Peanut butter recall

Q:  What is the causative agent of this outbreak?

A:  The causative agent in the current outbreak is the Typhimurium serotype of Salmonella enterica (note: there are more than 2000 serotypes of Salmonella enterica). Although the full name of the organism is Salmonella enterica serotype Typhimurium, it is often abbreviated to Salmonella typhimurium.

Q:  I have a patient with possible salmonellosis and a history of exposure to recalled treats, pet food or products that contain peanut butter. Where should I send samples?

A:  If you are presented with an animal with clinical signs consistent with salmonellosis and a suspected or confirmed history of exposure to potentially contaminated or recalled pet treats, or recalled human food products, the AAVLD and AVMA recommend the following:

Submit diarrhea (preferred) or vomitus samples to your state veterinary diagnostic laboratory for Salmonella culture and DNA fingerprinting. If your state laboratory cannot perform the fingerprinting procedure, the laboratory will forward the sample within its network to a laboratory that can perform the procedure.

To locate an AAVLD lab in your area, go to http://www.aavld.org/mc/page.do?sitePageId=33930&orgId=aavld or go to the AAVLD's home page at http://www.aavld.org/mc/page.do and click on the "Accreditation" link on the left side menu bar.

In response to the confirmed case of salmonellosis in a dog in Oregon, the Oregon Veterinary Medical Association (OVMA) and the Oregon Department of Human Services have established a surveillance system. Veterinarians in Oregon should follow the protocol detailed on the OVMA Web site at http://www.oregonvma.org/news/salmonellacases.asp#report.

Q:  The pet's owner brought a sample of the treats that made their pet ill, and requested they be tested. Where do I send those samples?

A:  If the animal sample tests positive for Salmonella typhimurium, the FDA may request a food/treat sample if one is available for testing, and will provide directions for sample submission if they differ from those below.

Submit pet treat samples either to your state laboratory (call first to ensure they will accept food samples) or a veterinary laboratory that is a member of the Food Emergency Response Network (FERN) for microbiological agents. An alphabetical list of veterinary laboratories that are members of the FERN is below.

Athens Veterinary Diagnostic Laboratory University of Georgia (Athens, GA)

California Animal Health and Food Safety Laboratory (Davis, CA)

Centralia Animal Disease Laboratory, Illinois Dept of Agriculture (Centralia, IL)

Deparment of Defense Veterinary Food Analysis & Diagnostic Laboratory (Fort Sam Houston, TX)

Florida Department of Agriculture and Consumer Services Diagnostic Laboratory (Kissimmee, FL)

Indiana Animal Disease Diagnostic Lab at Purdue University (West Lafayette, IN)

Iowa State University Veterinary Diagnostic Laboratory (Ames, IA)

National Veterinary Services Laboratory (Ames, IA)

New Mexico Veterinary Diagnostic Services (Las Cruces, NM)

Ohio Animal Disease Diagnostic Laboratory (Reynoldsburg, OH)

Pennsylvania Veterinary Laboratory, Penn Dept of Agriculture (Harrisburg, PA) or

Pennsylvania State University Animal Diagnostic Laboratory (University Park, PA)

South Dakota State University Animal Disease Diagnostic Laboratory (Brookings, SD)

University of Minnesota Veterinary Diagnostic Laboratory (Twin Cities, MN)

Q:  How do I submit Salmonella isolates from animals to the NVSL?

A:  If the sample was submitted to an AAVLD laboratory and Salmonella was isolated, the sample can be forwarded by that laboratory to the NVSL for further tests as necessary or as requested.

If you choose to ship a known Salmonella sample to the NVSL from your clinic, the sample should be transported in an approved container by a trained shipping service. Failure to ship the samples appropriately violates US Department of Transportation regulations and could result in fines up to $100,000. For this reason, it is recommended you allow the laboratories to handle shipping the samples.

Veterinarians wanting to further characterize Salmonella isolates from animals can submit these isolates to the Diagnostic Bacteriology Laboratory at the National Veterinary Services Laboratory in Ames, Iowa. Isolates should be submitted with a completed form VS-103 indicating whether serotyping, pulsed-field gel electrophoresis (PFGE), or both are requested.

Form VS-103 and additional information on sample submission can be found at http://www.aphis.usda.gov/animal_health/lab_info_services/diagnos_tests.shtml.

Q:  How do I know what test to request when I send the sample to NVSL?

A:  In almost all cases when an isolate is sent as part of an outbreak investigation, both tests (serotyping and PFGE) are recommended. Once the organism has been identified as Salmonella enterica, serotyping is necessary to determine if it is the Typhimurium serotype.

If the serotype has already been determined at another laboratory and the sample is confirmed to be Salmonella enterica serotype Typhimurium (S. typhimurium), only the PFGE should be requested when the sample is submitted to NVSL. PFGE is the "DNA fingerprinting" test, and determines if the specific isolate is genetically identical or similar to the outbreak's causative organism(s).

Alternatively, you can submit the sample and request only serotyping at the initial request, then add a request for PFGE if the serotype testing confirms Salmonella typhimurium.

Q:  Who pays for the testing?

A:  These labs will charge the cost of the testing to the veterinarian who submitted the samples. The veterinarian will then determine how the charges will be billed to the client.

Q:  Do I need to report the suspected or confirmed animal case?

A:  Yes. Please contact your regional FDA Consumer Complaint Coordinator. For a state-by-state listing of Consumer Complaint Coordinators, go to http://www.fda.gov/opacom/backgrounders/complain.html.

Please also report the case to your state veterinarian/state public health veterinarian. For a state-by-state listing of state public health veterinarians, go to http://www.nasphv.org/Documents/StatePublicHealthVeterinariansByState.pdf. For a state-by-state listing of state veterinarians, go to http://www.usaha.org/StateAnimalHealthOfficials.pdf.

The product manufacturer should also be contacted and made aware of the illness. The contact information should be available on the product package and/or the company's Web site.

Q:  What should I include with the FDA complaint?

A:  Veterinarians or owners should include with their complaint any laboratory results that confirm disease in the pet. The FDA may collect samples of products associated with laboratory confirmed cases of salmonellosis in pets.

Q:  Will the companies reimburse the veterinarian or the owner for the expenses?

A:  At this time, we have no knowledge of reimbursement from manufacturers for costs other than the purchase of the treats. Clients seeking reimbursement should be instructed to contact the manufacturer.

Q:  What other measures should I take?

A:  Be sure to discuss with the client the fact that salmonellosis is an infectious and zoonotic disease, and inform them of proper hygiene and sanitation precautions to protect themselves and their family as well as any other pets they may have. If the client or any of their family members are ill, encourage them to contact a physician immediately. It is also an opportunity to remind owners not to feed human products to their pets for health and safety reasons.

If you have questions or comments about this document, please contact Dr. Kimberly May (847-285-6667).