Published Date: 2010-07-30 18:00:04
Subject: PRO/AH/EDR> Salmonellosis, reptile feed - UK, USA: st Typhimurium DT 191A
Archive Number: 20100730.2555

SALMONELLOSIS, REPTILE FEED - UK, USA: SEROTYPE TYPHIMURIUM DT 191A
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In this posting:
[1] News report
[2] UK: 2009 report

******
[1] News report
Date: Fri 30 Jul 2010
Source: The New York Times [edited]
<http://www.nytimes.com/2010/07/30/business/global/30mice.html?src=busln>


The 1st salmonella outbreak linked to MiceDirect began in Great
Britain in August 2008. Since then, more than 400 people have fallen
ill there, about two thirds of them have been children under 10,
according to Chris Lane, a senior epidemiologist of the Health
Protection Agency's Center for Infections in London. Although the
shipments of tainted mice were halted in 2009, people continue to get
sick there, Mr Lane said.

The 1st case in the USA appeared in January 2010, according Dr Barton
Behravesh. The CDC has identified more than 30 cases in 17 states with
the same strain as the British outbreak. She said the cases were not
concentrated in a region but spread across the country. Half the
victims were under 12.

British investigators looking into the outbreak found that many of the
victims came from families where snakes were kept as pets. They
eventually began looking at the frozen mice fed to the snakes and
found shipments from MiceDirect that contained the same strain of
salmonella as that isolated from the victims. British officials
contacted MiceDirect, Mr Lane said, and the company promised to act to
prevent further contamination.

Kristen Nordlund, a CDC spokeswoman, said the British officials told
the agency in May 2009 of the outbreak there and the connection to
MiceDirect. She said that the CDC found no cases of infection in the
USA at that time. But it did tell the FDA, which regulates pet food
companies like MiceDirect, about the British investigation. This
spring [2010] the CDC became aware of reports of salmonella and began
an inquiry.

Siobhan DeLancey, an FDA spokeswoman, said the agency was checking to
see if it had a record of the 2009 contact from the CDC. She said the
FDA was not told of the American outbreak until May 2010 and that
investigators did not establish a likely connection with MiceDirect
until the beginning of July 2010. It was not until 6 Jul 2010,
however, that officials of the agencies went to MiceDirect to conduct
an inspection, according to a timeline provided by the FDA.

On 21 Jul 2010, the FDA told the company that tests of its products
and plant had found salmonella. 2 days later, the agency said,
MiceDirect agreed to a recall. The company's recall notice was not
prominently posted on its website until Thu 29 Jul 2010. And neither
the company's site nor the FDA's site gave clear instructions on what
to do with mice that customers still had.

Mr Lane said the outbreak has persisted in Britain, perhaps because
snake owners, unaware of the dangers, continue to use mice kept in
their freezers.

"Bacterial infections don't have borders," Mr Lane said. "Things can
become contaminated and be exported very easily."

[Byline: William Neuman]

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Communicated by:
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[It now is apparent that there had been a similar outbreak beginning
in 2008 in the UK. Below is a June 2009 report from DEFRA (Department
of Environment, Food and Rural Affairs) regarding the outbreak and its
cause, _S. enterica_ serotype Typhimurium DT191A. - Mod.LL/JW]

******
[2] UK: 2009 report
Date: Wed 24 Jun 2009
Source: DEFRA (UK Department for Environment, Food, and Rural Affairs)
[edited]
<http://www.defra.gov.uk/foodfarm/farmanimal/diseases/monitoring/documents/salmonella-typhimurium-090624.pdf>


Since July 2008, there have been reports of cases of _Salmonella
enterica_ serotype Typhimurium DT 191A from people across England,
Wales, and Scotland. This serotype was previously unknown in the UK.
Epidemiological investigations carried out by the Health Protection
Agency (HPA) have indicated that these cases may be associated with
ownership of pet snakes (HPA, 2009).

