Creating student sleuths: how a team of graduate students helped solve an outbreak of Salmonella Heidelberg infections associated with kosher broiled chicken livers.

Since 2009, the New York City Department of Health and Mental Hygiene (DOHMH) has received FoodCORE funding to hire graduate students to conduct in-depth food exposure interviews of salmonellosis case patients. In 2011, an increase in the number of Salmonella Heidelberg infections with pulsed-field gel electrophoresis Xba I pattern JF6X01.0022 among observant Jewish communities in New York and New Jersey was investigated. As this pattern is common nationwide, some cases identified were not associated with the outbreak. To reduce the number of background cases, DOHMH focused on the community initially identified in the outbreak and defined a case as a person infected with the outbreak strain of Salmonella Heidelberg with illness onset from 1 April to 17 November 2011 and who consumed a kosher diet, spoke Yiddish, or self-identified as Jewish. Nationally, 190 individuals were infected with the outbreak strain of Salmonella Heidelberg; 63 New York City residents met the DOHMH case definition. In October 2011, the graduate students (Team Salmonella) interviewed three case patients who reported eating broiled chicken livers. Laboratory testing of chicken liver samples revealed the outbreak strain of Salmonella Heidelberg. Although they were only partially cooked, the livers appeared fully cooked, and consumers and retail establishment food handlers did not cook them thoroughly before eating or using them in a ready-to-eat spread. This investigation highlighted the need to prevent further illnesses from partially cooked chicken products. Removing background cases helped to focus the investigation. Training graduate students to collect exposure information can be a highly effective model for conducting foodborne disease surveillance and outbreak investigations for local and state departments of public health.

Evaluating the effectiveness of food recalls in retail establishments in New York City.

Information on how promptly food recalls of U.S. Food and Drug Administration (FDA)-regulated products are disseminated to retailers is not well documented. Store managers were surveyed after recalls were declared to estimate the proportion aware of a recall, to describe the methods by which they learned of the recall, and to ascertain how they would prefer to be notified of recalls in the future. From 1 January 2008 to 31 December 2009, we identified FDA Class I products recalled because of potential contamination with an infectious agent such as Salmonella, which were sold in New York City. After each recall, a sample of retailers who carried the products was contacted, a standardized questionnaire was administered to store managers, and a sample of stores was inspected to determine if the product had been removed. Among nine recalls evaluated, 85 % (range, 12 to 100 % ) of managers were aware of the recall affecting a product at their store. Chain store managers were more aware of recalls than were independent store managers (93 versus 78%, P < 0.0001). More chain store managers first heard about the recall via e-mail as compared with independent store managers (35 versus 4%, P < 0.0001). E-mail notification was preferred by large chain store managers (38 versus 8%, P < 0.0001); on inspection, chain stores were more likely to have removed the item than were independent stores (85 versus 56%, P = 0.0071). Although recall information reaches many stores, faster electronic notifications are not effective at reaching small, independent stores, which may lack computers or fax machines. Alternate means to disseminate recall notifications rapidly are needed for stores without electronic communication capabilities.