multi-state outbreak of _Salmonella_ serotype Schwarzengrund

The Centers for Disease Control and Prevention (CDC) is collaborating
with public health officials in Pennsylvania and other state health
departments and the US Food and Drug Administration to investigate a
multi-state outbreak of _Salmonella_ serotype Schwarzengrund
infections in humans. These human illnesses have been linked with dry
pet food produced by Mars Petcare US at a single manufacturing
facility in Pennsylvania. People who think they might have become ill
after contact with dry pet food or with an animal that has eaten dry
pet food should consult their health-care providers.

As of 28 Aug 2007, 66 persons infected with the same strain of
_Salmonella_ Schwarzengrund have been reported to CDC from 18 states:
Pennsylvania (25 cases), New York (12 cases), Ohio (6 cases),
Massachusetts (5 cases), Maine (2 cases), North Dakota (2 cases),
Virginia (2 cases), Minnesota (2 cases), Alabama (1 case), California
(1 case), Delaware (1 case), Illinois (1 case), Kentucky (1 case),
Maryland (1 case), Michigan (1 case), New Jersey (1 case), North
Carolina (1 case), and Wisconsin (1 case). Of the ill persons for
whom an age is available, 39 percent were one year of age or younger.
Of ill persons for whom clinical information is available, 32 percent
developed bloody diarrhea and 10 (25 percent) were hospitalized. No
deaths have been reported.

State and local health departments and CDC continue to receive
reports of cases, suggesting the outbreak is ongoing.

Illness related to this outbreak has not been reported in pets.
However, the outbreak strain of _S._ Schwarzengrund was isolated from
fecal specimens from 2 dogs that ate dry pet food in the homes of 2
of the ill persons.

Investigation of the Outbreak
-----------------------------
A multi-state case-control study demonstrated an association between
illness and purchase of dry pet foods produced by Mars Petcare
US. Households with ill persons were significantly more likely than
matched households without ill persons to usually purchase a brand of
dry pet food made by Mars PetCare US that may have been produced at a
single facility in Pennsylvania.

The Pennsylvania Department of Health (PADOH) conducted environmental
testing in this pet food production facility. One of the
environmental samples collected by PADOH yielded the outbreak strain
of _S._ Schwarzengrund. In tests by the FDA of unopened bags of
finished dog food produced by this facility, 2 brands yielded the
outbreak strain of _S. _Schwarzengrund. On 21 Aug 2007, Mars Petcare
US announced a voluntary recall of select bags of these 2 brands: Red
Flannel Large Breed Adult Formula dry dog food and Krasdale Gravy dry dog food
(<http://www.marspetcare.com/safety/index.html>).

Neither of these brands has been linked to human illness.

Investigations are ongoing to determine why human illness, especially
among infants, is associated with dry pet food. Factors under
investigation include handling and storage of dry pet food,
hand-washing practices, exposure of children to dry pet food, and
location in the home where pets are fed.

Transmission and Clinical Features
----------------------------------
_Salmonella_ bacteria live in the intestines of many food animals,
such as cows and chickens, and commonly contaminate foods of animal
origin. People get Salmonella infection by ingesting these germs,
usually in contaminated food or water, but also by putting objects or
fingers contaminated with these germs into the mouth.

Most people infected with salmonellosis develop diarrhea, fever, and
abdominal cramps 12-72 hours after infection. Infection is usually
diagnosed by culture of a stool sample. The illness usually lasts 4-7
days, and most people recover without treatment. Infants, elderly
persons, and people with impaired immune systems are more likely than
others to develop severe illness. In severe infection, _Salmonella_
spreads from the intestines to the bloodstream and then to other body
sites, and death can occur if the person is not treated promptly with
antibiotics.

Advice to Consumers
-------------------
- Wash hands for at least 20 seconds with warm water and soap right
after handling dry pet foods and treats.
- Wash hands before preparing food and before eating;
- Keep infants away from pet feeding areas. Do not allow them to
touch or eat dog food;
- Follow the Food and Drug Administration's Safe Handling Tips for
Pet Foods and Treats; see:
<http://www.fda.gov/consumer/updates/petfoodtips080307.html>