On follow-up investigations, consignments of snake food (frozen
rodents) imported to the UK from a particular exporter from the USA
have tested positive for _S._ Typhimurium DT 191A. The affected
consignments have been currently withdrawn from the market by the
operator.

The HPA epidemiological investigations showed direct correlation
between _S._ Typhimurium DT 191A infection and ownership of (mainly
corn) snakes which are fed frozen rodents. These rodents are often
imported from outside the EU specifically as reptile food. Following
the outcome of the HPA investigation, the VLA [Veterinary Laboratories
Agency] carried out screening surveillance of frozen feed for reptiles
imported from 6 main suppliers in the UK. This testing revealed that 3
out of 21 samples from the 6 major import/distribution companies
tested positive for _S._ Typhimurium DT 191A. These 3 positive samples
were directly traced back to a consignment imported from a single
company in the USA to a single UK distributor. Re-testing of more
samples from the same consignment from the USA importers showed that a
high proportion of the consignment (9 out of 10 bags) was positive for
_S._ Typhimurium DT 191A. This was the 1st time that _S._ Typhimurium
DT 191A has been identified as an emerging zoonosis in the UK. To
date, Defra has not requested testing of any samples of imported
frozen rodent feed on the basis of animal health concerns as these
products were considered to pose low risk to animal and public health.

Frozen rodents are imported into the EU and UK for feeding non-farmed
animals, including reptiles. Under EU rules (European Commission,
2006), animal by-products are subdivided into 3 categories. This
particular consignment of imported frozen feed for rodents is
classified as category 2 and no testing is carried out as this product
is generally considered to be of low risk to animal health. EU rules
(European Commission, 2002) do require that the product should
originate from a premises with good general hygiene and be subject to
veterinary checks on entry through a BIP [Border Inspection Post].
This allows for risk-based random testing for such contaminants as
_Salmonella_, if required, and would be subject to national rules. If
risk-based testing identifies any such contamination, the destination
local authority would be informed and they would deal with the
consignment according to their local policy. Future consignments from
the same importer would be held at the BIP until testing shows the
product is contaminant free.

Available data from the literature show no reports of _S._ Typhimurium
DT 191A occurring in the UK before these cases emerged in July 2008.
The Veterinary Laboratories Agency, Weybridge, carry out continual
surveillance for _Salmonella_ spp. infections in farmed, pet and zoo
animals, including reptiles. No cases of _S._ Typhimurium DT 191A had
been detected by this surveillance prior to these cases in humans.
Late in 2008, 2 cattle herds and a sample from a Great Bustard [_Otis
tarda_, a large ground-living bird - Mod.LL/JW] tested positive for
_S._ Typhimurium DT 191A suggesting the serotype is not widely
distributed in other animal populations.

Defra and the HPA monitor for new and emerging diseases and zoonotic
infections, to ensure a joined-up approach to disease monitoring and
control. On the basis of epidemiological investigations and Defra's
follow up, these findings of _S._ Typhimurium DT 191A would indicate
emergence and spread of a new type of _Salmonella_ that has not been
detected in the UK before. These findings provide a clear indication
of the source of infection and a direct link to human health in the UK.

Currently, figures for _S._ Typhimurium DT 191A cases stand at nearly
200 in Great Britain with the case rate of about 5 a week. The last
cases were reported at the end of May/beginning of June 2009 in
England and Scotland. The mean age of infection is 15 years, median is
10 years old, and cases range from people of 2 months to 69 years of
age. No travel has been reported from any of the cases (HPA, 2009).
Interestingly, the National Salmonella Reference Laboratory of Ireland
(2008) reported that 4 cases of _S._ DT 191A have been recorded since
July 2008, but none had a reported history of contact with reptiles
(one had travelled recently to Spain) and infection appeared be linked
to eating raw chicken.

This is not the 1st time a _S._ Typhimurium outbreak has been
associated with rodents fed to snakes but it is the 1st time in the
UK. One study in the USA reported that 21 human cases were reported
from 5 states in 2005 and 2006. The same serotype was detected at the
supplier's rodent facility. The study concluded that more oversight of
the commercial rodent industry in the USA may be required (Fuller and
others, 2007).

