Jackson Heights Life

Investigation of Outbreak of Infections Caused by Salmonella Saintpaul

Information updated June 9, 2008


CDC is collaborating with public health officials in many states, the Indian Health Service, and the U.S. Food and Drug Administration (FDA) to investigate an ongoing multi-state 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 those states. The specific type and source of tomatoes is under investigation; however, the data suggest that large tomatoes, including Roma and round red, are the source.

Since mid-April, 167 persons infected with Salmonella Saintpaul with the same genetic fingerprint have been identified in 17 states: Arizona (12 persons), California (2), Colorado (1), Connecticut (1), Idaho (2), Illinois (27), Indiana (7), Kansas (5), Michigan (2), New Mexico (39), Oklahoma (3), Oregon (3), Texas (56), Utah (1), Virginia (2), Washington (1), and Wisconsin (3). 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 73 persons who have been interviewed, illnesses began between April 16 and May 27, 2008. Patients range in age from 1 to 82 years; 49% are female. At least 23 persons were hospitalized. No deaths have been reported.

Only 3 persons infected with this strain of Salmonella Saintpaul were identified in the country during the same period in 2007. The previous rarity of this strain and the distribution of illnesses in all U.S. regions suggest that the implicated tomatoes are distributed throughout much of the country. Because of inherent delays in reporting and because many persons with Salmonella illness do not have a stool specimen tested, it is likely many more illnesses have occurred than those reported. Some of these unreported illnesses may be in states that are not on todays map.
Clinical features of Salmonella Infection

Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 1272 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

At this time, FDA is advising U.S. consumers to limit their tomato consumption to those that are not the likely source of this outbreak. These include cherry tomatoes; grape tomatoes; tomatoes sold with the vine still attached; tomatoes grown at home; and raw red Roma, red plum, and round red tomatoes from specific sources listed at: http://www.fda.gov/oc/opacom/hottopics/tomatoes.html*. Consumers should be aware that raw tomatoes are often used in the preparation of fresh salsa, guacamole, and pico de gallo, are part of fillings for tortillas, and are used in many other dishes.

Customers everywhere are advised to:

    * Refrigerate within 2 hours or discard cut, peeled, or cooked tomatoes.
    * Avoid purchasing bruised or damaged tomatoes and discard any that appear spoiled.
    * Thoroughly wash all tomatoes under running water.
    * 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.

FDA recommends that U.S. retail outlets, restaurants, and food service operators offer only fresh and fresh cut red Roma, red plum, and round red tomatoes and food products made from these tomatoes from specific sources listed at: http://www.fda.gov/oc/opacom/hottopics/tomatoes.html#retailers*. Cherry tomatoes, grape tomatoes, and tomatoes sold with the vine still attached from any source may be offered.

FDA information on this investigation can be found at: http://www.fda.gov/oc/opacom/hottopics/tomatoes.html*

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

    * Salmonella FAQs
    * New Mexico Department of Health Announces Link Between Tomatoes, Salmonella PDF Document Icon (PDF – 191 KB)
    * ADHS News Release - Tomatoes: Caution Urged*
    * Texas Department of State Health Services - News Update, June 9, 2008*
    * Kansas Identifies 3 Cases Linked to Multi-State Salmonella Outbreak*
    * Indiana State Department of Health Media Update on Salmonella Outbreak*

* Links to non-Federal organizations found at this site are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. CDC is not responsible for the content of the individual organization Web pages found at these links.

Page Located on the Web at http://www.cdc.gov/salmonella/saintpaul/#advice
Department of Health and Human Services

The Food and Drug Administration is alerting consumers nationwide that a salmonellosis outbreak appears to be linked to consumption of certain types of raw red tomatoes and products containing raw red tomatoes. The bacteria causing the illnesses are Salmonella serotype Saintpaul, an uncommon type of Salmonella.

The specific type and source of tomatoes are under investigation. However, preliminary data suggest that raw red plum, raw red Roma, or raw round red tomatoes are the cause. At this time, consumers should limit their tomato consumption to tomatoes that have not been implicated in the outbreak. These include cherry tomatoes, grape tomatoes, tomatoes sold with the vine still attached, and tomatoes grown at home.

Red Plum/Red Roma tomatoes implicated in outbreak


Update on the Outbreak

June 10, 2008: The Food and Drug Administration has expanded its warning to consumers nationwide that a salmonellosis outbreak has been linked to consumption of certain raw, red tomatoes.

At this time, FDA is advising consumers to limit their consumption of tomatoes to the following types of tomatoes. The following types of tomatoes listed below are NOT likely to be the source of this outbreak.

    * cherry tomatoes
    * grape tomatoes
    * tomatoes sold with the vine still attached
    * tomatoes grown at home

Also, FDA recommends consuming raw red plum, raw red Roma, or raw red round tomatoes only if grown and harvested from the following areas that HAVE NOT BEEN ASSOCIATED WITH THE OUTBREAK:

Alabama
Arkansas
California
Georgia
Hawaii
Louisiana
Maine
Maryland
Minnesota
Mississippi
New York
Nebraska
North Carolina
Ohio
Pennsylvania
South Carolina
Tennessee
Texas
West Virginia

Belgium
Canada
Dominican Republic
Guatemala
Israel
Netherlands
Puerto Rico

Consumers who are unsure of where the tomatoes are from that they  have in their home are encouraged to contact the store or place of  purchase for that information.

Consumers should also be aware that raw tomatoes are often used in  the preparation of fresh salsa, guacamole, and pico de gallo, are  part of fillings for tortillas, and are used in other dishes.

Restaurants, grocery stores, and food service operators have been advised by the FDA not to offer for sale or service raw red plum, Roma, or red tomatoes and products made from these types of tomatoes unless they are from one of the areas listed above.

Since mid April, there have been 167 reported cases of salmonellosis  nationwide caused by Salmonella Saintpaul, an uncommon form of  Salmonella.  At least 23 hospitalizations have been reported.

Advice for Retailers, Restaurateurs and Food Service Operators

Frequently Asked Questions

FDA traceback review, in addition to production and distribution pattern information, has indicated that tomatoes from the following sources are not associated with the outbreak:

    * Alabama
    * Arkansas
    * California
    * Georgia
    * Hawaii
    * Louisiana
    * Maine
    * Maryland
    * Minnesota
    * Mississippi
    * New York
    * Nebraska
    * North Carolina
    * Ohio
    * Pennsylvania
    * South Carolina
    * Tennessee
    * Texas
    * West Virginia
    * Belgium
    * Canada
    * Dominican Republic
    * Guatemala
    * Israel
    * Netherlands
    * Puerto Rico

FDA recommends that retailers, restaurateurs, and food service operators offer only fresh and fresh cut red Roma, red plum, and round red tomatoes and food products made from these tomatoes for sale or service from the sources listed above.

FDA further recommends that retailers, restaurateurs, and food service operators continue to offer cherry tomatoes, grape tomatoes, and tomatoes sold with the vine still attached, from any source.