Investigation Update: Salmonella outbreak, Backyard Poultry - May 2023

Key points

These outbreak investigations are over. Backyard poultry can still carry Salmonella germs that can make you sick. Always take steps to stay healthy around your flock.

Image of chicken and chicks.

Latest update

October 19, 2023

CDC and public health officials in several states investigated several multistate outbreaks of Salmonella infections with serotypes Braenderup, Enteritidis, Indiana, Infantis, Mbandaka, and Typhimurium.

Epidemiologic, traceback, and laboratory data showed that contact with backyard poultry made people sick.

As of Oct 19, 2023, these outbreak investigations are over.

Epidemiologic Data

A total of 1,072 people infected with the outbreak strains of Salmonella were reported from 48 states and Puerto Rico (see map). Illnesses started on dates ranging from January 1, 2023, to September 25, 2023 (see timeline). Of 786 people with information available, 247 (31%) were hospitalized. No deaths were reported.

The true number of sick people in this outbreak is likely much higher than the number reported, and this 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 animals they came into contact within 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=1,066)
Range from <1 to 94 years
Median age of 33
22% under 5 years
Sex
(n=1,049)
56% female
44% male
Race*
(n=795)
92% White
3% African American/Black
2% Native American or Alaska Native
1% Asian
<1% Native Hawaiian or other Pacific Islander
3% reported more than one race
Ethnicity
(n=752)
91% non-Hispanic
9% Hispanic

*Percentages do not total 100 due to rounding.

State and local public health officials interviewed people about the animals they came into contact within the week before they got sick. Of the 656 people interviewed, 509 (78%) reported contact with backyard poultry or an area where they live and roam.

Traceback Data

Of 378 people with information on poultry purchases, 258 (68%) reported recently purchasing or obtaining poultry after January 1, 2023. Sixty-five people reported purchasing poultry from more than one location. Purchase locations included feedstores, hatcheries, local farms, friends, relatives, and universities. Fifteen people reported purchasing poultry directly from hatcheries online. Of purchases made from feedstores, 235 retail locations owned by 70 companies were reported. These feedstores were supplied by at least 16 hatcheries. A common poultry supplier was not identified across all outbreaks.

Laboratory Data

Public health investigators used the PulseNet system to identify illnesses that were part of these outbreaks. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause gastrointestinal illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS).

WGS showed that bacteria from sick people's samples were closely related genetically. This means that people in these outbreaks likely got sick from the same type of animal.

Investigators in Massachusetts, Michigan, Minnesota, Nevada, Utah, and Wisconsin collected samples from chickens or the areas where chicks were housed in stores or at sick people's homes. WGS showed that Salmonella serotypes Braenderup, Enteritidis, Mbandaka, Infantis, and Typhimurium found in the poultry's environments were closely related to bacteria from sick people. Poultry that lived in these environments were supplied to stores or poultry owners by at least four different poultry hatcheries.

WGS analysis was used to predict resistance to antibiotics for bacteria from 1,067 people's samples, 63 environmental samples, and 16 animal samples. Of these, 97 (8.5%) were predicted to be resistant to one or more of the following antibiotics: amoxicillin-clavulanic acid, ampicillin, cefoxitin, ceftiofur, ceftriaxone, ciprofloxacin, gentamicin, nalidixic acid, streptomycin, sulfisoxazole, and tetracycline. Bacteria from the remaining 1,049 samples had no predicted resistance. Testing of bacteria from 10 sick people's samples using standard antibiotic susceptibility testing methods by CDC's National Antimicrobial Resistance Monitoring System (NARMS) largely confirmed these results. Streptomycin and ceftiofur were not tested by this method, and one person's sample showed resistance to colistin. (NARMS added colistin to the list of drugs tested for Salmonella in 2020; resistance is defined as a minimum inhibitory concentration [MIC] of ≥4 µg/mL. Some Salmonella serotypes may have higher MICs naturally, even without acquired resistance identified.) Most people with Salmonella illness recover without antibiotics. However, if antibiotics are needed, this resistance is unlikely to affect the choice of antibiotic used to treat most people.

Public Health Actions

CDC advises everyone to take steps to stay healthy around backyard poultry. CDC and state partners continue to work with hatcheries and stores that sell poultry to find ways to reduce Salmonella germs in birds and to educate new poultry owners on safe handling of birds.

Previous updates

CDC and public health officials in several states are collecting different types of data to investigate multistate outbreaks of Salmonella infections with serotypes Braenderup, Enteritidis, Indiana, Infantis, Mbandaka, and Typhimurium.

Epidemiologic data show that contact with backyard poultry is making people sick.

