Step 1: Gather Background Information 1. 1 Background / Why Problem Exists The case study on the Multistate Outbreak of Salmonella Enteritidis Infections Linked to Bean Sprouts tackles the problem of infections from eating bean sprouts. In the end of 2014, there was an outbreak of Salmonella Enteritidis (SE) reported amongst 12 states in America. Through thorough investigation resulting in the Wonton Foods, Inc. being the source of the outbreak, findings showed that their growth process produced bacteria growth in the bean sprouts (CDC, 2015).
This health problem is prevalent due to the fact that bean sprouts are minimally processed leading it to be a common origin of food borne illness (Landry et al. , 2015). 1. 2 Issues From animal to human transmission Salmonella enterica serotype Enteritidis is one of two main serotypes that affect people (WHO, 2016). It may infect anyone of any age or gender that consume contaminated foods from animal sources which can happen at any time or place.
Young children especially have the highest risks and severe conditions from this type of infection because their immune systems are not strong enough to handle diarrhoeal diseases. The infection starts from the intestinal tract and may have the possibility of spreading to the bloodstream where it could then spread to other parts of the body. 1. 3 Additional Information Salmonella Enteritidis infectious outbreaks prominently became a problem in the United States in the beginning of the 1970s. It became the most common Salmonella serotype especially in the Northeast where laboratories reported. 5 outbreaks occurred during this time carrying 2119 cases, 257 hospitalizations, and 11 deaths (Braden, 2006). Laboratories at the time identified shell eggs as being the prime source of SE infections which were internally contaminated inside of the hens that laid these eggs. Prevention programs were implemented to stop the bacteria from spreading in egg-laying flocks. 1996, the Salmonella Enteritidis infections significantly decreased. Step 2: Analyze the Current Situation 2. 1 Evaluate Decision Context
Collaborative efforts from the local, state, and public health officials as well as the Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) considered social factors such as the types of food people ate and executed their solution to identify the problem through traceback investigations through interviews asking the ill people what they consumed within the past few days (CDC, 2015). Conducting interviews allowed the officials to find that the common ground these ill people had was the consumption of ean sprouts from same restaurants or grocery stores. Finally the FDA traced back the investigation to a Wonton Foods, Inc. located in Brooklyn, New York.
2. 2 SWOT Analysis of Organizations A strength of the collaborative efforts performed is the swiftness in investigating the source of the outbreak and stopping the distribution of contaminated bean sprouts as well as working well together with everyone involved in the investigation. A weakness in this group organization is that no matter the efforts in investigation or prevention, sprouts are a known source of food-borne illness.
An opportunity for these organizations to better prevent these illnesses is to educate the public in food safety practices. A threat for this group would be the minimal efforts towards foodborne illnesses because of how common it occurs. 2. 3 Evaluate Mission / Goals of Organizations Although there were many people involved in this case, the CDC was the main organization reporting and investigating the case. The CDC’s mission and goal is to protect America’s health from disease and provide for its security and safety (CDC, 2014).
The CDC actively looks out for the health of the American people while treating each and everyone as equals with honesty and respect. They also try to promote the community and environment in active participation to better the health of its people. Step 3: Prioritize Issues 3. 1 What Are The Root Causes In general, Salmonella is a common bacterial disease that affects the intestinal tract causing foodborne illnesses; the bacteria is usually transferred through consumption of spoiled food from animals such as dairy products and mainly meat and poultry (WHO, 2016).
In this particular outbreak, the specific bacteria is called Salmonella enterica serotype Enteritidis, serotype meaning a strain of Salmonella based on reactions to specific antibodies. The cause of SE from bean sprouts is from the ideal warm, moist, and nutrient-rich environments in which seeds and beans grow that are also the the perfect conditions for bacteria to grow in as well (Dechet et al. , 2014). Usually the seed of the sprout is the origin of the bacteria that causes these outbreaks. 3. Prioritize, Finalize or State Core Problems/Issues/ Opportunities Towards the end of 2014, a Salmonella Enteritidis outbreak occurred causing 115 people to be infected in 12 different states- 64% of which were women. Most people infected all reported to have consumed bean sprouts from Asian-style food service establishments (CDC, 2015). Wonton Foods, Inc. of Brooklyn, New York was the only supplier of bean sprouts that distributed to those restaurants. They eliminated the soiled bean sprouts and performed a thorough cleaning to control the problem.
