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Investigation of Multistate Outbreak of Salmonella Bareilly and Salmonella Nchanga Infections Associated with Nakaochi Scrape AA or AAA Frozen Raw Tuna from India

June 21, 2012

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Recall Information
 

Updated Recall Information
May 10, 2012 

Moon Fishery (India) Pvt. Ltd. Recalls Tuna Strips

FDA Sampling of Shipment Attempting to Enter the U.S. Yields Salmonella

Moon Fishery (India) Pvt. Ltd., the manufacturer of the frozen yellowfin tuna Nakaochi scrape recently recalled, is now also recalling its 22-pound boxes of “Tuna Strips”, Product of India, marked as “AA” or “AAA Grade” because the product has the potential to be contaminated with Salmonella. 

FDA sampling yielded Salmonella with a pattern matching the outbreak strain of Salmonella Bareilly that has caused more than 250 illnesses in 24 states and the District of Columbia.

This product was intended for wholesale distribution, and was not sold directly to consumers.

Although the shipment in question did not enter into commerce, previous shipments of the tuna strips may still be in the marketplace. Moon Marine (USA) Corporation, the importer of these products, reports four shipments from Moon Fishery (India) since January 2012. According to the company, distribution of the tuna strips product is limited for four wholesalers in Georgia, Massachusetts, New Jersey, and New York. All wholesalers have been contacted with recall instructions regarding the product.

However, the wholesalers may have broken the shipments into smaller lots for further distribution. The frozen raw yellowfin tuna product was originally packaged in white boxes with black writing naming the importer as Moon Marine (USA) Corporation, and identifying the contents as Tuna Strips AA or AAA, Product of India. The 22-pound boxes contain several vacuum-packages with no further labeling.

Original Recall Notice
April 13, 2012

Moon Marine USA Corporation voluntarily recalls frozen raw yellowfin tuna product

“Nakaochi Scrape” associated with a multistate outbreak of Salmonella Bareilly and Salmonella Nchanga  infections

  • Moon Marine USA Corporation (also known as MMI) of Cupertino, Calif. is voluntarily recalling 58,828 lbs of a frozen raw yellowfin tuna product, labeled as Nakaochi Scrape AA or AAA. Nakaochi Scrape is tuna backmeat, which is specifically scraped off from the bones, and looks like a ground product.
  • The Nakaochi Scrape AA and AAA from MMI was sold through distributors to restaurants and grocery stores that make sushi, and has been linked to the ongoing outbreak of Salmonella Bareilly and Salmonella Nchanga, which has caused 200 illnesses in 24 states and the District of Columbia to date.
  • Many of the people who became ill reported eating raw tuna in sushi as “spicy tuna.”
  • The product is not available for sale to individual consumers, but may have been used to make sushi, sashimi, ceviche and similar dishes available in restaurants and grocery stores.
  • The company name and Nakaochi Scrape AA or AAA were printed on boxes of the product when it was initially sold to distributors. However, the boxes may have been broken into smaller lots for further sale and may not be available to the end retailer or consumer. Therefore, the tuna may not be readily identifiable by retail outlets or by consumers as being from the implicated lots.
  • If you purchase “spicy tuna” or other sushi, sashimi, ceviche, or similar dishes that might contain Nakaochi Scrape from a restaurant or grocery store, check with the establishment to make sure that it does not contain raw recalled product from Moon Marine USA Corporation, also known as MMI. When in doubt, don’t eat it. Consumers who think they might have become ill from eating possibly contaminated raw Nakaochi Scrape should consult their health care providers.


Questions and Answers 

What are the Symptoms of Illness/Injury?

Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts four to seven days, and most persons recover without treatment. However, in certain cases, the diarrhea may be so severe that the patient needs to be hospitalized. In these patients, the Salmonella infection may spread from the intestines to the blood stream, and then to other body sites and can cause death unless these patients are treated promptly with antibiotics.

Who is at Risk?

Infants, older adults, pregnant women, and persons with impaired immune systems are more likely than others to develop severe illness and should not eat raw or partially cooked fish or shellfish. If you are unsure of your risk, ask your healthcare provider.

