A Gatlinburg Chili Cook-Off Salmonella outbreak in 2020 sickened 99 people, according to a study conducted by epidemiologists at the Tennessee Department of Health (TDH). On November 17, 2020, the TDH was notified by the USDA of a complaint of gastrointestinal illness among attendees of the cookbook, which was held on November 12, 2020. The next day, the Sevier County Environmental Health Specialist received another complaint of more illnesses. An outbreak investigation was launched.
TDH notified the host of the event, the Gatlinburg Chamber of Commerce, of the complaints and requested contact information for the vendors and attendees. All 13 vendors that participated in the event were contacted. The information they provided was used to create an event-specific questionnaire, which was distributed via email on December 1, 2020 to vendors and attendees. A case control study was conducted.
The confirmed case definition was anyone who attended the Chili Cook-Off in Gatlinburg who had onset of illness a minimum of one day after the event and a maximum of 10 days. Symptoms included at least diarrhea or vomiting, with lab confirmed diagnosis of Salmonella.
The Hilton Garden Inn, where the Cook-Off was conducted, said it had leftover chili, but as it turned out it was not available. TDH collected food samples on November 30, 2020 from two vendors who also had leftovers. An environmental assessment was conducted at the Hilton Garden Inn on December 8 2020. Ground pork invoices and supplier information were also collected and forwarded to the USDA for traceback. The supplier of the pork, Swaggerty’s Sausage Company, was notified about the outbreak, but officials determined that no further follow-up was warranted.
The Tennessee State Public Health Laboratory conducted Salmonella culture testing, and whole genome sequencing was conducted. Because there was a bigh number of out of state attendees, the CDC was notified on December 11, 2020, and PulseNet issued outbreak code to help identify patients.
The questionnaire was sent to 528 individuals, and 300 responded. Ninety-nine cases were identified from 19 states. Six cases were confirmed, and 93 were probable. The cases had a median age of 45 yers. Four people were hospitalized.
In the initial analysis, multiple chili vendors were associated with the illnesses, but that was probably because attendees sampled chili from multiple vendors. After controlling for confounding, the Hilton Garden Inn was the only exposure that remained independently associated with illness. The odds of eating chili from the Hilton Garden Inn were 3.5 times higher in persons experiencing symptoms of Salmonella than the odds of eating chili from the Hilton Garden Inn among well persons.
Four contributing factors were found during environmental assessment on December 8, 2020. First, raw pork and beef were cooked using a hot-holding device that was not designed or intended for cooking raw animal foods. These products were likely undercooked, which allowed the bacteria to survive. Second, the re-use of buckets for both pre-cooked and finished chili likely contributed to cross-contamination because proper sanitation may not have occurred. Third, heated chili was improperly cooled. It was placed in 5-gallon buckets, potentially allowing bacteria to proliferate. The buckets were filed to the top, covered, and stacked inside a walk-in cooler immediately after cooking. And fourth, the chili in 5-gallon buckets was inadequately reheated using a cabinet-style heating device that was not designed or intended to reheat foods.
Six human isolates from four states teated positive for Salmonella Muenchen and were highly related. Nine environmental samples collected from the Hilton Garden Inn were negative for Salmonella. CDC PulseNet identified a Salmonella positive pork sample collected by the USDA in September 2020 the was highly related to the outbreak strain by whole genome sequencing. That sample was collected from Swaggerty’s Sausage Company, which was the supplier of ground pork sausage for the Hilton Garden Inn chili.
Environmental assessment, laboratory evidence, and epidemiological findings suggest that the Hilton Garden Inn chili was the source of the outbreak. The contamination likely originated from the raw ground pork sausage purchased form Swaggerty’s Sausage Company. The outbreak demonstrated the importance of safe food handling at the point of service.
Symptoms of a Salmonella infection include a fever, chills, nausea, vomiting, abdominal cramps, and diarrhea that may be bloody. If you ate chili at that Cook-Off in November 2020 and experienced those symptoms, you may have been part of the Gatlinburg Chili Cook-Off Salmonella outbreak. It would be a good idea to mention the illness to your doctor, since long term complications of a Salmonella infection, even after full recovery, can include high blood pressure, reactive arthritis, irritable bowel syndrome, and endocarditis.
If you or a loved one have been sickened with a Salmonella infection after eating Hilton Garden Inn chili at the Gatlinburg Chili Cook-Off in 2020, please contact our experienced attorneys for help at 1-888-377-8900 or 612-338-0202.
