Tomato-linked Salmonella cases push past 600

Jun 24, 2008 (CIDRAP News) – The number of cases confirmed in a nationwide Salmonella outbreak linked to certain types of fresh tomatoes swelled to 613 over the past 3 days, as federal officials ruled out several Mexican states in an investigation that has focused on Mexico and parts of Florida as possible sources of the contaminated produce.

The latest update, released yesterday by the US Centers for Disease Control and Prevention (CDC), shows that over the past 3 days 61 cases have been added to the tally and that Massachusetts has been added to the list of states affected by the outbreak, raising the total to 33.

The illnesses are linked to an unusual strain, Salmonella enterica serotype Saintpaul. In early June the Food and Drug Administration (FDA) warned consumers not to eat raw red plum, red Roma, or red round tomatoes, or products that contain any of those varieties, unless the growing areas are on a list posted on the agency's Web site.

As in other recent updates on the outbreak, the CDC said the new cases mainly reflect increased surveillance by state health departments and completion of lab tests, rather than a spike in new cases.

Based on information from 316 patients, illness onset dates ranged from Apr 10 to June 13. Ages ranged from younger than 1 to 99 years, and 50% of the patients were female. At least 69 people were hospitalized, but no deaths have been blamed on the outbreak. (As mentioned in the CDC's earlier updates, however, salmonellosis may have contributed to the death of a Texas man who died of cancer.)

Meanwhile, the Food and Drug Administration (FDA), in an update on its investigation yesterday, added 28 more Mexican states to its list of growing areas that have not been associated with the outbreak. In the FDA's previous update, only one Mexican state, Baja California Norte, had been ruled out. Jim Prevor, a produce industry expert who hosts a blog called Perishable Pundit, wrote today that only three Mexican states have not been ruled out yet: Coahuila, Sinaloa, and Jalisco.

In other Salmonella outbreak news, public health officials in Kansas are investigating a Salmonella enterica serotype Enteritidis outbreak that they fear might have a wide reach beyond Harvey County, where nine cases have already been confirmed. The county is in south-central Kansas, north of Wichita.

Rita Flickinger, director of the county's health department, told CIDRAP News that the illnesses surfaced in the wake of a large youth basketball tournament held in Newton, the Harvey County seat, in early June. A total of 650 teams from 15 different states competed in the Mid America Youth Basketball tournament, which was held in several Kansas towns. She said 64 of the teams, mostly 8th grade boys and girls, competed at venues in Newton.

Flickinger said that because of the expanding scope of the outbreak, the Kansas Department of Health and Environment is taking over the epidemiologic investigation.

So far, officials have not identified the source of the outbreak, but they suspect it might be linked to a popular restaurant in Newton, she said.

According to the CDC, Salmonella Enteritidis is one of the most common Salmonella serotypes and sources of foodborne disease in the United States.

See also:

Jun 23 CDC press release

Perishable Pundit blog

CDC background information on salmonellosis

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