Published Date: 2008-01-27 18:00:15
Subject: PRO/AH/EDR> Salmonellosis, serotype Paratyphi B, raw tuna - USA
Archive Number: 20080127.0343
SALMONELLOSIS, SEROTYPE PARATYPHI B, RAW TUNA - USA
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Sat 26 Jan 2008
Source: Honolulu Advertiser [edited]
The state Department of Health and the USA Food and Drug Administration are
investigating a series of illnesses caused by salmonella in Hawai'i,
Colorado, and California that may be linked to imported frozen 'ahi that
was consumed raw.
Hawai'i typically has more than 300 cases of salmonella poisoning a year,
which causes a severe diarrheal gastrointestinal illness. The 32 recent
cases that prompted the investigation were reported between 27 Oct and 29
Dec 2007 and stood out because they were caused by a strain of salmonella
not normally seen in Hawai'i, state health officials said.
Outbreaks of that strain, _Salmonella [enterica_ serotype] Paratyphi B,
have been associated with smoked white fish, unpasteurized milk and goat
cheese and alfalfa spouts, and normally only about 10 cases are reported
here a year, said Health Department spokeswoman Janice Okubo. That
particular type of salmonella also is associated with ornamental fish,
turtles and reptiles.
All of the cases in the Hawai'i cluster were on O'ahu, and 5 of the 32
people here who became ill were hospitalized, according to a Health
Department medical alert on the subject. An additional Hawai'i case that
may be caused by the same type of salmonella was reported in 2008 but has
not yet been confirmed.
Okubo said the Health Department will not identify any retail outlets the
tainted fish could have come from because "there needs to be more product
tracing in order for someone to determine the source."
Dr Paul Effler, state epidemiologist for the Health Department, said
interviews of the Hawai'i people who became sick "almost universally"
implicated 'ahi poke, and health officials also were informed of 2 similar
cases in Colorado and one in California. Checks of the DNA fingerprint of
the bacteria matched the major strain in Hawai'i. That suggested the fish
was likely imported and distributed across a number of states, which
prompted the Health Department to bring in the FDA on 11 Jan 2008, Effler said.
The FDA is still trying to identify the distributors of each of the
establishments that may have been the source of contaminated fish, which
has been complicated because the volume of fish is high, Effler said.
Effler said that while there have been more Paratyphi B cases than normal,
it appears to be "low-level" contamination, meaning relatively little of
the large overall supply of 'ahi is tainted.
[byline: Kevin Dayton]
ProMED-mail rapporteur Brent Barrett
[Although not specifically stated, the serotype here is the d-tartrate
fermenting variant _S. enterica_ subspecies _enterica_ serovar Paratyphi B
dT+ (sometimes referred to as _S._ Java). This organism has well
characterized animal reservoirs and has been involved in 2 recent outbreaks
reported in ProMED-mail, one in the USA (Salmonellosis, human, pet turtles
- USA 20080125.0317) and the other in Europe (Salmonellosis, serotype
Paratyphi var Java - Europe 20071221.4100).
The organism has been linked to human salmonellosis acquired from
ornamental aquaria (Levings RS, Lightfoot D, Hall RM, et al. Aquariums as
reservoirs for multidrug-resistant Salmonella Paratyphi B. Emerg Infect Dis
2006; 12: 507-10 <http://www.cdc.gov/ncidod/EID/vol12no03/05-1085.htm>.
Outbreaks of human salmnellosis related to fish for eating are uncommon and
are more likely to be related to contamination of the fish after they are
The yellowfin tuna <http://en.wikipedia.org/wiki/Yellowfin_tuna>
(_Neothunnus macropterus_) is a type of tuna eaten by humans as food. It
has been reported to be up to 239 cm (94 inches) in length and 200 kg (440
lb) in weight. The fish is also known as 'ahi tuna, after the Hawaiian word
for fire, due to the smoke from their fishing ropes rubbing violently on
the gunwales of their wooden canoes while pulling the fish in. A picture of
this fish can be found at the above URL. - Mod.LL]