Turkey and Salmonella: Separating Fact from Fiction

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But two days later, Arjes woke up with cold sweats and started vomiting. His fever spiked to 104 degrees. Arjes spent the next four days in the hospital, fighting salmonella and a potentially fatal sepsis infection while drifting in and out of consciousness.

“It was the closest to death that I’ve been,” said Arjes, then 32.

Following the dinner in Swisher, which is between Cedar Rapids and Iowa City, 115 people reported being ill. As a result, state and local public health investigators spoke with the victims and tested any leftover food because Arjes was one of them. They discovered that the most common item on the menu—turkey that was purchased at a supermarket and smoked at someone’s house for the occasion—was the cause of the food poisoning.

“Go figure,” Arjes said. “It’s a wild game feed dinner. Almost anything you can imagine is there, and turkey was the item that most people became ill from. ”.

The event would turn out to be part of a nationwide outbreak of a rare type of salmonella known as Reading — except that this strain was far more virulent and less responsive to antibiotics, and it spread like wildfire through the turkey industry from 2017 to 2019. The outbreak led to recalls from grocery stores and to clusters of illnesses linked to potlucks like the one Arjes attended.

But it could have been far worse.

ProPublica revealed this fall that multidrug-resistant infantis, a different strain of salmonella, has been spreading like wildfire through the chicken industry for almost four years, sickening tens of thousands of people. The unchecked spread of infantis exposed stark gaps in the authority of the U. S. Department of Agriculture, which has little power to stop dangerous strains of salmonella from making people sick.

Some of the same flaws in our food safety system were highlighted by the Reading outbreak in the turkey industry, but the reaction to Reading provides a clear picture of some possible solutions, along with an explanation of why they won’t be simple.

The decision by the turkey industry to track down the virulent strain on its own was what ultimately made the difference. To combat Reading, the National Turkey Federation promptly established a task force focused on salmonella and devised a plan that included immunizing breeding flocks, improving barn sanitation, and altering processing facilities to lower cross-contamination. Crucially, a number of Turkish businesses also sought the assistance of outside experts to gain a deeper understanding of the strain’s apparent abrupt transformation.

It was a striking contrast to how the chicken industry has responded to infantis. The Centers for Disease Control and Prevention (CDC) and the National Chicken Council have met multiple times to discuss infantis; however, the CDC claims that the trade association has not provided the agency with much information regarding the strain and its efforts to eradicate it.

“The industry controls the flow of information and the actions taken to address an issue,” stated Thomas Gremillion, the Consumer Federation of America’s director of food policy. We are at the mercy of the industry, which determines what is profitable and what is reasonable to handle from a business standpoint. ”.

Thus, even though infantis has persisted in the chicken industry, the rate of readings discovered in Turkey during routine USDA sampling has decreased by %2073% since 2018. A ProPublica analysis of the data revealed Furthermore, the CDC’s reports of cases of people falling ill from the strain have decreased by 65% when compared to the outbreak period.

The U. S. The chicken industry, which is headed by some of the biggest food corporations in the world, is large enough and politically powerful enough to withstand the strain of a product-related public health emergency. In contrast, the turkey industry is still quite close-knit, with leading players who are primarily associated with turkey even though they are a part of larger food processors. While the chicken industry has pushed its way into practically every aspect of the American diet, this industry’s economic interest has been carefully wrapped in the wholesomeness of yearly holiday gatherings.

There are also vast differences in scale and the logistics of solving the salmonella problem. The U. S. produces more than 9 billion chickens a year across more than 25,000 farms and 200 processing plants. By contrast, the nation raises 40 times fewer turkeys annually, or roughly 225 million, on 2,500 farms and 40 plants.

The USDA’s response to the outbreaks has been different too. After the CDC opened its Reading investigation, the USDA immediately notified the public of the outbreak and later released a review of its efforts. But almost four years into the infantis outbreak, the USDA still hasn’t said anything to consumers about infantis, which has become the most common type of salmonella found in chicken and is one of the biggest public health threats in a product the agency regulates.

The USDA didn’t respond to questions seeking comment for this article. However, senior agency public health officials told ProPublica this year that they were unable to connect infantis to a specific chicken product and therefore concluded there was nothing useful they could advise consumers of.

ProPublica was informed by the National Chicken Council that the industry has taken action to combat infantis. The council also supplied a list of general precautions that businesses take to control salmonella, such as immunizing breeding flocks against specific strains. However, it was unable to pinpoint the extent of industry efforts to investigate the strain or the number of specific changes the industry has made to address infantis.