Now Wonton Foods, Inc. ‘s bean sprouts products must be discarded after the implemented 12 day shelf life (CDC, 2015). The foodsafety. gov also recommends that any sprouts consumed should be thoroughly cooked to reduce risk of illness (2009). Step 4: Analyze Alternatives 4. 1 Theoretical Perspectives The health belief model would be a suitable approach to execute a successful solution to Salmonella Enteritidis outbreaks caused by bean sprouts. The public needs to understand an individual’s basic perceived benefits vs. arriers, perceived seriousness, and perceived susceptibility in order to engage in health-promoting behavior towards the probability of being infected from bean sprouts.
Often times individuals do not understand the severity or the possibility of an infection from bean sprouts until they get it, so educating them would present as a benefit. Then consumers, restaurants, and other retailers as a whole will be able to properly practice food safety. 4. 2 Solutions/Alternatives and Evaluation The best procedure to go about a solution would be to follow ood safety guidelines. Foodsafety. gov recommends several practices: first, cook the sprouts thoroughly in order to refrain from the risk of infection. Second, children, pregnant women, and the elderly should stay away from eating raw sprouts of any kind. This is also be applied to people with very weak immune systems. Lastly, it would be best to ask for raw sprouts not to be added to your dish and to double check the food after requesting.
Step 5: Provide Recommendations 5. 1 Recommendations One recommendation to prevent any future SE outbreaks would be to have the FDA provide sprout industries with guidance on how to detect and reduce contamination of sprouts by harmful bacteria which would basically mean to educate the industry on how to prevent Salmonella outbreaks. Another recommendation would be to have the FDA and other federal and state agencies regularly continue to work with industries on detecting and reducing contamination and keeping contaminated sprouts out of the marketplace.
There are also studies testing out antimicrobial carvacrol nanoemulsion which would be a treatment method tested against Salmonella Enteritidis in contaminated sprouting seeds (Landry et al. , 2015). 5. 2 Analyze Recommendations In order for sprout industries to properly understand the care in the growth of bean sprouts, the FDA should educate the industry to inspect the sprouts before packaging them and store the sprouts in clean, sanitized areas (FDA, 2004).
The FDA also needs to be actively engaging in the sprout industry to check for contamination by testing out batches of sprouts that are being produced on the weekly (2004). This would save the possibility of sprouts being distributed to the public and causing an outbreak. The treatment method of antimicrobial carvacrol nanoemulsion would be a great way to save the contaminated sprouts because it would inactivate low levels on Salmonella in the sprouts (Landry et al. , 2015). Step 6: Establish Action Plan 6. 1 Specify Activities Needed to Achieve Solutions & 6. Identify Groups/Persons Responsible for Implementation Public health officials should have the FDA keep track of those who own large bean sprout plantations that are responsible for most of the regular distribution of sprouts to food incorporations. Not only should they keep track of the plantations but furthermore do regular checkups and evaluations on them for contamination. In addition, food corporations should take the necessary precaution and have the FDA check up on the bean sprouts that have been shelved longer than recommended and dispose of them.
6. 3 Timeline To create a timeline to see progression, goals should be made in time increments. A goal should be made by 2020 to have all large bean sprout plantations properly identified and monitored by the FDA. By the year 2025, all bean sprout plantation owners should be informed on how to detect and reduce contamination through implemented education. Then in the year 2030, Salmonella Enteritidis and in general Salmonella outbreaks should be a minimal due to the increase in proper care of bean sprouts.
There should also be medical advancements in the treatment of Salmonella infections. With that being said, the antimicrobial carvacrol nanoemulsion should be fully enabled. Conclusion Opinion In my opinion I think that with proper education and care, the outbreaks of Salmonella Enteritidis will come to a minimal. It is a matter of prevention and active inspection. I personally like bean sprouts in my soup or stir fry, but I rarely ever eat them raw. Now knowing that raw bean sprouts could possibly give me an infection will definitely prompt me in staying away from raw sprouts as a whole.
My recommendation to Vietnamese restaurants would be to not serve raw bean sprouts on the side but rather have it all cooked if they were to serve it. Comparison with Nation or History In October and November of 2011, there was an outbreak of Salmonella enterica serovar Newport from mung bean sprouts in Germany. Compared to the US, they did thorough investigation and constant communication with different city and local officials (ECDC, 2014), Ultimately, it was traced back to the distributors and producers in the Netherlands.
