2008 United States salmonellosis outbreak

The 2008 United States salmonellosis outbreak began in the spring of 2008 when hundreds of people throughout the United States fell ill after consuming contaminated food. The U.S. Food and Drug Administration currently believes that the contaminated food products responsible are fresh jalapeño and serrano peppers from Mexico, and perhaps raw tomatoes. Fresh cilantro is also under investigation. As of July 30, 2008, the FDA and the Centers for Disease Control and Prevention have narrowed their investigation to certain farms in Mexico that they believe are responsible for the contaminated produce.

514 hospitalizations from the current outbreak.]

ource of the contamination

As of July 31, 2008, the CDC has sent 39 people into the field to work with other health officials in investigating the outbreak. The exact sources of the contaminated food are not yet known. The time frame of the outbreak had led the FDA to suspect that a source or sources of the outbreak may be among tomato farms producing winter crops in either of the following areas:

* Parts of Mexico, such as the State of Sinaloa, which exports over 300 million pounds of winter tomatoes to the U.S. via the Arizona border. Tomatoes from Sinaloa enter the U.S. through the hardest hit region of the southwest, which has suffered over half of the total reported cases in the outbreak. By contrast, tomatoes from Baja California, which have been listed by the FDA as "not associated with the outbreak," are exported to the relatively unaffected California. [cite news | title = More illnesses linked to bad tomatoes | author = Lauran Neergaard | work = San Diego Union-Tribune | date = 2008-06-13 | url = http://www.signonsandiego.com/uniontrib/20080613/news_1n13tomatoes.html]

* The southern and east-central regions of Florida. Southern and central Florida produce the majority of domestically consumed winter tomatoes, though only two cases of food poisoning have actually been reported in Florida - and one of those involved a Florida man who had eaten a raw tomato in New York. [http://www.cdc.gov/salmonella/saintpaul/ August 12, 2008: Investigation of Outbreak of Infections Caused by Salmonella Saintpaul | Salmonella CDC ] ] cite news | title = State ag chief urges precise tomato IDs | author = Susan Salisbury | work = Palm Beach Post | date = 2008-06-26 | accessdate = 2008-06-26 | url = http://www.palmbeachpost.com/business/content/business/epaper/2008/06/26/a9b_tomatoes_0627.html]

As of July 31, the latest reported illness onset occurred on July 12, and the latest estimated illness onset occurred on July 25. Illness onsets well into July suggest that fresh winter tomatoes are not the only source of the outbreak. In response to the continuing progression of illness onset dates, the CDC has proposed that a contaminated farm might have switched from tomato production to jalapeño production in the middle of the outbreak, causing crops of both types of foods to become contaminated. Jalapeño peppers, a food strongly suspected in the outbreak by the FDA, are primarily grown throughout Mexico, Texas, and New Mexico.

Contaminated pepper samples

On July 21, 2008, the FDA released a notice that the outbreak strain of "Salmonella" Saintpaul was found on a sample of jalapeño pepper from the McAllen, Texas produce importer/distributor Agricola Zaragoza, Inc. Agricola Zaragoza is a small distributor with only 600,000 dollars in annual sales and three employees. It distributes only jalapeños and tomatillos [ [http://www.fda.gov/bbs/transcripts/2008/salmonella072108.pdf] ] , the latter of which is not a suspect in the outbreak. No other samples, swabs, or tests taken at the facility have tested positive for "Salmonella".

The contaminated pepper sample in question was imported from Mexico, and it is from a load that had been distributed to Texas and Georgia beginning on June 30. [ [http://ap.google.com/article/ALeqM5ijaaf9rEEqJFRI_zJo1YK8TYcBFgD922EMBO0 The Associated Press: FDA finds salmonella strain in jalapeno pepper ] ] No other peppers from the same load have yet been found to be contaminated. The means by which the pepper became contaminated is unknown. Between June 30 and July 12, there have been approximately 40 reported new illness onsets, representing three percent of total reported illness onsets. The number of illnesses thought to be associated with Mexican peppers from Agricola Zaragoza is undisclosed. Peppers from that distributor are the main suspects in an illness cluster involving a restaurant in Minnesota.

