Thursday, July 24, 2008

Salmonella Saintpaul: Updating the Stats

The outbreak clearly is winding down, but new cases still trickle in. As of 9pm (EDT) on July 23rd, CDC has amassed a total of 1,284 lab-confirmed cases of Salmonella Saintpaul infections. Only seven states – Alaska, Hawaii, Delaware, North Dakota, South Dakota, Nebraska and Wyoming – have avoided involvement in this produce-related outbreak.

Twenty-six of the victims became ill between July 1st and July 7th, the most recent onset date reported. Two deaths are blamed – at least in part – on the outbreak, and 239 people have been hospitalized.

FDA reported this week that it has detected the outbreak strain of Salmonella Saintpaul in a jalapeño pepper sample obtained from Agricola Zaragosa, a small importer/distributor based in McAllen, Texas. The contaminated pepper was grown in Mexico, but FDA was quick to say that the shipment might have been contaminated after it left the farm.

The agency, with the cooperation of the importer, is tracing the source of the jalapeño, and its entire passage through the distribution chain. Agricola Zaragosa has recalled all jalapeño peppers shipped from its facility since June 30th.

As a result of the Salmonella Saintpaul finding, FDA modified its warning to consumers this week. The government now is advising that all consumers avoid consuming "...raw jalapeno peppers or foods made from raw jalapeno peppers...," essentially the same advice given in this blog when peppers first were identified as a possible source of the outbreak.

As David Acheson of FDA pointed out in a telephone news conference on July 21st, the contaminated jalapeño pepper is just one piece of the investigation puzzle – albeit an important one. There is still a strong connection between consumption of raw tomatoes and illness, especially in the earlier phases of the outbreak. Eighty-six percent (86%) of victims in the first case control studies reported having eaten raw tomatoes, compared to a much lower percentage of healthy control individuals who were questioned by investigators.

With luck, tracing the contaminated shipment of jalapeño peppers back through the distribution chain will enable FDA to identify the hands that held the smoking gun.

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