What Do Consumers Need To Do?

Because raw seafood is not fully cooked to assure that pathogens are destroyed, it is not considered as “safe” as cooked seafood. The handling of raw seafood can also affect the safety of the product. Because the tuna may have been broken into unmarked sublots and may not be readily identifiable, consumers should take precautions in choosing to eat raw Nakaochi Scrape and be sure that it is not from the implicated lots.

To report problems, including adverse reactions, related to any food except meat and poultry, contact the FDA district office consumer complaint coordinator for your geographic area.

What Do Product Sellers Need To Do?

Product sellers, including distributors and restaurants, should consult their suppliers to determine whether the Nakaochi Scrape AA or AAA in their possession originated from Moon Marine USA Corporation (also known as MMI). The product may not be accompanied by lot numbers or labeling information.

What Does the Product Look Like?

MMI distributed the Nakaochi Scrape AA and AAA to several distributors that may have broken the shipments into smaller lots for further distribution. The frozen raw yellowfin tuna product was originally packaged in white boxes with black writing naming the importer as Moon Marine USA Corporation (also known as MMI) and identifying the contents as either Nakaochi Scrape AA or AAA. The boxes contain several vacuum-wrapped packages with no further labeling.

What is Being Done about the Problem?

The FDA continues to work with the Centers for Disease Control and Prevention (CDC) and state and local partners to investigate the outbreak. The FDA worked closely with MMI to identify the implicated product and assist with its removal from the market.

FoodSafety.gov on Salmonella


Update on the FDA Investigation

May 17, 2012 

A Seafood HACCP (Hazard Analysis and Critical Control Point) inspection was conducted by FDA April 19-24 at the nakaochi scrape yellowfin tuna and tuna strips manufacturer, Moon Fishery Pvt Ltd. in Aroor, India. FDA was informed that April 12, 2012 was the last day of tuna processing at the firm due to the seasonal nation-wide ban of tuna harvest from the Indian Ocean. 

Based on the initial tour of the facility, inspectors identified several seafood HACCP deficiencies such as lack of controls for histamine at receipt of product, lack of controls for Clostridium botulinum at storage, and several significant sanitation observations of concern. 

A copy of the inspection observations is available, see FDA Form 483 for Moon Fishery (India) Pvt. Ltd.

April 26, 2012

On April 19, 2012, FDA’s Office in New Delhi, India initiated a seafood HACCP (Hazard Analysis Critical Control Point) inspection at the Nakaochi scrape yellowfin tuna manufacturer, Moon Fishery Pvt Ltd. in Aroor, India. FDA was informed that April 12, 2012 was the last day of tuna processing at the firm due to the seasonal nationwide ban on tuna harvest from the Indian Ocean.  

A report on the inspection will be posted to the fda.gov website when finalized by FDA.

April 20, 2012  

Collaborative investigative efforts of state and local public health agencies, FDA, and the Centers for Disease Control and Prevention (CDC) have identified frozen, raw yellowfin tuna product from India, labeled as Nakaochi Scrape AA or AAA (AA and AAA refer to the grade of the tuna) as the likely source of the Salmonella Bareilly outbreak which has caused more than 140 illnesses in 20 states and the District of Columbia.

Hypothesis-generating interviews of ill persons conducted by local and state health departments in March and April suggested consumption of sushi made with raw tuna as a possible source for these illnesses. The percentage of ill persons reporting sushi consumption was significantly higher when compared with results of a survey of healthy persons used by CDC.

A total of 7 “clusters” at restaurants or grocery stores were identified, where two or more unrelated ill persons reported eating in the week before becoming ill. In each cluster, at least one ill person reported eating sushi purchased at the restaurant or grocery store. Clusters were located in five states. While tuna was the most common ingredient in the sushi items, there were also other types of fish identified, as well as many other ingredients, including several types of sauces that were also investigated as possible sources of this outbreak. 