Epidemiologic Data

Since the last update on June 15, 280 more illnesses have been reported. As of July 12, a total of 690 people infected with one of the outbreak strains have been reported from 47 states and Puerto Rico (see map). Illnesses started on dates ranging from January 1, 2023, to June 30, 2023 (see timeline). Of 459 people with information available, 141 (31%) have been hospitalized. No deaths have been reported.

The true number of sick people in an 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 animals they came into contact with during 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=672)
Range from 1 month to 92 years
Median age of 31
23% under 5 years
Sex
(n=674)

57% female
43% male
Race
(n=455)
92% White
2% African American/Black
2% Native American or Alaska Native
1% Asian
1% Native Hawaiian or other Pacific Islander
3% reported more than one race
Ethnicity
(n=438)
93% non-Hispanic
7% Hispanic

State and local public health officials are interviewing people about the animals they came into contact with in the week before they got sick. Of the 390 people with information about animal contact, 314 (81%) reported contact with backyard poultry before getting sick. Of 296 people who were asked about eggs from their backyard poultry, 78 (26%) reported eating eggs from their flock.

Laboratory and Traceback Data

Investigators in Michigan, Minnesota, Nevada, Utah, and Wisconsin collected samples from the areas where chicks are housed in stores or at sick people's homes. Whole genome sequencing (WGS) showed that Salmonella Braenderup, Enteritidis, Mbandaka, and Infantis found in the poultry's environments are closely related to bacteria from sick people. Poultry that lived in these environments were supplied to stores or poultry owners by at least four different poultry hatcheries.

Of 242 people with information on poultry purchases, 187 (77%) reported purchasing or obtaining poultry after January 1, 2023. Forty-four people reported purchasing poultry from multiple locations. People reported purchasing or obtaining poultry from at least 178 different locations, and 10 people reported purchasing poultry directly from hatcheries online. Investigators are continuing to work with stores and hatcheries that are identified during the investigation to find ways to reduce Salmonella in poultry.

WGS analysis was used to predict resistance to antibiotics for bacteria from 688 people's samples. Of these, 64 (9%) were predicted to be resistant to one or more of the following antibiotics: amoxicillin-clavulanic acid, ampicillin, cefoxitin, ceftiofur, ceftriaxone, ciprofloxacin, gentamicin, streptomycin, sulfamethoxazole, and tetracycline. Bacteria from the remaining 624 samples had no predicted resistance. Testing of bacteria from 8 sick people's samples using standard antibiotic susceptibility testing methods by CDC's National Antimicrobial Resistance Monitoring System (NARMS) largely confirmed these results. Streptomycin and ceftiofur were not tested by this method, and one person's sample showed resistance to colistin. (NARMS added colistin to the list of drugs tested for Salmonella in 2020; resistance is defined as a minimum inhibitory concentration [MIC] of ≥4 µg/mL. Some Salmonella serotypes may have higher MICs naturally, even without acquired resistance identified.) Most people with Salmonella illness recover without antibiotics. However, if antibiotics are needed, this resistance is unlikely to affect the choice of antibiotic used to treat most people.

Public Health Actions

CDC advises everyone to take steps to stay healthy around backyard poultry. CDC and state partners are working with hatcheries and stores that sell poultry to educate new poultry owners and control the spread of Salmonella at hatcheries.

CDC and public health officials in several states are collecting different types of data to investigate multistate outbreaks of Salmonella infections with serotypes Braenderup, Enteritidis, Indiana, Infantis, Mbandaka, and Typhimurium.

Epidemiologic data show that contact with backyard poultry is making people sick.

Epidemiologic Data

Since the last update on May 19, 2023, 306 more illnesses have been reported. As of June 7, 2023, a total of 410 people infected with one of the outbreak strains have been reported from 45 states (see map). Illnesses started on dates ranging from January 1, 2023, to May 25, 2023 (see timeline).

The true number of sick people in an 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 animals they came into contact with during the week before they got sick. This information provides clues to help investigators identify the source of the outbreak.

Of 407 people with age information available, sick people range in age from 1 month to 92 years, with a median age of 25 years, and 116 (29%) are children under 5 years of age. Of 398 people with sex information available, 217 people (55%) are female. Of 277 people with race information available, 254 (92%) are White, 7 (2.5%) are African American/Black, 4 (1.4%) are Native American or Alaska Native, 2 (0.7%) are Asian, 2 (0.7%) are Native Hawaiian or other Pacific Islander, and 8 people (2.9%) reported more than one race. Of 268 people with ethnicity information available, 22 (8%) are Hispanic. Of 282 people with hospitalization information available, 84 (30%) have been hospitalized. No deaths have been reported.