On July 29, a jalapeño pepper bought at a Wal-Mart in Montezuma County, Colorado, tested positive for the outbreak strain of "Salmonella". Brian Grubbs, a Colorado man who was hospitalized for salmonellosis, is suing Wal-Mart for allegedly selling him contaminated peppers that got him sick in early July. [ [http://www.denverpost.com/headlines/ci_10082060 Man who says he got salmonella from jalapeños sues Wal-Mart - The Denver Post ] ]

On July 30, the FDA announced that it found samples of the outbreak strain of "Salmonella" in samples of serrano peppers and groundwater at a Mexican farm in Nuevo León. That same farm also supplied jalapeños to a packing facility in Mexico that did business with Agricola Zaragoza. Mexico's Agriculture Ministry is protesting the findings of the FDA, claiming that a soil sample was taken after the harvest and was not "scientifically valid." [ [http://uk.reuters.com/article/latestCrisis/idUKN3029027320080731 FDA says Salmonella strain found on Mexican farm | Reuters ] ]

A different farm in Tamaulipas actually supplied the contaminated peppers found at Agricola Zaragoza. Results from FDA samples taken at that farm are pending, [ [http://www.washingtonpost.com/wp-dyn/content/article/2008/07/30/AR2008073002366.html Mexican Farm Tied to Salmonella Outbreak - washingtonpost.com ] ] and Mexican investigators have already found "Salmonella" on samples taken in Tamaulipas. [http://www.coalingarecord.com/articles/2008/08/03/ap/health/d9294g800.txt]

Health officials have not yet indicated any positive "Salmonella" cultures from other samples (aside from a load of basil from Mexico [ [http://www.azcentral.com/news/articles/2008/07/11/20080711basil-ON.html FDA: Salmonella found in basil grown in Mexico ] ] and loads of jalapeño and serrano peppers imported from Mexico [http://www.charlotte.com/109/story/717746.html] [ [http://efoodalert.blogspot.com/2008/07/avocados-and-peppers-from-mexico.html eFoodAlert.com: Avocados And Peppers From Mexico Recalled ] ] , none of which were found to be contaminated with the particular strain of "Salmonella" responsible for the outbreak).

Tracebacks

The FDA has posted on its website that "the agency has been able to trace the pathway of some tomatoes from the point of purchase (e.g. supermarket) or consumption (e.g. restaurant) to each point on the distribution chain down to certain farms in Mexico and Florida." In a press conference on June 20, the FDA elaborated: "What the traceback has done is take us back to a number of different farms in Florida and in Mexico.... [W] e've got several farms in both Florida and Mexico and those are the places along with their associated distribution chain that we are going to be getting into as quickly as possible." At the very same press conference, however, the FDA also stated: "Right now all of the traceback data that we have point to this being Mexico or Florida. Currently we do not believe it's both."

Notably, the FDA states that "there's no clear indication that there's any obvious crossover point" where tomatoes from both Mexico and Florida could have been contaminated at the same place. Dismissing the possibility of coincidence of outbreaks from two independent distribution chains as "very unlikely from a natural perspective," the FDA also insists that there is "nothing to suggest that this [food poisoning outbreak] is deliberate." The FDA expects to find that the contaminated tomatoes have been coming from only one area. This expectation is based in part on the FDA's consultations with the United States Department of Agriculture and the United States Department of Homeland Security, neither of which support the conclusion that tomatoes were deliberately poisoned. [cite news | title = Transcript for FDA Media Briefing: Salmonella Outbreak Involving Certain Type of Tomatoes | date = 2008-06-20 | url = http://www.fda.gov/bbs/transcripts/2008/tomato062008.pdf "What the traceback has done is take us back to a number of different farms in Florida and in Mexico.... [T] here's no clear indication that there's any obvious crossover point [where tomatoes from both Mexico and Florida could have been contaminated at the same place] .... I don't want to give the impression that we think even remotely this is deliberate. I put that out there not to raise concerns but simply to complete the picture for you. Because now that we have narrowed this down to two tracks - two pathways that the tomatoes began their life in Florida or they began their life in Mexico and they tracked through and we're looking at the whole pathway there is the obvious question -- could it have happened in two places at once? Very unlikely from a natural perspective. That raises the question of was it deliberate? Absolutely no indication it was deliberate. And I want to continue to emphasize that. We've got nothing to suggest that this is deliberate."]

The FDA now thinks that tomatoes are responsible for only part of the outbreak, at most. The agency is no longer advising caution regarding tomato consumption, given that winter tomatoes are generally no longer in circulation.

Criticism of the FDA

Prevor has criticized the FDA for maintaining a list of areas where crops "have not been associated with the outbreak," because if tomatoes have in fact been contaminated elsewhere along the supply line, the FDA's list of safe farm areas would be inappropriate and misleading to consumers. [http://www.perishablepundit.com/ Jim Prevor's Perishable Pundit ] ] Charles Bronson, Agriculture Commissioner of the State of Florida, also indicated that repacking could be responsible for "Salmonella" contamination. Bronson said that there is a "99.99 percent" chance that the Florida tomato farms are not the source of the "Salmonella" outbreak.

