Salmonella outbreak investigation intensifies

Published 8 July 2008

Hunt continues for the source of the Salmonella outbreak in the U.S.; FDA and CDC still see tomatoes as the cause; this weekend three states in Mexico became the focal point of the search

The Center for Disease Control and Prevention (CDC) says it is collaborating with public health officials in many states, the Indian Health Service, and the U.S. Food and Drug Administration (FDA) to investigate an ongoing multi-state outbreak of human Salmonella serotype Saintpaul infections. An initial epidemiologic investigation comparing foods eaten by ill and well persons identified consumption of raw tomatoes as strongly linked to illness. Recently, many clusters of illnesses have been identified in several states among persons who ate at restaurants. CDC says that these clusters led the agency to broaden the investigation to be sure that it encompasses food items that are commonly consumed with tomatoes. Fresh tomatoes, fresh hot chili peppers such as jalapeסos, and fresh cilantro are the lead hypotheses. At this point in the investigation,however, CDC says it can neither directly implicate one of these ingredients as the single source, nor discard any as a possible source.

Since April 971 persons infected with Salmonella Saintpaul with the same genetic fingerprint have been identified in 40 states, the District of Columbia, and Canada. These were identified because clinical laboratories in all states send Salmonella strains from ill persons to their State public health laboratory for characterization. Among the 693 persons with information available, illnesses began between 10 April and 26 June 2008, including 258 who became ill on 1 June or later. Many steps must occur between a person becoming ill and the determination that the illness was caused by the outbreak strain of Salmonella; these steps take an average of two to three weeks. Therefore, an illness reported today may have begun two to theree weeks ago. At least 189 persons were hospitalized. One death in a man in Texas in his eighties has been associated with this outbreak. In addition, a man in his sixties who died in Texas from cancer had an infection with the outbreak strain of Salmonella Saintpaul at the time of his death; the infection may have contributed to his death.