The multi-state outbreak of Salmonella Poona linked to imported cucumbers has grown. Now at least 341 people in 30 states are sick. this is an increase of 56 cases in the last 5 days. Two people have, sadly, died of their illnesses; one in Texas and one in California. And 70 people have been hospitalized.
Epidemiologic, laboratory, and traceback investigations have identified imported cucumbers from Mexico, distributed by Andrew & Williamson Fresh Produce as the likely source of this outbreak. Ninety-one percent of the 134 people interviewed so far reported eating cucumbers the week before they got sick.
So far, Arizona, California, Montana, and Nevada isolated Salmonella from samples of cucumbers collected from locations that were distributed by Andrew & Williamson Fresh Produce. Those cucumbers have been recalled. The cucumbers were distributed in Alaska, Arizona, Arkansas, California, Colorado, Florida, Idaho, Illinois, Kansas, Kentucky, Louisiana, Minnesota, Mississippi, Montana, Nevada, New Jersey, New Mexico, Oklahoma, Oregon, South Carolina, Texas, and Utah, and most likely were sold in other states as well.
Since the case count includes people who live in states where the cucumbers were not distributed, this indicates this outbreak is widespread and very complex. People who live in Hawaii, Missouri, Nebraska, New York, North Dakota, Ohio, Pennsylvania, Virginia, Washington, Wisconsin, and Wyoming are sick, but their states are not on the distribution list for cucumbers. And people living in states where the cucumbers were known to be sold have not been sick.
The case count by state is: Alaska (9), Arizona (66), Arkansas (6), California (72), Colorado (14), Hawaii (1), Idaho (8), Illinois (6), Kansas (1), Kentucky (1), Louisiana (4), Minnesota (12), Missouri (8), Montana (10), Nebraska (2), Nevada (7), New Mexico (18), New York (4), North Dakota (1), Ohio (2), Oklahoma (8), Oregon (8), Pennsylvania (2), South Carolina (7), Texas (18), Utah (30), Virginia (1), Washington (10), Wisconsin (2), and Wyoming (3). Illnesses began on July 3, 2015 and the last reported cases were on August 30, 2015. It can take up to 4 weeks from the time a person gets sick until the time a case is reported to public health officials.
Patients range in age from less than 1 year to 99 years, with a median age of 15. Fifty-three percent of ill persons, or 180 patients, are children under the age of 18. Among 214 people who have been interviewed, 70, or 33%, are hospitalized. This is much higher than the typical hospitalization rate of 20% in any general Salmonella outbreak. The bacteria are being tested to see if they are resistant to antibiotics, which would make treating these infections more difficult.
The symptoms of a Salmonella infection include nausea, abdominal cramps, diarrhea that may be bloody, a fever, headache, muscle pains, and vomiting. Children, the elderly, those with compromised immune systems, and people with chronic illnesses are more likely to have serious complications from this infection. And long term complications can be serious, including reactive arthritis, heart problems, and irritable bowel syndrome.
Since the CDC’s last update on September 4, 2015, the Nevada Department of Health and Human Services isolated one of the outbreak strains of Salmonella Poona from a cucumber purchased at a retail location. The Arizona Department of Health Services and the Montana Department of Public Health and Human Services also found Salmonella bacteria from cucumbers purchased at stores. Preliminary information indicates that these cucumbers were distributed by Andrew & Williamson Fresh Produce. DNA fingerprinting for these bacteria samples is ongoing.
The cucumbers in question are dark green, about 7 to 10 inches long, and about 1.75 to 2.5 inches in diameter. They are usually sliced to serve, and are called “slicer” or “American” cucumbers. In grocery stores they are sold in bulk bins with no individual packaging, labeling, or wrapping. In grocery stores, they are usually sold in salads.
The CDC included a link to the Andrew & Williamson Fresh Produce page so people can tell who sold the cucumbers, but some of those facilities have contacted us to say they did not sell the produce. We do know that the cucumbers were sold at Red Lobster restaurants. We also know that these stores have posted recalls of the cucumbers on their web sites: Walmart, WinCo, Ralphs, Kroger, Food4Less, and US Food distributors. But we don’t know which stores actually sold the recalled cucumbers. If you purchased this type of cucumber, you might want to throw it out just to be safe.
The cucumbers had to have been sold in wide areas across the country for the outbreak to be this large. The multiplier for Salmonella outbreaks is 30.3, since most people do not report their illnesses to authorities. That means that more than 10,000 people are most likely sick with Salmonella infections across the country. No distribution list has been released yet; most people are waiting for it. We’ll let you know if and when it’s released.