms. Laboratory samples collected from human cases and subsequently recalled product matched the outbreak pulsed-field gel electrophoresis subtype of E. coli O157:H7. Hazelnut harvesting practices create a plausible route of contamination from fecal matter from domestic ruminants or wild deer. This outbreak investigation demonstrates the use of product traceback data to rapidly test an epidemiological hypothesis.
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Research Article|
February 01 2012
Use of Traceback Methods To Confirm the Source of a Multistate Escherichia coli O157:H7 Outbreak Due to In-Shell Hazelnuts
BENJAMIN D. MILLER;
BENJAMIN D. MILLER
*
1Minnesota Department of Agriculture, 625 Robert Street N., Saint Paul, Minnesota 55155
*Author for correspondence. Tel: 651-201-6670; Fax: 651-201-6119; E-mail: Benjamin.miller@state.mn.us.
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CARRIE E. RIGDON;
CARRIE E. RIGDON
1Minnesota Department of Agriculture, 625 Robert Street N., Saint Paul, Minnesota 55155
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JILL BALL;
JILL BALL
2Wisconsin Department of Agriculture, Trade and Consumer Protection, P.O. Box 2811, Madison, Wisconsin 53708-8911
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JOSHUA M. ROUNDS;
JOSHUA M. ROUNDS
3Minnesota Department of Health, 625 Robert Street N., Saint Paul, Minnesota 55155
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RACHEL F. KLOS;
RACHEL F. KLOS
4Wisconsin Division of Public Health, P.O. Box 2659, Madison, Wisconsin 53701-2659
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BRENDA M. BRENNAN;
BRENDA M. BRENNAN
5Michigan Department of Agriculture and Rural Development, 525 West Allegan Street, Lansing, Michigan 48909
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KATHERINE D. ARENDS;
KATHERINE D. ARENDS
6Michigan Department of Community Health, 201 Townsend Street, Lansing, Michigan 48913
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PATRICK KENNELLY;
PATRICK KENNELLY
7California Department of Public Health, 1500 Capitol Avenue, MS-7602, Sacramento, California 95899-7435
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CRAIG HEDBERG;
CRAIG HEDBERG
8School of Public Health, University of Minnesota, 420 Delaware Street S.E., Minneapolis, Minnesota 55455, USA
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KIRK E. SMITH
KIRK E. SMITH
3Minnesota Department of Health, 625 Robert Street N., Saint Paul, Minnesota 55155
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J Food Prot (2012) 75 (2): 320–327.
Article history
Received:
June 22 2011
Accepted:
September 13 2011
Citation
BENJAMIN D. MILLER, CARRIE E. RIGDON, JILL BALL, JOSHUA M. ROUNDS, RACHEL F. KLOS, BRENDA M. BRENNAN, KATHERINE D. ARENDS, PATRICK KENNELLY, CRAIG HEDBERG, KIRK E. SMITH; Use of Traceback Methods To Confirm the Source of a Multistate Escherichia coli O157:H7 Outbreak Due to In-Shell Hazelnuts. J Food Prot 1 February 2012; 75 (2): 320–327. doi: https://doi.org/10.4315/0362-028X.JFP-11-309
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