Raw Tomato and Pepper Salmonella Outbreak

Raw Tomato and Pepper Salmonella Outbreak - 43 States, DC, Canada

A rare strain of salmonella, the serotype Saintpaul, has sickened 1438 people in 43 states, the District of Columbia, and Canada and may have contributed to two deaths. The outbreak originally appeared in Texas (which now has 559 ill) and New Mexico (114), then widened to :Alabama (6 persons), Arkansas (21), Arizona (59), California (16), Colorado (17), Connecticut (5), Florida (4), Georgia (42), Idaho (6), Illinois (120), Indiana (21), Iowa (2), Kansas (21), Kentucky (2), Louisiana (3), Maine (1), Maryland (39), Massachusetts (31), Michigan (28), Minnesota (31), Mississippi (2), Missouri (20), Montana (1), New Hampshire (6), Nevada (14), New Jersey (16), New York (41), North Carolina (28), Ohio (10), Oklahoma (38), Oregon (11), Pennsylvania (15), Rhode Island (3), South Carolina (2), Tennessee (10), Utah (2), Virginia (31), Vermont (2), Washington (18), West Virginia (1), Wisconsin (13), and the District of Columbia (1). Five ill persons are reported from Canada. Four appear to have been infected while traveling in the United States; the travel status of the fifth ill person is unknown.

