By: Heather Williams

Sprouts might be a great superfood, but raw might not be such a good idea.  This crunchy microgreen has been linked to many outbreaks of various pathogenic bacteria in the past 20 years.  This week we discover yet another outbreak associated with sprouts and an all too familiar sandwich chain.  A Salmonella Montevideo outbreak has been linked to raw sprouts at Jimmy John’s restaurants.

This information was gathered using a public health laboratory online network called PulseNet, which tracks DNA fingerprinting data across the United States to identify epidemiological trends.  With 8 people fallen ill so far across 3 states, the Center for Disease Control and Prevention (CDC) and the Illinois Public Health Department is urging Jimmy Johns restaurants at a minimum in Illinois and Wisconsin to stop serving raw sprouts at Jimmy John’s restaurants and for customers to not consume raw sprouts served at Jimmy John’s. As a result, Jimmy John’s has temporarily removed sprouts from their menu across the United States as a precautionary measure.  So far, the last CDC update on January 19, 2018 indicates the majority of illnesses reported are in Wisconsin, followed by Illinois, then Minnesota.

CDC Investigation

Current epidemiologic evidence points to raw sprouts from Jimmy John’s as the outbreak source.  Patients with the same strain of Salmonella are interviewed and questioned about their dining habits over that past few weeks to help identify what they may have in common.  In this case, sprouts from Jimmy John’s became a unifying factor.  The CDC is continuing traceback investigations to identify more information about the source so that a recall can be possible if needed.  This traceback will hopefully identify where the sprouts were distributed and how they became contaminated.  Though sprouts have been cited as a source of many previous foodborne outbreaks, they are already a high-risk food.  At this time, six Jimmy John’s restaurants are being investigated, though that number could rise as more information becomes available.

Illnesses began reporting from December 20, 2017 to January 3, 2018.  More individuals may be impacted by this outbreak, as results can take anywhere between 2 to 4 weeks to be officially reported.  Additionally, many recover without the need for medical assistance, so often illness goes undocumented.

The Dangers of Sprouts

Sprouts are highly prone to pathogenic bacteria contamination.  Consuming them raw has an inherent risk for normally healthy individuals, but certain groups are at a higher risk for infection and complication.  The very young, the very old, and those with a compromised immune system are advised to avoid raw sprouts.  Those that fall into these high-risk categories should ask to omit raw or lightly cooked sprouts from dishes that may normally come with them.  If at a restaurant or deli consuming a salad or sandwich, be sure that it does not contain raw sprouts.  If you choose to eat sprouts, be sure to fully cook them to kill any harmful bacteria that might be lurking.

Many produce have been indicated in foodborne outbreaks.  This is inherent to the ready-to-eat nature of fresh fruits and vegetables.  Many people do not appropriately clean (if at all) fruits and vegetables prior to eating them.  This allows any pathogenic bacteria that might have been in the soil, water, or distribution center to contaminate the produce, rendering it harmful for human consumption.

The nature of sprouts creates an additional risk factor.  These super foods need warm and humid conditions to, well… Sprout.  These same conditions that allow the sprout to grow are also an ideal breeding ground for harmful bacteria such as E. coli, Listeria, and Salmonella.  It is no surprise that at least 30 outbreaks have been linked to sprouts in the past 20 years.  This accounts for over 1,800 illnesses.  However, for every 20 to 100 illness reported, as much as another 100,000 are likely unreported during this time-frame.

This Isn’t the First Jimmy John’s Outbreak Associated with Sprouts

With so many outbreaks related to this one ingredient in certain Jimmy John’s sandwiches, it is a wonder why they haven’t been completely eliminated from the menu.  A terrible outbreak in December of 2011 left 29 ill with E. coli O26.  This prompted Jimmy John’s to remove clover sprouts from the menu, which were thought to be a “safer alternative” to alfalfa sprouts.  This was, in part due to Salmonella illness related to the alfalfa sprouts in 2010.  The past was all but forgotten when Jimmy John’s added sprouts back to the menu in 2012.  In 2014, sprouts presented another outbreak.  This time with a Shiga toxin-producing E. coli O121.  Several restaurants, including Jimmy John’s were impacted by a recall for raw clover sprouts as a result.

Is There a Way to “Clean” Sprouts?

The U.S. Food and Drug Administration (FDA) has issued guidelines for producers and distributors of sprouts to help mitigate the inherent risk of the contamination risk associated with sprouts.  This may involve several steps, but at a minimum, soaking seeds in 20,000 parts per million solution of Calcium hypochlorite solution.  Growers often avoid this decontamination method, among other methods as they impact the germination rates and overall product yield of sprouts from seeds.

Enforcing decontamination and healthy growing practices in the pathogen prone sprouts is a major concern for food safety.  Stephen Sundlof, the director of National Center for Food Safety and Applied Nutrition at the FDA issued the following letter in 2009, pleading with seed suppliers, distributors, and sprout growers:

“This letter is intended to make you aware of the Food and Drug Administration’s (FDA’s) serious concern with the continuing outbreaks of foodborne illness associated with the consumption of raw and lightly cooked sprouts… Sprouts are often consumed raw (or lightly cooked in the case of bean sprouts) without processing to reduce pathogens that may be present. Therefore, the manner in which they are produced, packed, and distributed is crucial to minimizing microbial contamination, thereby reducing the risk of illness to consumers.”

Even 8 years later we seem to be having the same conversation.  The risk of foodborne illness should outweigh the benefit of the vitamins, minerals, and health benefits of consuming sprouts raw.  Yet it remains on the menu.

The Investigation Continues

Will sprouts leave the menu at Jimmy John’s and other restaurants forever?  Unless banned, this is highly doubtful.  Meanwhile, the CDC and local public health departments continue the investigation to identify how far the reach of this Salmonella outbreak has spread.  Antibiotic susceptibility testing is currently underway to better treat those with serious infections.

UnsafeFoods is closely monitoring this outbreak and will update as more information becomes available.