Public Health Notice: Outbreak of extensively drug-resistant Salmonella infections linked to raw pet food and contact with cattle

OTTAWA, ON, Nov. 11, 2023 /CNW/ -

The Public Health Agency of Canada (PHAC) is collaborating with provincial public health partners, the Canadian Food Inspection Agency and Health Canada to investigate an outbreak of extensively drug-resistant (XDR) Salmonella infections in six provinces.

Many of the individuals who became sick are children 5 years of age or younger. Illnesses associated with this outbreak strain may be difficult to treat with commonly recommended antibiotics, if antibiotic treatment is needed.

The outbreak is ongoing, as recent illnesses continue to be reported to PHAC.

Based on the investigation findings to date, two sources have been identified:

• Exposure to raw meat prepared for pets (raw pet food) has been identified as a likely source for some of the illnesses reported in this outbreak. Some of the individuals who became sick reported exposure to raw pet food, or to dogs fed raw pet food, before their illnesses occurred. A single common supplier of raw pet food has not been identified.
• Contact with cattle, particularly calves, has also been identified as a likely source for some of the illnesses reported in the outbreak.

The outbreak investigation is ongoing and it's possible that additional sources may be identified.

The outbreak is a reminder that Salmonella bacteria can be found in raw pet food and in many species of animals, including dogs and cattle. Always use safe food handling practices when preparing, cooking, or storing raw pet food to prevent illness. Practice good hand hygiene and frequent handwashing after contact with dogs fed raw pet food, cattle, and their environments.

The outbreak strain of Salmonella that made people sick has been found in raw pet food from the home of an ill individual. If contaminated, raw pet food can also make your pets sick. Infected pets can also spread bacteria, like Salmonella, to individuals they are in contact with, even if they do not show any signs of illness. This outbreak strain of Salmonella has also been found in sick dogs and cattle, and some of these animals have died.  This public health notice will be updated as the investigation evolves.

As of November 11, 2023 there are 40 confirmed cases of XDR Salmonella I 4,[5],12:i:-illness in six provinces: Manitoba (1), Ontario (14), Quebec (21), New Brunswick (1), Nova Scotia (2), and Prince Edward Island (1). Individuals became sick between July 2020 and September 2023. Thirteen individuals have been hospitalized. No deaths have been reported. Individuals who became ill are between 0 and 91 years of age. Just under half (43%) of the cases are in children 5 years of age or younger. About half of the cases (53%) are female.

The collaborative outbreak investigation was initiated because of an increase in reports of XDR Salmonella illnesses in multiple jurisdictions across Canada. Using a laboratory method called whole genome sequencing, it was determined that some Salmonella illnesses dating back to 2020 were caused by the same outbreak strain as the illnesses that occurred in 2023. More recent illnesses may be reported in the outbreak because there is a period between when a person becomes ill and when the illness is reported to public health officials. For this outbreak, the illness reporting period is between 4 and 8 weeks.

Symptoms typically start 6 to 72 hours after exposure to Salmonella bacteria, and usually last for 4-7 days.

Symptoms may include:

• fever
• chills
• nausea
• vomiting
• diarrhea
• headache
• abdominal cramps

People who are infected with Salmonella bacteria can spread Salmonella to other people several days to several weeks after they have become infected, even if they don't have symptoms. Salmonella can spread by person to person contact and contaminated surfaces. Most people who become ill from a Salmonella infection will recover fully after a few days without treatment, but it can also cause severe illness and hospitalization.

The Salmonella strain associated with this outbreak investigation is extensively drug-resistant, which means it's resistant to all commonly recommended antibiotics (ceftriaxone, azithromycin, trimethoprim/sulfamethoxazole, ampicillin, and ciprofloxacin). This outbreak strain is also resistant to older antibiotic drugs (aminoglycosides, chloramphenicol, and tetracycline). Illnesses resulting from this outbreak strain may be difficult to treat with commonly recommended antibiotics, if antibiotic treatment is considered necessary.

Anyone can become sick with a Salmonella infection. If you think you're experiencing symptoms from a Salmonella infection, contact your health care provider.

Those at higher risk for serious illness include:

• older adults 
• young children
• people who are pregnant
• people with weakened immune systems 

Follow the advice outlined in this section to prevent the direct or indirect spread of Salmonella and reduce your risk of becoming ill from exposure to raw pet food, to dogs fed raw pet food, or contact with cattle.

Raw Pet Food

PHAC does not recommend feeding raw pet food to pets, especially in households with young children or individuals who have a compromised immune system, as they are at greater risk for more serious illness.

• Harmful germs such as Salmonella and E. coli have been found in commercially prepared raw pet food and treats and can be found in many raw meats and products used in homemade diets.
• Animals fed raw meat diets (raw pet food) are more likely to pass (shed) harmful germs through their feces than those fed exclusively kibble or cooked diets, even when they appear healthy.
• When deciding what to feed to your pet, always talk to your veterinarian first. They can help you determine what is best to keep your pet and your family healthy.

If you choose to feed your pet raw pet food, the following tips may help reduce the risk of a Salmonella infection:

• Always wash your hands thoroughly with soap and water after feeding, playing, handling or cleaning up after pets.
• Wash and sanitize any containers, utensils and surfaces that have come into contact with raw pet food before using them again. This includes food and water bowls, countertops, microwaves and refrigerators.  
• Use dedicated dishes and utensils to serve your pet and wash them separately from other dishes and utensils.
• Store all pet food and treats away from where human food is stored or prepared and away from reach of young children. Pick up treats and food bowls when your pet is done with them.
• Raw pet food may need to be stored frozen or refrigerated. If thawing raw food:
  • Keep your pet's food away from human food
  • Place it in a sealed, clean container that will hold any juices that may leak out
  • Thaw only as much as needed
  • Thaw on the bottom shelf of the refrigerator
  • Do not re-freeze food after thawing
• Don't allow your dog to lick your face, mouth, or open wounds.

Contact with Cattle

• Always wash your hands before and after you touch cattle, or anything in the areas where they live, roam or eat. Wash with soap and warm water for at least 20 seconds. Use an alcohol-based hand rub if soap and water are not available.
• If visiting a farm or petting zoo, wash your hands when you leave animal areas, even if you did not touch the animals directly.
• Do not eat or drink around cattle. Keep food and drinks away from animal areas.
• Always supervise children around animals, such as cattle. Do not let children put their fingers or objects (like pacifiers) in their mouths when they are around animals or in an animal area.

• Salmonellosis (Salmonella)
• Pets: Healthy animals, healthy people
• General food safety tips

SOURCE Public Health Agency of Canada