The strains of infantis and Reading have a lot in common. Both appear to have appeared out of nowhere, and by 2018, the CDC had classified them as outbreaks because of how many people they had infected. In contrast to most outbreaks linked to a particular product or processing facility, both strains spread widely throughout the supply chain, impacting numerous businesses. And both are resistant to multiple antibiotics, though infantis is far more difficult to treat.

The two strains also revealed that consolidation in the poultry industry, already a concern for business regulators, may be a public health problem, too. Following a string of acquisitions and partnerships in the past few decades, nearly all the chicken and turkey that the world eats now descends from birds bred by two chicken companies and two turkey companies. According to researchers, that concentration in poultry breeding appears to be leading to global epidemics of foodborne illness.

Yet regulators in the U. S. lack the authority to concentrate their efforts higher up the supply chain, according to food industry consultant Mansour Samadpour. “There are many opportunities for salmonella to enter at different stages,” he stated, “but it’s a major issue if it’s occurring at the top.” ”.

The pervasive nature of Reading intrigued Tim Johnson, a poultry microbiologist at the University of Minnesota. In mid-2018, he began getting calls from veterinarians, farmers and others in the turkey industry. Something strange was happening. And they needed his help.

He recalled clearly the first day when a veterinarian from one of the companies approached him and said, “We have a big problem on our hands,” in not too many words.

The veterinarian informed him that the percentage of Reading discovered in the company’s internal salmonella tests had more than doubled from a few years prior. People were starting to get sick from it. And they couldn’t figure out how to get rid of it. After thorough cleaning, some turkey farmers were still finding the bacteria, so they had to tear down and replace the barn walls.

A number of corporate representatives visited Johnson’s laboratory in Willmar, Minnesota, which was housed in a former mental health facility built in the Spanish Colonial style and converted into a biotech center.

Reading, which was initially isolated in Reading, England, in 1916, had been regarded as comparatively benign until that point. It had caused an outbreak in the U. S. , mostly among children, in 1956-57, but since then, outbreaks had been rare.

The new strain was especially causing problems in ground turkey, where salmonella in general is found much more frequently. While USDA inspectors rarely detect salmonella in whole turkey during testing, last year they found it in 18% of ground turkey samples.

According to Johnson, the companies were interested in finding out what made this Reading strain unique from others they had encountered and, in the event that something was, what steps they could take to address it.

“I believe it truly made them realize that we need to respond to this by acting swiftly and effectively and by going above and beyond what we’ve done in the past,” he said.

Johnson originally intended to become a doctor, but a college course hooked him on the study of bacteria that cause disease, which is how he ended up becoming a microbiologist. Having grown up in the turkey-producing region of west-central Minnesota, Johnson was also acquainted with children who worked on poultry farms and turkey growers.

“As I grew older and noticed that the family farm appeared to be disappearing, it truly piqued my curiosity about how I could use my skills and knowledge to support farmers,” he said. ”.

Johnson, 44, seized the chance to return home to the region and concentrate his research on turkeys when it presented itself. Johnson immediately won the trust of the area’s turkey farmers, who look better in work boots and casual attire than in button-down shirts. During his year-long leave of absence, he worked for a company that produces feed additives for turkeys and visited farms to gain a better understanding of the problems they faced with bacteria such as salmonella.

To Johnson, investigating Reading was the kind of project the lab was designed for. Surrounding the campus is an expanse of farmland that’s home to more than 100 turkey operations.

A tool to recognize novel and dangerous strains of salmonella on farms and contain them before they cause outbreaks would be developed as a result of the research.

Johnson was bewildered as to how a particular strain of bacteria could appear out of nowhere and take over an entire industry, so he had to respond to that question first.

After the on-campus meeting, companies started bringing petri dishes streaked with salmonella to the lab in Willmar.

Testing some of the theories that were confounding farmers and turkey companies was Johnson’s first assignment with Reading. For instance, his team discovered that this strain of salmonella was not more resistant than other strains to the disinfectants used to clean barns. Furthermore, it did not perform any better in the formation of biofilms, which are essentially slimy force fields that help bacteria adhere to surfaces and become more difficult to kill.

There was nothing about the barn environment that was causing the problem, Johnson said. Something else was going on. And to find it, they’d have to extract the bacteria’s DNA and examine its genome.

From the moment the two strains of infantis were discovered in raw pet food, the turkey industry responded to Reading differently than the chicken industry did.

A year before the wild game feast, a 2-year-old girl and her 4-year-old sister tested positive for salmonella. The 4-year-old’s infection was so severe that it had spread to her bones.

The family dog was fed raw turkey pet food that contained the same strain of Reading that had sickened the girls, so investigators think the girls may have contracted the bacteria while playing with the dog. The girl’s parents were unaware that their daughters had contracted food poisoning.

