September 28, 2022

Salmonella Enteritidis Outbreak at Nebraska Correctional Facility

A Salmonela Enteritidis outbreak at a Nebraska correctional facility this year sickened at least 15 people, according to the CDC’s Morbidity and Mortality Weekly Report (MMWR) for the week of July 15, 2022. The Lincoln-Lancaster County Health Department (LLCDH) notified the Nebraska Department of Health and Human Services of two cases of laboratory-confirmed Salmonella in inmates on January 14, 2022.

Salmonella Enteritidis Outbreak at Nebraska Correctional Facility

The investigation linked consumption of mechanically separated chicken to the illnesses. Mechanically separated chicken is produced by separating edible meat from bone and cartilage under pressure. It is often used for use in institutions like prisons, jails, and correctional facilities because it’s cheap. A Salmonella Heidelberg outbreak linked to that product sickened at least nine inmates in Tennessee in 2015.

Because prison inmates are a captive audience, it is considered cruel and unusual punishment to serve them food contaminated with pathogens because they don’t have a choice in what they eat.

Staff members reported about 100 inmates who were sick for a few days. No staff member reported illness. It is likely that more cases occurred, since a COVID-19 outbreak was ongoing at the same time, and access to inmates to interview them was limited. A probable case was defined as the onset of diarrhea, stomach cramps, or vomiting during the time period of January 9 to 11, 2022. A confirmed case had isolates of Salmonella Enteritidis highly related to the outbreak strain by core genome multi locus sequencing typing in a clinical specimen.

A total of 15 cases of Salmonella Enteritidis infection were identified. Two patients were hospitalized. All cases occurred in food workers. All of them said they ate chili that was prepared from the raw mechanically separated chicken.

Salmonela Enteritidiss that genetically matched the outbreak strain was isolated from the raw mechanically separated chicken sample.  But since Salmonella is not considered an adulterant in raw poultry products, no regulatory action was taken.

The environmental assessment identified food safety risks in incomplete thawing and cooking processes for the chicken product. It was sometimes still frozen or partially frozen when cooked, and cooking temperatures were not routinely monitored during food preparation. The Nebraska Correctional facility was not able to verify that the chicken reached a safe final internal temperature before it was served.

Mechanically separated chicken products tested by the USDA have a higher prevalence of Salmonella (82.9%) than ground chicken (39%), and other comminuted chicken products (41.7%) tested during the time period of June 1, 2013 through December 31, 2014. Mechanically separated chicken is typically used in processed meat products such as hot dogs, which are then thermally processed to a safe temperature.

The report ends with these words: “Populations who are obligated to eat in certain locations and who have limited choice regarding what they eat are dependent on societal responsibility to ensure their health and the facility’s food safety procedures. Mitigating the risks of food handling and processing and cooking in vulnerable populations and institutions requires two key actions: 1) providing a less highly contaminated poultry product in the absence of contamination threshold regulatory requirements for poultry products and 2) implementing a preventive food safety management system to ensure thawing, cooking, and cooling processes meet food safety requirements.”

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