Prevor has also criticized the FDA for refusing to disclose data on whether subjects generally recalled eating suspected foods from restaurants or from retail stores: "Retail and restaurants often have completely different products with a completely different supply chain." For example, mature green winter tomatoes, which are primarily distributed to the foodservice market, are dominated by Florida producers. Vine ripe winter tomatoes, which are distributed to both the foodservice and retail markets, usually come from Mexican producers. [cite news | title = North American Greenhouse Tomatoes Emerge as a Major Market Force | date = 2005-04 | url = http://www.ers.usda.gov/AmberWaves/April05/Features/GreenhouseTomatoes.htm] "All this information is not confidential," Prevor writes concerning data on the origins of purchase. "There is no reason not to release it." [cite news | title = Plea For CDC To Release Sickness Details And Origin Of Purchase | date = 2008-07-03 | url = http://www.perishablepundit.com/#1i] At least three Mexican restaurants (two Adobo Grills and one Los Tres Amigos) in Illinois have been publicly identified by the Chicago Department of Public Health and the Madison County Health Department as responsible for clusters of the outbreak, despite the FDA's nondisclosure stance. [ [http://www.chicagotribune.com/business/chi-thu-tomatoes-chicago-adobo-gjun19,0,5811242.story City IDs salmonella cluster - chicagotribune.com ] ] [ [http://www.stltoday.com/stltoday/news/stories.nsf/news/illinoisnews/story/7514da64483737038625746c0066cc03?OpenDocument STLtoday - Salmonella outbreak in Wood River ] ] According to unnamed sources close to the investigation, most illness clusters in the outbreak involve Mexican restaurants. [cite news | title = Deconstructing Salsa In Search of Salmonella | author = Annys Shin and Simone Baribeau | work = Washington Post | date = 2008-07-08 | url = http://www.washingtonpost.com/wp-dyn/content/article/2008/07/07/AR2008070702488_2.html?hpid=moreheadlines]

Earlier in the investigation, some produce industry insiders expressed doubt that fresh produce is to blame for the outbreak. They pointed to the absence of Salmonella on all of the tested produce samples to date, as well as divergent results from produce tracebacks. They also said that the extended time frame of new sicknesses made it unlikely that either raw tomatoes or fresh jalapeños, the government's two main suspects, could be solely responsible. Some have looked to cross-contamination at restaurants as a more probable cause of the outbreak. Contaminated foods such as raw chicken could have spread the "Salmonella" to fresh salsa at restaurants. Customers would not have become ill from contaminated chicken once it was cooked, but they might have become ill from the raw produce that had contacted raw chicken. [cite news | title = Lukewarm Indictment of Jalapeños: Solving Outbreak Requires Thinking Outside the Box | work = Perishable Pundit | date = 2008-07-10 | url = http://www.perishablepundit.com/#1a]

Others suggested that processed foods such as canned tomatoes and canned jalapeños might have been responsible for the outbreak. Health officials generally do not consider processed foods high-risk suspects in food outbreaks, as the canning and bottling processes are supposed to kill any bacteria. Nevertheless, the FDA and the CDC were surprised in 2007 by outbreaks from "Salmonella" contamination in pasteurized peanut butter [ [http://www.usatoday.com/news/health/2007-02-14-salmonella-peanut-butter_x.htm Salmonella outbreak, rare in peanut butter, stuns health officials - USATODAY.com ] ] and from "Clostridium botulinum" contamination in improperly pasteurized canned chili. [ [http://www.msnbc.msn.com/id/19980894/ Tainted chili cans bursting with botulism - Diet and nutrition - MSNBC.com ] ] Will Steele, President and CEO of Frontera Produce, said that "the outbreak is probably related to processed goods and [the FDA is] looking in the wrong closets." [cite news | title = Reality On The Border: Businesses Suffer At Hands Of FDA | author = Mira Slott | work = Perishable Pundit | date = 2008-07-10 | url = http://www.perishablepundit.com/#1d]

The FDA's recommendation that consumers stop eating any fresh jalapeños, regardless of their origin, has elicited more disapproval from the produce industry. Criticism of the FDA's decision comes on the grounds that there was only a solitary positive sample among numerous negative samples both at the distribution facility and at many other farms and facilities. Additionally, Agricola Zaragoza is a small distributor that imports from a known source in Mexico and distributes peppers to limited parts of the country. [ [http://www.perishablepundit.com/punditprint.php?date=07/22/08&pundit=1a Jim Prevor's Perishable Pundit ] ] Four days after making the recommendation not to eat any fresh jalapeños, the FDA announced that peppers grown in the United States are indeed safe to eat.

ee also

*Salmonellosis
*List of United States foodborne illness outbreaks

References