Introduction

CDC is working with public health and regulatory officials in Missouri, several other states, and the U.S. Food and Drug Administration (FDA) to investigate a multistate outbreak of Salmonella Oranienburg infections.

Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. PulseNet, coordinated by CDC, is the national subtyping network of public health and food regulatory agency laboratories. PulseNet performs DNA fingerprinting on Salmonella bacteria isolated from ill people by using techniques called pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS). CDC PulseNet manages a national database of these DNA fingerprints to identify possible outbreaks.

Eight people infected with the outbreak strain of Salmonella Oranienburg have been reported from three states. A list of states and the number of cases in each can be found on the Case Count Map page.

Among people for whom information is available, illnesses started on dates ranging from April 23, 2016 to August 24, 2016. Ill people range in age from 1 year to 85, with a median age of 44. Sixty-three percent of ill people are female. Among seven people with available information, two (29%) have been hospitalized. No deaths have been reported.

WGS showed that isolates from ill people are closely related genetically to one another. This close genetic relationship means that people in this outbreak are more likely to share a common source of infection.

The strain of Salmonella Oranienburg in this outbreak also is closely related genetically to a Salmonella Oranienburg strain from a 2015 outbreak linked to the Good Earth Egg Company. In the 2015 outbreak, 52 people infected with the outbreak strain were reported from six states. In response to the 2015 outbreak, Good Earth Egg Company recalled all of its shell eggs on January 9, 2016.

The current outbreak can be illustrated with a chart showing the number of people who became ill each day. This chart is called an epidemic curve, or epi curve. Illnesses that occurred after September 9, 2016, might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 2 to 4 weeks. Please see the Timeline for Reporting Cases of Salmonella Infection for more details.

Investigation of the Outbreak

Epidemiologic, laboratory, and traceback investigations identified shell eggs distributed by Good Earth Egg Company of Bonne Terre, Missouri as the likely source of this outbreak.

In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Of the six ill people who were interviewed, all six (100%) reported eating or possibly eating shell eggs in the week before illness started. Ill people reported eating eggs in restaurants as well as at home.

Federal, state, and local health and regulatory officials performed a traceback investigation from one restaurant location in Missouri where three ill people reported eating eggs. This investigation indicated that Good Earth Egg Company supplied eggs to that restaurant.

Missouri health officials collected and tested shell eggs from the Missouri restaurant location and isolated the outbreak strain of Salmonella Oranienburg. Additionally, environmental samples taken at the Good Earth Egg Company processing facility isolated the outbreak strain of Salmonella Oranienburg. WGS showed that the isolates of Salmonella Oranienburg from eggs distributed by Good Earth Egg Company are closely related genetically to isolates from ill people in this outbreak and from ill people and environmental samples in the 2015 outbreak. This close genetic relationship provides additional evidence that ill people in this outbreak and in the 2015 outbreak got sick from eating shell eggs distributed by Good Earth Egg Company of Bonne Terre, Missouri.

CDC recommends that consumers do not eat and restaurants and retailers do not serve or sell shell eggs distributed by Good Earth Egg Company at this time. Eggs distributed by Good Earth Egg Company were sold under different brand names. If you don't know if your eggs were distributed by Good Earth Egg Company, ask the store where you bought them or the restaurant where they were served.

This investigation is ongoing, and we will update the public when more information becomes available. CDC and state and local public health partners are continuing laboratory surveillance through PulseNet to identify additional ill people and to interview those people about foods they ate before they got sick.