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SALMONELLOSIS, SEROTYPE SAINTPAUL, TOMATOES - USA (12): MORE DOUBTS
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[1]
Date: Fri 4 Jul 2008
Source: CDC [edited]
http://www.cdc.gov/salmonella/saintpaul/

Case count information as of 9 pm EDT, 3 Jul 2008

The CDC is collaborating with public health officials in many states,
the Indian Health Service, and the FDA to investigate an ongoing
multi-state outbreak of human _Salmonella [enterica_] serotype
Saintpaul infections. An initial epidemiologic investigation
comparing foods eaten by ill and well persons identified consumption
of raw tomatoes as strongly linked to illness. Recently, many
clusters of illnesses have been identified in Texas and other states
among persons who ate at restaurants. These clusters have led us to
broaden the investigation to be sure that it encompasses food items
that are commonly consumed with tomatoes.

Since April 2008, 943 persons infected with _S._ Saintpaul with the
same genetic fingerprint have been identified in 40 states, the
District of Columbia, and Canada. These were identified because
clinical laboratories in all states send Salmonella strains from ill
persons to their State public health laboratory for characterization.
No new states report ill persons. The number of ill persons
identified in each state is as follows: Alabama (2 persons), Arkansas
(10), Arizona (45), California (8), Colorado (12), Connecticut (4),
Florida (2), Georgia (24), Idaho (4), Illinois (93), Indiana (14),
Iowa (2), Kansas (17), Kentucky (1), Louisiana (1), Maine (1),
Maryland (29), Massachusetts (22), Michigan (7), Minnesota (8),
Missouri (12), New Hampshire (4), Nevada (11), New Jersey (9), New
Mexico (98), New York (28), North Carolina (10), Ohio (7), Oklahoma
(23), Oregon (10), Pennsylvania (8), Rhode Island (3), South Carolina
(1), Tennessee (8), Texas (356), Utah (2), Virginia (29), Vermont
(2), Washington (4), Wisconsin (10), and the District of Columbia
(1). One ill person is reported from Ontario, Canada. The ill person
reported travel to the USA and became ill on the day of the return
trip to Canada.

Among the 645 persons with information available, illnesses began
between 10 Apr 2008 and 26 Jun 2008, including 225 who became ill on
1 Jun 2008 or later. Many steps must occur between a person becoming
ill and the determination that the illness was caused by the outbreak
strain; 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 less than 1 to 99 years; 50 percent 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 130 persons were hospitalized.

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[Since ProMED’s last posting on this still ongoing outbreak, 92
additional cases have been linked to the implicated strain of _S._
Saintpaul, 4 more states are involved (Iowa, Louisiana, Alabama, and
South Carolina) and 52 more cases (more than half of all the newly
reported cases) have occurred in June 2008. To date, 225/943 (nearly
24 percent) of all cases had the onset of illness essentially after
the announcement of the tomato risk. Additionally, the 1st case
reported from Canada has occurred (but was acquired in the USA). More
and more interest continues to occur regarding alternative sources,
but sources likely tied to meals with tomatoes. - Mod. LL]

*****
[2]
Date: Sat 5 Jul 2008
Source: CNN [edited]
http://www.cnn.com/2008/HEALTH/07/05/salmonella.outbreak/

Starting Mon 7 Jul 2008, FDA inspectors will expand the salmonella
search beyond tomatoes to include cilantro, jalapeno and serrano
peppers, scallions and onions. Tomatoes have been the suspected
source of a salmonella outbreak, but other foods are being looked at.

The FDA said it is going to test some foods from Mexico for
salmonella before they enter the USA market as part of the agency’s
investigation into the recent salmonella outbreak. The samples will
be taken to warehouses, where they will be tested.

“If [the sample] tests negative, it’s open to release” into the
marketplace, David Acheson, FDA’s associate commissioner for food
protection, said Saturday [5 Jul 2008]. “The amount of testing is
unlikely to have a significant impact to the flow of products into
the USA,” he added.

A former director of the Food and Drug Administration’s import
operations said the expanded search raises a number of questions
about the salmonella investigation.

“Where’s the contaminated product?” asked Carl Nielsen. “How would
you know? And where along the supply chain did it happen? Was it at
the retail level? Is somebody doing something to expose the product
at the retailer? Is it at the wholesale? Is it at the grower? Is it
at the processor? Is it in transport? Where is it? They don’t know.”

Although the source of the outbreak of the rare form of bacteria,
_S._ Saintpaul, remains unknown, it has produced many casualties,
including a 450 million dollar slice off tomato growers’ income, said
Tommy Thompson, former secretary of the Department of Health and
Human Services.

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