FDA focused its investigation on four of the restaurant clusters and issued assignments through its District Offices to collect invoices and other product records. Records were then analyzed in an effort to identify restaurants receiving shipments of the same product or products several days prior to illness occurrence. Eventually, a common link was found for all four of the restaurant clusters – shipments of the same frozen ground tuna. Further investigation of where these shipments went, and when, began to overlap with the map of where and when the illnesses were occurring in various parts of the country.

Records obtained by FDA and traceback efforts indicated that the suspect product was imported by Moon Marine USA Corporation of Cupertino, California. When the company was notified by FDA of the potential contamination, Moon Marine agreed to recall all their frozen raw yellowfin tuna product imported from India, labeled as Nakaochi Scrape AA or AAA, totaling approximately 58,000 pounds.

Nakaochi Scrape is tuna meat, which is specifically scraped off from the backbone/ribs, and resembles a ground product. This particular product is designed for retail distribution only to restaurants and grocery stores and is used to make sushi, sashimi, ceviche and similar dishes. It is not intended for sale direct to consumers.

FDA continues to monitor the recall to ensure that all product is removed from the marketplace.

Regulatory Activities

Among the prevention measures used by FDA to keep unsafe foods from reaching consumers is issuing an import alert.  

On April 13 and 14, 2012, FDA issued import alerts for fresh and frozen tuna from Moon Fishery India Pvt Ltd: 

These alerts let FDA field staff know that the Agency has enough evidence or other information to detain future shipments of this product because they appear to be adulterated. Screening criteria is currently in place to target those shipments. They may be denied admission into the United States unless the importer shows the product is compliant.

April 11, 2012

CDC reports that on initial interviews, many of the ill persons reported consuming sushi, sashimi, or similar foods in a variety of locations in the week before becoming ill.

FDA’s investigation is ongoing. FDA will provide updates on the investigation as new information becomes available. 

FDA Initial Investigation 

  • FDA has been collaborating with CDC and the states in its investigation of this outbreak

  • The investigation into individual food items and their sources is ongoing.

  • FDA, through its District offices, continues to conduct an extensive traceback investigation of various food products.

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FDA Laboratory Sampling Results

May 17, 2012 

Of the 18 yellowfin tuna samples (17 were nakaochi scrape and 1 was saku all sourced from Moon Fishery [India] Pvt. Ltd.) collected as part of the traceback investigations, 4 were negative for Salmonella (including the saku); 5 yielded Salmonella with a pulsed-field gel electrophoresis (PFGE) pattern indistinguishable from the outbreak strain of Salmonella Bareilly (including the tuna strips); 2 yielded Salmonella with a PFGE pattern indistinguishable from the outbreak strain of Salmonella Nchanga; and 7 yielded Salmonella with PFGE patterns indistinguishable from the outbreak strains of both Salmonella Bareilly and Salmonella Nchanga.

Increased surveillance efforts resulted in the collection of 13 additional samples of tuna sourced from Moon Fishery (India) Pvt Ltd: 1 sample of saku, 1 sample of tuna strips, and 11 samples of nakaochi scrape. Of those, 1 was negative for Salmonella (saku); 5 yielded Salmonella with a PFGE pattern indistinguishable from the outbreak strain of Salmonella Bareilly; 1 yielded Salmonella with a PFGE pattern indistinguishable from the outbreak strain of Salmonella Nchanga; 4 yielded Salmonella with PFGE patterns indistinguishable from the outbreak strains of both Salmonella Bareilly and Salmonella Nchanga; and 2 are still in progress.

April 26, 2012

FDA laboratories have identified Salmonella in a sample of Nakaochi scrape yellowfin tuna with a Pulsed-Field Gel Electrophoresis (PFGE) pattern indistinguishable from the outbreak-associated strain of Salmonella Bareilly strain involving 190 cases in 21 states and the District of Columbia. This sample also yielded another type of Salmonella with a PFGE pattern indistinguishable from an additional cluster of 10 cases of Salmonella Nchanga infections in 5 states associated with this outbreak. See CDC's website on the outbreak for information on cases. The sample was collected from a distributor of such tuna. The Nakaochi scrape yellowfin tuna associated with this outbreak is being voluntarily recalled by Moon Marine USA Corporation, based in Cupertino, California.