State and local public health officials are interviewing people about the animals they came into contact with in the week before they got sick. Of the 232 people with information about animal contact, 187 (81%) reported contact with backyard poultry before getting sick. Of 157 people who were asked about eggs from their backyard poultry, 40 (25%) reported eating eggs from their flock.

Laboratory and Traceback Data

Investigators in Michigan, Minnesota, Utah, and Wisconsin collected samples from the areas where chicks are housed at stores that sell poultry or at sick people's homes. Whole genome sequencing (WGS) showed that Salmonella Braenderup, Enteritidis, Mbandaka, and Infantis from the animals' environment are closely related to bacteria from sick people. These poultry were supplied by four different poultry hatcheries.

Of 144 people with information on poultry purchases, 101 (70%) reported purchasing or obtaining poultry after January 1, 2023. Nineteen people reported purchasing poultry from multiple locations. People reported purchasing or obtaining poultry from 109 different locations, and 5 people reported purchasing poultry directly from hatcheries online. Investigators are continuing to work with stores and hatcheries that are identified during the investigation to find ways to reduce Salmonella in poultry.

WGS analysis was used to predict resistance to antibiotics for bacteria from 408 people's samples and 16 environmental samples. Of the 424 total samples, 33 (8%) were predicted to be resistant to one or more of the following antibiotics: ampicillin, cefoxitin, ceftiofur, ceftriaxone, ciprofloxacin, gentamicin, streptomycin, sulfamethoxazole, tetracycline, and amoxicillin-clavulanic acid. Bacteria from the remaining 391 samples had no predicted resistance. Testing of bacteria from 3 sick people's samples using standard antibiotic susceptibility testing methods by CDC's National Antimicrobial Resistance Monitoring System (NARMS) largely confirmed these results. Streptomycin and ceftiofur were not tested by this method, and one person's sample showed resistance to colistin. (NARMS added colistin to the list of drugs tested for Salmonella. Resistance is defined as a minimum inhibitory concentration (MIC) of at least 4 µg/mL. Some bacteria may have higher MICs naturally, even without acquired resistance identified.) Most people with Salmonella illness recover without antibiotics. However, if antibiotics are needed, this resistance is unlikely to affect the choice of antibiotic used to treat most people.

Public Health Action

CDC advises everyone to take steps to stay healthy around backyard poultry. CDC and state partners are working with hatcheries and stores that sell poultry to educate new poultry owners and control the spread of Salmonella at hatcheries.

CDC and public health officials in several states are collecting different types of data to investigate multistate outbreaks of Salmonella infections with serotypes Braenderup, Enteritidis, and Infantis.

Epidemiologic data show that contact with backyard poultry is making people sick.

Epidemiologic Data

As of May 8, 2023, 104 people infected with one of the outbreak strains have been reported from 31 states (see map). Illnesses started on dates ranging from January 1, 2023, to April 20, 2023 (see timeline).

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

Sick people range in age from 2 months to 83 years, with a median age of 26 years, and 62 people (60%) are female. Of 78 people with race or ethnicity information available, 71 (91%) are White, 2 (2.6%) are African American/Black, 2 (2.6%) are Native American or Alaska Native, and 3 (3.4%) selected Other. Of 84 people with information available, 19 (23%) have been hospitalized. No deaths have been reported.

The true number of sick people in an 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.

State and local public health officials are interviewing people about the animals they had contact within the week before they got sick. Of the 69 people with information about animal contact, 48 (70%) reported contact with backyard poultry before getting sick. Of 45 people with information available, 10 (22%) reported eating eggs from backyard poultry.

Laboratory Data

Public health investigators are using the PulseNet system to identify illnesses that may be part of these outbreaks. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause gastrointestinal illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS). WGS showed that bacteria from sick people's samples are closely related genetically. This means that people in these outbreaks likely got sick from the same type of animal.

WGS analysis was used to predict resistance to antibiotics for bacteria from 104 people's samples and one environmental sample. Of the 105 total samples, 8 (7.6%) were predicted to be resistant to one or more of the following antibiotics: gentamicin, streptomycin, sulfamethoxazole, and tetracycline. Bacteria from the remaining 97 samples had no predicted resistance. Testing of bacteria using standard antibiotic susceptibility testing methods by CDC's National Antimicrobial Resistance Monitoring System (NARMS) is currently underway. Most people with Salmonella illness recover without antibiotics. However, if antibiotics are needed, this resistance is unlikely to affect the choice of antibiotic used to treat most people.

Public Health Action

CDC advises everyone to take steps to stay healthy around backyard poultry. CDC and state partners are working with hatcheries and stores that sell poultry to educate new poultry owners and control the spread of Salmonella at hatcheries.