The Food and Drug Administration (FDA) is in charge of practically all other foods, including pet food, whereas the USDA regulates meat and poultry. The FDA swiftly issued a recall notice for the contaminated dog food.

Within two weeks, the turkey industry responded. The National Turkey Federation advised its members to cease providing turkey to companies that produce raw pet food unless they had a method to eradicate the bacteria during its annual convention in February 2018. The chicken industry hasn’t instructed its members to cease doing business with the producers of what public health officials view as a potentially hazardous product, despite the infantis strain having also prompted a recall of raw dog food.

“Keeping a bowl of raw meat on your floor is not a good idea, especially if you have children,” stated Carlota Medus, the Minnesota Department of Health’s head of the foodborne diseases unit. “Your dog is not using utensils. They’re putting their face in their food. And then that face goes everywhere. So you’re basically going to cross-contaminate your kitchen, your living room, your hands. ”.

But the case was far from closed. There were two other Reading cases in Minnesota, and neither had a link to the dog food.

Medus’ team of epidemiologists had noticed small clusters of the strain popping up as far back as 2015. The new rise in Reading cases added to the mystery. Maybe if they could figure out where the pet food company originally purchased its turkey, they could identify a common source. But they couldn’t connect the dots.

So they searched a national database of foodborne bacteria samples, known as isolates. And as a result, Medus stated, “we discovered that there were highly related isolates across the nation.”

Medus called the CDC’s outbreak response team.

A few months later, in July 2018, Lisa Wallenda Picard received a call from the CDC, which was scheduled to provide an annual update to the industry, while she was in the middle of the Turkey Federation’s Summer Leadership Conference. Executives from nearly every major turkey company were in a room at a Washington, D. C. , hotel awaiting the presentation.

The group’s senior vice president of policy, trade, and regulatory affairs, Wallenda Picard, recalled, “We got a phone call that, ‘By the way, we’re gonna have to tell you guys there’s an outbreak,’ as the CDC was getting ready to talk to us.” I like to think I didn’t say anything else, but that’s probably not true. And we’re like, ‘What?’ ”.

Medus’ tip to the CDC had checked out. Reading wasn’t just a problem in raw dog food. It was sickening people who’d eaten whole turkey and ground turkey and who worked in turkey plants.

Even though the news was upsetting, Wallenda Picard—who, perhaps appropriately, is descended from a well-known tightrope walker family known as the Flying Wallendas—said it came at a fortunate moment.

“Everybody who needed to be there was literally in the room,” she said. And we essentially shut the doors after declaring, “This is a big deal, people. What the heck are we going to do? ’”.

Starting at that meeting and over the next several weeks, the turkey federation worked with public health experts and regulators to hammer out a list of more than 100 potential strategies from the hatchery to the grocery store to prevent salmonella.

The turkey industry could have chosen to ignore the outbreak. Neither the USDA nor the CDC have much power to make companies cooperate or to reduce salmonella.

However, the turkey industry was more vulnerable to consumer pressure due to its smaller size and limited product selection than the chicken industry was. “Therefore, epidemics and recalls truly affect them more profoundly,” stated Brian Ronholm, Consumer Reports’ director of food policy. “And so there’s more of a collective approach to tackle the problem. ”.

As the industry began devising a plan, the Reading outbreak continued to grow. Health and agriculture officials in Arizona and Michigan collected packages of Jennie-O ground turkey from victims’ homes. Both tested positive for the outbreak strain.

The findings led Jennie-O Turkey Store to voluntarily recall about 310,000 pounds of ground turkey. The two recalls coming just days before Thanksgiving and Christmas created an crisis not only for the brand, which is owned by Hormel Foods, but for the turkey industry as a whole.

Johnson said, “Jennie-O got blamed for a lot of this in the public realm when, in fact, it was not solely their fault.” “The industry definitely realized that we’re all at risk here, not just a specific company. ”.

The USDA knew that Jennie-O wasn’t the only company with the Reading strain. Its inspectors had found the strain at plants owned by nearly all of the country’s major turkey producers. State health officials had found it in turkey products being sold at supermarkets under several different brands. And Canada had announced its own Reading outbreak, noting that none of the products recalled in the U. S. had been imported or distributed in the country.

But under the USDA’s rules, finding an outbreak strain in poultry plants wasn’t enough to recommend a recall. Nor was it enough to find it in raw meat on store shelves. It had to be tied to a specific patient who was already sick.

So, the outbreak continued.