[Authors: Sabirovic M, Roberts H, Kingston A]

References
----------
1. European Commission (2002) EC Decision 1774/2002 Regulation (EC) No
1774/2002 of the European Parliament and of the Council of 3 October
2002 laying down health rules concerning animal by-products not
intended for human consumption;
<http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2002:273:0001:0095:EN:PDF> Accessed 23 Jun
2009
2. European Commission (2006) Commission Regulation (EC) No 1877/2006
of 18 December 2006 amending Regulation (EC) No 878/2004 laying down
transitional measures in accordance with Regulation (EC) No 1774/2002
for certain animal by-products classified as Category 1 and 2
materials and intended for technical
purposes;
<http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2006:360:0133:0136:EN:PDF>.
3. Fuller CC, Jawahir SL, Leano FT, et al: A multistate _Salmonella_
Typhimurium outbreak associated with frozen vacuum-packed rodents used
to feed snakes. Zoonoses Public Health. 55(8-10): 481-7 [abstract
available at
<http://www.ncbi.nlm.nih.gov/pubmed/18833597>].
4. HPA (2009): Ongoing investigations into reptile associated
salmonella infections;
<http://www.hpa.org.uk/hpr/archives/2009/news1409.htm#reptiles>.
5. National Salmonella Reference Laboratory of Ireland (2008) Annual Report;
<http://www.fsai.ie/uploadedFiles/News_Centre/News/NSRL_Report_2008.pdf>.

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Communicated by:
ProMED-mail
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[It is now clear that the outbreak is due to _S._ Typhimurium DT
(definitive phage type) 191A and that there had been one ongoing since
mid-2008 in the UK, ending in mid-2009.

Photo of Great Bustard (_Otis tarda_):
<http://blogs.nationalgeographic.com/blogs/news/chiefeditor/great-bustard-chicks-picture.jpg>
- Mod.LL/JW]

See Also

Salmonellosis, reptile feed - USA: recall 20100729.2545
Salmonellosis - Canada: (ON, BC) headcheese, alert 20100726.2499
Salmonellosis, unpasteurized milk - USA (02): (UT) serotype Newport
20100709.2287
Salmonellosis, unpasteurized milk - USA: (UT) 20100517.1616
Salmonellosis, serotype Hvittingfoss - USA: (IL) restaurant chain
20100609.1932
Salmonellosis, serotype Newport - USA (02): sprouts, alert, recall
20100604.1855
Salmonellosis, serotype Newport - USA: sprouts, alert, recall 20100522.1701
Salmonellosis, salami - USA (07): black & red pepper 20100313.0804
Salmonellosis, salami - USA: alert, recall 20100124.0270
2009
----
Salmonellosis, serotype Typhimurium - USA (13): frogs 20091208.4178
Salmonellosis, serotype Typhimurium - USA (12): poss. lettuce source
20090927.3382
Salmonellosis, serotype Newport - USA: ground beef, alert, recall
20090806.2779
Salmonellosis, serotype Saintpaul - USA (03): sprouts, geo. spread
20090310.0992
Salmonellosis, serotype Saintpaul - USA (02): sprouts recall 20090306.0929
Salmonellosis, serotype Saintpaul - USA: (NE) 20090303.0873
Salmonellosis, serotype Typhimurium - USA (11): peanut butter 20090210.0606
Salmonellosis, serotype Typhimurium - USA: RFI 20090108.0077
2008
----
Salmonellosis Schwarzengrund, human, dog food - USA (02) 20081107.3502
2006
----
Salmonellosis, students - USA (MA)(03): owl pellets 20060714.1939
2005
----
Salmonellosis, pet rodents, 2003-2004 - USA (multistate) 20050506.1258
2000
----
Salmonella, dog treats - Denmark (02) 20000121.0105
1999
----
Salmonella, pig's ear dog treats - Canada (Alberta) 19990910.1607
........................................ll/mj/jw
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