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Posted June 2, 2008

Multistate Outbreak of Salmonella Saintpaul Infections Linked to Raw Produce

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This outbreak appears to be over. However, Salmonella is an important cause of human illness in the United States. More information about Salmonella, and steps people can take to reduce their risk of infection, can be found on the CDC Salmonella Web Page.

 

Persons infected with the outbreak strain of Salmonella Saintpaul, United States, by state, April 23 to June 2, 2008

CDC is collaborating with public health officials in several states, the Indian Health Service, and the U.S. Food and Drug Administration (FDA) to investigate an ongoing multistate outbreak of human Salmonella serotype Saintpaul infections. An epidemiologic investigation conducted by the New Mexico and Texas Departments of Health and the Indian Health Service using interviews comparing foods eaten by ill and well persons has identified consumption of raw tomatoes as the likely source of the illnesses in New Mexico and Texas. The specific type and source of tomatoes are under investigation; however, preliminary data suggest that large tomatoes, including Roma and red round are the source.

Since late April, 40 persons infected with Salmonella Saintpaul with the same genetic fingerprint have been identified in Texas (21 persons) and New Mexico (19 persons). The New Mexico Department of Health is investigating 17 additional Salmonella Saintpaul illnesses. 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 38 persons who have been interviewed, illnesses began between April 23 and May 27, 2008. Patients range in age from 3 to 82 years; 48% are female. At least 17 persons were hospitalized. No deaths have been reported.

In addition, approximately 30 persons with Salmonella Saintpaul infection have been reported since late April in residents of Arizona, Colorado, Idaho, Illinois, Indiana, Kansas, and Utah. Investigations are underway to determine if consumption of raw tomatoes is also associated with illness in these states.

Clinical features of Salmonella Infection

Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12-72 hours after infection. Infection is usually diagnosed by culture of a stool sample. The illness usually lasts 4-7 days. Although most people recover without treatment, severe infections may occur. Infants, elderly persons, and those with impaired immune systems are more likely than others to develop severe illness. When severe infection occurs, Salmonella may spread from the intestines to the bloodstream and then to other body sites, and can cause death. In these severe cases, antibiotic treatment may be necessary.

Advice to consumers

  • In New Mexico and Texas, until the source of the implicated tomatoes is determined,
    • persons with increased risk of severe infection, including infants, elderly persons, and those with impaired immune systems, should not eat raw Roma or red round tomatoes other than those sold attached to the vine or grown at home, and
    • persons who want to reduce their risk of Salmonella infection can avoid consuming raw Roma or red round tomatoes other than those sold attached to the vine or grown at home.
  • Avoid purchasing bruised or damaged tomatoes and discard any that appear spoiled.
  • Thoroughly wash all tomatoes under running water.
  • Refrigerate within 2 hours or discard cut, peeled, or cooked tomatoes.
  • Keep tomatoes that will be consumed raw separate from raw meats, raw seafood, and raw produce items.
  • Wash cutting boards, dishes, utensils, and counter tops with hot water and soap when switching between types of food products.

You can check the CDC and FDA websites for updates on this investigation and changes in recommendations.

More information about Salmonella and this investigation can be found at:

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