Investigation Update: Salmonella Outbreak, Eggs - September 2024

Key points

This outbreak is over. Recalled eggs are no longer available for sale and are outside their shelf life.

Carton of eggs

October 17, 2024

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) collected different types of data to investigate a multistate outbreak of Salmonella Enteritidis infections.

Epidemiologic, laboratory, and traceback data showed that eggs supplied by Milo's Poultry Farms were contaminated with Salmonella and made people sick.

Epidemiologic data

As of October 17, 2024, a total of 93 people infected with the outbreak strain of Salmonella have been reported from 12 states. Illnesses started on dates ranging from May 23, 2024, to September 13, 2024. Of 87 people with information available, 34 have been hospitalized and no deaths have been reported.

The true number of sick people in this outbreak was likely much higher than the number reported, and the outbreak may not have been limited to the states with known illnesses. This is because many people recover without medical care and are not tested for Salmonella.

Public health officials collected many different types of information from sick people, including their age, race, ethnicity, other demographics, and the foods they ate in the week before they got sick. This information provided clues to help investigators identify the source of the outbreak.

The table below has information about sick people in this outbreak ("n" is the number of people with information available for each demographic).

Demographics
Information
Age
(n=93)
Range from 2 to 88 years
Median age of 55 years
Sex
(n=93)
56% female
44% male
Race
(n=88)
92% White
5% African American/Black
2% Asian
0% Native American or Alaska Native
0% Native Hawaiian or other Pacific Islander
0% reported more than one race
Ethnicity
(n=89)
92% non-Hispanic
8% Hispanic

State and local public health officials interviewed people about the foods they ate in the week before they got sick. Several sick people reported eating at the same restaurants before getting sick. These illness clusters provided clues about what food item made people sick. If several unrelated sick people ate or shopped at the same location of a restaurant or store within several days of each other, it suggests that the contaminated food item was served or sold there. The Wisconsin Department of Health Services identified three illness clusters at restaurants where eggs were served.

Laboratory and traceback data

Public health investigators used the PulseNet system to identify illnesses that may be part of this outbreak. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause foodborne illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS). WGS showed that bacteria from sick peoples' samples are closely related genetically. This suggests that people in this outbreak got sick from the same food.

The Wisconsin Department of Agriculture, Trade, and Consumer Protection traced the source of eggs supplied to restaurants where ill people ate before they got sick. Records show that Milo's Poultry Farms supplied eggs to those restaurants.

FDA conducted an inspection at Milo's Poultry Farms and collected samples. The outbreak strain of Salmonella was found in the packing facility, the hen egg laying house, and in recalled eggs.

Based on WGS analysis, bacteria from 83 people's samples and 72 environmental samples are predicted to be nonsusceptible to ciprofloxacin and are related to a strain of Salmonella Enteritidis that has also been isolated from chicken. Most people with Salmonella illness recover without antibiotics. However, if antibiotics are needed, illnesses in this outbreak may be difficult to treat with some commonly recommended antibiotics and may require a different antibiotic choice. More information is available at the National Antimicrobial Resistance Monitoring System (NARMS) site.

Public health actions

Milo's Poultry Farm recalled all eggs supplied by their farm. Recalled eggs are past shelf life and should no longer be available for sale.

Previous updates

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are collecting different types of data to investigate a multistate outbreak of Salmonella Enteritidis infections.

Epidemiologic, laboratory, and traceback data show that eggs supplied by Milo's Poultry Farms are contaminated with Salmonella and are making people sick.

Epidemiologic Data

As of September 6, 2024, a total of 65 people infected with the outbreak strain of Salmonella have been reported from 9 states. Illnesses started on dates ranging from May 23, 2024, to August 10, 2024. Of 63 people with information available, 24 have been hospitalized and no deaths have been reported.

The true number of sick people in this outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses. This is because many people recover without medical care and are not tested for Salmonella. In addition, recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak.

Public health officials collect many different types of information from sick people, including their age, race, ethnicity, other demographics, and the foods they ate in the week before they got sick. This information provides clues to help investigators identify the source of the outbreak.

The table below has information about sick people in this outbreak ("n" is the number of people with information available for each demographic).

Demographics
Information
Age
(n=65)
Range from 2 to 88 years
Median age of 55 years
Sex
(n=65)
56% female
44% male
Race
(n=62)
92% White
5% African American/Black
3% Asian
0% Native American or Alaska Native
0% Native Hawaiian or other Pacific Islander
0% reported more than one race
Ethnicity
(n=62)
94% non-Hispanic
6% Hispanic

State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Several sick people reported eating at the same restaurants before getting sick. These illness clusters can provide clues about what food item may be making people sick. If several unrelated sick people ate or shopped at the same location of a restaurant or store within several days of each other, it suggests that the contaminated food item was served or sold there. The Wisconsin Department of Health Services identified four illness clusters at restaurants where eggs were served.

Laboratory and Traceback Data

Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause foodborne illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS). WGS showed that bacteria from sick peoples' samples are closely related genetically. This suggests that people in this outbreak got sick from the same food.

The Wisconsin Department of Agriculture, Trade, and Consumer Protection traced the source of eggs supplied to restaurants where ill people ate before they got sick. Records show that Milo's Poultry Farms supplied eggs to those restaurants.

FDA conducted an inspection at Milo's Poultry Farms and collected samples. FDA's analysis showed the outbreak strain of Salmonella was found in the packing facility and the hen egg laying house.

WGS analysis of bacteria from 65 people's samples showed predicted resistance to nalidixic acid and ciprofloxacin. More information is available at the National Antimicrobial Resistance Monitoring System (NARMS) site. Most people with Salmonella illness recover without antibiotics. However, if antibiotics are needed, illnesses in this outbreak may be difficult to treat with some commonly recommended antibiotics and may require a different antibiotic choice.

Public Health Actions

On September 6, 2024, Milo's Poultry Farms recalled eggs. CDC is advising people not eat, sell, or serve recalled eggs.