Salmonella Sickness Toll Climbs to 1,148

42 states now reporting illnesses; source still elusive

TUESDAY, July 15, 2008 (HealthDay News) -- The salmonella toll continues to mount in what has become the largest foodborne outbreak in the United States in more than a decade.

With the latest cases reported as of July 4, the nationwide toll from Salmonella Saintpaul now stands at 1,148 people in 42 states, the District of Columbia and Canada, according to the latest figures posted on the Web site of the U.S. Centers for Disease Control and Prevention. At least 220 people have been hospitalized.

Statistically speaking, the patients range in age from under 1 to 99 years old; 50 percent are female. The rate of illness is highest among those 20 to 29 years old; it is lowest among adolescents 10 to 19 years old and people over 80.

Officials, meanwhile, appear no closer to zeroing in on the cause. Last week, they broadened the search, which had focused on certain types of tomatoes, to include jalapeno and serrano peppers and fresh cilantro.

While health investigators are hard at work, the CDC said on its Web site, "people often have difficulty remembering exactly what foods they ate, and remembering specific ingredients in those foods is even more difficult.

"When food items are mixed together and consumed in the same dish, all the items may be statistically linked to illness. In that case, determining by statistical means which item caused the illness can be difficult or impossible. Tracing suspect produce items back to processors and growers is an integral part of the effort to identify a single source and a possible means of contamination," the agency added.

Meanwhile, a team of Mexican health and agriculture officials is scheduled to meet with U.S. Food and Drug Administration officials in Washington to demand that Mexican tomatoes be cleared of any suspicion in the outbreak, according to the Associated Press.

Mexico said last week that its own tests found no salmonella in Mexican tomatoes. The FDA has not released the results of tests it conducted in Mexico, the AP reported.

According to the CDC's latest count, the breakdown by state of ill people shows: Alabama (2), Arkansas (14), Arizona (52), California (9), Colorado (15), Connecticut (4), Florida (2), Georgia (25), Idaho (6), Illinois (104), Indiana (16), Iowa (2), Kansas (17), Kentucky (1), Louisiana (1), Maine (1), Maryland (32), Massachusetts (26), Michigan (21), Minnesota (19), Mississippi (2), Missouri (17), New Hampshire (4), Nevada (11), New Jersey (12), New Mexico (102), New York (32), North Carolina (14), Ohio (8), Oklahoma (25), Oregon (10), Pennsylvania (12), Rhode Island (3), South Carolina (2), Tennessee (8), Texas (448), Utah (2), Virginia (31), Vermont (2), Washington (17), West Virginia (1), Wisconsin (11), and the District of Columbia (1). There are four ill persons in Canada, all of whom appear to have been infected while traveling in the United States.

An initial investigation of the outbreak, in New Mexico and Texas, suggested raw tomatoes as the likely source of the contamination. But a larger, nationwide study comparing persons who fell ill in June found that those who were sickened were likely to have recently eaten raw tomatoes, as well as fresh jalapeno and serrano peppers, and fresh cilantro.

Health officials continue to warn consumers to avoid raw red plum tomatoes and red Roma and round red tomatoes, and products containing these raw tomatoes.

But last week, CDC officials cautioned that people at risk of infection, including infants and elderly people, should avoid eating jalapeno and serrano peppers.

Raw jalapeno peppers are often used in the fresh preparation of salsa, pico de gallo, and other dishes. Raw tomatoes are often used in the preparation of fresh salsa, guacamole, and pico de gallo.

Salmonella is a bacteria that can cause bloody diarrhea in humans. Some 40,000 cases of salmonellosis are reported in the United States each year, although the CDC estimates that because milder cases are not diagnosed or reported, the actual number of infections may be 30 or more times greater. Approximately 600 people die each year after being infected.

However, the strain of Salmonella saintpaul had been previously considered rare. In 2007, according to the CDC, there were only three people infected in the country during April through June.

More information

Visit the FDA for lots more on the salmonella outbreak.

SOURCES: July 14, 2008, news release, U.S. Centers for Disease Control and Prevention; Associated Press
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