Salmonella montevideo infections associated with salami products made with contaminated imported black and red pepper — United States, July 2009-April 2010

In August and September 2009, PulseNet, the national molecular subtyping network for foodborne disease surveillance, detected a multistate cluster of Salmonella Montevideo infections with an indistinguishable pulse-field gel electrophoresis (PFGE) pattern (XbaI PFGE pattern JIXX01.0011). Cases were geographically dispersed, and the age and sex distributions were typical for reported Salmonella cases. Montevideo is the seventh most common Salmonella serotype in the United States; of 1,225 PFGE patterns in the PulseNet Montevideo database, the outbreak strain pattern is the most common. PulseNet monitored this pattern and detected an increase in the number of isolates in November 2009, leading CDC to begin coordinating a multistate investigation. This report summarizes the results of that investigation, which identified 272 cases from 44 states and the District of Columbia, with illness onset from July 1, 2009, to April 14, 2010. In a multistate case-control study, consumption of salami was associated with illness. Purchase information from membership card records helped determine specific brands of Italian-style meat products associated with cases. The outbreak strain was identified in salami products, one company A facility environmental sample, and sealed containers of black and red pepper used to produce company A salami products. This outbreak highlights the importance of preventing post-processing contamination of ready-to-eat products from raw ingredients such as spices.