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      Outbreaks of Salmonella illness associated with frozen raw breaded chicken products in Canada, 2015–2019

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          Abstract

          Frozen raw breaded chicken products (FRBCP) have been identified as a risk factor for Salmonella infection in Canada. In 2017, Canada implemented whole genome sequencing (WGS) for clinical and non-clinical Salmonella isolates, which increased understanding of the relatedness of Salmonella isolates, resulting in an increased number of Salmonella outbreak investigations. A total of 18 outbreaks and 584 laboratory-confirmed cases have been associated with FRBCP or chicken since 2017. The introduction of WGS provided the evidence needed to support a new requirement to control the risk of Salmonella in FRBCP produced for retail sale.

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          Estimates of the burden of foodborne illness in Canada for 30 specified pathogens and unspecified agents, circa 2006.

          M Kate Thomas, Regan Murray, Logan Flockhart … (2013)
          Estimates of foodborne illness are important for setting food safety priorities and making public health policies. The objective of this analysis is to estimate domestically acquired, foodborne illness in Canada, while identifying data gaps and areas for further research. Estimates of illness due to 30 pathogens and unspecified agents were based on data from the 2000-2010 time period from Canadian surveillance systems, relevant international literature, and the Canadian census population for 2006. The modeling approach required accounting for under-reporting and underdiagnosis and to estimate the proportion of illness domestically acquired and through foodborne transmission. To account for uncertainty, Monte Carlo simulations were performed to generate a mean estimate and 90% credible interval. It is estimated that each year there are 1.6 million (1.2-2.0 million) and 2.4 million (1.8-3.0 million) episodes of domestically acquired foodborne illness related to 30 known pathogens and unspecified agents, respectively, for a total estimate of 4.0 million (3.1-5.0 million) episodes of domestically acquired foodborne illness in Canada. Norovirus, Clostridium perfringens, Campylobacter spp., and nontyphoidal Salmonella spp. are the leading pathogens and account for approximately 90% of the pathogen-specific total. Approximately one in eight Canadians experience an episode of domestically acquired foodborne illness each year in Canada. These estimates cannot be compared with prior crude estimates in Canada to assess illness trends as different methodologies were used.
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            Characterization of Foodborne Outbreaks of Salmonella enterica Serovar Enteritidis with Whole-Genome Sequencing Single Nucleotide Polymorphism-Based Analysis for Surveillance and Outbreak Detection.

            Angela Taylor, Victoria Lappi, William J Wolfgang … (2015)
            Salmonella enterica serovar Enteritidis is a significant cause of gastrointestinal illness in the United States; however, current molecular subtyping methods lack resolution for this highly clonal serovar. Advances in next-generation sequencing technologies have made it possible to examine whole-genome sequencing (WGS) as a potential molecular subtyping tool for outbreak detection and source trace back. Here, we conducted a retrospective analysis of S. Enteritidis isolates from seven epidemiologically confirmed foodborne outbreaks and sporadic isolates (not epidemiologically linked) to determine the utility of WGS to identify outbreaks. A collection of 55 epidemiologically characterized clinical and environmental S. Enteritidis isolates were sequenced. Single nucleotide polymorphism (SNP)-based cluster analysis of the S. Enteritidis genomes revealed well supported clades, with less than four-SNP pairwise diversity, that were concordant with epidemiologically defined outbreaks. Sporadic isolates were an average of 42.5 SNPs distant from the outbreak clusters. Isolates collected from the same patient over several weeks differed by only two SNPs. Our findings show that WGS provided greater resolution between outbreak, sporadic, and suspect isolates than the current gold standard subtyping method, pulsed-field gel electrophoresis (PFGE). Furthermore, results could be obtained in a time frame suitable for surveillance activities, supporting the use of WGS as an outbreak detection and characterization method for S. Enteritidis.
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              Frozen chicken nuggets and strips and eggs are leading risk factors for Salmonella Heidelberg infections in Canada.

              Jennifer S. Isaacs, Steven J. C. Gaulin, Mohamed Ahmed … (2005)
              A case-control study was conducted from 1 January to 31 May 2003 to identify risk factors for S . Heidelberg infection in Canada. Controls were pair-matched by age group and telephone exchange to 95 cases. Exposures in the 7 days before illness/interview were assessed using multivariate conditional logistic regression. Consumption of home-prepared chicken nuggets and/or strips [matched odds ratio (mOR) 4.0, 95% confidence interval (CI) 1.4-13.8], and undercooked eggs (mOR 7.5, 95% CI 1.5-75.5) increased the risk of illness. Exposure to a farm setting lowered the risk (mOR 0.22, 95% CI 0.03-1.00). The population-attributable fraction associated with chicken nuggets/strips was 34% and with undercooked eggs was 16%. One-third of study participants did not perceive, handle or prepare chicken nuggets and strips as high-risk products, although the majority of the products on the Canadian market are raw. These findings have prompted changes in product-labelling policy and consumer education.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Epidemiol Infect
                Journal ID (iso-abbrev): Epidemiol. Infect
                Journal ID (publisher-id): HYG
                Title: Epidemiology and Infection
                Publisher: Cambridge University Press (Cambridge, UK )
                ISSN (Print): 0950-2688
                ISSN (Electronic): 1469-4409
                Publication date Collection: 2019
                Publication date (Electronic): 22 August 2019
                Volume: 147
                Electronic Location Identifier: e254
                Affiliations
                [1 ]Centre for Foodborne Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada , Guelph ON, Canada
                [2 ]National Microbiology Laboratory, Public Health Agency of Canada , Winnipeg MB, Canada
                [3 ]Communications and Public Affairs, Public Health Agency of Canada , Ottawa ON, Canada
                [4 ]Office of Food Safety and Recall, Canadian Food Inspection Agency , Ottawa ON, Canada
                [5 ]Food Safety and Consumer Protection, Canadian Food Inspection Agency , Ottawa ON, Canada
                Author notes
                Author for correspondence: Vanessa Morton, E-mail: Vanessa.morton@ 123456canada.ca
                Author information
                https://orcid.org/0000-0002-4471-1985
                Article
                Publisher Item ID: S0950268819001432 Publisher ID: 00143
                DOI: 10.1017/S0950268819001432
                PMC ID: 6805751
                PubMed ID: 31436145
                SO-VID: c63b44a8-7be1-4496-8ad9-9bb483f22d15
                Copyright © © The Author(s) 2019
                License:

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence ( http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.

                History
                Date received : 16 May 2019
                Date revision received : 07 June 2019
                Date accepted : 03 July 2019
                Page count
                Tables: 1, References: 15, Pages: 3
                Categories
                Subject: From the Field

                ScienceOpen disciplines: Public health
                Keywords: salmonella,outbreak,raw uncooked chicken,frozen raw breaded chicken products
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: salmonella, outbreak, raw uncooked chicken, frozen raw breaded chicken products

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