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Lessons Learned from an Outbreak: Listeria monocytogenes infections linked to deli ham PulseNet/ OutbreakNet East Coast Regional Meeting January 15, 2019 Nicole Lee, MPH Foodborne Epidemiologist [email protected]

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Page 1: Lessons Learned from an Outbreak: Listeria monocytogenes ... · Lessons Learned from an Outbreak: Listeria monocytogenes infections linked to deli ham PulseNet/ OutbreakNet East Coast

Lessons Learned from an Outbreak: Listeria monocytogenes infections linked

to deli ham

PulseNet/ OutbreakNet East Coast Regional MeetingJanuary 15, 2019

Nicole Lee, MPHFoodborne Epidemiologist

[email protected]

Page 2: Lessons Learned from an Outbreak: Listeria monocytogenes ... · Lessons Learned from an Outbreak: Listeria monocytogenes infections linked to deli ham PulseNet/ OutbreakNet East Coast

JCH recall

Page 3: Lessons Learned from an Outbreak: Listeria monocytogenes ... · Lessons Learned from an Outbreak: Listeria monocytogenes infections linked to deli ham PulseNet/ OutbreakNet East Coast

Onset & Hospital Admission

Denied ham on LI form

JCH recall

Remembered ham consumption

Remembered purchase location

LHD site visit

Ladyfingers(Distributor)

Site visitPing pong email and phone

LM +

Purchase Date = 3rd or 4th week in June 2018

WGS matches cluster; CDC asks about ham/brand

exposures

Page 4: Lessons Learned from an Outbreak: Listeria monocytogenes ... · Lessons Learned from an Outbreak: Listeria monocytogenes infections linked to deli ham PulseNet/ OutbreakNet East Coast

Packaging of Country Ham Rolls sent to Southern Home & Kitchen from Ladyfingers

Page 5: Lessons Learned from an Outbreak: Listeria monocytogenes ... · Lessons Learned from an Outbreak: Listeria monocytogenes infections linked to deli ham PulseNet/ OutbreakNet East Coast

Website screenshot

https://www.countryhamrolls.com/

Page 6: Lessons Learned from an Outbreak: Listeria monocytogenes ... · Lessons Learned from an Outbreak: Listeria monocytogenes infections linked to deli ham PulseNet/ OutbreakNet East Coast

LadyFingers is one facility inspected by multiple agencies

USDA, FSIS

• Entrees containing meat and/or

poultry

FDA

• Vegetable entrees and closed faced

sandwich products

Environmental Health

• Catering service

Page 7: Lessons Learned from an Outbreak: Listeria monocytogenes ... · Lessons Learned from an Outbreak: Listeria monocytogenes infections linked to deli ham PulseNet/ OutbreakNet East Coast

Site Visit Questions1. Who inspects LadyFingers?

2. What ham products are received?

3. Who provides ham to LadyFingers?

4. Any additional processing after receipt?

5. What are the lot numbers/codes?

6. Did LadyFingers have more than one supplier since Jan 2018?

• NC Dept of Ag (Food & Drug (for FDA), Meat & Poultry (for FSIS), Environmental Health

• Country ham & deli ham – fully cooked

• Johnston County Hams & Farmland

• Yes. Chopped, placed in yeast rolls & sauce added.

• Invoices do not have lot codes

• No

Page 8: Lessons Learned from an Outbreak: Listeria monocytogenes ... · Lessons Learned from an Outbreak: Listeria monocytogenes infections linked to deli ham PulseNet/ OutbreakNet East Coast
Page 9: Lessons Learned from an Outbreak: Listeria monocytogenes ... · Lessons Learned from an Outbreak: Listeria monocytogenes infections linked to deli ham PulseNet/ OutbreakNet East Coast
Page 10: Lessons Learned from an Outbreak: Listeria monocytogenes ... · Lessons Learned from an Outbreak: Listeria monocytogenes infections linked to deli ham PulseNet/ OutbreakNet East Coast

OnsetDenied ham on

LI form

JCH recall

Remembered ham consumption

Remembered purchase location

LHD site visit

Ladyfingers(Distributor)

Site visitPing pong email and phone

LM +(Hospital)

Purchase Date = 3rd or 4th week in June 2018

WGS matches cluster; CDC asks about ham/brand

exposures

Page 11: Lessons Learned from an Outbreak: Listeria monocytogenes ... · Lessons Learned from an Outbreak: Listeria monocytogenes infections linked to deli ham PulseNet/ OutbreakNet East Coast

Thank you!

NC State Lab of Public Health

CDC

Amanda Conrad & Jessie Marus

Rizza TonsayCounty Health Department

Tammra MorrisonNC Division of Public Health

Dr Beth YongueNC Dept of Ag, Meat & Poultry Inspection