Foodborne Illnesses / Salmonella /

Citterio Salame Stick Oubreak

On October 18, 2021, the Centers for Disease Control and Prevention (CDC), the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS), and state partners initiated and investigated a multistate outbreak of Salmonella I 4,[5],12:i:-. This outbreak was assigned the CDC outbreak code 2110MLJPX-1.

As of December 12, 2021, a total of 36 Salmonella confirmed cases were reported from 11 states (CA, IL, KS, MD, MI, MN, NJ, NY, PA, and VA). Illnesses onsets ranged from September 18, 2021, to October 30, 2021. Cases ranged in age from 1 to 75 years (median 8). Most cases (79%) were younger than 18 years of age, and 55% were female. Of 29 people with information available, seven (24%) were hospitalized. No deaths were reported. A case was defined as someone with a Salmonella I 4,[5],12:i:- infection, with allele code SALM1.0 - 6785.1.2x, and a specimen isolated between September 18, 2021 – October 30, 2021.

Whole-genome sequencing (WGS) analyses showed that bacteria from case samples were closely related genetically (within 0-2 alleles from 12 clinical and one food isolates), suggesting that cases in this outbreak were infected from the same source. One USDA ground pork isolate from California, isolated on July 15, 2021, was included in this cluster. Early on, public health officials noticed a strong salame signal during case interviews, with multiple cases reporting salame or salame sticks purchased from Trader Joe’s.

In total, from interview data, public health officials had collected exposure information for 30 cases, of whom 26 reported yes or maybe to Citterio brand Salame Sticks (87%). California state public health officials found Salmonella in two unopened packages of Citterio brand Premium Italian-Style Salame Sticks that they collected for testing. WGS identified a different strain of Salmonella (Salmonella Derby) in these products, which was not closely related to samples from sick people. Nevertheless, the presence of Salmonella in these products suggests contamination in the production and/or distribution process.

On November 12, 2021, the CDC stated epidemiologic, traceback, and laboratory data show that Citterio brand Premium Italian-Style Salame Sticks were the likely cause of the outbreak. Among 27 cases interviewed, 26 (96%) reported eating salame sticks, and 25 (93%) reported eating or maybe eating Citterio brand Premium Italian-Style Salame Sticks. This percentage was significantly higher than the 39.8% of respondents who reported eating salame, pepperoni, or other Italian-style meat in the FoodNet Population Survey—a survey that helps estimate how often people eat various foods. This comparison suggests that people in this outbreak got sick from eating salame sticks.

On November 10, 2021, Euro Foods, Inc., a Freeland, PA establishment, recalled approximately 119,091 pounds of salame stick products produced prior to October 25, 2021, with “best by” dates through January 23, 2022, due to suspected contamination with the Salmonella bacteria. Trader Joe’s voluntarily stopped selling this product in its stores nationwide during the investigation.

As of December 17, 2021, this outbreak was deemed over.