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Anandi N. Sheth, Mike Hoekstra, Nehal Patel, Gwen Ewald, Cathy Lord, Carmen Clarke, Elizabeth Villamil, Katherine Niksich, Cheryl Bopp, Thai-An Nguyen, Donald Zink, Michael Lynch, A National Outbreak of Salmonella Serotype Tennessee Infections From Contaminated Peanut Butter: A New Food Vehicle for Salmonellosis in the United States, Clinical Infectious Diseases, Volume 53, Issue 4, 15 August 2011, Pages 356–362, https://doi.org/10.1093/cid/cir407
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Abstract
Background. Salmonella serotype Tennessee is a rare cause of the estimated 1 million cases of salmonellosis occurring annually in the United States. In January 2007, we began investigating a nationwide increase in Salmonella Tennessee infections.
Methods. We defined a case as Salmonella Tennessee infection in a patient whose isolate demonstrated 1 of 3 closely related pulsed-field gel electrophoresis patterns and whose illness began during the period 1 August 2006 through 31 July 2007. We conducted a case-control study in 22 states and performed laboratory testing of foods and environmental samples.
Results. We identified 715 cases in 48 states; 37% of isolates were from urine specimens. Illness was associated with consuming peanut butter more than once a week (matched odds ratio [mOR], 3.5 [95% confidence interval {95% CI}, 1.4–9.9]), consuming Brand X peanut butter (mOR, 12.1 [95% CI, 3.6–66.3]), and consuming Brand Y peanut butter (mOR, 9.1 [95% CI, 1.0–433]). Brands X and Y were produced in 1 plant, which ceased production and recalled products on 14 February 2007. Laboratories isolated outbreak strains of Salmonella Tennessee from 34 Brands X and Y peanut butter jars and 2 plant environmental samples.
Conclusions. This large, widespread outbreak of salmonellosis is the first linked to peanut butter in the United States; a nationwide recall resulted in outbreak control. Environmental contamination in the peanut butter plant likely caused this outbreak. This outbreak highlights the risk of salmonellosis from heat-processed foods of nonanimal origin previously felt to be low risk for Salmonella contamination.