About 225 people crammed into the American Legion hall in Swisher on the evening of the wild game feast hosted by the Swisher Men’s Club, and they sat at long banquet tables. Most of the food on the menu had been hunted, trapped or caught. There were goose kabobs and rabbit sliders, pheasant Alfredo and even raccoon. But the club had also purchased about 20 turkey breasts from a supermarket.

The menu didn’t faze Matthew Arjes. This was his third year going to the dinner. He had a plate of venison, fish and smoked turkey and tried the Cajun turtle.

The next day, he started feeling sick. “I realized it wasn’t just food poisoning around 8 or 10 a.m. the next morning,” stated Arjes, a professional installer of dental and medical equipment. “I experienced severe flu-like symptoms, including a high fever, chills, vomiting, and diarrhea — the worst you could possibly imagine.” ”.

At the hospital in Cedar Rapids, Arjes was admitted to the intensive care unit. After the second or third day, he asked a nurse if he was going to live. “She’s like, ‘Well, we’ll just see how you feel,’” he recalled.

After his illness with salmonella, Arjes eventually recovered, but he missed a month of work due to exhaustion.

The Swisher Men’s Club worked with the state Health Department to identify the cause. The group’s president, Mike Brown, said the club decided to hold a catered banquet in place of the game feast but he would not comment.

Cross-contamination and incorrect cooking were attributed by state investigators, who pointed out that a club member had only checked the temperature of half the smoked turkeys before returning them to the same coolers used to thaw and brine the raw turkeys.

Investigators also traced the turkey to a company that hadn’t been involved in the previous recalls. They notified the USDA, giving the agency another opportunity to take action to protect the public from Reading. Now that it knew the brand, the USDA could have issued a public health alert. Pulling the contaminated meat from stores would have required more evidence. However, given the inadequate food handling, state records indicate that the USDA “did not feel any regulatory actions were necessary.”

The CDC closed its investigation into the nationwide Reading outbreak in April 2019, noting that 358 people had been infected and 133 hospitalized, including one person who died. But because the CDC estimates that for every confirmed salmonella case, about an additional 30 are never reported, more than 10,000 people had likely been infected by the outbreak. And since the strain was widespread, the CDC noted that “people could continue to get sick.”

Nearly a year and a half into the outbreak, it was clear that the source wasn’t the slaughterhouses. Similar to the infantis outbreak, it occurred in hatcheries, feed mills, or turkey barns further up the supply chain. However, the USDA’s Food Safety and Inspection Service, which employs 8,700 people and is tasked with guaranteeing the safety of meat and poultry, lacks the authority to control or look into cases of salmonella on farms.

“Seeing very clearly the limits of FSIS’ authority was one of the really frustrating things about this investigation,” Medus said. “I mean, something happened, and if it was something, we might be able to address it and bring this under control. But basically the response we were getting was: ‘Well, this reaches the limits of our authority. This is as far as we can take it. ’”.

If not for the turkey industry’s collaboration with Johnson, the Reading story might have turned out similarly to the current infantis outbreak. By looking at the genome, Johnson’s team was learning a lot about the Reading strain.

Following the sequencing of the bacteria samples at the Willmar lab, Elizabeth Miller, a research scientist at the St. In the beginning of 2019, Paul started examining the genomic data in an effort to find mutations that would explain why Reading had become so dangerous.

She started charting the strain’s evolution by compiling information on almost 1,000 additional Reading samples spanning almost 20 years.

Reading had indeed changed. The strain had acquired a virulence gene that made it more invasive to humans. It then underwent another mutation that improved its ability to engage in “microbial warfare,” or combating other bacteria in the stomachs of turkeys. The new iteration of Reading acquired genes containing multiple antibiotic resistance through plasmids, which are genetic elements.

Equipped with this knowledge, Johnson’s group examined the strain in the laboratory and validated the findings it had observed in the genome.

Studying the findings, the researchers concluded in a paper last year that the new Reading strain had to have come “from a common source, likely through supply birds at the top of the genetic breeding pyramid.”

Johnson saw that the strain’s appearance in 2015 was timed to coincide with an outbreak of bird flu that had wiped out the Upper Midwest’s supply of turkey breeders. Early in the year, turkeys were observed gasping, wildly arching their heads and necks, and flapping their wings at a 15,000-bird breeder farm in Minnesota. Within days, more than 70% of the birds died. According to additional University of Minnesota researchers, the illness swiftly expanded to hundreds of farms, impacting roughly 50 million chickens and turkeys nationwide.

“All of a sudden they had to replace everything all at the same time,” Johnson said. Additionally, the new Reading strain spread swiftly throughout the turkey industry due to the timing and limited number of businesses providing the breeding stocks.

