Officials say Salmonella outbreak winding down

Aug 21, 2008 (CIDRAP News) A nationwide Salmonella outbreak linked mainly to fresh hot peppers from Mexico is ending, the US Centers for Disease Control and Prevention (CDC) said yesterday, amid reports that contaminated shipments had been turned back at the US border well before the outbreak and that some restaurants and grocery stores are still buying the imported peppers.

Though federal officials still suspect that tomatoes played a role in some of the early illnesses, investigations of case clusters that emerged later in the outbreak pointed more toward jalapeno and Serrano peppers. In July, authorities found the Salmonella enterica serotype Saintpaul outbreak strain on a jalapeno pepper at a produce importer in McAllen, Tex., and at a patient's home in Colorado. During testing at a farm in Mexico they also found positive samples from irrigation water and from a Serrano pepper.

According to an update yesterday from the CDC, the outbreak is ongoing but has slowed to a trickle. "The average number of persons who became ill in recent weeks continues to decrease, indicating that the outbreak is ending," the agency said in its update.

Since April, 1,434 cases have been linked to the outbreak, which has sickened patients in 43 states, the District of Columbia, and Canada. So far at least 273 patients have been hospitalized. No deaths have been linked directly to the outbreak, but officials said illnesses may have contributed to the death of two older Texas men who had preexisting medical conditions.

The CDC estimated that the latest illness onset date is Aug 5. One patient who got sick early in the outbreak, on Apr 10, was deleted from the case count because further testing revealed the Salmonella Saintpaul isolate did not match the outbreak strain.

In other developments, jalapeno and Serrano peppers from Mexico are still being sold in the United States, according to a report today from USA Today. In July officials from the Food and Drug Administration (FDA) advised consumers not to eat fresh jalapenos and Serranos from Mexico. One produce distributor, Agricola Zaragoza, based in McAllen, Tex., recalled its jalapeno peppers after one of them tested positive for the outbreak strain.

Raul Ramirez, a produce manager at a Los Angelesbased distributor, told USA Today that buyers of the Mexican peppers, which his company sells, are typically small Hispanic grocers and small restaurants. He and another distributor, based in Edinburgh, Tex., said big supermarkets and restaurants are avoiding the Mexican peppers, according to the report.

Meanwhile, federal inspectors at the US-Mexico border on many occasions blocked the entry of contaminated peppers into the United States months before the Salmonella outbreak surfaced, the Associated Press (AP) reported on Aug 19.

The AP said its review of FDA inspection records found that peppers and chiles were the top Mexican crop rejected at the border over the last year. The AP's analysis showed that 88 shipments were blocked, 10% of them because of Salmonella contamination. In the last year, the pathogen was detected in 85 of 158 shipments of fresh and dried chiles that the FDA inspected.

FDA officials did not comment on the AP's findings. David Acheson, MD, the FDA's associate commissioner for foods, has previously said the agency focuses its inspection effort on high-risk foodsthose that have been implicated in outbreaks, according to the AP report. Acheson has also said that based on the recent outbreak, the FDA is increasing its sampling of peppers.

Ami Gadhia, policy counsel with Consumer's Union, a nonprofit group, told the AP that she questioned the FDA's definition of risk. "If the fact that they were showing up on problem lists for a year doesn't make them high-risk, I don't know what does," she said. "If it's across the board, then that's a systemic problem that the FDA needs to be able to nimbly respond to."

Bob Buchanan, a former science advisor to the FDA, said the apparent delay in classifying peppers as high risk might stem from the fact that the FDA sets priorities for high-risk foods years in advance, according to the AP report. He added that imported dried chiles have been considered risky because spice merchants often dry the peppers in the sun where they risk contamination from birds and other animals.