8/27/08 - A joint probe by the CDC and the Food and Drug Administration has found strong evidence that jalapeno peppers were a major carrier of the bacteria, and that serrano peppers were also a carrier. The strain that caused the outbreak has been traced back to a produce distribution center in Texas, and to a Mexican farm that grew peppers. The investigation hasn’t found any contaminated tomatoes, but investigators say they can’t rule out that tomatoes might have been a carrier, particularly early on. The agencies believe that the outbreak is over.
8/1/08 - Marler Clark files a salmonella Saintpaul lawsuit against Wal-Mart on behalf of Brian Grubbs.
7/30/08 - Salmonella Saintpaul is found in the irrigation water of a farm in Mexico. The FDA states that there is “more than one vehicle” in the outbreak.
7/28/08 - The Colorado Health Department announces that the peppers from the Grubbs’ home test positive for salmonella Saintpaul.
7/25/08 - The advisory is narrowed to raw jalapeno and serrano peppers grown in Mexico. All US-grown peppers are deemed safe.
7/23/08 - The Minnesota Department of Health investigators traced the source of the salmonella outbreak to peppers.
7/21/08 - Jalapeno peppers distributed by Agricola Zaragoza are recalled after testing positive for salmonella saintpaul. The peppers were grown in Mexico and distributed by a company in McAllen, Texas. It is still unclear where the peppers became tainted.
7/18/08 - Montana reports a case and joins the list. Produce recalled from Mexico packing house tests positive for a different salmonella serotype - the search continues.
7/17/08 - The FDA lifts the advisory on raw tomatoes, recalls begin on peppers and avocados from Mexico. Testing continues to see if the salmonella in the recalled produce matches that of the nationwide saintpaul serotype.
7/14/08 - Infections as recent as July 4 - Investigators focus on clusters that may provide clues.
7/11/08 - The Colorado Health Department picks up raw peppers from the Grubbs’ home.
7/11/08 One new state, Mississippi, reports ill persons. A new infection is reported in Nevada.
7/9/09 - West Virginia is added to the list of states with infections. Investigations continue into peppers and cilantro.
7/7/08 The investigation widens to include items often consumed with tomatoes - fresh hot peppers such as jalapeno peppers, cilantro, and onions. Among the 693 persons with information available, illnesses began between April 10 and June 26, 2008, including 258 who became ill on June 1 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 2-3 weeks. Therefore, an illness reported today may have begun 2-3 weeks ago. Patients range in age from <1 to 99 years; 48% are female. The rate of illness is highest among persons 20 to 29 years old; the rate of illness is lowest in children 10 to 19 years old and in persons 80 or more years old. 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.
7/5/08 According to CNN, �starting Monday [July 7 2008], health inspectors will halt the shipment of ingredients common to Mexican cuisine from Mexico to the United States� � this will include cilantro, jalapeno peppers, Serrano peppers, scallions and bulb onions. Total ill 943, nearly 150 have been hospitalized.
7/3/08 - Brian Grubbs falls ill with Salmonella infection - he later tests positive for salmonella saintpaul.
7/3/08 Two more states are added: Iowa and Louisiana. A Canadian person became ill after a trip to the US. The latest onset date is now June 25. Total ill 922.
7/2/08 Two new states are added: Alabama and South Carolina. Total number stands at 887.
7/1/08 - The US Food and Drug Administration (FDA) said today that it was activating an emergency network of laboratories to help out in the quest to determine if other food items commonly served with fresh tomatoes could be the source of a nationwide Salmonella outbreak that has now grown to 869 confirmed cases. David Acheson, MD, the FDA’s associate commissioner for foods, said at a news briefing today that the FDA has activated the Food Emergency Response Network (FERN), a voluntary system that was established after the Sept 11 terrorist attacks to temporarily increase laboratory capacity. Acheson said 10 of about 100 labs in the system have already offered to help with additional food-product testing. FERN was previously activated during the spinach-related Escherichia coli O157:H7 outbreak and during the investigation of melamine contamination in pet food, he said.
7/1/08 As new illnesses continue to appear, the FDA is broadening the investigation to include “food items that are commonly consumed with tomatoes”. Among the 588 persons with information available, illnesses began between April 10 and June 20, 2008, including 179 who became ill on June 1 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 2-3 weeks. Therefore, an illness reported today may have begun 2-3 weeks ago. Patients range in age from <1 to 99 years; 48% are female. The rate of illness is highest among persons 20 to 29 years old; the rate of illness is lowest in children 10 to 19 years old and in persons greater than 80 years old. At least 107 persons were hospitalized.
6/27/08 As salmonella cases continue to climb, the government is checking if tainted tomatoes really are to blame for the record outbreak - or if the problem is with another ingredient, or a warehouse that is contaminating newly harvested tomatoes. Federal health officials say there’s no evidence clearing tomatoes. But inspectors haven’t yet found the outbreak’s source even as cases continue to rise - to 810 confirmed ill. Most worrisome, the latest victim became sick on June 15. Patricia Griffin of the Centers for Disease Control and Prevention says the agency is looking into other ingredients, just in case tomatoes were not to blame.
6/26/08 - The Grubbs family purchases raw jalapeno peppers from the Wal-Mart supercenter in Cortez, CO.
6/26/08 Among the 492 persons with information available, illnesses began between April 10 and June 13, 2008. Patients range in age from <1 to 99 years; 50 percent are female. At least 76 persons were hospitalized.
6/25/08 Nevada is added to the list with 4 confirmed ill. Among the 325 persons with information available, illnesses began between April 10 and June 13, 2008. Patients range in age from <1 to 99 years; 50% are female. At least 71 persons were hospitalized.
6/24/08 Investigations continue in Mexico and Florida for a source of the salmonella. Among the 316 persons with information available, illnesses began between April 10 and June 13, 2008. Patients range in age from <1 to 99 years; 50% are female. At least 69 persons were hospitalized.
6/20/08 The number of reported ill persons increased mainly because some states improved surveillance for Salmonella in response to this outbreak and because laboratory identification of many previously submitted strains was completed. In particular, the number of ill persons reported from Texas markedly increased, and two new states, New Jersey and Rhode Island, reported ill persons.Among the 281 persons with information available, illnesses began between April 10 and June 10, 2008. Patients range in age from <1 to 88 years; 49% are female. At least 53 persons were hospitalized.
The FDA's David Acheson indicates that the tainted fruit probably came from Florida, because it "fits with the time frame," and investigators have not found evidence that could rule out the state. He said contrary to some earlier reports, he knows of no evidence showing tainted fruit came from Mexico.
6/18/08 Among the 243 persons with information available, illnesses began between April 10 and June 5, 2008. Patients range in age from <1 to 88 years; 47% are female. At least 48 persons were hospitalized. Investigations into the source of the tomatoes continues, with the latest concentration of interest in Mexico and the southern counties of Florida.
6/17/08 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 202 persons with information available, illnesses began between April 10 and June 5, 2008. Patients range in age from <1 to 88 years; 46% are female. At least 43 persons were hospitalized. No deaths have been officially attributed to this outbreak. However, 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.
6/12/08 These states were added: Florida, Georgia, Missouri, New York, Tennessee and Vermont. Dr. Patricia Griffin, the chief of the disease centers� enteric disease epidemiology branch, was cited as saying the agency estimated that only 1 in 38 cases were ever reported to the authorities, so the problem was likely to be greater.
6/10/08 The Food and Drug Administration has expanded its warning to consumers nationwide that a salmonellosis outbreak has been linked to consumption of certain raw, red tomatoes. At this time, FDA is advising consumers to limit their consumption of tomatoes to the following types of tomatoes. The following types of tomatoes listed below are NOT likely to be the source of this outbreak: cherry tomatoes, grape tomatoes, tomatoes sold with the vine still attached, and tomatoes grown at home.
The FDA advised restaurants, grocery stores and food service operators not to sell products made with the three tomato varieties unless they were certain that the fruit was grown in approved states.
6/7/08 The Food and Drug Administration expanded its original, limited tomato warning (6/5/08) to include consumers nationwide, stating that a salmonellosis outbreak has been linked to consumption of certain raw red plum, red Roma, and red round tomatoes, and products containing raw, red tomatoes.
FDA recommended that consumers not eat raw red Roma, raw red plum, raw red round tomatoes, or products that contain these types of raw red tomatoes unless the tomatoes source from certain locations, listed below. If unsure of where tomatoes are grown or harvested, consumers have been encouraged to contact the store where the tomato purchase was made.
6/5/08 Using traceback and other distribution pattern information, FDA published a list of states, territories, and countries where tomatoes are grown and harvested which have not been associated with this outbreak.
This updated list (6/10/08) includes: Alabama, Arkansas, California, Colorado, Delaware, Florida (counties of: Jackson, Gadsden, Leon, Jefferson, Madison, Suwannee, Hamilton, Hillsborough, Polk, Manatee, Hardee, DeSoto, Sarasota, Highlands, Pasco, Sumter, Citrus, Hernando, Charlotte), Georgia, Hawaii, Louisiana, Maine, Maryland, Minnesota, Mississippi, New Jersey, New York, Nebraska, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas,
West Virginia, and Wisconsin. Cleared imports include Belgium, Canada, Dominican Republic, Guatemala, Israel, and the Netherlands. The list is available at www.fda.gov/oc/opacom/hottopics/tomatoes.html#retailers. They will continue to update the list as more information becomes available.

Raw Tomato and Pepper Salmonella Outbreak - 43 States, DC, Canada

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