The theory about Reading’s origin was one in a series of recent findings linking the concentration of breeders to outbreaks. This summer, University of Georgia researchers traced the worldwide spread of another type of salmonella to the international trade of chicken breeding stocks. And the CDC has pointed to breeding flocks as a potential source of the infantis outbreak.

Tyson Foods’ chicken breeder Cobb-Vantress stated to ProPublica in a statement that it had “serious concerns about the methodology used in the research and the reliability of the findings made.” ” But the company didn’t detail its concerns. Aviagen, the other major chicken breeder, declined to comment. Additionally, neither of the two main turkey breeders—Select Genetics, owned by Aviagen and Life-Science Innovations, nor Hendrix Genetics—responsed to messages requesting comment.

Johnson’s findings not only provided a probable origin story. It also presented an answer for how to defeat the strain.

“It turns out that eliminating it from within the birds was the only effective way to really control it,” he stated. In order “to ensure that if we get a positive flock, we don’t allow that to spread to other flocks,” he said, vaccinations and other precautions were necessary.

Some turkey companies had already taken desperate measures to stop the spread, euthanizing entire breeding flocks. It’s a practice that’s almost unheard of in the U. S. because of the cost but commonly practiced in some European countries to fight salmonella.

Johnson stated, “In some of these companies, that’s the point they got to, where they just didn’t have a choice anymore.”

The drastic measures would aid in changing the course of the outbreak, along with close monitoring and a vaccine breakthrough.

Inside Confinement Rearing Room 19 at the University of Minnesota’s Poultry Teaching and Research Facility in St. Paul, the 6-week-old turkeys chirped softly in their pens. Food safety microbiologist Anup Johny bent down in the wood shavings, opened a wire-cage door to one of the pens, and held one of the birds.

The turkeys, which were test subjects in a study to make food safer, were the size of footballs and covered in white feathers. The turkeys would be taken out of the pen and given Reading in around six weeks to evaluate the efficacy of a vaccine in combination with cheese-making bacteria against the pathogen.

According to Johny, the objective is to create defense plans against newly discovered salmonella strains in case they ever pose a threat.

“It’s just like devising tools before an outbreak occurs,” he said.

The USDA recently announced that it’s rethinking its approach to salmonella in an effort to reduce an illness rate that hasn’t gone down in 25 years. Last month, the agency asked a key advisory committee for suggestions on how to improve its testing program to focus more on public health risks and on efforts to control the bacteria on farms. In early December, it also asked poultry companies for proposals to test new strategies for reducing contamination.

Critical hints could be found by closely examining how the turkey industry dominated Reading and the ongoing efforts in Minnesota.

Turkey companies tested whether a commercially available vaccine created for another type of salmonella could also protect turkeys against Reading as the outbreak spread. They also started creating custom vaccines.

Elanco Animal Health, which makes that vaccine, said it found that vaccinating newborn birds reduced Reading in ground turkey samples by 57%.

When the vaccination was used in conjunction with other interventions, Michelle Kromm, vice president of animal health and welfare at Jennie-O, reported that the company had also seen decreases in Reading. In the fall of 2018, it started vaccinating breeder flocks against Reading. It stopped reusing poultry litter, which lines barn floors, and started fumigating targeted barns between flocks. Later, it also began vaccinating the turkeys raised for food. In 2019, it required breeders to meet certain salmonella standards. And since last year, Jennie-O has sent flocks to be cooked into products in order to destroy any bacteria it finds.

“We really started to see reductions pretty quickly when we started seeing the birds that were able to have that whole program as part of their rearing process,” Kromm said.

The percentage of Jennie-O ground turkey samples with a reading has decreased by more than 90% since 2018, according to USDA records.

Given how COVID-19 has impacted food poisoning statistics, public health officials are hesitant to declare victory just yet, but the data that is currently available is pointing in the right direction. Wallenda Picard cautioned that no vaccine can protect against all strains.

Indeed, despite the fact that existing vaccinations have demonstrated some efficacy against infantis, the chicken industry has found it difficult to make a dent.

Alarmingly, while the strain has typically been found in chicken, it recently crossed into turkey, Johnson said. Thus, using the same resources they used on reading, University of Minnesota researchers are now focusing on infantis with funding from the USDA. If successful, the strategy might eventually put an end to the infantis outbreak, which the CDC has classified as an epidemic.

In the interim, the group is still testing farm-sourced bacterial samples in an effort to identify the next potentially harmful strain. Thanks to their work on Reading, the researchers have developed a web-based tool that allows businesses to upload a sample and obtain a preliminary assessment of a strain’s potential risk, Johnson said. Lab tests would then be necessary to confirm the results. ProPublic.

Salmonella a risk in Thanksgiving turkeys