Between July 1, 2009 and April 20, 2010, a total of 272 were infected by one of two matching strains of Salmonella Montevideo in 44 states and the District of Columbia.  Ultimately, with some key help from state health agencies like the Rhode Island Department of health, the CDC was able to identify the product responsible for causing these illnesses:  italian salami products produced by Daniele, Inc. 

A good article, based on the CDC’s recently presented abstract, by Robert Susman appeared yesterday on MedPage Today:   

In painstaking sleuthing, foodborne illness detectives from the CDC established that while the salami itself was prepared safely, rolling the product in red and black pepper introduced another ingredient: Salmonella montevideo bacteria, researchers said here.

During a 10-month period, the S. montevideo outbreak in the U.S. sickened at least 272 individuals, 26% of whom required hospitalization. However, no one died from S. Montevideo infection, according to data from the CDC’s salami sleuths reported at the annual meeting of the Infectious Diseases Society of America.

"This outbreak highlights the importance of preventing raw ingredient contamination and the potential for spices, such as pepper, contaminating ready-to-eat products," said Laura Gieraltowski, PhD, MPH, epidemic intelligence service officer at the CDC.

CDC investigators noticed a cluster of S. montevideo cases in 13 states on September 4, 2009. By November 23, 2009, 102 cases were reported in 30 states — which triggered a multi-state investigation.

Through open-ended interviews and shopper card information from seven ill patients, investigators began narrowing the exposure window, until they determined that the suspected food was salami distributed by Company A in Rhode Island. "We didn’t name the company in this report because the outbreak is over and the food products have been recalled," Gieraltowski said in a press briefing.

However, when the CDC team examined the processing and curing of the salami products, they found nothing wrong with the company’s procedures. Yet, there was confirmation that S. montevideo was found in unopened packages of the meat products.

"We discovered that the product was cured prior to being rolled in spices," Gieraltowski explained.

When the spices were tested separately they were found to be contaminated with the bacteria.

Further investigation took investigators to the company that prepared the spices and determined that the steam bath intended to kill bacteria in the spices was not sufficient for the job. Since then, Gieraltowski said, the spices have been irradiated instead.

The investigation led to the recall of about 1.5 million pounds of meat products and more than 100,000 pounds of crushed red pepper and crushed black pepper.