Investigation Details
Posted November 24, 2023
Epidemiologic and laboratory data show that cantaloupes are contaminated with Salmonella and are making people in this outbreak sick.
Canada is also investigating this outbreak and has linked illness in Canada with the same Salmonella strain to cantaloupes.
Epidemiologic Data
Since the last update on November 17, 2023, 56 more illnesses have been reported. As of November 24, 99 people infected with the outbreak strain of Salmonella have been reported from 32 states (see map). Illnesses started on dates ranging from October 17, 2023, to November 10, 2023 (see timeline). Of 77 people with information available, 45 have been hospitalized. Two deaths have been reported from Minnesota.
The true number of sick people in this outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses. This is because many people recover without medical care and are not tested for Salmonella. In addition, recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak.
Public health officials collect many different types of information from sick people, including their age, race, ethnicity, other demographics, and the foods they ate in the week before they got sick. This information provides clues to help investigators identify the source of the outbreak.
The table below has information about sick people in this outbreak (“n” is the number of people with information available for each demographic).
| Demographics | Information |
|---|---|
| Age (n=97) |
Range from <1 to 100 years Median age of 62 years |
| Sex (n=98) |
60% Male 40% Female |
| Race (n=75) |
88% White 9% African American/Black 1% Asian 1% reported more than one race |
| Ethnicity (n=73) |
86% non-Hispanic 14% Hispanic |
State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Of the 33 people interviewed, 29 (88%) reported eating cantaloupe. This percentage was significantly higher than the 19.6% of respondents who reported eating cantaloupe in the FoodNet Population Survey—a survey that helps estimate how often people eat various foods linked to diarrheal illness.
Laboratory Data
WGS analysis of bacteria from 89 people’s samples did not predict resistance to any antibiotics. More information is available at the National Antimicrobial Resistance Monitoring System (NARMS) site.
Public Health Actions
On November 22, 2023, more recalls for whole and pre-cut cantaloupes were issued. Trufresh expanded their recall again to include all Malichita brand and Rudy brand whole cantaloupes. Crown Jewels recalled Malitchita brand whole cantaloupes. CF Dallas recalled pre-cut fruit products containing recalled cantaloupes.
CDC is advising people not to eat, sell, or serve recalled fruit.
CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are collecting different types of data to investigate a multistate outbreak of Salmonella Sundsvall infections.
Epidemiologic and laboratory data show that cantaloupes are making people in this outbreak sick.
Epidemiologic Data
As of November 17, 43 people infected with the outbreak strain of Salmonella have been reported from 15 states (see map). Illnesses started on dates ranging from October 17, 2023, to November 6, 2023 (see timeline). Of 30 people with information available, 17 have been hospitalized. No deaths have been reported.
The true number of sick people in this outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses. This is because many people recover without medical care and are not tested for Salmonella. In addition, recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak.
Public health officials collect many different types of information from sick people, including their age, race, ethnicity, other demographics, and the foods they ate in the week before they got sick. This information provides clues to help investigators identify the source of the outbreak.
The table below has information about sick people in this outbreak (“n” is the number of people with information available for each demographic).
| Demographics | Information |
|---|---|
| Age (n=43) |
Range from 1 to 100 years Median age of 62 years |
| Sex (n=43) |
58% Female 42% Male |
| Race (n=33) |
94% White 3% Asian 3% reported more than one race |
| Ethnicity (n=32) |
81% non-Hispanic 19% Hispanic |
State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Of the 29 people interviewed, 15 (52%) reported eating cantaloupe. This percentage was significantly higher than the 19.6% of respondents who reported eating cantaloupe in the FoodNet Population Survey—a survey that helps estimate how often people eat various foods linked to diarrheal illness.
Laboratory Data
Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause foodborne illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS). WGS showed that bacteria from sick people’s samples are closely related genetically. This suggests that people in this outbreak got sick from the same food.
Canada is also investigating a Salmonella outbreak linked to cantaloupes. The strain causing the outbreak in Canada is the same as the US outbreak strain. The Canadian Food Inspection Agency found Salmonella in a sample of Malichita brand cantaloupe, and WGS showed that the Salmonella on the cantaloupe is closely related genetically to the bacteria from sick people in Canada. This suggests that people in the Canadian and US outbreaks likely got sick from eating cantaloupe.
WGS analysis of bacteria from 41 people’s samples did not predict resistance to any antibiotics. More information is available at the National Antimicrobial Resistance Monitoring System (NARMS) site.
Public Health Actions
On November 1, 2023, Malichita brand cantaloupes were recalled in Canada.
On November 8, Trufresh recalled Malichita brand whole cantaloupes that were sold to US businesses between October 16 and October 23. On November 15, Trufresh expanded their recall to include additional whole cantaloupes.
Additional products containing Malichita brand cantaloupes were also recalled. On November 14, Vinyard Fruit and Vegetable Company recalled pre-cut fruit products and ALDI recalled [PDF – 2 pages] its whole cantaloupe, cantaloupe chunks, and pineapple spears.
CDC is advising people not to eat, sell, or serve recalled fruit.