Another sample of Nakaochi scrape yellowfin tuna, collected on 4/11/12 from a different distributor, identified Salmonella with a PFGE pattern indistinguishable from the outbreak strain of Salmonella Bareilly.


Case Update from CDC

Case Count Update
June 21, 2012

A total of 390 persons infected with the outbreak strains of Salmonella Bareilly (376 persons) or Salmonella Nchanga (14 persons) have been reported from 27 states and the District of Columbia.  Forty-seven (47) ill persons have been hospitalized; no deaths have been reported.

Case Count Update
May 17, 2012

A total of 316 persons infected with the outbreak strains of Salmonella Bareilly (304 persons) or Salmonella Nchanga (12 persons) have been reported from 26 states and the District of Columbia.  Thirty-seven (37) ill persons have been hospitalized; no deaths have been reported.

Case Count Update
May 2, 2012

A total of 258 persons infected with the outbreak strains of Salmonella Bareilly (247 persons) or Salmonella Nchanga (11 persons) have been reported from 24 states and the District of Columbia.

Thirty two (32) ill persons have been hospitalized, and no deaths have been reported. CDC and state and local public health partners are continuing surveillance to identify new cases.

Case Count Update
April 26, 2012 

Based on an epidemiological link and results of laboratory testing, CDC has combined this Salmonella Bareilly investigation with an ongoing multistate outbreak investigation of Salmonella serotype Nchanga infections. The two associated PFGE patterns have been grouped together as the "outbreak strains." 

A total of 200 persons infected with the outbreak strains of Salmonella Bareilly or Salmonella Nchanga have been reported from 21 states and the District of Columbia.

190 persons infected with the outbreak strain of Salmonella Bareilly have been reported from 21 states and the District of Columbia. The number of ill persons with the outbreak strain of Salmonella Bareilly identified in each state is as follows: Alabama (2), Arkansas (1), Connecticut (8), District of Columbia (2), Florida (1), Georgia (9), Illinois (15), Louisiana (3), Maryland (20), Massachusetts (24), Mississippi (2), Missouri (4), New Jersey (18), New York (33), North Carolina (3), Pennsylvania (7), Rhode Island (6), South Carolina (3), Texas (4), Virginia (9), Vermont (1), and Wisconsin (15).

Ten (10) persons infected with the outbreak strain of Salmonella Nchanga have been reported from 5 states. The number of ill persons with the outbreak strain of Salmonella Nchanga identified in each state is as follows: Georgia (2), New Jersey (1), New York (5), Virginia (1), and Wisconsin (1). Twenty-eight (28)  ill persons have been hospitalized, and no deaths have been reported.

Case Count Update
April 20, 2012

A total of 160 individuals infected with the outbreak strain of Salmonella Bareilly have been reported from 20 states and the District of Columbia. The 19 new cases are from Illinois (1), Massachusetts (14), New York (2), North Carolina (1), and Virginia (1).

Among 160 persons for whom information is available, illness onset dates range from January 28 to April 10, 2012. Ill persons range in age from 4 to 78 years, with a median age of 30. Sixty six percent of patients are female. Among 140 persons with available information, 26 (19%) reported being hospitalized. No deaths have been reported.

Illnesses that occurred after March 24, 2012, might not be reported yet due to the time it takes between when a person becomes ill and when the illness is reported.

The number of ill persons identified in each state is as follows: Alabama (2), Arkansas (1), Connecticut (6), District of Columbia (2), Florida (1), Georgia (6), Illinois (14), Louisiana (3), Maryland (14), Massachusetts (23), Mississippi (2), Missouri (4), New Jersey (8), New York (30), North Carolina (3), Pennsylvania (6), Rhode Island (5), South Carolina (3), Texas (4), Virginia (9), and Wisconsin (14).

Twenty-six (26) ill persons have been hospitalized, and no deaths have been reported.

