In February 2020, Marler Clark, the Food Safety law firm, filed a lawsuit against Moby Dick House of Kabob in the Circuit Court of Arlington, Virginia. Marler Clark represents eight people affected by this Salmonella outbreak. At this time, six of these cases have been successfully settled, achieving settlements covering medical expenses, wage loss, and pain and suffering.
Prince George’s County Health Department and Maryland Department of Health (MDH) were notified of a cluster of 3 confirmed Salmonella cases on September 18, 2019, and an investigation was launched. On September 23, a health center at a local university was notified of a group of people who ate together at Moby Dick House of Kabob and became ill with similar symptoms. The Virginia Department of Health was also investigating multiple outbreaks related to food catered from Moby Dick House of Kabob at the time and collaborated with the MDH in this investigation. It was discovered that hummus was the main link to the illnesses.
On September 24, MDH contacted the restaurant and requested that the production of hummus be halted. The commissary was inspected on September 25, during which an assessment of manufacturing practices and preventative controls was done. Public health officials also took environmental swabs of equipment used to produce the hummus. Food samples of hummus ingredients and opened hummus containers from outbreak-related events were also collected. A total of 26 environmental samples were collected.
The inspection of the commissary also identified concerns regarding the general sanitation, cleanliness, and operations of the facility. This included findings of food debris in walk-in coolers and in grinders, the presence of flies around the facility, the poor quality of equipment, the improper storing of equipment with food ingredients, the lack of protocol to prevent cross contamination, the lack of HACCP plans, and a lack of records necessary for traceback.
On September 26, the MDH sent a memo to all local health departments to request that all Salmonella cases be prioritized for interview. Local, state, and federal agencies were asked to notify MDH of any Salmonella cases that were reported to have eaten at Moby Dick House of Kabob. Maryland residents were informed of the outbreak and asked to discard any hummus from Moby Dick House of Kabob. On October 1, the commissary was ordered to destroy all detained hummus.
MDH was notified by the Centers for Disease Control and Prevention (CDC) that raw chicken collected by the US Department of Agriculture on August 21, 2019, was genetically matched to the outbreak strain of Salmonella. MDH collected traceback information on any chicken ordered to the commissary due to the possibility of cross-contamination. On October 4, documents emailed to the department showed that Moby Dick sourced its chicken from the same processor where Salmonella positive USDA samples, matching the outbreak strain, were collected.
The outbreak included 23 confirmed and 5 probable cases reported in Maryland. Other cases were identified in the District of Columbia and Virginia. Six Maryland and one Virginia Moby Dick House of Kabob locations were associated with this outbreak. Cases ranged from 8-79 years of age. Of all cases, 61 percent were female. Three cases were hospitalized. Of 23 cases for whom information was available, exposure to the restaurant was reported between September 2 – September 17, 2019. Of 26 cases for whom information was available, hummus was consumed by 80 percent, and chicken was consumed by 77 percent.
A total of 19 isolates from cases were subtyped, and 18 were found to contain Salmonella Enteritidis. One isolate, from a patient who ate neither hummus nor chicken from the restaurant, was found to contain Salmonella Braenderup. All S. Enteritidis isolates were analyzed with whole-genome sequencing and found to be within 0-2 alleles of one another, indicating that they were all highly related. All environmental and food samples collected tested negative for Salmonella.
Epidemiological evidence suggests that hummus was the food vehicle that caused the illnesses associated with the outbreak. Given the practices observed at the commissary, and the source of the chicken, it was deemed likely that Salmonella from raw chicken contaminated ready-to-eat hummus, which was distributed to the retail locations involved. Undercooked chicken was considered unlikely to be the primary source of this outbreak, but it could explain some of the cases reported. Cross-contamination of other Moby Dick House of Kabob products could also explain some of the illnesses reported.