Salmonella Enteritidis Outbreak Linked 

to Frozen, Raw, Breaded, Stuffed 

Chicken Products

Outbreak Investigation After Action Review, Report 2021-07 

Highlights 

• Fourteen outbreaks associated with not 

ready-to-eat (NRTE) frozen, raw, 

breaded, stuffed chicken products have 

been investigated by public health 

officials since 1998. Prior to this 2021

outbreak, the last multistate outbreak of 

NRTE stuffed chicken products was in

2015. 

• In this investigation, some consumers

reportedly did not cook the stuffed 

chicken products using a validated 

process (oven), as described on the product label, to ensure that the product was 

thoroughly cooked to an internal temperature of 165°F. Instead, some consumers 

reported using a microwave or air fryer and did not use a meat thermometer to 

verify proper internal temperature.

• As a result of this outbreak, and previous outbreaks associated with these 

products, FSIS sought advice from the National Advisory Committee on Meat and 

Poultry Inspection (NACMPI), which advises FSIS on matters affecting Federal 

inspection program activities. FSIS is currently assessing the recommendations.

 

Outbreak at a Glance

Illnesses 36

States included 11

Hospitalizations 12

Deaths 0 

Response at a Glance

Investigative samples tested by 

FSIS and state partners

9 

Recall or Public Health Alert Yes

Food Safety and Inspection Service

U.S. DEPARTMENT OF AGRICULTURE
Ill persons infected with Salmonella Enteritidis by state of residence, N = 36

What happened? 

From April through August 2021, state public health officials, the Centers for Disease 

Control and Prevention (CDC), and FSIS investigated an outbreak of 36 Salmonella 

Enteritidis illnesses linked to NRTE stuffed chicken products. Ill people reported

preparing and eating these products, and some reported that they did not follow the 

manufacturer’s cooking instructions on the label. Instead, some people reported that 

they cooked the product in a microwave, air fryer, or for a shorter time than 

recommended in a conventional oven, and they did not use a food thermometer to 

check that the product reached an internal temperature of 165°F as instructed on the 

product label. The Minnesota Department of Agriculture conducted retail product 

sampling of these products as part of the investigation and isolated the outbreak strain.

Based on the strong epidemiologic information and product sampling results, FSIS 

posted a public health alert and CDC posted an investigation notice on June 2, 2021, to 

alert the public that ill people had reported eating NRTE stuffed chicken prior to illness 

onset. FSIS collected unopened packages of NRTE stuffed chicken from the homes of

two ill people. One leftover product tested positive for the outbreak strain. FSIS traced
the product to an FSIS-regulated establishment, and on August 9, 2021, the 

establishment voluntarily recalled the affected products.

Lessons learned from NRTE stuffed chicken 

outbreaks

NACMPI Recommendations

Following the 2021 outbreak, FSIS sought advice from NACMPI 

regarding additional preventive actions FSIS could consider. 

Below are some of the recommendations from NACMPI: 

• Review labels and cooking instructions 

• Review establishment food safety programs

• Update FSIS labeling guidance to industry

• Consider exploratory sampling for Salmonella and 

indicators in product

• Conduct further consumer research

• Conduct consumer outreach to encourage thermometer 

use

• Create an FSIS webpage to address these specific 

products to give visual cues and guidance for safe 

consumer handling and preparation

• FSIS is currently considering NACMPI recommendations 

and other potential Agency response to the latest 

outbreak.

Review of 2015 Outbreak

After the 2015 outbreak, FSIS conducted an after action review (AAR).

The AAR mentioned exploratory sampling of these products as an action 

that the Agency would consider; however, FSIS ultimately did not take this 

action because establishments involved in the 2015 outbreak took

corrective actions to address Salmonella contamination. Establishments 

also changed labels to improve consumer understanding on how to safely

handle and cook the product, and no additional multistate outbreaks 

occurred until the 2021 outbreak.
What can you do to prevent or solve the next NRTE 

stuffed chicken outbreak? 

Helpful Links 

Helpful Links

• FSIS Recall 28-2021, August 9, 2021 

• FSIS Public Health Alert, June 2, 2021

• CDC Food Safety Alert, October 13, 2021 

Establishments that 

produce NRTE stuffed 

chicken products should 

reassess their hazard 

analysis and critical 

control points plans and 

review their labels and 

validated cooking 

instructions. 

Consider addressing 

Salmonella

contamination in source 

materials used for 

manufacturing of NRTE 

stuffed chicken products, 

knowing the finished 

product may appear 

ready-to-eat to 

consumers. 

Consider updating the

images of the product on 

the package to make the 

product appear to be raw 

or uncooked.

Continue to work closely 

with local, state, and 

federal partners to detect 

and investigate 

outbreaks. Email 

FoodborneDiseaseRepo

rts@usda.gov to notify 

FSIS if FSIS-regulated 

products may be 

involved in an outbreak. 

Consider including 

questions regarding 

NRTE stuffed chicken 

products to the

Salmonella illness 

questionnaire. 

Public Health Partners

Follow the 

manufacturer’s cooking 

instructions on product 

packaging. Do not use 

microwaves, convection 

ovens, or air fryers to 

cook these products 

unless there are specific 

cooking instructions for 

those appliances on the 

product package. After 

cooking, use a meat 

thermometer to measure 

that the internal

temperature rises to 

165 ̊F. A meat 

thermometer must be 

inserted in the center of 

the thickest part of the 

product of both the 

poultry and stuffing 

component to take the 

reading.

If you feel ill, seek

treatment from a health 

care provider and 

document all food eaten 

up to 7 days prior to 

illness.

Industry Consumers
• NACMPI: 

o Public Meeting 

o Federal Register Notice

o Stuffed Chicken Presentation 

o Stuffed Chicken Meeting Transcript 

o Stuffed Chicken Recommendations from Sub Committee II 

• FSIS Consumer Research on Stuffed Chicken 

• Doneness versus Safety

• Report a Problem with Food | Food Safety and Inspection Service (usda.gov)

• FSIS Outbreak Page