Case Count Update
April 18, 2012

A total of 141 persons infected with the outbreak strain of Salmonella Bareilly have been reported from 20 states and the District of Columbia.

The number of ill persons identified in each state is as follows: Alabama (2), Arkansas (1), Connecticut (6), District of Columbia (2), Florida (1), Georgia (6), Illinois (13), Louisiana (3), Maryland (14), Massachusetts (9), Mississippi (2), Missouri (4), New Jersey (8), New York (28), North Carolina (2), Pennsylvania (6), Rhode Island (5), South Carolina (3), Texas (4), Virginia (8), and Wisconsin (14). 21 ill persons have been hospitalized, and no deaths have been reported.

Case Count Update
April 11, 2012

A total of 116 individuals infected with the outbreak strain of Salmonella Bareilly have been reported from 20 states and the District of Columbia. The 16 new cases are from Florida (1), Georgia (1), Illinois (1), Maryland (1), Massachusetts (4), Missouri (1), New York (1), Pennsylvania (2), Rhode Island (1), and Wisconsin (3).

Among 100 persons for whom information is available, illness onset dates range from January 28 to March 31, 2012. Ill persons range in age from 4 to 78 years, with a median age of 31. Fifty percent of patients are female. Among 71 persons with available information, 12 (17%) reported being hospitalized. No deaths have been reported.

Illnesses that occurred after March 14, 2012, might not be reported yet due to the time it takes between when a person becomes ill and when the illness is reported.

Case Count Update
April 6, 2012

A total of 100 individuals infected with the outbreak strain of Salmonella Bareilly have been reported from 19 states and the District of Columbia. The 7 new cases are from Connecticut (1), Illinois (1), Maryland (2), New Jersey (1), Pennsylvania (1), and Wisconsin (1).

Among 100 persons for whom information is available, illness onset dates range from January 28 to March 25, 2012. Ill persons range in age from 4 to 78 years, with a median age of 31. Forty-seven percent of patients are female. Among 51 persons with available information, 10 (20%) reported being hospitalized. No deaths have been reported.

Illnesses that occurred after March 8, 2012, might not be reported yet due to the time it takes between when a person becomes ill and when the illness is reported.

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Background

The U.S. Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC) and several states are collaborating to investigate a multistate outbreak of Salmonella serotype Bareilly infections. 

FDA, CDC and the states are working closely together in the ongoing investigation into individual food items and the sources of those items; however, at this time, the investigation has not conclusively identified a food source.

Persons who think they might have become ill from eating any potentially contaminated food product should consult their health care providers.

FDA will provide updates on this outbreak and the investigation as new information becomes available.

Initial Information from CDC on Illnesses

April 4, 2012

A total of 93 persons infected with the outbreak strain of Salmonella Bareilly have been reported from 19 states and the District of Columbia.

The number of ill persons identified in each state is as follows: Alabama (2), Arkansas (1), Connecticut (4), District of Columbia (2), Georgia (4), Illinois (8), Louisiana (2), Maryland (8), Massachusetts (4), Mississippi (1), Missouri (1), New Jersey (6), New York (23), North Carolina (2), Pennsylvania (2), Rhode Island (4), South Carolina (3), Texas (3), Virginia (5), and Wisconsin (8).

Ten ill persons have been hospitalized, and no deaths have been reported.


Advice to Consumers 

  • Consumers can be assured that FDA and CDC are working closely on this investigation and will provide updates as soon as they are available.

  • Persons who think they might have become ill from eating any potentially contaminated food product should consult their health care providers.

Approximately 42,000 cases of salmonellosis are reported in the United States, annually. Most people infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts 4 to 7 days, and most people recover without treatment. However, in some individuals, the diarrhea may be so severe that the patient needs to be hospitalized. In these patients, the Salmonella infection may spread from the intestines to the blood stream, and then to other body sites and can cause death if the person is not treated promptly with antibiotics. The elderly, infants, and those with impaired immune systems are most likely to have a severe illness.


For more information:

  

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